Photodynamic Therapy or Palliative Resection Versus Biliary Stenting for Advanced Cholangiocarcinoma: A Network Meta-Analysis

Background: We assessed the efficacy of evaluating palliative resection (R1/R2 resection), photodynamic therapy (PDT), and biliary stenting (stent) alone in the treatment of advanced cholangiocarcinoma using a reticulated meta-analysis. Methods: A systematical retrieval in PubMed, Web of Science, and the Cochrane Library was performed for relative literature on the effects of PDT, palliative resection, and simple biliary stenting in the treatment of advanced cholangiocarcinoma. A literature search updated to January 30, 2024, was performed. Newcastle-Ottawa Scale and Risk Of Bias In Non-randomised Studies-of Interventions (ROBINS-I) tools were used to assess the methodological quality of the included studies, and Addis-1.16 0.6 software for reticulated meta-analysis. Results: The results showed that PDT and palliative resection were superior to biliary stenting alone in improving 1-, 2-, and 3-year survivals, and the incidence of cholangitis. The relative effectiveness of PDT, palliative resection, and biliary stent placement alone in improving survival was as follows: PDT, palliative resection, and biliary stent placement alone. Conclusion: There is no significant difference between PDT and palliative resection in improving patient survival time, and PDT does not increase the incidence of cholangitis.