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Published in: Journal of Gastrointestinal Surgery 8/2013

01-08-2013 | Review Article

External Stent Versus No Stent for Pancreaticojejunostomy: A Meta-analysis of Randomized Controlled Trials

Authors: Shukun Hong, Hongye Wang, Shiyong Yang, Kunxing Yang

Published in: Journal of Gastrointestinal Surgery | Issue 8/2013

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Abstract

Background

The effectiveness of an external pancreatic duct stent for reduction of the pancreatic fistula after pancreaticoduodenectomy remains controversial.

Methods

MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials were searched for eligible randomized controlled trials (RCTs). Reviews of each trial were conducted and data were extracted. The primary outcome was pancreatic fistula. Statistical pooling used the fixed or random effects model and reported as risk ratio (RR) or mean difference (MD) with the corresponding 95 % confidence intervals (CI).

Results

Four RCTs including a total of 416 patients were detected. Methodological quality assessment revealed a better quality of all analyzed trials. Placing an external stent across pancreaticojejunal anastomosis could significantly reduce the incidence of pancreatic fistula (RR = 0.57, 95 % CI = 0.41–0.80, P = 0.001, I 2 = 0 %), overall morbidity (RR = 0.79, 95 % CI = 0.64–0.98, P = 0.03), and the length of hospital stay (MD = −3.98 days, 95 % CI = −6.42 to −1.54, P = 0.001, I 2 = 13 %). No significant difference was found in terms of hospital mortality, delayed gastric emptying, operation time, operative blood loss, blood replacement, and reoperation rate.

Conclusions

This meta-analysis provides compelling evidence that the application of an external pancreatic duct stent after pancreaticoduodenectomy can decrease the incidence of pancreatic leakage when compared with no stent. Moreover, the external drainage of pancreatic juice is associated with lower postoperative overall morbidity and shorter hospital stay.
Literature
1.
go back to reference Kausch W. Das Carcinoma der Papilla duodeni und seine radikale Entfernung. Beitrag Z Klin Chir 1912;78:439–486. Kausch W. Das Carcinoma der Papilla duodeni und seine radikale Entfernung. Beitrag Z Klin Chir 1912;78:439–486.
2.
go back to reference Whipple AO, Parsons WB, Mullins CR. Treatment of carcinoma of the ampulla of Vater. Ann Surg 1935;102:763–779.PubMedCrossRef Whipple AO, Parsons WB, Mullins CR. Treatment of carcinoma of the ampulla of Vater. Ann Surg 1935;102:763–779.PubMedCrossRef
3.
go back to reference Trede M, Schwall G, Saeger HD. Survival after pancreatoduodenectomy. 118 consecutive resections without an operative mortality. Ann Surg 1990;211:447–458.PubMedCrossRef Trede M, Schwall G, Saeger HD. Survival after pancreatoduodenectomy. 118 consecutive resections without an operative mortality. Ann Surg 1990;211:447–458.PubMedCrossRef
4.
go back to reference Yeo CJ, Cameron JL, Sohn TA, Lillemoe KD, Pitt HA, Talamini MA, Hruban RH, Ord SE, Sauter PK, Coleman J, Zahurak ML, Grochow LB, Abrams RA. Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes. Ann Surg 1997;226:248–260.PubMedCrossRef Yeo CJ, Cameron JL, Sohn TA, Lillemoe KD, Pitt HA, Talamini MA, Hruban RH, Ord SE, Sauter PK, Coleman J, Zahurak ML, Grochow LB, Abrams RA. Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes. Ann Surg 1997;226:248–260.PubMedCrossRef
5.
go back to reference Poon RT, Fan ST, Lo CM, Liu CL, Lam CM, Yuen WK, Yeung C, Wong J. Pancreaticoduodenectomy with en bloc portal vein resection for pancreatic carcinoma with suspected portal vein involvement. World J Surg 2004;28:602–608.PubMedCrossRef Poon RT, Fan ST, Lo CM, Liu CL, Lam CM, Yuen WK, Yeung C, Wong J. Pancreaticoduodenectomy with en bloc portal vein resection for pancreatic carcinoma with suspected portal vein involvement. World J Surg 2004;28:602–608.PubMedCrossRef
6.
