Konstantinos Perivoliotis, Eleni Sioka, Athina Tatsioni, Ioannis Stefanidis, Elias Zintzaras, Dimitrios Zacharoulis
{"title":"Pancreatogastrostomy versus Pancreatojejunostomy: An Up-to-Date Meta-Analysis of RCTs.","authors":"Konstantinos Perivoliotis, Eleni Sioka, Athina Tatsioni, Ioannis Stefanidis, Elias Zintzaras, Dimitrios Zacharoulis","doi":"10.1155/2017/7526494","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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 <i>Q</i> test.</p><p><strong>Results: </strong>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).</p><p><strong>Discussion: </strong>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.</p>","PeriodicalId":45960,"journal":{"name":"International Journal of Surgical Oncology","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2017/7526494","citationCount":"16","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Surgical Oncology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2017/7526494","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2017/7/17 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 16
Abstract
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.
期刊介绍:
International Journal of Surgical Oncology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies in all areas of surgical oncology.