Endoscopic palliative treatment versus surgical bypass in malignant low bile duct obstruction: A systematic review and meta-analysis

Aims: Despite technological advances, only about 20% of periampullary tumors are found to be resectable at the time of presentation. Biliary tree obstruction and consequent jaundice occur in 70–90% of those patients and has important consequences for a patient’s quality of life. Relief of biliary tree obstruction is the main goal for treatment, and few options for palliative therapy of biliary tree obstruction can be performed, including surgical bypass, percutaneous stenting, and endoscopic stenting. Objective: The aim of the present study was to acquire and analyze data to compare the success of procedures, procedure-related complication, mortality in 30