go back to reference Cleary SP, Gryfe R, Guindi M, Greig P, Smith L, Mackenzie R, Strasberg S, Hanna S, Taylor B, Langer B, Gallinger S. Prognostic factors in resected pancreatic adenocarcinoma: analysis of actual 5-year survivors. J Am Coll Surg 2004;198:722–731.PubMedCrossRef Cleary SP, Gryfe R, Guindi M, Greig P, Smith L, Mackenzie R, Strasberg S, Hanna S, Taylor B, Langer B, Gallinger S. Prognostic factors in resected pancreatic adenocarcinoma: analysis of actual 5-year survivors. J Am Coll Surg 2004;198:722–731.PubMedCrossRef
7.
go back to reference Beger HG, Gansauge F, Schwarz M, Poch B. Pancreatic head resection: the risk for local and systemic complications in 1315 patients—a monoinstitutional experience. Am J Surg 2007;194:S16-S19.CrossRef Beger HG, Gansauge F, Schwarz M, Poch B. Pancreatic head resection: the risk for local and systemic complications in 1315 patients—a monoinstitutional experience. Am J Surg 2007;194:S16-S19.CrossRef
8.
go back to reference Gouma DJ, van Geenen RC, van Gulik TM, de Haan RJ, de Wit LT, Busch OR, Obertop H. Rates of complications and death after pancreaticoduodenectomy: risk factors and the impact of hospital volume. Ann Surg 2000;232:786–795.PubMedCrossRef Gouma DJ, van Geenen RC, van Gulik TM, de Haan RJ, de Wit LT, Busch OR, Obertop H. Rates of complications and death after pancreaticoduodenectomy: risk factors and the impact of hospital volume. Ann Surg 2000;232:786–795.PubMedCrossRef
9.
go back to reference Bassi C, Falconi M, Salvia R, Mascetta G, Molinari E, Pederzoli P. Management of complications after pancreaticoduodenectomy in a high volume centre: results on 150 consecutive patients. Dig Surg 2001;18:453–458.PubMedCrossRef Bassi C, Falconi M, Salvia R, Mascetta G, Molinari E, Pederzoli P. Management of complications after pancreaticoduodenectomy in a high volume centre: results on 150 consecutive patients. Dig Surg 2001;18:453–458.PubMedCrossRef
10.
go back to reference Adam U, Makowiec F, Riediger H, Schareck WD, Benz S, Hopt UT. Risk factors for complications after pancreatic head resection. Am J Surg 2004;187:201–208.PubMedCrossRef Adam U, Makowiec F, Riediger H, Schareck WD, Benz S, Hopt UT. Risk factors for complications after pancreatic head resection. Am J Surg 2004;187:201–208.PubMedCrossRef
11.
go back to reference Cameron JL, Pitt HA, Yeo CJ, Lillemoe KD, Kaufman HS, Coleman J. One hundred and forty-five consecutive pancreaticoduodenectomies without mortality. Ann Surg 1993;217:430–438.PubMedCrossRef Cameron JL, Pitt HA, Yeo CJ, Lillemoe KD, Kaufman HS, Coleman J. One hundred and forty-five consecutive pancreaticoduodenectomies without mortality. Ann Surg 1993;217:430–438.PubMedCrossRef
12.
go back to reference Montorsi M, Zago M, Mosca F, Capussotti L, Zotti E, Ribotta G, Fegiz G, Fissi S, Roviaro G, Peracchia A, Et A. Efficacy of octreotide in the prevention of pancreatic fistula after elective pancreatic resections: a prospective, controlled, randomized clinical trial. Surgery 1995;117:26–31.PubMedCrossRef Montorsi M, Zago M, Mosca F, Capussotti L, Zotti E, Ribotta G, Fegiz G, Fissi S, Roviaro G, Peracchia A, Et A. Efficacy of octreotide in the prevention of pancreatic fistula after elective pancreatic resections: a prospective, controlled, randomized clinical trial. Surgery 1995;117:26–31.PubMedCrossRef
13.
go back to reference Miedema BW, Sarr MG, van Heerden JA, Nagorney DM, McIlrath DC, Ilstrup D. Complications following pancreaticoduodenectomy. Current management. Arch Surg 1992;127:945–950.PubMedCrossRef Miedema BW, Sarr MG, van Heerden JA, Nagorney DM, McIlrath DC, Ilstrup D. Complications following pancreaticoduodenectomy. Current management. Arch Surg 1992;127:945–950.PubMedCrossRef
14.
go back to reference Aranha GV, Aaron JM, Shoup M, Pickleman J. Current management of pancreatic fistula after pancreaticoduodenectomy. Surgery 2006;140:561–569.PubMedCrossRef Aranha GV, Aaron JM, Shoup M, Pickleman J. Current management of pancreatic fistula after pancreaticoduodenectomy. Surgery 2006;140:561–569.PubMedCrossRef
15.
