Pancreaticogastrostomy or pancreaticojejunostomy? Methods of digestive continuity reconstruction after pancreaticodudenectomy: a meta-analysis of randomized controlled trials

Abstract

Background and aims: Reconstruction of digestive tract after pancreaticodudenectomy now has been proved associated with pancreatic fistula and complication incidence. The meta-analysis was conducted at the appropriate time enough randomized controlled trials were reported.

Methods: Systematically literature search was performed through PubMed, EMBASE and Cochrane Library database without restriction to regions, or languages, only randomized controlled trials was included. 7 studies compared pancreatogastrostomy with pancreaticojejunostomy were included for meta-analysis. Fixed and random-effects models were used to measure the pooled estimates.

Results: Patient underwent pancreatogastrostomy after pancreatoduodenectomy suffered less pancreatic fistula(p = 0.001) and bile leakage (p = 0.02), while the operative time, hospital stay, delayed gastric emptying and overall morbidity were comparable.

Conclusion: Pancreatogastrostomy is a recommended anastomosis technique according to the meta-analysis due to minimize incidence of pancreatic fistula and bile leakage.

Keywords: Meta-analysis; Pancreatic fistula; Pancreaticodudenectomy; Pancreaticojejunostomy; Pancreatogastrostomy; Reconstruction.