Comparison of postoperative complications between internal and external pancreatic duct stenting during pancreaticoduodenectomy: a meta-analysis

作     者：Fa-Yong Ke Xiang-Song Wu Yong Zhang Hong-Cheng Zhang Ming-Zhe Weng Ying-Bin Liu Christopher Wolfgang Wei Gong 

作者机构：Department of General Surgery Xinhua Hospital Shanghai Jiao Tong University School of Medicine Department of Hepatobiliary and Pancreatic Surgery Johns Hopkins School of Medicine 

出 版 物：《Chinese Journal of Cancer Research》 (中国癌症研究（英文版）)

年 卷 期：2015年第27卷第4期

页      面：397-407页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：supported by Introductory Funding Project from Shanghai Science and Technolodge Bureau (124119a0600) 

主　　题：Pancreatic duct stent pancreaticoduodenectomy(PD) meta analysis 

摘      要：Background：Two types of pancreatic duct stents are used to improve postoperative outcomes of pancreatic *** aim of this meta-analysis was to evaluate and compare the postoperative outcomes of patients with internal or external stenting during pancreaticoduodenectomy（PD）.Methods：We searched Pub Med,EMBASE,the Cochrane Library and Web of Science databases until the end of December,*** comparing outcomes of external *** stent placement in PD were eligible for *** literature was extracted and assessed by two independent ***：Seven articles were identified for inclusion：three randomized controlled trials（RCTs）and four observational clinical studies（OCS）.The meta-analyses revealed that use of external stents had advantage on reducing the incidences of pancreatic fistula（PF）in total[odds ratio（OR）=0.69;95%confidence interval（CI）,0.48-0.99;P=0.04],PF in soft pancreas（OR=0.30;95%CI,0.16-0.56;P=0.0002）and delayed gastric emptying（DGE）（OR=0.58;95%CI,0.38-0.89;P=0.01）compared with internal *** were no significant differences in other postoperative outcomes between two stenting methods,including postoperative morbidity（OR=0.93;95%CI,0.39-2.23;P=0.88）,overall mortality（OR=0.70;95%CI,0.22-2.25;P=0.55）,and intra-abdominal collections（OR=0.67;95%CI,0.26-1.71;P=0.40）.Conclusions：Based upon this meta-analysis,the use of external pancreatic stents might have potential benefit in reducing the incidence of PF and *** to the limited number of original studies,more RCTs are needed to further support our result and clarify the issue.