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International Journal of Surgical Oncology
Volume 2017 (2017), Article ID 7526494, 18 pages
https://doi.org/10.1155/2017/7526494
Review Article

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

1Department of Surgery, University Hospital of Larissa, Mezourlo, 41110 Larissa, Greece
2Postgraduate Programme (MSc): Research Methodology in Biomedicine, Biostatistics and Clinical Bioinformatics, University of Thessaly, Larissa, Greece
3Research Unit for General Medicine and Primary Health Care, Faculty of Medicine, School for Health Sciences, University of Ioannina, Ioannina, Greece
4Tufts University School of Medicine, Boston, MA, USA
5Department of Nephrology, Medical School, University of Thessaly, Larissa, Greece
6Department of Biomathematics, University of Thessaly School of Medicine, Larissa, Greece

Correspondence should be addressed to Konstantinos Perivoliotis; moc.liamg@91irepk

Received 14 January 2017; Revised 22 April 2017; Accepted 14 May 2017; Published 17 July 2017

Academic Editor: George H. Sakorafas

Copyright © 2017 Konstantinos Perivoliotis et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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 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.