go back to reference Hosotani R, Doi R, Imamura M. Duct-to-mucosa pancreaticojejunostomy reduces the risk of pancreatic leakage after pancreatoduodenectomy. World J Surg 2002;26:99–104.PubMedCrossRef Hosotani R, Doi R, Imamura M. Duct-to-mucosa pancreaticojejunostomy reduces the risk of pancreatic leakage after pancreatoduodenectomy. World J Surg 2002;26:99–104.PubMedCrossRef
16.
go back to reference Yeo CJ, Cameron JL, Maher MM, Sauter PK, Zahurak ML, Talamini MA, Lillemoe KD, Pitt HA. A prospective randomized trial of pancreaticogastrostomy versus pancreaticojejunostomy after pancreaticoduodenectomy. Ann Surg 1995;222:580–592.PubMed Yeo CJ, Cameron JL, Maher MM, Sauter PK, Zahurak ML, Talamini MA, Lillemoe KD, Pitt HA. A prospective randomized trial of pancreaticogastrostomy versus pancreaticojejunostomy after pancreaticoduodenectomy. Ann Surg 1995;222:580–592.PubMed
17.
go back to reference Lillemoe KD, Cameron JL, Kim MP, Campbell KA, Sauter PK, Coleman JA, Yeo CJ. Does fibrin glue sealant decrease the rate of pancreatic fistula after pancreaticoduodenectomy? Results of a prospective randomized trial. J Gastrointest Surg 2004;8:766–774.PubMedCrossRef Lillemoe KD, Cameron JL, Kim MP, Campbell KA, Sauter PK, Coleman JA, Yeo CJ. Does fibrin glue sealant decrease the rate of pancreatic fistula after pancreaticoduodenectomy? Results of a prospective randomized trial. J Gastrointest Surg 2004;8:766–774.PubMedCrossRef
18.
go back to reference Tran K, Van Eijck C, Di Carlo V, Hop WC, Zerbi A, Balzano G, Jeekel H. Occlusion of the pancreatic duct versus pancreaticojejunostomy: a prospective randomized trial. Ann Surg 2002;236:422–428.PubMedCrossRef Tran K, Van Eijck C, Di Carlo V, Hop WC, Zerbi A, Balzano G, Jeekel H. Occlusion of the pancreatic duct versus pancreaticojejunostomy: a prospective randomized trial. Ann Surg 2002;236:422–428.PubMedCrossRef
19.
go back to reference Buchler M, Friess H, Klempa I, Hermanek P, Sulkowski U, Becker H, Schafmayer A, Baca I, Lorenz D, Meister R, Et A. Role of octreotide in the prevention of postoperative complications following pancreatic resection. Am J Surg 1992;163:125–131.PubMedCrossRef Buchler M, Friess H, Klempa I, Hermanek P, Sulkowski U, Becker H, Schafmayer A, Baca I, Lorenz D, Meister R, Et A. Role of octreotide in the prevention of postoperative complications following pancreatic resection. Am J Surg 1992;163:125–131.PubMedCrossRef
20.
go back to reference Yeo CJ, Cameron JL, Lillemoe KD, Sauter PK, Coleman J, Sohn TA, Campbell KA, Choti MA. Does prophylactic octreotide decrease the rates of pancreatic fistula and other complications after pancreaticoduodenectomy? Results of a prospective randomized placebo-controlled trial. Ann Surg 2000;232:419–429.PubMedCrossRef Yeo CJ, Cameron JL, Lillemoe KD, Sauter PK, Coleman J, Sohn TA, Campbell KA, Choti MA. Does prophylactic octreotide decrease the rates of pancreatic fistula and other complications after pancreaticoduodenectomy? Results of a prospective randomized placebo-controlled trial. Ann Surg 2000;232:419–429.PubMedCrossRef
21.
go back to reference Winter JM, Cameron JL, Campbell KA, Chang DC, Riall TS, Schulick RD, Choti MA, Coleman J, Hodgin MB, Sauter PK, Sonnenday CJ, Wolfgang CL, Marohn MR, Yeo CJ. Does pancreatic duct stenting decrease the rate of pancreatic fistula following pancreaticoduodenectomy? Results of a prospective randomized trial. J Gastrointest Surg 2006;10:1280–1290.PubMedCrossRef Winter JM, Cameron JL, Campbell KA, Chang DC, Riall TS, Schulick RD, Choti MA, Coleman J, Hodgin MB, Sauter PK, Sonnenday CJ, Wolfgang CL, Marohn MR, Yeo CJ. Does pancreatic duct stenting decrease the rate of pancreatic fistula following pancreaticoduodenectomy? Results of a prospective randomized trial. J Gastrointest Surg 2006;10:1280–1290.PubMedCrossRef
22.
