Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012:2012:627095.
doi: 10.1155/2012/627095. Epub 2012 Feb 19.

Reconstruction by Pancreaticogastrostomy versus Pancreaticojejunostomy following Pancreaticoduodenectomy: A Meta-Analysis of Randomized Controlled Trials

Affiliations

Reconstruction by Pancreaticogastrostomy versus Pancreaticojejunostomy following Pancreaticoduodenectomy: A Meta-Analysis of Randomized Controlled Trials

Yinfeng Shen et al. Gastroenterol Res Pract. 2012.

Abstract

Objectives. The aim of our study was to evaluate and compare the results of pancreaticogastrostomy (PG) and pancreaticojejunostomy (PJ) after pancreaticoduodenectomy (PD). Methods. Published data of randomized clinical trials (RCTs) comparing the clinically relevant outcomes of PG versus PJ after PD were analyzed. Two reviewers assessed the quality of each trial and collected data independently. The Cochrane Collaboration's RevMan 5.0 software was used for statistical analysis. Proportions were combined, and the odds ratio (OR) with its 95% CI was used as the effect size estimate. Results. Four RCTs published in 1995 or later were included in this meta-analysis, in which 276 patients underwent PG and 277 patients underwent PJ followed PD. In the combined results of PG versus PJ, a significant difference in the morbidity of intra-abdominal complications (OR, 0.34; 95% CI, 0.23-0.49; P < 0.00001) was found, but no significant difference could be found for pancreatic fistula (OR, 0.69; 95% CI, 0.42-1.12 , P = 0.13) mortality (OR, 1.09; 95% CI, 0.42-2.83; P = 0.87), recovery with no complications (OR, 1.26; 95% CI, 0.90-1.78; P = 0.18), biliary fistula (OR, 0.55; 95% CI, 0.22-1.35; P = 0.19), or in delayed gastric emptying (OR, 0.55; 95% CI, 0.33-1.01; P = 0.06). Conclusions. Current RCTs suggest that PG is better than PJ for pancreatic reconstruction after PD.

PubMed Disclaimer

Figures

Figure 1
Figure 1
QUOROM flow diagram of included and excluded studies.
Figure 2
Figure 2
Forest plot of morbidity of IACs between PG and PJ.
Figure 3
Figure 3
Forest plot of pancreatic fistula between PG and PJ.
Figure 4
Figure 4
Forest plot of mortality between PG and PJ.
Figure 5
Figure 5
Forest plot of recovery with no complications between PG and PJ.
Figure 6
Figure 6
Forest plot of biliary fistula between PG and PJ.
Figure 7
Figure 7
Forest plot of delayed gastric emptying between PG and PJ.

Similar articles

Cited by

References

    1. Shrikhande SV, Qureshi SS, Rajneesh N, Shukla PJ. Pancreatic anastomoses after pancreaticoduodenectomy: do we need further studies? World Journal of Surgery. 2005;29(12):1642–1649. - PubMed
    1. Talamini MA, Moesinger RC, Pitt HA, et al. Adenocarcinoma of the ampulla of Vater: a 28-year experience. Annals of Surgery. 1997;225(5):590–600. - PMC - PubMed
    1. Peng SY, Wang JW, Lau WY, et al. Conventional versus binding pancreaticojejunostomy after pancreaticoduodenectomy: a prospective randomized trial. Annals of Surgery. 2007;245(5):692–698. - PMC - PubMed
    1. Winter JM, Cameron JL, Campbell KA, et al. 1423 pancreaticoduodenectomies for pancreatic cancer: a single-institution experience. Journal of Gastrointestinal Surgery. 2006;10(9):1199–1211. - PubMed
    1. Poon RTP, Fan ST, Lo CM, et al. EXternal drainage of pancreatic duct with a stent to reduce leakage rate of pancreaticojejunostomy after pancreaticoduodenectomy: a prospective randomized trial. Annals of Surgery. 2007;246(3):425–433. - PMC - PubMed

LinkOut - more resources