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Meta-Analysis
. 2020 Oct 21;10(1):17896.
doi: 10.1038/s41598-020-74812-4.

Blumgart anastomosis reduces the incidence of pancreatic fistula after pancreaticoduodenectomy: a systematic review and meta-analysis

Zhenlu Li  1   2 , Ailin Wei  1   3 , Ning Xia  2 , Liangxia Zheng  4 , Dujiang Yang  2   5   6 , Jun Ye  7 , Junjie Xiong  8 , Weiming Hu  9
Affiliations
Meta-Analysis

Blumgart anastomosis reduces the incidence of pancreatic fistula after pancreaticoduodenectomy: a systematic review and meta-analysis

Zhenlu Li et al. Sci Rep. .

Abstract

Postoperative pancreatic fistula (POPF) is the most serious complication after pancreaticoduodenectomy (PD). Recently, Blumgart anastomosis (BA) has been found to have some advantages in terms of decreasing POPF compared with other pancreaticojejunostomy (PJ) using either the duct-to-mucosa or invagination approach. Therefore, the aim of this study was to examine the safety and effectiveness of BA versus non-Blumgart anastomosis after PD. The PubMed, EMBASE, Web of Science and the Cochrane Central Library were systematically searched for studies published from January 2000 to March 2020. One RCT and ten retrospective comparative studies were included with 2412 patients, of whom 1155 (47.9%) underwent BA and 1257 (52.1%) underwent non-Blumgart anastomosis. BA was associated with significantly lower rates of grade B/C POPF (OR 0.38, 0.22 to 0.65; P = 0.004) than non-Blumgart anastomosis. Additionally, in the subgroup analysis, the grade B/C POPF was also reduced in BA group than the Kakita anastomosis group. There was no significant difference regarding grade B/C POPF in terms of soft pancreatic texture between the BA and non-Blumgart anastomosis groups. In conclusion, BA after PD was associated with a decreased risk of grade B/C POPF. Therefore, BA seems to be a valuable PJ to reduce POPF comparing with non-Blumgart anastomosis.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
PRISMA diagram showing selection of articles for review BA Blumgart anastomosis, PG pancreaticogastrostomy.
Figure 2
Figure 2
The forest plot of primary outcomes in Blumgart group versus non-Blumgart group.
Figure 3
Figure 3
Funnel plot to investigate publication bias basing on POPF.
See this image and copyright information in PMC

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