Duct-to-mucosa versus invagination pancreaticojejunostomy after pancreaticoduodenectomy: a meta-analysis / 中华医学杂志(英文版)
Chinese Medical Journal
;
(24): 4340-4347, 2013.
Article
in English
| WPRIM
| ID: wpr-327574
ABSTRACT
<p><b>BACKGROUND</b>Postoperative pancreatic fistula remains one of the most common and troublesome complications following pancreaticoduodenectomy. No consensus exists regarding the optimal pancreaticojejunostomy reconstruction technique to reduce this complication. We aimed to perform a systematic review comparing two commonly used techniques of pancreaticojejunostomy reconstruction (duct-to-mucosa versus invagination), by meta-analysis and assessment of evidence quality.</p><p><b>METHODS</b>Databases searched including The Cochrane Library, Medline, PubMed, Embase, etc. Randomized controlled trials (RCTs) comparing duct-to-mucosa and invagination pancreaticojejunostomy were included. Outcomes of interest were pancreatic fistula rate, mortality, morbidity, reoperation and hospital stay. Pooled estimates were expressed as risk ratio (RR) or mean difference.</p><p><b>RESULTS</b>From 321 identified abstracts, four RCTs (467 patients; duct-to-mucosa 232; invagination 235) were included. Pancreatic fistula rate (RR, 0.74; 95% confidence interval (CI) 0.24-2.28; P = 0.60), mortality (RR, 1.18; 95% CI 0.39- 3.54; P = 0.77), morbidity (RR, 0.91; 95% CI 0.69-1.21; P = 0.53), reoperation (RR, 1.09; 95% CI 0.54-2.22; P = 0.81) and hospital stay (mean difference, -1.78; 95% CI -4.60-1.04; P = 0.22) were similar between techniques.</p><p><b>CONCLUSIONS</b>Duct-to-mucosa and invagination pancreaticojejunostomy are comparable with regards to assessed parameters. High-quality, large-volume, multi-center RCTs with standard outcome definitions are required.</p>
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Pancreaticojejunostomy
/
Pancreaticoduodenectomy
/
Methods
Type of study:
Controlled clinical trial
/
Systematic reviews
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
Language:
English
Journal:
Chinese Medical Journal
Year:
2013
Type:
Article
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