go back to reference Smyrniotis V, Arkadopoulos N, Kyriazi MA, Derpapas M, Theodosopoulos T, Gennatas C, Kondi-Paphiti A, Vassiliou I. Does internal stenting of the pancreaticojejunostomy improve outcomes after pancreatoduodenectomy? A prospective study. Langenbecks Arch Surg 2010;395:195–200.PubMedCrossRef Smyrniotis V, Arkadopoulos N, Kyriazi MA, Derpapas M, Theodosopoulos T, Gennatas C, Kondi-Paphiti A, Vassiliou I. Does internal stenting of the pancreaticojejunostomy improve outcomes after pancreatoduodenectomy? A prospective study. Langenbecks Arch Surg 2010;395:195–200.PubMedCrossRef
23.
go back to reference Poon RT, Fan ST, Lo CM, Ng KK, Yuen WK, Yeung C, Wong J. External drainage of pancreatic duct with a stent to reduce leakage rate of pancreaticojejunostomy after pancreaticoduodenectomy: a prospective randomized trial. Ann Surg 2007;246:425–435.PubMedCrossRef Poon RT, Fan ST, Lo CM, Ng KK, Yuen WK, Yeung C, Wong J. External drainage of pancreatic duct with a stent to reduce leakage rate of pancreaticojejunostomy after pancreaticoduodenectomy: a prospective randomized trial. Ann Surg 2007;246:425–435.PubMedCrossRef
24.
go back to reference Pessaux P, Sauvanet A, Mariette C, Paye F, Muscari F, Cunha AS, Sastre B, Arnaud JP. External pancreatic duct stent decreases pancreatic fistula rate after pancreaticoduodenectomy: prospective multicenter randomized trial. Ann Surg 2011;253:879–885.PubMedCrossRef Pessaux P, Sauvanet A, Mariette C, Paye F, Muscari F, Cunha AS, Sastre B, Arnaud JP. External pancreatic duct stent decreases pancreatic fistula rate after pancreaticoduodenectomy: prospective multicenter randomized trial. Ann Surg 2011;253:879–885.PubMedCrossRef
25.
go back to reference Motoi F, Egawa S, Rikiyama T, Katayose Y, Unno M. Randomized clinical trial of external stent drainage of the pancreatic duct to reduce postoperative pancreatic fistula after pancreaticojejunostomy. Br J Surg 2012;99:524–531.PubMedCrossRef Motoi F, Egawa S, Rikiyama T, Katayose Y, Unno M. Randomized clinical trial of external stent drainage of the pancreatic duct to reduce postoperative pancreatic fistula after pancreaticojejunostomy. Br J Surg 2012;99:524–531.PubMedCrossRef
26.
go back to reference Kuroki T, Tajima Y, Kitasato A, Adachi T, Kanematsu T. Stenting versus non-stenting in pancreaticojejunostomy: a prospective study limited to a normal pancreas without fibrosis sorted by using dynamic MRI. Pancreas 2011;40:25–29.PubMedCrossRef Kuroki T, Tajima Y, Kitasato A, Adachi T, Kanematsu T. Stenting versus non-stenting in pancreaticojejunostomy: a prospective study limited to a normal pancreas without fibrosis sorted by using dynamic MRI. Pancreas 2011;40:25–29.PubMedCrossRef
27.
go back to reference Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF. Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. Quality of Reporting of Meta-analyses. Lancet 1999;354:1896–1900.PubMedCrossRef Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF. Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. Quality of Reporting of Meta-analyses. Lancet 1999;354:1896–1900.PubMedCrossRef
28.
go back to reference Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 updated March 2011]. The Cochrane Collaboration 2011. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 updated March 2011]. The Cochrane Collaboration 2011.
