Reconstruction by Pancreaticogastrostomy versus Pancreaticojejunostomy following Pancreaticoduodenectomy: A Meta-Analysis of Randomized Controlled Trials

Objectives. The aim of our study was to evaluate and compare the results of pancreaticogastrostomy (PG) and pancreaticojejunostomy (PJ) after pancreaticoduodenectomy (PD). Methods. Published data of randomized clinical trials (RCTs) comparing the clinically relevant outcomes of PG versus PJ after PD...

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Main Authors: YinFeng Shen, WenYin Jin
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2012/627095
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author YinFeng Shen
WenYin Jin
author_facet YinFeng Shen
WenYin Jin
author_sort YinFeng Shen
collection DOAJ
description Objectives. The aim of our study was to evaluate and compare the results of pancreaticogastrostomy (PG) and pancreaticojejunostomy (PJ) after pancreaticoduodenectomy (PD). Methods. Published data of randomized clinical trials (RCTs) comparing the clinically relevant outcomes of PG versus PJ after PD were analyzed. Two reviewers assessed the quality of each trial and collected data independently. The Cochrane Collaboration’s RevMan 5.0 software was used for statistical analysis. Proportions were combined, and the odds ratio (OR) with its 95% CI was used as the effect size estimate. Results. Four RCTs published in 1995 or later were included in this meta-analysis, in which 276 patients underwent PG and 277 patients underwent PJ followed PD. In the combined results of PG versus PJ, a significant difference in the morbidity of intra-abdominal complications (OR, 0.34; 95% CI, 0.23–0.49; 𝑃<0.00001) was found, but no significant difference could be found for pancreatic fistula (OR, 0.69; 95% CI, 0.42–1.12 , 𝑃=0.13) mortality (OR, 1.09; 95% CI, 0.42–2.83; 𝑃=0.87), recovery with no complications (OR, 1.26; 95% CI, 0.90–1.78; 𝑃=0.18), biliary fistula (OR, 0.55; 95% CI, 0.22–1.35; 𝑃=0.19), or in delayed gastric emptying (OR, 0.55; 95% CI, 0.33–1.01; 𝑃=0.06). Conclusions. Current RCTs suggest that PG is better than PJ for pancreatic reconstruction after PD.
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spelling doaj-art-48f7ef31ea9640e58dd7fe98f04d72e92025-02-03T07:26:07ZengWileyGastroenterology Research and Practice1687-61211687-630X2012-01-01201210.1155/2012/627095627095Reconstruction by Pancreaticogastrostomy versus Pancreaticojejunostomy following Pancreaticoduodenectomy: A Meta-Analysis of Randomized Controlled TrialsYinFeng Shen0WenYin Jin1Surgery, Chinese Medicine Hospital of Hubei Province, Hubei University of Chinese Medicine, Wuhan 430061, ChinaSurgery, Chinese Medicine Hospital of Hubei Province, Hubei University of Chinese Medicine, Wuhan 430061, ChinaObjectives. The aim of our study was to evaluate and compare the results of pancreaticogastrostomy (PG) and pancreaticojejunostomy (PJ) after pancreaticoduodenectomy (PD). Methods. Published data of randomized clinical trials (RCTs) comparing the clinically relevant outcomes of PG versus PJ after PD were analyzed. Two reviewers assessed the quality of each trial and collected data independently. The Cochrane Collaboration’s RevMan 5.0 software was used for statistical analysis. Proportions were combined, and the odds ratio (OR) with its 95% CI was used as the effect size estimate. Results. Four RCTs published in 1995 or later were included in this meta-analysis, in which 276 patients underwent PG and 277 patients underwent PJ followed PD. In the combined results of PG versus PJ, a significant difference in the morbidity of intra-abdominal complications (OR, 0.34; 95% CI, 0.23–0.49; 𝑃<0.00001) was found, but no significant difference could be found for pancreatic fistula (OR, 0.69; 95% CI, 0.42–1.12 , 𝑃=0.13) mortality (OR, 1.09; 95% CI, 0.42–2.83; 𝑃=0.87), recovery with no complications (OR, 1.26; 95% CI, 0.90–1.78; 𝑃=0.18), biliary fistula (OR, 0.55; 95% CI, 0.22–1.35; 𝑃=0.19), or in delayed gastric emptying (OR, 0.55; 95% CI, 0.33–1.01; 𝑃=0.06). Conclusions. Current RCTs suggest that PG is better than PJ for pancreatic reconstruction after PD.http://dx.doi.org/10.1155/2012/627095
spellingShingle YinFeng Shen
WenYin Jin
Reconstruction by Pancreaticogastrostomy versus Pancreaticojejunostomy following Pancreaticoduodenectomy: A Meta-Analysis of Randomized Controlled Trials
Gastroenterology Research and Practice
title Reconstruction by Pancreaticogastrostomy versus Pancreaticojejunostomy following Pancreaticoduodenectomy: A Meta-Analysis of Randomized Controlled Trials
title_full Reconstruction by Pancreaticogastrostomy versus Pancreaticojejunostomy following Pancreaticoduodenectomy: A Meta-Analysis of Randomized Controlled Trials
title_fullStr Reconstruction by Pancreaticogastrostomy versus Pancreaticojejunostomy following Pancreaticoduodenectomy: A Meta-Analysis of Randomized Controlled Trials
title_full_unstemmed Reconstruction by Pancreaticogastrostomy versus Pancreaticojejunostomy following Pancreaticoduodenectomy: A Meta-Analysis of Randomized Controlled Trials
title_short Reconstruction by Pancreaticogastrostomy versus Pancreaticojejunostomy following Pancreaticoduodenectomy: A Meta-Analysis of Randomized Controlled Trials
title_sort reconstruction by pancreaticogastrostomy versus pancreaticojejunostomy following pancreaticoduodenectomy a meta analysis of randomized controlled trials
url http://dx.doi.org/10.1155/2012/627095
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