Chen ZH, Zhang LJ, Lin ZX, Lin SX, Song ZF, Wu ZJ, Lin W. Safety and efficacy of three-dimensional reconstruction technology-assisted percutaneous transhepatic biliary drainage: A meta-analysis. World J Gastrointest Surg 2025; 17(9): 105134 [DOI: 10.4240/wjgs.v17.i9.105134]
Corresponding Author of This Article
Ze-Jian Wu, Department of Anorectal Surgery, The Affiliated Hospital of Putian University, No. 999 Dongzhen East Road, Licheng District, Putian 351100, Fujian Province, China. zejianwu55555@163.com
Research Domain of This Article
Surgery
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Ze-Hui Chen, Zheng-Fu Song, Ze-Jian Wu, Department of Anorectal Surgery, The Affiliated Hospital of Putian University, Putian 351100, Fujian Province, China
Li-Juan Zhang, Department of Hematology, West China Xiamen Hospital, Sichuan University, Xiamen 361003, Fujian Province, China
Zhi-Xin Lin, Department of Thoracic Surgery, Fuzhou Hospital of Traditional Chinese Medicine Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou 350001, Fujian Province, China
Shu-Xiang Lin, Department of Pathology, The Affiliated Hospital of Putian University, Putian 351100, Fujian Province, China
Wei Lin, Department of Gastrointestinal Surgery, The Affiliated Hospital of Putian College, Putian 351100, Fujian Province, China
Co-first authors: Ze-Hui Chen and Li-Juan Zhang.
Co-corresponding authors: Ze-Jian Wu and Wei Lin.
Author contributions: Chen ZH and Zhang LJ wrote the original draft, conceived, and designed the study, they contributed equally to this article, they are the co-first authors of this manuscript; Lin ZX, Lin SX, and Song ZF participated in data processing and data curation; Wu ZJ and Lin W supervised the review of the study, they contributed equally to this article, they are the co-corresponding authors of this manuscript; and all authors thoroughly reviewed and endorsed the final manuscript.
Supported by the Natural Science Foundation of Fujian Province, No. 2022J011442.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ze-Jian Wu, Department of Anorectal Surgery, The Affiliated Hospital of Putian University, No. 999 Dongzhen East Road, Licheng District, Putian 351100, Fujian Province, China. zejianwu55555@163.com
Received: January 13, 2025 Revised: April 3, 2025 Accepted: July 30, 2025 Published online: September 27, 2025 Processing time: 254 Days and 19 Hours
Abstract
BACKGROUND
Percutaneous transhepatic biliary drainage (PTBD) is one of the primary clinical treatment options for patients with obstructive jaundice. In recent years, PTBD assisted by three-dimensional (3D) reconstruction technology has been widely implemented, but its advantages over traditional methods remains inconclusive. Thus, a discussion is warranted.
AIM
To explore the safety and efficacy of 3D reconstruction technology-assisted PTBD.
METHODS
We systematically searched the databases including the Cochrane Library, PubMed, EMBASE, Web of Science and China National Knowledge Infrastructure. The search period extended from the establishment of each database to November, 2024. We screened the literature according to predefined inclusion and exclusion criteria, assessed the quality of the studies, and extracted data. Meta-analysis was performed using Revman 5.4.1 software.
RESULTS
A total of 15 studies were included, involving 1434 patients. The results of the meta-analysis showed that compared with the traditional group, the overall post-operative complications rate in the 3D reconstruction technology group was significantly lower [odds ratio = 0.25; 95% confidence interval (CI): 0.17-0.36, P < 0.00001]. The overall puncture success rate in the 3D reconstruction group was better than those in the traditional group (odds ratio = 3.61; 95%CI: 1.98-6.55, P < 0.0001). However, there was no significant difference between the two groups in the reduction levels of postoperative total bilirubin (mean difference = -1.38; 95%CI: -3.29 to 0.53, P = 0.16). Subgroup analysis were conducted on the surgery time according to guidance stages of the 3D reconstruction, 3D reconstruction imaging modalities, and types of studies. The results were stable, with no significant changes observed.
CONCLUSION
3D reconstruction technology significantly improves the puncture success rate and safety of PTBD. However, it has no significant advantage in bile drainage effectiveness. Continued research is warranted to further explore its clinical value and optimize its application.
Core Tip: This meta-analysis of 15 studies demonstrates that three-dimensional reconstruction technology significantly improves the safety and puncture success rate of percutaneous transhepatic biliary drainage compared to traditional methods. Although no significant advantage in bile drainage efficacy was observed, the technology exhibits critical clinical value by reducing complication risks through precise preoperative planning and real-time intraoperative navigation. Future large-scale studies, particularly stratified studies based on biliary anatomy and disease subtypes, are required to clarify its applicability across diverse clinical scenarios, thereby advancing standardized protocols and widespread clinical adoption of this innovative approach.