29.
go back to reference Cohen J. Weighted kappa: nominal scale agreement with provision for scaled disagreement or partial credit. Psychol Bull 1968;70:213–220.PubMedCrossRef Cohen J. Weighted kappa: nominal scale agreement with provision for scaled disagreement or partial credit. Psychol Bull 1968;70:213–220.PubMedCrossRef
30.
go back to reference Bassi C, Dervenis C, Butturini G, Fingerhut A, Yeo C, Izbicki J, Neoptolemos J, Sarr M, Traverso W, Buchler M. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery 2005;138:8–13.PubMedCrossRef Bassi C, Dervenis C, Butturini G, Fingerhut A, Yeo C, Izbicki J, Neoptolemos J, Sarr M, Traverso W, Buchler M. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery 2005;138:8–13.PubMedCrossRef
31.
go back to reference Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004;240:205–213.PubMedCrossRef Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004;240:205–213.PubMedCrossRef
32.
go back to reference Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 1996;17:1–12.PubMedCrossRef Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 1996;17:1–12.PubMedCrossRef
33.
go back to reference Hozo SP, Djulbegovic B, Hozo I. Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol 2005;5:13.PubMedCrossRef Hozo SP, Djulbegovic B, Hozo I. Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol 2005;5:13.PubMedCrossRef
34.
go back to reference Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003;327:557–560.PubMedCrossRef Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003;327:557–560.PubMedCrossRef
35.
go back to reference Sterne JA, Egger M. Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis. J Clin Epidemiol 2001;54:1046–1055.PubMedCrossRef Sterne JA, Egger M. Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis. J Clin Epidemiol 2001;54:1046–1055.PubMedCrossRef
36.
go back to reference Matsusue S, Takeda H, Nakamura Y, Nishimura S, Koizumi S. A prospective analysis of the factors influencing pancreaticojejunostomy performed using a single method, in 100 consecutive pancreaticoduodenectomies. Surg Today 1998;28:719–726.PubMedCrossRef Matsusue S, Takeda H, Nakamura Y, Nishimura S, Koizumi S. A prospective analysis of the factors influencing pancreaticojejunostomy performed using a single method, in 100 consecutive pancreaticoduodenectomies. Surg Today 1998;28:719–726.PubMedCrossRef
37.
go back to reference Roder JD, Stein HJ, Bottcher KA, Busch R, Heidecke CD, Siewert JR. Stented versus nonstented pancreaticojejunostomy after pancreatoduodenectomy: a prospective study. Ann Surg 1999;229:41–48.PubMedCrossRef Roder JD, Stein HJ, Bottcher KA, Busch R, Heidecke CD, Siewert JR. Stented versus nonstented pancreaticojejunostomy after pancreatoduodenectomy: a prospective study. Ann Surg 1999;229:41–48.PubMedCrossRef
38.
go back to reference Tani M, Onishi H, Kinoshita H, Kawai M, Ueno M, Hama T, Uchiyama K, Yamaue H. The evaluation of duct-to-mucosal pancreaticojejunostomy in pancreaticoduodenectomy. World J Surg 2005;29:76–79.PubMedCrossRef Tani M, Onishi H, Kinoshita H, Kawai M, Ueno M, Hama T, Uchiyama K, Yamaue H. The evaluation of duct-to-mucosal pancreaticojejunostomy in pancreaticoduodenectomy. World J Surg 2005;29:76–79.PubMedCrossRef
39.
go back to reference Imaizumi T, Hatori T, Tobita K, Fukuda A, Takasaki K, Makuuchi H. Pancreaticojejunostomy using duct-to-mucosa anastomosis without a stenting tube. J Hepatobiliary Pancreat Surg 2006;13:194–201.PubMedCrossRef Imaizumi T, Hatori T, Tobita K, Fukuda A, Takasaki K, Makuuchi H. Pancreaticojejunostomy using duct-to-mucosa anastomosis without a stenting tube. J Hepatobiliary Pancreat Surg 2006;13:194–201.PubMedCrossRef
40.
go back to reference Hakamada K, Narumi S, Toyoki Y, Nara M, Ishido K, Miura T, Kubo N, Sasaki M. An easier method for performing a pancreaticojejunostomy for the soft pancreas using a fast-absorbable suture. World J Gastroenterol 2008;14:1091–1096.PubMedCrossRef Hakamada K, Narumi S, Toyoki Y, Nara M, Ishido K, Miura T, Kubo N, Sasaki M. An easier method for performing a pancreaticojejunostomy for the soft pancreas using a fast-absorbable suture. World J Gastroenterol 2008;14:1091–1096.PubMedCrossRef
41.
go back to reference Sriussadaporn S, Pak-Art R, Sriussadaporn S, Kritayakirana K, Prichayudh S. Pancreaticoduodenectomy with external drainage of the pancreatic remnant. Asian J Surg 2008;31:167–173.PubMedCrossRef Sriussadaporn S, Pak-Art R, Sriussadaporn S, Kritayakirana K, Prichayudh S. Pancreaticoduodenectomy with external drainage of the pancreatic remnant. Asian J Surg 2008;31:167–173.PubMedCrossRef
42.
