Meta-analysis of duct-to-mucosa and invagination of pancreaticoduodenectomy / 国际外科学杂志

ABSTRACT

Objective To systematically evaluate the surgical effect in duct-to-mucosa and invagination groups of pancreaticojejunostomy after pancreaticoduodenectomy.Methods The Cochrane Library,PubMed,EMbase and CBM data bases were searched to identify randomized controlled trials that compared the postoperative pancreatic fistula,mortality,incidence of complications,delayed gastric emptying,postoperative haemorrhage,infection,reoperate rate,postoperative hospital stay of duct-to-mucosa and invagination for pancreaticcoduodenectomy.Meta-analysis was performed using the software RevMan 5.3.Results Nine trials with 1 163 patients comparing the duct-to-mucosa group with invagination group were included,the duct-to-mucosa group with 579 patients and the invagination group with 584 patients.The meta-analysis revealed that,compared the duct-to-mucosa group with the invagination group,the rate of postoperative pancreatic fistula was not significantly reduced (RR =1.13,95 ％ CI0.88-1.45,P =0.34),there was no significa nt difference between the two group.To systematically evaluate the total mortality (RR =0.80,95 ％ CI0.42-1.52,P =0.49),incidence of complications (RR =1.04,95 ％ CI0.88-1.24,P =0.63),delayed gastric emptying (RR =1.26,95 ％ CI0.90-1.76,P =0.18),postoperative haemorrhage (RR =0.86,95 ％ CI0.51-1.44,P =0.57),postoperative infection (RR =1.20,95％ CI0.86-1.69,P =0.29),reoperate rate (RR =1.05,95％ CI0.62-1.78,P =0.84),postoperative hospital stay (WMD =-1.36,95％ CI-2.91-0.20,P =0.09) in duct-to-mucosa and invagination groups.There was no significant difference between the two group.Conclusions There was no significant difference of postoperative pancreatic fistul and mortality,incidence of complications,delayed gastric emptying,postoperative haemorrhage,postoperative infection,reoperate rate,postoperative hospital stay in duct-to-mucosa and invagination groups of pancreaticojejunostomy after pancreaticoduodenectomy.