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.
Artigo
em Chinês
| WPRIM (Pacífico Ocidental)
| ID: wpr-254373
Biblioteca responsável:
WPRO
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>
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Disponível
Contexto em Saúde:
Doenças Negligenciadas
/
ODS3 - Meta 3.3 Acabar com as doenças tropicais negligenciadas e combater as doenças transmissíveis
Problema de saúde:
Diarreia
/
Infecções Diarreicas
Base de dados:
WPRIM (Pacífico Ocidental)
Assunto principal:
Pâncreas
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Complicações Pós-Operatórias
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Período Pós-Operatório
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Reoperação
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Cirurgia Geral
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Anastomose Cirúrgica
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Pancreaticojejunostomia
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Ensaios Clínicos Controlados Aleatórios como Assunto
/
Stents
/
Drenagem
Tipo de estudo:
Ensaio clínico controlado
/
Estudo prognóstico
/
Revisão sistemática
Limite:
Humanos
Idioma:
Chinês
Revista:
Chinese Journal of Gastrointestinal Surgery
Ano de publicação:
2014
Tipo de documento:
Artigo