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Langenbeck's Archives of Surgery

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01-12-2019 | Pancreatectomy | original article

Central pancreatectomy: a comprehensive, up-to-date meta-analysis

Authors: Mihnea P. Dragomir, Alexandru A. Sabo, George E. D. Petrescu, Yongfeng Li, Traian Dumitrascu

Published in: Langenbeck's Archives of Surgery | Issue 8/2019

Abstract

Background

Central pancreatectomy (CP) is the alternative to distal pancreatectomy (DP) for specific pathologies of the mid-pancreas. However, the benefits of CP over DP remain controversial. This study aims to compare the two procedures by conducting a meta-analysis of all published papers.

Methods

A systematic search of original studies comparing CP vs. DP was performed using PubMed, Scopus, and Cochrane Library databases up to June 2018. The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) checklist was followed.

Results

Twenty-one studies were included (596 patients with CP and 1070 patients with DP). Compared to DP, CP was associated with significantly higher rates of overall and severe morbidity (p < 0.0001), overall and clinically relevant pancreatic fistula (p < 0.0001), postoperative hemorrhage (p = 0.02), but with significantly lower incidences of new-onset (p < 0.0001) and worsening diabetes mellitus (p = 0.004). Furthermore, significantly longer length of hospital stay (p < 0.0001) was observed for CP patients.

Conclusions

CP is superior to DP regarding the preservation of pancreatic functions, but at the expense of significantly higher complication rates and longer hospital stay. Proper selection of patients is of utmost importance to maximize the benefits and mitigate the risks of CP.

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Title: Central pancreatectomy: a comprehensive, up-to-date meta-analysis
Authors: Mihnea P. Dragomir
Alexandru A. Sabo
George E. D. Petrescu
Yongfeng Li
Traian Dumitrascu
Publication date: 01-12-2019
Publisher: Springer Berlin Heidelberg
Keywords: Pancreatectomy
Diabetes
Published in: Langenbeck's Archives of Surgery / Issue 8/2019
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-019-01829-3

At a glance: The STEP trials

Springer Medicine

Central pancreatectomy: a comprehensive, up-to-date meta-analysis

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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