Clinical effect of pancreaticoduodenectomy with total mesopancreas excision versus traditional pancreaticoduodenectomy in treatment of pancreatic head carcinoma and periampullary cancer: A Meta-analysis
10.3969/j.issn.1001-5256.2020.08.026
- VernacularTitle:胰十二指肠联合全系膜切除术与胰十二指肠切除术治疗胰头癌及壶腹周围癌效果比较的Meta分析
- Author:
Peihe YU
1
,
2
;
Song SU
1
;
Shi CHEN
2
;
Jincheng WANG
1
,
2
;
Xinpei CHEN
1
,
2
;
De LUO
2
Author Information
1. Department of Hepatobiliary Surgery
2. Department of Thyroid Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China
- Publication Type:Research Article
- Keywords:
pancreatic neoplasms;
pancreaticoduodenectomy;
total mesopancreas excision with pancreaticoduodenectomy;
treatment outcome;
Meta-analysis as topic
- From:
Journal of Clinical Hepatology
2020;36(8):1811-1815
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the safety and clinical effect of pancreaticoduodenectomy with total mesopancreas excision (TMpE) versus traditional pancreaticoduodenectomy (PD) in the treatment of pancreatic head carcinoma and periampullary cancer. MethodsPubMed, Web of Science, Cochrane Library, CBM, CNKI, Wanfang Data, and VIP were searched for the Chinese and English articles on the clinical effect of TMpE and PD in the treatment of pancreatic head carcinoma and periampullary cancer published from January 2007 to February 2020. Quality assessment was performed for the articles included, and Revman 5.3 software was used to perform the Meta-analysis. ResultsFive retrospective cohort studies were included after screening, with a total of 358 patients, among whom 188 underwent TMpE and 170 underwent PD. The results of the meta-analysis showed that compared with the PD group, the TMpE group had a significant increase in the incidence rate of pancreatic fistula (odds ratio ［OR］=1.69, 95% confidence interval ［CI］: 1.03-2.78, P=0.04), while there was no significant difference in the incidence rate of postoperative complications between the two groups (OR=1.51, 95% CI: 0.76-2.98, P=0.24). In addition, TMpE improved R0 resection rate (OR=2.89, 95% CI: 1.30-6.43, P=0.009), number of dissected lymph nodes (mean difference ［MD］=5.14, 95% CI: 4.16-6.13, P＜0.001), and 1-year survival rate after surgery (OR=260, 95% CI: 1.45-4.69, P=0.001), without increasing the time of operation (MD=7.74, 95% CI: -42.84 to 58.33, P=076), intraoperative blood loss (MD = -45.89, 95% CI: -198.19 to 106.41, P=0.55), and the length of postoperative hospital stay (MD=-4.62, 95% CI: -16.60 to 7.36, P=0.45). ConclusionTMpE is safe and feasible in the treatment of pancreatic head carcinoma and periampullary cancer and has the advantages of high R0 resection rate and 1-year survival rate after surgery, and therefore, it may become a preferred treatment method for pancreatic head carcinoma and periampullary cancer.
