The role of prophylactic transpapillary pancreatic stenting in distal pancreatectomy: a meta-analysis

doi:10.1007/s11684-013-0296-9

Front Med

0, Vol.

Issue () : 499-505 https://doi.org/10.1007/s11684-013-0296-9

RESEARCH ARTICLE

The role of prophylactic transpapillary pancreatic stenting in distal pancreatectomy: a meta-analysis

Xiangsong Wu, Maolan Li, Wenguang Wu, Jiasheng Mu, Lin Zhang, Qichen Ding, Qian Ding, Hao Weng, Runfa Bao, Yijun Shu, Ping Dong, Jun Gu, Jianhua Lu, Yingbin Liu(

)

Department of General Surgery, Xinhua Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200092, China

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Abstract

Pancreatic fistula (PF) is the most frequent complication after distal pancreatectomy (DP). Prophylactic transpapillary pancreatic stenting (PTPS) has been proposed recently for the prevention of PF after DP. In this meta-analysis, a comprehensive search was performed in the PubMed, Embase, and Cochrane Library databases. Studies analyzing the results of PTPS in DP were considered eligible for this meta-analysis. The analyzed outcome variables included PF rate, postoperative morbidity, non-PF-related complications, mortality, operation duration, and hospital stay. Four studies with 200 patients were included in this review. Only one was a randomized controlled trial (RCT). The results showed that PTPS was associated with less PF formation (odds ratio, 0.45; 95% confidence interval [CI], 0.22–0.94; P = 0.03) and shorter hospital stay (mean difference, -6.31; 95% CI, -6.99 to -5.62; P<0.00001). There was no significant difference in terms of the other variables. In conclusion, current evidence indicates that PTPS could reduce PF incidence and hospital stay after DP, without increasing other complications or operative time. However, the evidence is not solid, because the single RCT conflicted with the other three retrospective reports. Thus, considering the limitation, more well-designed RCTs on this topic are needed in the future.

Keywords pancreatic fistula distal pancreatectomy pancreatic stent meta-analysis

Corresponding Author(s): Liu Yingbin,Email:liuybphd@126.com

Issue Date: 05 December 2013

Cite this article:

Qichen Ding,Qian Ding,Hao Weng, et al. The role of prophylactic transpapillary pancreatic stenting in distal pancreatectomy: a meta-analysis[J]. Front Med, 0, (): 499-505.

URL:

https://academic.hep.com.cn/fmd/EN/10.1007/s11684-013-0296-9
https://academic.hep.com.cn/fmd/EN/Y0/V/I/499

Fig.1 Flow diagram indicating the selection of studies.

Tab.1 Basic data of the included studies

Fig.2 Meta-analysis of pancreatic fistula studies. The result shows that PTPS significantly decreased the pancreatic fistula rate.

Fig.3 Meta-analysis of studies on postoperative morbidity. No significant difference was detected between the two cohorts.

Fig.4 Meta-analysis of studies on non-PF-related morbidity. The result shows that PTPS did not significantly increase the non-PF-related morbidity rate.

Fig.5 Meta-analysis of studies on hospital stay. The result shows that PTPS significantly decreased the hospital stay.

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