Reconstruction methods of digestive tract after pancreaticodudenectomy: a systematic review and meta-analysis of RCTs / 中华胃肠外科杂志
Chinese Journal of Gastrointestinal Surgery
;
(12): 1002-1008, 2014.
Artículo
en Chino
| WPRIM
| ID: wpr-254373
ABSTRACT
<p><b>OBJECTIVE</b>To investigate different types of anastomosis and reconstruction techniques after pancreaticodudenectomy with meat-analysis.</p><p><b>METHODS</b>Systematically literature search was performed through Wanfang, PubMed, EMBASE, Web of Science and Cochrane Library database without restriction to regions, publication types, or languages. A total of 17 randomized controlled trials met the criteria and were evaluated by Jadad scale. Fixed and random-effects models were used to measure the pooled estimates, including pancreatic fistula, bile leakage, hemorrhage, delay gastric emptying(DGE), mortality, reoperation.</p><p><b>RESULTS</b>Meta analysis revealed that patients undergoing pancreaticogastrostomy had a lower incidence of pancreatic fistula and bile leakage(OR=0.60, 95%CI0.44-0.82, P=0.001; OR=0.33, 95%CI0.13-0.82, P=0.02) as compared to pancreaticojejunostomy. In pancreaticoenterostomy group, pancreatic duct-mucosa pancreaticoenterostomy had no significant differences with traditional end-to-end anastomosis in terms of overall postoperative morbidity, and development of postoperative pancreatic fistula, reoperation, perioperative death. External stent placement drainage group had a lower postoperative overall complication rate and incidence of pancreatic fistula, especially the II(-III( grade pancreatic fistula, and a shorter hospital stay than non-stent drainage group(all P<0.05).</p><p><b>CONCLUSIONS</b>Pancreaticogastrostomy should be recommended as digestive tract reconstruction after pancreaticodudenectomy and assistant external stent drainage is also necessary.</p>
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Páncreas
/
Complicaciones Posoperatorias
/
Periodo Posoperatorio
/
Reoperación
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Cirugía General
/
Anastomosis Quirúrgica
/
Pancreatoyeyunostomía
/
Ensayos Clínicos Controlados Aleatorios como Asunto
/
Stents
/
Drenaje
Tipo de estudio:
Ensayo Clínico Controlado
/
Estudio pronóstico
/
Revisiones Sistemáticas Evaluadas
Límite:
Humanos
Idioma:
Chino
Revista:
Chinese Journal of Gastrointestinal Surgery
Año:
2014
Tipo del documento:
Artículo
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