术前胆道引流对胰十二指肠切除术后影响的Meta分析

贺学荣; 张宝华; 龚建平

doi:10.3969/j.issn.1001-5256.2017.09.024

术前胆道引流对胰十二指肠切除术后影响的Meta分析

DOI: 10.3969/j.issn.1001-5256.2017.09.024

1. 重庆市永川区人民医院肝胆外科
2. 重庆医科大学附属第二医院重庆市重点肝胆外科学实验室肝胆外科

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中图分类号: R657.5
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出版历程
- 收稿日期: 2017-04-13
- 出版日期: 2017-09-20

Effect of preoperative biliary drainage on complications and short-term mortality after pancreaticoduodenectomy: a Meta-analysis

Department of Hepatobiliary Surgery, The People's Hospital of Yongchuan District

摘要

摘要: 目的旨在评估术前胆道引流（PBD）对胰十二指肠切除术（PD）后的并发症及短期病死率的影响。方法检索Pub Med、Embase、Cochrane等数据库以及美国主要消化有关杂志在2010年1月1日-2017年1月1日发表的PBD对PD影响的最新研究。采用Rev Man5.3软件对手术后总并发症发生率、术后感染发生率、术后吻合口瘘发生率、术后短期病死率进行统计学分析。结果最终纳入8篇文献共2687例患者,分为PBD组（PD术前经PBD处理）和n-PBD组（PD术前未经处理）。在短期病死率方面,PBD组与n-PBD组无明显统计学差异[比值比（OR）=1.19,95%可信区间（CI）:0.791.80,P=0.41];术后总并发症发生率和术后感染发生率方面,PBD组比n-PBD组明显增高（OR=1.95,95%CI:1.243.06,P=0.004;OR=2.37,95%CI:1.453.87,P=0.000 5）;术后吻合口瘘的发生率两组间无明显统计学差异（OR=1.43,95%CI:0.952.14,...
- 胆道疾病 /
- 胰十二指肠切除术 /
- 引流术 /
- Meta分析
Abstract: Objective To investigate the effect of preoperative biliary drainage ( PBD) on complications and short-term mortality after pancreaticoduodenectomy ( PD) . Methods Related databases such as Pub Med, Embase, and the Cochrane Library, as well as main gastroenterological journals in the US, were searched for the articles on the effect of PBD on PD published from January 1, 2010 to January 1, 2017. Reviews Manager 5. 3 software was used for the statistical analysis of the incidence rates of total complications, infection, and anastomotic fistula and short-term mortality rate after surgery. Results Eight articles involving 2687 patients were included in the meta-analysis. These patients were divided into PBD group and non-PBD group according to whether they underwent PBD before PD. There was no significant difference in short-term mortality rate between the PBD group and the non-PBD group ( odds ratio [OR]= 1. 19, 95% confidence interval [CI]: 0. 79-1. 80, P = 0. 41) . Compared with non-PBD group, the PBD group had significantly higher incidence rates of total postoperative complications ( OR = 1. 95, 95% CI: 1. 24-3. 06, P = 0. 004) and postoperative infection ( OR = 2. 37, 95% CI: 1. 45-3. 87, P = 0. 000 5) . There was no significant difference in the incidence rate of postoperative anastomotic leak between the two groups ( OR =1. 43, 95% CI: 0. 95-2. 14, P = 0. 09) . Conclusion PBD does not bring benefits to patients'prognosis after surgery and it may increase the incidence rates of total postoperative complications and postoperative infection. Therefore, PBD is not recommended as conventional preoperative treatment for PD.
- biliary tract diseases /
- pancreaticoduodenectomy /
- drainage /
- Meta-analysis

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参考文献(22)

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