Pancreatogastrostomy versus Pancreatojejunostomy: An Up-to-Date Meta-Analysis of RCTs

Abstract EN

Background.

A meta-analysis was conducted in order to provide an up-to-date comparison of pancreatogastrostomy (PG) and pancreatojejunostomy (PJ), after pancreatoduodenectomy (PD), in terms of clinically significant postoperative pancreatic fistula (POPF) and other postoperative complications.

Methods.

This meta-analysis was conducted according to the PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions.

A systematic literature search in MEDLINE and Cochrane Central Register of Controlled Clinical Trials was performed.

Fixed Effects or Random Effects model was used, based on the Cochran Q test.

Results.

In total, 10 studies (1629 patients) were included.

There was no statistical significance between PG and PJ regarding the rate of clinically significant POPF (OR: 0.70, 95%CI: 0.46–1.06).

PG was associated with a higher rate of postpancreatoduodenectomy haemorrhage (PPH) (OR: 1.52, 95%CI: 1.08–2.14).

There was no difference between the two techniques in terms of clinically significant PPH (OR: 1.35, 95%CI: 0.95–1.93) and clinically significant postoperative delayed gastric emptying (DGE) (OR: 0.98, 95%CI: 0.59–1.63).

Discussion.

There is no difference between the two anastomotic techniques regarding the rate of clinically significant POPF.

Given several limitations, more large scale high quality RCTs are required.