Overall Postoperative Morbidity and Pancreatic Fistula Are Relatively Higher after Central Pancreatectomy than Distal Pancreatic Resection: A Systematic Review and Meta-Analysis
Joint Authors
Yang, Qin
Liu, Fei
Ma, Wenjie
Hu, Haijie
Li, Fuyu
Regmi, Parbatraj
Karn, Hare Ram
Ran, Cong-Dun
Source
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-15, 15 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-02-22
Country of Publication
Egypt
No. of Pages
15
Main Subjects
Abstract EN
Objective.
To compare the intraoperative and postoperative outcomes of central pancreatectomy (CP) with distal pancreatectomy (DP).
Methods.
A systematic literature search was performed on electronic databases from MEDLINE, Embase, and PubMed from 1998 to 2018.
Statistical analysis and meta-analysis were performed using statistics/data analysis (Stata®) software, version 12.0 (StataCorp LP, College Station, Texas 77845, USA).
Dichotomous variables were analyzed by estimation of relative risk (RR) with a 95 percent (%) confidence interval (CI) and continuous variables were analyzed by standardized mean differences (SMD) with 95% CI.
Results.
Twenty-four studies with 593 CP and 1226 DP were included in the meta-analysis.
CP had significantly longer operation time (SMD: 1.03; 95% CI 0.62 to 1.44; P<0.001) and lengthier postoperative hospital stay (SMD: 0.63; 95% CI 0.20 to 1.05; P<0.01).
Estimated blood loss was significantly lower in CP (SMD: −0.34; 95% CI −0.58 to −0.09; P=0.007).
Overall postoperative morbidity (RR: 1.30; 95% CI: 1.13 to 1.50; P<0.001), overall pancreatic fistula (RR: 1.41; 95% CI: 1.20 to 1.66; P<0.001), clinically relevant fistula (RR: 1.64; 95% CI: 1.25 to 2.16; P<0.001), and postoperative hemorrhage (RR: 1.90; 95% CI: 1.18 to 3.06; P<0.05) were all significantly higher after CP.
On long-term follow-up, DP patients were more likely to have postoperative exocrine (RR: 0.56; 95% CI: 0.37 to 0.84; P<0.05) and endocrine (RR: 0.27; 95% CI: 0.18 to 0.40; P<0.001) insufficiency.
There was no statistically significant difference in transfusion requirement, postoperative mortality, reoperation, and tumor recurrence.
Conclusion.
CP is associated with significantly higher morbidity and clinically relevant pancreatic fistula.
CP should only be reserved for selected patients who require postoperative pancreatic function preservation.
American Psychological Association (APA)
Regmi, Parbatraj& Yang, Qin& Hu, Haijie& Liu, Fei& Karn, Hare Ram& Ma, Wenjie…[et al.]. 2020. Overall Postoperative Morbidity and Pancreatic Fistula Are Relatively Higher after Central Pancreatectomy than Distal Pancreatic Resection: A Systematic Review and Meta-Analysis. BioMed Research International،Vol. 2020, no. 2020, pp.1-15.
https://search.emarefa.net/detail/BIM-1136433
Modern Language Association (MLA)
Regmi, Parbatraj…[et al.]. Overall Postoperative Morbidity and Pancreatic Fistula Are Relatively Higher after Central Pancreatectomy than Distal Pancreatic Resection: A Systematic Review and Meta-Analysis. BioMed Research International No. 2020 (2020), pp.1-15.
https://search.emarefa.net/detail/BIM-1136433
American Medical Association (AMA)
Regmi, Parbatraj& Yang, Qin& Hu, Haijie& Liu, Fei& Karn, Hare Ram& Ma, Wenjie…[et al.]. Overall Postoperative Morbidity and Pancreatic Fistula Are Relatively Higher after Central Pancreatectomy than Distal Pancreatic Resection: A Systematic Review and Meta-Analysis. BioMed Research International. 2020. Vol. 2020, no. 2020, pp.1-15.
https://search.emarefa.net/detail/BIM-1136433
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1136433