go back to reference Choe YM, Lee KY, Oh CA, Lee JB, Choi SK, Hur YS, Kim SJ, Cho YU, Ahn SI, Hong KC, Shin SH, Kim KR. Risk factors affecting pancreatic fistulas after pancreaticoduodenectomy. World J Gastroenterol 2008;14:6970–6974.PubMedCrossRef Choe YM, Lee KY, Oh CA, Lee JB, Choi SK, Hur YS, Kim SJ, Cho YU, Ahn SI, Hong KC, Shin SH, Kim KR. Risk factors affecting pancreatic fistulas after pancreaticoduodenectomy. World J Gastroenterol 2008;14:6970–6974.PubMedCrossRef
43.
go back to reference Satoi S, Toyokawa H, Yanagimoto H, Yamamoto T, Hirooka S, Yui R, Yamaki S, Takahashi K, Matsui Y, Mergental H, Kwon AH. Is a nonstented duct-to-mucosa anastomosis using the modified Kakita method a safe procedure? Pancreas 2010;39:165–170.PubMedCrossRef Satoi S, Toyokawa H, Yanagimoto H, Yamamoto T, Hirooka S, Yui R, Yamaki S, Takahashi K, Matsui Y, Mergental H, Kwon AH. Is a nonstented duct-to-mucosa anastomosis using the modified Kakita method a safe procedure? Pancreas 2010;39:165–170.PubMedCrossRef
44.
go back to reference Matsumoto Y, Fujii H, Miura K, Inoue S, Sekikawa T, Aoyama H, Ohnishi N, Sakai K, Suda K. Successful pancreatojejunal anastomosis for pancreatoduodenectomy. Surg Gynecol Obstet 1992;175:555–562.PubMed Matsumoto Y, Fujii H, Miura K, Inoue S, Sekikawa T, Aoyama H, Ohnishi N, Sakai K, Suda K. Successful pancreatojejunal anastomosis for pancreatoduodenectomy. Surg Gynecol Obstet 1992;175:555–562.PubMed
45.
go back to reference Hiraoka T, Kanemitsu K, Tsuji T, Saitoh N, Takamori H, Akamine T, Miyauchi Y. A method for safe pancreaticojejunostomy. Am J Surg 1993;165:270–272.PubMedCrossRef Hiraoka T, Kanemitsu K, Tsuji T, Saitoh N, Takamori H, Akamine T, Miyauchi Y. A method for safe pancreaticojejunostomy. Am J Surg 1993;165:270–272.PubMedCrossRef
46.
go back to reference Takao S, Shimazu H, Maenohara S, Shinchi H, Aikou T. Modified pancreaticogastrostomy following pancreaticoduodenectomy. Am J Surg 1993;165:317–321.PubMedCrossRef Takao S, Shimazu H, Maenohara S, Shinchi H, Aikou T. Modified pancreaticogastrostomy following pancreaticoduodenectomy. Am J Surg 1993;165:317–321.PubMedCrossRef
47.
go back to reference Hamanaka Y, Suzuki T. Total pancreatic duct drainage for leakproof pancreatojejunostomy. Surgery 1994;115:22–26.PubMed Hamanaka Y, Suzuki T. Total pancreatic duct drainage for leakproof pancreatojejunostomy. Surgery 1994;115:22–26.PubMed
48.
go back to reference Shibuya T, Uchiyama K, Imai S, Shibuya J, Shoji T. Improvement of pancreaticojejunostomy in pancreatoduodenectomy. Int Surg 1995;80:57–60.PubMed Shibuya T, Uchiyama K, Imai S, Shibuya J, Shoji T. Improvement of pancreaticojejunostomy in pancreatoduodenectomy. Int Surg 1995;80:57–60.PubMed
49.
go back to reference Howard JM. Pancreatojejunostomy: leakage is a preventable complication of the Whipple resection. J Am Coll Surg 1997;184:454–457.PubMed Howard JM. Pancreatojejunostomy: leakage is a preventable complication of the Whipple resection. J Am Coll Surg 1997;184:454–457.PubMed
50.
