To compare effect of palliative R1, R2 incision, drainage treatment and curative effect of photodynamic therapy with endoscopic drainage for advanced cholangiocarcinoma.

PUBMED, the Chinese Biomedical database (CBM), Wanfangdata, China academic journals full-text (CNKI) were selected for randomized controlled trials from January 1980 to December 2013 comparing efficacy of palliative (R1, R2) removal and stent therapy, and Photodynamic therapy and endoscopic drainage for bile duct cancer. In accordance with the inclusion and exclusion criteria, data quality were extracted and assessed for Meta analysis with RevMan 5.2 software.

A total of nine researches of palliative surgery and endoscopic drainage analysis, including 585 patients, were selected. Among them, 208 cases received R1 or R2 resection, and 377 cases were in the drainage treatment group. There were four researches of 252 patients about Photodynamic therapy and stent drainage analysis, including photodynamic treatment of 132 cases, and drainage treatment of 120 patients. Analysis indicated that the number of 1-year survival in the R1 or R2 resection treatment group were higher; there was statistical significance [(OR 0.79, 95% CI 0.42~1.50, P=0.48),(RD-0.00, 95%CI-0.04~0.04, P=0.94), (OR 2.87, 95% CI 1.82~4.54, P<0.05)]. Incidence of biliary fistula, cholangitis and biliary obstructions had no significant differences [(OR 1.74, 95% CI 0.73~4.17, P=0.21), (OR 0.50, 95% CI 0.22~1.12, P=0.09)]. Patients in Photodynamic therapy group showed prolonged postoprative survival than the endoscopic drainage treatment group.

For advanced bile duct carcinoma patients, both palliative R1, R2 resection and Photodynamic therapy are better than only endoscopic drainage. Meanwhile, compared with surgery, Photodynamic therapy is a more safe, quick and minimally invasive option.