Meta-analysis of modified Blumgart anastomosis and interrupted transpancreatic suture in pancreaticojejunostomy after pancreaticoduodenectomy
Postoperative pancreatic fistula (POPF) remains the main cause of surgery related mortality after pancreaticoduodenectomy. Various pancreatoenteric anastomosis methods have been developed to reduce the POPF rate. However, the optimum choice has not been clarified.A literature search is performed in...
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Elsevier
2020-11-01
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| Series: | Asian Journal of Surgery |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1015958420300300 |
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| author | Feng Cao Xiaogang Tong Ang Li Jia Li Fei Li |
| author_facet | Feng Cao Xiaogang Tong Ang Li Jia Li Fei Li |
| author_sort | Feng Cao |
| collection | DOAJ |
| description | Postoperative pancreatic fistula (POPF) remains the main cause of surgery related mortality after pancreaticoduodenectomy. Various pancreatoenteric anastomosis methods have been developed to reduce the POPF rate. However, the optimum choice has not been clarified.A literature search is performed in electronic databases, including PubMed, Medline, Embase, CNKI and the Cochrane Library. Studies comparing modified Blumgart anastomosis with interrupted transpancreatic suture are included in this meta-analysis. Grade B/C POPF, overall POPF rate and overall sever complication rate (Clavien-Dindo classification IIIa or more) are measured as primary outcomes. Revman 5.3 was used to perform the analysis.Five retrospective comparative studies and 1 randomized controlled trial with a total number of 1409 patients are included in our analysis. Meta-analysis revealed that modified Blumgart anastomosis is associated with lower rate of grade B/C POPF [Odds Ratio (OR) 95% confidence interval (CI),0.32 (0.12–0.84); P = 0.02] and intra-abdominal abscess [OR 95%CI, 0.43 (0.29–0.65); P < 0.01] comparing with interrupted transpancreatic suture. However, this procedure could not reduce overall POPF [OR 95%CI,0.70 (0.34–1.44); P = 0.34] and overall sever complication rate [OR 95%CI,0.91 (0.48–1.72); P = 0.77].At current level of evidence, modified Blumgart anastomosis is superior to interrupted transpancreatic suture in terms of grade B/C POPF and intra-abdominal abscess. However, high-grade evidence will be necessary to confirm these results. |
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| issn | 1015-9584 |
| language | English |
| last_indexed | 2024-12-11T04:22:04Z |
| publishDate | 2020-11-01 |
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| series | Asian Journal of Surgery |
| spelling | doaj.art-092659ebb956430fb25b86df50e16d4c2022-12-22T01:21:05ZengElsevierAsian Journal of Surgery1015-95842020-11-01431110561061Meta-analysis of modified Blumgart anastomosis and interrupted transpancreatic suture in pancreaticojejunostomy after pancreaticoduodenectomyFeng Cao0Xiaogang Tong1Ang Li2Jia Li3Fei Li4Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, PR ChinaDepartment of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, PR ChinaDepartment of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, PR ChinaCorresponding author.; Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, PR ChinaCorresponding author.; Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, PR ChinaPostoperative pancreatic fistula (POPF) remains the main cause of surgery related mortality after pancreaticoduodenectomy. Various pancreatoenteric anastomosis methods have been developed to reduce the POPF rate. However, the optimum choice has not been clarified.A literature search is performed in electronic databases, including PubMed, Medline, Embase, CNKI and the Cochrane Library. Studies comparing modified Blumgart anastomosis with interrupted transpancreatic suture are included in this meta-analysis. Grade B/C POPF, overall POPF rate and overall sever complication rate (Clavien-Dindo classification IIIa or more) are measured as primary outcomes. Revman 5.3 was used to perform the analysis.Five retrospective comparative studies and 1 randomized controlled trial with a total number of 1409 patients are included in our analysis. Meta-analysis revealed that modified Blumgart anastomosis is associated with lower rate of grade B/C POPF [Odds Ratio (OR) 95% confidence interval (CI),0.32 (0.12–0.84); P = 0.02] and intra-abdominal abscess [OR 95%CI, 0.43 (0.29–0.65); P < 0.01] comparing with interrupted transpancreatic suture. However, this procedure could not reduce overall POPF [OR 95%CI,0.70 (0.34–1.44); P = 0.34] and overall sever complication rate [OR 95%CI,0.91 (0.48–1.72); P = 0.77].At current level of evidence, modified Blumgart anastomosis is superior to interrupted transpancreatic suture in terms of grade B/C POPF and intra-abdominal abscess. However, high-grade evidence will be necessary to confirm these results.http://www.sciencedirect.com/science/article/pii/S1015958420300300PancreaticoduodenectomyPancreaticojejunostomyMeta-analysis |
| spellingShingle | Feng Cao Xiaogang Tong Ang Li Jia Li Fei Li Meta-analysis of modified Blumgart anastomosis and interrupted transpancreatic suture in pancreaticojejunostomy after pancreaticoduodenectomy Asian Journal of Surgery Pancreaticoduodenectomy Pancreaticojejunostomy Meta-analysis |
| title | Meta-analysis of modified Blumgart anastomosis and interrupted transpancreatic suture in pancreaticojejunostomy after pancreaticoduodenectomy |
| title_full | Meta-analysis of modified Blumgart anastomosis and interrupted transpancreatic suture in pancreaticojejunostomy after pancreaticoduodenectomy |
| title_fullStr | Meta-analysis of modified Blumgart anastomosis and interrupted transpancreatic suture in pancreaticojejunostomy after pancreaticoduodenectomy |
| title_full_unstemmed | Meta-analysis of modified Blumgart anastomosis and interrupted transpancreatic suture in pancreaticojejunostomy after pancreaticoduodenectomy |
| title_short | Meta-analysis of modified Blumgart anastomosis and interrupted transpancreatic suture in pancreaticojejunostomy after pancreaticoduodenectomy |
| title_sort | meta analysis of modified blumgart anastomosis and interrupted transpancreatic suture in pancreaticojejunostomy after pancreaticoduodenectomy |
| topic | Pancreaticoduodenectomy Pancreaticojejunostomy Meta-analysis |
| url | http://www.sciencedirect.com/science/article/pii/S1015958420300300 |
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