International journal of surgical oncology · 2017
Pancreatogastrostomy versus Pancreatojejunostomy: An Up-to-Date Meta-Analysis of RCTs.
Сравнительное исследованиеСтатьяМетаанализОбзорНазвание и аннотация: Перевод в очереди
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Perivoliotis Konstantinos, Sioka Eleni, Tatsioni Athina, Stefanidis Ioannis, Zintzaras Elias, Zacharoulis Dimitrios
Аннотация
BACKGROUND: A meta-analysis was conducted in order to provide an up-to-date comparison of pancreatogastrostomy (PG) and pancreatojejunostomy (PJ), after pancreatoduodenectomy (PD), in terms of clinically significant postoperative pancreatic fistula (POPF) and other postoperative complications.
METHODS: This meta-analysis was conducted according to the PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. A systematic literature search in MEDLINE and Cochrane Central Register of Controlled Clinical Trials was performed. Fixed Effects or Random Effects model was used, based on the Cochran Q test.
RESULTS: In total, 10 studies (1629 patients) were included. There was no statistical significance between PG and PJ regarding the rate of clinically significant POPF (OR: 0.70, 95%CI: 0.46-1.06). PG was associated with a higher rate of postpancreatoduodenectomy haemorrhage (PPH) (OR: 1.52, 95%CI: 1.08-2.14). There was no difference between the two techniques in terms of clinically significant PPH (OR: 1.35, 95%CI: 0.95-1.93) and clinically significant postoperative delayed gastric emptying (DGE) (OR: 0.98, 95%CI: 0.59-1.63).
DISCUSSION: There is no difference between the two anastomotic techniques regarding the rate of clinically significant POPF. Given several limitations, more large scale high quality RCTs are required.
METHODS: This meta-analysis was conducted according to the PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. A systematic literature search in MEDLINE and Cochrane Central Register of Controlled Clinical Trials was performed. Fixed Effects or Random Effects model was used, based on the Cochran Q test.
RESULTS: In total, 10 studies (1629 patients) were included. There was no statistical significance between PG and PJ regarding the rate of clinically significant POPF (OR: 0.70, 95%CI: 0.46-1.06). PG was associated with a higher rate of postpancreatoduodenectomy haemorrhage (PPH) (OR: 1.52, 95%CI: 1.08-2.14). There was no difference between the two techniques in terms of clinically significant PPH (OR: 1.35, 95%CI: 0.95-1.93) and clinically significant postoperative delayed gastric emptying (DGE) (OR: 0.98, 95%CI: 0.59-1.63).
DISCUSSION: There is no difference between the two anastomotic techniques regarding the rate of clinically significant POPF. Given several limitations, more large scale high quality RCTs are required.