To evaluate the effect of preoperative biliary drainage on the postoperative outcomes of patients with obstructive jaundice caused by malignant tumors.

Literature search of clinical control trials from Cochrane Controlled Trials Register Center and its hepatobiliary subgroup, randomized controlled studies and non-randomized prospective controlled studies published before November 2017 in PUBMED/MEDLINE, EMBASE, SCI and Science Citation Index Expanded (SCIE) databases were conducted. Search terms included randomized/randomize/random, prospective, preoperative biliary drainage, obstructive jaundice, pancreatico-duodenectomy, periampullar carcinoma and hilar cholangiocarcinoma. Quality control and screening of the included literatures were performed according to the modified Jadad Scale. Meta-analysis was conducted using a random effect model.

6 randomized controlled trials and 5 non-randomized prospective studies consisting of 987 patients were included in the Meta-analysis. There were 477 patients in preoperative biliary drainage group and 510 cases in early surgery group. No significant difference was observed in the overall incidence of postoperative complications, incision infection, abdominal infection, lung infection and perioperative mortality between two group (OR=1.12, 1.36, 2.07, 0.57, 1.11; P>0.05). The postopoerative 1-year survival in preoperative biliary drainage group was significantly worse compared with that in early surgery group (OR=0.60, P<0.05).

Preoperative biliary drainage of obstructive jaundice caused by malignant tumors fails to bring significant benefits for patients, whereas has the risk of reducing the postoperative 1-year survival.