This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Meta‐analysis of delayed gastric emptying after pylorus‐preserving versus pylorus‐resecting pancreatoduodenectomy. BJS 2018; 105: 339-349.
Published: 7th February 2018
Authors: U. Klaiber, P. Probst, O. Strobel, C. W. Michalski, C. Dörr‐Harim, M. K. Diener et al.
Background
Delayed gastric emptying (DGE) is a frequent complication after pylorus‐preserving pancreatoduodenectomy. Recent studies have suggested that resection of the pylorus is associated with decreased rates of DGE. However, superiority of pylorus‐resecting pancreatoduodenectomy was not shown in a recent RCT. This meta‐analysis summarized evidence of the effectiveness and safety of pylorus‐preserving compared with pylorus‐resecting pancreatoduodenectomy.
Method
RCTs and non‐randomized studies comparing outcomes of pylorus‐preserving and pylorus‐resecting pancreatoduodenectomy were searched systematically in MEDLINE, Web of Science and CENTRAL. Random‐effects meta‐analyses were performed and the results presented as weighted odds ratios (ORs) or mean differences with their corresponding 95 per cent confidence intervals. Subgroup analyses were performed to account for interstudy heterogeneity between RCTs and non‐randomized studies.
Results
Three RCTs and eight non‐randomized studies with a total of 992 patients were included. Quantitative synthesis across all studies showed superiority for pylorus‐resecting pancreatoduodenectomy regarding DGE (OR 2·71, 95 per cent c.i. 1·48 to 4·96;
Conclusion
Pylorus‐resecting pancreatoduodenectomy is not superior to pylorus‐preserving pancreatoduodenectomy for reducing DGE or other relevant complications.
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