Authors: Michael Clerveus Antonio MorandeiraRivas Joaquín PicazoYeste Carlos MorenoSanz
Publish Date: 2014/06/06
Volume: 18, Issue: 9, Pages: 1693-1704
Abstract
Six databases were systematically reviewed to identify randomized controlled trials comparing pancreaticogastrostomy and pancreaticojejunostomy Studies reporting postoperative complications reoperations and mortality were included PROSPERO registration number CRD42013005383The search provided a total of 1646 references Seven studies were selected including 1121 patients 562 in the pancreaticogastrostomy group and 559 in the pancreaticojejunostomy group Overall incidence of pancreatic fistula and the incidence of more severe fistulas grade B/C were lower in the pancreaticogastrostomy group relative risk 067 95 confidence interval CI 052 to 086 p = 0002 and relative risk 061 95 CI 040 to 093 p = 002 Abdominal collections were more frequent in the pancreaticojejunostomy group However pancreaticogastrostomy was associated with an increased risk of postoperative intraluminal hemorrhage and there were no differences in overall morbidity reoperations or mortalityIn this systematic review and metaanalysis a reduction in the incidence of postoperative pancreatic fistula in the pancreaticogastrostomy group was observed Although this evidence comes from randomized trials pancreaticogastrostomy cannot be considered superior to pancreaticojejunostomy due to the presence of clinical heterogeneity among studies and the absence of differences in overall morbidity reoperations and mortality
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