Comparison of surgical outcomes between single-layer and double-layer pancreaticojejunostomy after pancreaticoduodenectomy: a meta-analysis.

• Tác giả: Wei Huang, Hongcun Sha, Li Wang, Qi Wu, Qingping Wu, Zhiyi Xiang, Jie Yin
• Ngôn ngữ: eng
• Ký hiệu phân loại: 333.783 *Parks
• Thông tin xuất bản: Italy : Minerva surgery , 2025
• Bộ sưu tập: NCBI
• ID: 753898

Tóm tắt

 INTRODUCTION: Postoperative pancreatic fistula (POPF) is the most severe complication after pancreaticoduodenectomy (PD), and this study investigates the effects of single-layer and double-layer pancreaticojejunostomy (PJ) on POPF. EVIDENCE ACQUISITION: Four electronic databases were systematically searched until March 2024: PubMed, Web of Science, Embase, and Cochrane Library. Statistical analysis was performed using Review Manager (RevMan) software. Mean difference (MD) or odds ratios (OR) with 95% confidence intervals (CI) were used to indicate continuous or dichotomous variables, respectively. Ten studies were included, comprising 1811 patients. EVIDENCE SYNTHESIS: Compared to the double-layer PJ group, the single-layer PJ group had a similar POPF rate (OR=0.73
  P=0.28) and grade C POPF rate (OR=0.55
  P=0.12), but a lower grade B POPF rate (OR=0.50
  95% CI: 0.31-0.81
  P=0.005). The clinically relevant POPF (CR-POPF) rate was lower in the single-layer PJ group (OR=0.47
  95% CI: 0.31-0.73
  P<
 0.002), especially in the 2017 International Study Group of Pancreatic Surgery (ISGPS) criteria subgroup (OR=0.44
  95% CI: 0.27-0.73
  P=0.002), the China subgroup (OR=0.41
  95% CI: 0.26-0.64
  P<
 0.002), and the minimally invasive subgroup (OR=0.40
  95% CI: 0.22-0.74
  P=0.003). CONCLUSIONS: Compared with double-layer PJ, single-layer PJ after PD might reduce the incidence of CR-POPF.