Roux-en-Y versus Billroth Ⅱ alimentary canal reconstruction after pancreaticoduodenectomy: a meta-analysis
10.3760/cma.j.issn.1007-8118.2018.07.011
- VernacularTitle:胰十二指肠切除术后Roux-en-Y与Billroth Ⅱ消化道重建的系统评价
- Author:
Haonan GUAN
1
;
Qiang HUANG
;
Ji YANG
;
Chao WANG
;
Fang XIE
;
Cheng WANG
Author Information
1. 安徽医科大学附属省立医院普外科肝胆胰安徽省重点实验室
- Keywords:
Pancreaticoduodenectomy (PD);
Roux-en-Y reconstruction;
Billroth Ⅱ reconstruction;
Complications;
Meta-analysis
- From:
Chinese Journal of Hepatobiliary Surgery
2018;24(7):470-475
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the effectiveness and safety comparing Roux-en-Y versus Billroth Ⅱ alimentary canal reconstruction after pancreaticoduodenectomy (PD).Methods A computer search was conducted on PubMed,Embase,Web of Science,Science Direct,Springer Link,Cochrane Center,CBM,CNKI,Wan Fang and VIP databases before September 2017 for all RCT and CCT articles on Roux-en-Y versus Billroth Ⅱ reconstruction after PD.The quality of the included trials was studied by assessing the inclusive and exclusive criteria (the PRISMA statement) by 2 researchers independently.The data were extracted and analyzed using the RevManS.3 software.Results 9 articles (3 RCTs,6 CCTs) which involved 1 599 patients (563 Roux-en-Y patients,1 036 Billroth Ⅱ patients) were studied.Meta analysis revealed that Billroth Ⅱ patients had a lower postoperative delayed gastric emptying (DGE,grades B,C) rate (OR =3.76,95％ CI:1.32 ～ 10.68,P ＜ 0.05) and a shorter operation time (WMD =32.75,95％ CI:8.17 ～57.33,P ＜ 0.05) than Roux-en-Y patients.There were no significant differences in the rates of postoperative delayed gastric emptying (grades A,B,C),pancreatic fistula,bile leak,postoperative hemorrhage,reoperation,postoperative complications and the duration of postoperative stay (P ＞ 0.05).Conclusions The incidence of DGE (grades B,C) after PD was lower after Billroth Ⅱ than that of Roux-en-Y reconstruction.Large prospective randomized controlled trials are needed to confirm the findings of this meta-analysis.
