Abstract: Objective  To determine the best initial procedure for performing preoperative biliary drainage in patients with perihilar cholangiocarcinoma (PHCC).Methods  PubMed, the Cochrane Library, Embase database, CNKI, CBM, Wanfang database were searched for all studies published until April 2017 comparing endoscopic biliary drainage (EBD) and percutaneous transhepatic biliary drainage (PTBD) for preoperative biliary drainage. A Metaanalysis was performed by using STATA 12.0 software.Results  A total of  799 patients with PHCC were involved in the 8 studies .The rates of initial technical failure(OR=2.50, 95%CI=1.314.79, P=0.006) and conversion(OR=9.71, 95%CI=4.6420.30, P=0.001) were higher in EBD group than those in PTBD group. However, there are no significant differences in overall complication(OR=1.27, 95%CI=0.891.82, P=0.185), procedurerelated morbidity rate(OR=0.45, 95%CI=0.131.58, P=0.212), and bilirubin levels(SMD=-0.47, 95%CI=-1.110.17, P=0.149).Conclusion  Compared to EBC, PTBD, with a lower rate of initial technical failure and conversion,  is a better initial procedure for performing preoperative biliary drainage in PHCC.

Key words: bile duct neoplasms； endoscopic biliary drainage, percutaneous transhepatic biliary drainage