go back to reference Takano S, Ito Y, Oishi H, Kono S, Yokoyama T, Kubota N, Iwai S. A retrospective analysis of 88 patients with pancreaticogastrostomy after pancreaticoduodenectomy. Hepatogastroenterology 2000;47:1454–1457.PubMed Takano S, Ito Y, Oishi H, Kono S, Yokoyama T, Kubota N, Iwai S. A retrospective analysis of 88 patients with pancreaticogastrostomy after pancreaticoduodenectomy. Hepatogastroenterology 2000;47:1454–1457.PubMed
51.
go back to reference Okamoto A, Tsuruta K. Fistulation method: simple and safe pancreaticojejunostomy after pancreatoduodenectomy. Surgery 2000;127:433–438.PubMedCrossRef Okamoto A, Tsuruta K. Fistulation method: simple and safe pancreaticojejunostomy after pancreatoduodenectomy. Surgery 2000;127:433–438.PubMedCrossRef
52.
go back to reference Satoi S, Toyokawa H, Yanagimoto H, Yamamoto T, Yamao J, Kim S, Matsui Y, Takai S, Mergental H, Kamiyama Y. A new guideline to reduce postoperative morbidity after pancreaticoduodenectomy. Pancreas 2008;37:128–133.PubMedCrossRef Satoi S, Toyokawa H, Yanagimoto H, Yamamoto T, Yamao J, Kim S, Matsui Y, Takai S, Mergental H, Kamiyama Y. A new guideline to reduce postoperative morbidity after pancreaticoduodenectomy. Pancreas 2008;37:128–133.PubMedCrossRef
53.
go back to reference Kimura W. Pancreaticojejunal anastomosis, using a stent tube, in pancreaticoduodenectomy. J Hepatobiliary Pancreat Surg 2009;16:305–309.PubMedCrossRef Kimura W. Pancreaticojejunal anastomosis, using a stent tube, in pancreaticoduodenectomy. J Hepatobiliary Pancreat Surg 2009;16:305–309.PubMedCrossRef
54.
go back to reference Prenzel KL, Holscher AH, Grabolle I, Fetzner U, Kleinert R, Gutschow CA, Stippel DL. Impact of duct-to-mucosa pancreaticojejunostomy with external drainage of the pancreatic duct after pancreaticoduodenectomy. J Surg Res 2011;171:558–562.PubMedCrossRef Prenzel KL, Holscher AH, Grabolle I, Fetzner U, Kleinert R, Gutschow CA, Stippel DL. Impact of duct-to-mucosa pancreaticojejunostomy with external drainage of the pancreatic duct after pancreaticoduodenectomy. J Surg Res 2011;171:558–562.PubMedCrossRef
55.
go back to reference Ohwada S, Tanahashi Y, Ogawa T, Kawate S, Hamada K, Tago KI, Yamada T, Morishita Y. In situ vs ex situ pancreatic duct stents of duct-to-mucosa pancreaticojejunostomy after pancreaticoduodenectomy with billroth I-type reconstruction. Arch Surg 2002;137:1289–1293.PubMedCrossRef Ohwada S, Tanahashi Y, Ogawa T, Kawate S, Hamada K, Tago KI, Yamada T, Morishita Y. In situ vs ex situ pancreatic duct stents of duct-to-mucosa pancreaticojejunostomy after pancreaticoduodenectomy with billroth I-type reconstruction. Arch Surg 2002;137:1289–1293.PubMedCrossRef
56.
go back to reference Kamoda Y, Fujino Y, Matsumoto I, Shinzeki M, Sakai T, Kuroda Y. Usefulness of performing a pancreaticojejunostomy with an internal stent after a pancreatoduodenectomy. Surg Today 2008;38:524–528.PubMedCrossRef Kamoda Y, Fujino Y, Matsumoto I, Shinzeki M, Sakai T, Kuroda Y. Usefulness of performing a pancreaticojejunostomy with an internal stent after a pancreatoduodenectomy. Surg Today 2008;38:524–528.PubMedCrossRef
57.
go back to reference Tani M, Kawai M, Hirono S, Ina S, Miyazawa M, Shimizu A, Yamaue H. A prospective randomized controlled trial of internal versus external drainage with pancreaticojejunostomy for pancreaticoduodenectomy. Am J Surg 2010;199:759–764.PubMedCrossRef Tani M, Kawai M, Hirono S, Ina S, Miyazawa M, Shimizu A, Yamaue H. A prospective randomized controlled trial of internal versus external drainage with pancreaticojejunostomy for pancreaticoduodenectomy. Am J Surg 2010;199:759–764.PubMedCrossRef
58.
