A web-based overview, systematic review and meta-analysis of pancreatic anastomosis techniques following pancreatoduodenectomy

HPB : the Official Journal of the International Hepato Pancreato Biliary Association
Lois A DaamenDutch Pancreatic Cancer Group

Abstract

Many pancreatic anastomoses have been proposed to reduce the incidence of postoperative pancreatic fistula (POPF) after pancreatoduodenectomy, but a complete overview is lacking. This systematic review and meta-analysis aims to provide an online overview of all pancreatic anastomosis techniques and to evaluate the incidence of clinically relevant POPF in randomized controlled trials (RCTs). A literature search was performed to December 2017. Included were studies giving a detailed description of the pancreatic anastomosis after open pancreatoduodenectomy and RCTs comparing techniques for the incidence of POPF (International Study Group of Pancreatic Surgery [ISGPS] Grade B/C). Meta-analyses were performed using a random-effects model. A total of 61 different anastomoses were found and summarized in 19 subgroups (www.pancreatic-anastomosis.com). In 6 RCTs, the POPF rate was 12% after pancreaticogastrostomy (n = 69/555) versus 20% after pancreaticojejunostomy (n = 106/531) (RR0.59; 95%CI 0.35-1.01, P = 0.05). Six RCTs comparing subtypes of pancreaticojejunostomy showed a pooled POPF rate of 10% (n = 109/1057). Duct-to-mucosa and invagination pancreaticojejunostomy showed similar results, respectively 14% (n = 39/278) versus 10% (...Continue Reading

Citations

Jul 10, 2019·Expert Review of Gastroenterology & Hepatology·Yien XiangXuewen Zhang
Apr 6, 2019·Indian Journal of Surgical Oncology·Mallika TewariH S Shukla
Aug 17, 2019·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Yuichiro UchidaShinji Uemoto
Jan 18, 2021·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Fabio AusaniaJosè Enrique Casal-Nuñez
Jun 15, 2021·World Journal of Gastrointestinal Surgery·Jian FengYong-Liang Chen
Aug 11, 2021·Surgery·Ekaterina PetrovaUNKNOWN Dutch Pancreatic Cancer Group and DGAV StuDoQ|Pancreas
Oct 6, 2021·Khirurgiia·K D DalgatovA V Sazhin
Feb 6, 2020·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Lyonell B KoneAjay V Maker

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