Meta-analysis of pylorus-preserving pancreaticoduodenectomy in the treatment of periampullary adenocarcinoma
10.3760/cma.j.issn.1671-0274.2015.01.011
- VernacularTitle:保留幽门胰十二指肠切除术治疗壶腹周围癌的Meta分析
- Author:
Junxiang YIN
1
;
Chao QU
;
Jun HUANG
;
Zixi HUANG
;
Junwen HU
;
Jianghua SHAO
Author Information
1. 330006,南昌大学第二附属医院普通外科 江西省分子医学重点实验室
- Keywords:
Pancreaticoduodenectomy,pylorus-preserving;
Periampullary aden ocarcinoma;
Meta-analysis
- From:
Chinese Journal of Gastrointestinal Surgery
2015;(1):41-45
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy and safety of pylorus-preserving pancreatico-duodenectomy (PPPD) in the treatment of periampullary adenocarcinoma by using Meta-analysis. Methods From January 1, 1980 to November 8, 2013, the articles of randomized controlled trials (RCTs) about PPPD versus PD in the treatment of periampullary adenocarcinoma were collected from Cochrane Libriary, Embase, PubMed, Ovid, Web of science and CBM etc. The methodological quality of the included studies was evaluated according to Cochrane system review valuator handbook of risk of bias standards. Meta-analysis was performed by RevMan 5.2 software. Results Seven RCTs were enrolled in the meta-analysis. Compared to PD group, PPPD group was associated with significantly less intraoperative blood loss (MD=-200.10, 95% CI:-400.66 to 0.46, P=0.05), shorter operation time (MD=-46.55, 95%CI:-91.02 to -2.07, P=0.04), and less postoperative blood transfusion (MD=-0.89, 95% CI:-1.59 to -0.19, P=0.01). There were no significant differences between the PPPD and PD group in pancreatic fistula, biliary fistula, intestinal fistula, abdominal abscess, postoperative bleeding, wound infection, relaparotomy, mortality and survival rate (all P>0.05). Conclusions PPPD in the treatment of the periampullary adenocarcinoma is safe and effective with similar survival of PD surgery. PPPD can reduce operative time, intraoperative blood loss, transfusion and does not increase the surgery complications as compared to PD.