go back to reference Lin JW, Cameron JL, Yeo CJ, Riall TS, Lillemoe KD. Risk factors and outcomes in postpancreaticoduodenectomy pancreaticocutaneous fistula. J Gastrointest Surg 2004;8:951–959.PubMedCrossRef Lin JW, Cameron JL, Yeo CJ, Riall TS, Lillemoe KD. Risk factors and outcomes in postpancreaticoduodenectomy pancreaticocutaneous fistula. J Gastrointest Surg 2004;8:951–959.PubMedCrossRef
59.
go back to reference Zhou Y, Yang C, Wang S, Chen J, Li B. Does external pancreatic duct stent decrease pancreatic fistula rate after pancreatic resection?: a meta-analysis. Pancreatology 2011;11:362–370.PubMedCrossRef Zhou Y, Yang C, Wang S, Chen J, Li B. Does external pancreatic duct stent decrease pancreatic fistula rate after pancreatic resection?: a meta-analysis. Pancreatology 2011;11:362–370.PubMedCrossRef
60.
go back to reference Patel AG, Toyama MT, Kusske AM, Alexander P, Ashley SW, Reber HA. Pylorus-preserving Whipple resection for pancreatic cancer. Is it any better? Arch Surg 1995;130:838–843.PubMedCrossRef Patel AG, Toyama MT, Kusske AM, Alexander P, Ashley SW, Reber HA. Pylorus-preserving Whipple resection for pancreatic cancer. Is it any better? Arch Surg 1995;130:838–843.PubMedCrossRef
61.
go back to reference Lin PW, Lin YJ. Prospective randomized comparison between pylorus-preserving and standard pancreaticoduodenectomy. Br J Surg 1999;86:603–607.PubMedCrossRef Lin PW, Lin YJ. Prospective randomized comparison between pylorus-preserving and standard pancreaticoduodenectomy. Br J Surg 1999;86:603–607.PubMedCrossRef
62.
go back to reference van Berge HM, van Gulik TM, DeWit LT, Allema JH, Rauws EA, Obertop H, Gouma DJ. Delayed gastric emptying after standard pancreaticoduodenectomy versus pylorus-preserving pancreaticoduodenectomy: an analysis of 200 consecutive patients. J Am Coll Surg 1997;185:373–379. van Berge HM, van Gulik TM, DeWit LT, Allema JH, Rauws EA, Obertop H, Gouma DJ. Delayed gastric emptying after standard pancreaticoduodenectomy versus pylorus-preserving pancreaticoduodenectomy: an analysis of 200 consecutive patients. J Am Coll Surg 1997;185:373–379.
63.
go back to reference Lermite E, Pessaux P, Brehant O, Teyssedou C, Pelletier I, Etienne S, Arnaud JP. Risk factors of pancreatic fistula and delayed gastric emptying after pancreaticoduodenectomy with pancreaticogastrostomy. J Am Coll Surg 2007;204:588–596.PubMedCrossRef Lermite E, Pessaux P, Brehant O, Teyssedou C, Pelletier I, Etienne S, Arnaud JP. Risk factors of pancreatic fistula and delayed gastric emptying after pancreaticoduodenectomy with pancreaticogastrostomy. J Am Coll Surg 2007;204:588–596.PubMedCrossRef
64.
go back to reference Markar SR, Vyas S, Karthikesalingam A, Imber C, Malago M. The impact of pancreatic duct drainage following pancreaticojejunostomy on clinical outcome. J Gastrointest Surg 2012;16:1610–1617.PubMedCrossRef Markar SR, Vyas S, Karthikesalingam A, Imber C, Malago M. The impact of pancreatic duct drainage following pancreaticojejunostomy on clinical outcome. J Gastrointest Surg 2012;16:1610–1617.PubMedCrossRef
65.
go back to reference Hopewell S, Loudon K, Clarke MJ, Oxman AD, Dickersin K. Publication bias in clinical trials due to statistical significance or direction of trial results. Cochrane Database Syst Rev 2009:R6. Hopewell S, Loudon K, Clarke MJ, Oxman AD, Dickersin K. Publication bias in clinical trials due to statistical significance or direction of trial results. Cochrane Database Syst Rev 2009:R6.
Metadata
Title
External Stent Versus No Stent for Pancreaticojejunostomy: A Meta-analysis of Randomized Controlled Trials
Authors
Shukun Hong
Hongye Wang
Shiyong Yang
Kunxing Yang
Publication date
01-08-2013
Publisher
Springer US
Published in
Journal of Gastrointestinal Surgery / Issue 8/2013
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-013-2187-4

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