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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 36 Issue 8
Aug.  2020
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Article Navigation >  Journal of Clinical Hepatology  > 2020  >  36(8): 1811-1815

Clinical effect of pancreaticoduodenectomy with total mesopancreas excision versus traditional pancreaticoduodenectomy in treatment of pancreatic head carcinoma and periampullary cancer:A Meta-analysis

DOI: 10.3969/j.issn.1001-5256.2020.08.026

  • The Affiliated Hospital of Southwest Medical University

Research funding:

 

  • Published Date: 2020-08-20
    Abstract

  • Objective To investigate the safety and clinical effect of pancreaticoduodenectomy with total mesopancreas excision(TMpE)versus traditional pancreaticoduodenectomy(PD) in the treatment of pancreatic head carcinoma and periampullary cancer.Methods PubMed,Web of Science,Cochrane Library,CBM,CNKI,Wanfang Data,and VIP were searched for the Chinese and English articles on the clinical effect of TMpE and PD in the treatment of pancreatic head carcinoma and periampullary cancer published from January 2007 to February 2020.Quality assessment was performed for the articles included,and Revman 5.3 software was used to perform the Meta-analysis.Results Five retrospective cohort studies were included after screening,with a total of 358 patients,among whom 188 underwent TMpE and 170 underwent PD.The results of the meta-analysis showed that compared with the PD group,the TMpE group had a significant increase in the incidence rate of pancreatic fistula(odds ratio [OR]=1.69,95% confidence interval [CI]:1.03-2.78,P=0.04),while there was no significant difference in the incidence rate of postoperative complications between the two groups(OR=1.51,95% CI:0.76-2.98,P=0.24).In addition,TMpE improved R0 resection rate(OR=2.89,95% CI:1.30-6.43,P=0.009),number of dissected lymph nodes(mean difference [MD]=5.14,95% CI:4.16-6.13,P<0.001),and 1-year survival rate after surgery(OR=2.60,95% CI:1.45-4.69,P=0.001),without increasing the time of operation(MD=7.74,95% CI:-42.84 to 58.33,P=0.76),intraoperative blood loss(MD=-45.89,95% CI:-198.19 to 106.41,P=0.55),and the length of postoperative hospital stay(MD=-4.62,95% CI:-16.60 to 7.36,P=0.45).Conclusion TMpE is safe and feasible in the treatment of pancreatic head carcinoma and periampullary cancer and has the advantages of high R0 resection rate and 1-year survival rate after surgery,and therefore,it may become a preferred treatment method for pancreatic head carcinoma and periampullary cancer.

     

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