文献类型：期刊文献

英文题名：Pancreatic outflow tract reconstruction after pancreaticoduodenectomy: a meta-analysis of randomized controlled trials

作者：Wang, Xin Xin[1,2];Yan, Yu Ke[1];Dong, Bao Long[1];Li, Yuan[1];Yang, Xiao Jun[1,3,4,5]

第一作者：Wang, Xin Xin;王学香;王小霞

通信作者：Yang, XJ[1];Yang, XJ[2];Yang, XJ[3];Yang, XJ[4]

机构：[1]Gansu Prov Hosp, Dept Gen Surg, 204 Donggang West Rd, Lanzhou 730000, Gansu, Peoples R China;[2]Gansu Univ Chinese Med, Clin Med Coll 1, Lanzhou 730000, Gansu, Peoples R China;[3]Lanzhou Univ, Peoples Clin Med Coll, Lanzhou 730000, Gansu, Peoples R China;[4]Gansu Prov Hosp, Gansu Key Lab Mol Diagnost & Precis Med Surg Onco, Lanzhou 730000, Gansu, Peoples R China;[5]Gansu Prov Hosp, Gansu Res Ctr Prevent & Control Project Digest On, Lanzhou 730000, Gansu, Peoples R China

第一机构：Gansu Prov Hosp, Dept Gen Surg, 204 Donggang West Rd, Lanzhou 730000, Gansu, Peoples R China

通信机构：[1]corresponding author), Gansu Prov Hosp, Dept Gen Surg, 204 Donggang West Rd, Lanzhou 730000, Gansu, Peoples R China;[2]corresponding author), Lanzhou Univ, Peoples Clin Med Coll, Lanzhou 730000, Gansu, Peoples R China;[3]corresponding author), Gansu Prov Hosp, Gansu Key Lab Mol Diagnost & Precis Med Surg Onco, Lanzhou 730000, Gansu, Peoples R China;[4]corresponding author), Gansu Prov Hosp, Gansu Res Ctr Prevent & Control Project Digest On, Lanzhou 730000, Gansu, Peoples R China.

年份：2021

卷号：19

期号：1

外文期刊名：WORLD JOURNAL OF SURGICAL ONCOLOGY

收录：;Scopus(收录号：2-s2.0-85109785258);WOS:【SCI-EXPANDED(收录号:WOS:000672516800004)】；

基金：This work was supported by the National Natural Science Foundation of China, No. 81660398; Hospital Key Program of National Scientific Research Cultivation Plan, No.19SYPYA-12. And the fundings can support the publication of this manuscript.

语种：英文

外文关键词：Pancreaticoduodenectomy; Pancreaticogastrostomy; Pancreaticojejunostomy; Meta-analysis; Pancreatic fistula; Delayed gastric emptying

摘要：Background: To evaluate the outcomes of pancreaticogastrostomy and pancreaticojejunostomy after pancreatoduodenectomy with the help of a meta-analysis. Methods: Randomized controlled trials comparing pancreaticogastrostomy and pancreaticojejunostomy were searched electronically using PubMed, The Cochrane Library, and EMBASE. Fixed and random-effects were used to measure pooled estimates. Research indicators included pancreatic fistula, delayed gastric emptying, postoperative hemorrhage, intraperitoneal fluid collection, wound infection, overall postoperative complications, reoperation, and mortality. Results: Overall, 10 randomized controlled trials were included in this meta-analysis, with a total of 1629 patients. The overall incidences of pancreatic fistula and intra-abdominal collections were lower in the pancreaticogastrostomy group than in the pancreaticojejunostomy group (OR=0.73, 95% CI 0.55 similar to 0.96, p=0.02; OR= 0.59, 95% CI 0.37 similar to 0.96, p=0.02, respectively). The incidence of B/C grade pancreatic fistula in the pancreaticogastrostomy group was lower than that in the pancreaticojejunostomy group, but no significant difference was observed (OR=0.61, 95%Cl 0.34 similar to 1.09, p=0.09). Postoperative hemorrhage was more frequent in the pancreaticogastrostomy group than in the pancreaticojejunostomy group (OR=1.52; 95% CI 1.08 similar to 2.14, p=0.02). No significant differences in terms of delayed gastric emptying, wound infection, reoperation, overall postoperative complications, mortality, exocrine function, and hospital readmission were observed between groups. Conclusion: This meta-analysis suggests that pancreaticogastrostomy reduces the incidence of postoperative pancreatic fistula and intraperitoneal fluid collection but increases the risk of postoperative hemorrhage compared with pancreaticojejunostomy.