Effect of Billroth II or Roux-en-Y Reconstruction for the Gastrojejunostomy After Pancreaticoduodenectomy: Meta-analysis of Randomized Controlled Trials
Tóm tắt
This study aimed to compare Billroth II with Roux-en-Y reconstruction after pancreaticoduodenectomy (PD). A literature search was carried out to identify all randomized controlled trials (RCTs) comparing postoperative complications of Billroth II versus Roux-en-Y reconstruction following PD published from 1 January 1990 to 31 August 2014. Pooled risk ratios (RRs) with 95 % confidence intervals (CIs) were calculated using fixed effects or random effects models In total, three RCTs with 470 patients were included. Using International Study Group of Pancreatic Surgery (ISGPS) definitions, incidences of delayed gastric emptying (DGE) [grades B and C (3.9 versus 12.9 %; RR 0.30, 95 % CI 0.11–0.79; P = 0.01), DGE grade C (0.7 versus 9.6 %; RR 0.11, 95 % CI 0.02–0.61; P = 0.01)] were significantly lower in the Billroth II group than in the Roux-en-Y group, as was the length of hospital stay (weighted mean difference −4.72, 95 % CI −8.91, −0.53; P = 0.03). Meta-analysis revealed that the incidence of DGE (grades B and C) after PD can be decreased by using Billroth II rather than Roux-en-Y reconstruction.
Tài liệu tham khảo
Cameron JL, Riall TS, Coleman J, et al. One thousand consecutive pancreaticoduodenectomies. Ann Surg, 2006,244:10–15.
Arnaud JP, Tuech JJ, Cervi C, et al. Pancreaticogastrostomy compared with pancreaticojejunostomy after pancreaticoduodenectomy. Eur J Surg, 1999, 165:357
Addeo P, Delpero JR, Paye F, Oussoultzoglou E, Fuchshuber PR, Sauvanet A, Sa Cunha A, Le Treut YP, Adham M, Mabrut JY, Chiche L, Bachellier P. Pancreatic fistula after a pancreaticoduodenectomy for ductal adenocarcinoma and its association with morbidity: a multicentre study of the French Surgical Association. HPB 2014;16:46–55.
Muscari F, Suc B, Kirzin S, Hay JM, Fourtanier G, Fingerhut A, Sastre B, Chipponi J, Fagniez PL, Radovanovic A. Risk factors for mortality and intra-abdominal complications after pancreatoduodenectomy: multivariate analysis in 300 patients. Surgery 2006; 139:591–8.
Winter JM, Cameron JL, Campbell KA, Arnold MA, Chang DC, Coleman J, Hodgin MB, et al. 1423 pancreaticoduodenectomies for pancreatic cancer: a single-institution experience. J Gastrointest Surg 2006; 10:1199–210.
Yeo CJ, Cameron JL, Sohn TA, Lillemoe KD, Pitt HA, Talamini MA, et al. Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes. Ann Surg 1997; 226:248–57.
Gooiker GA, van Gijn W, Wouters MW, Post PN, van de Velde CJ, et al. Systematic review and meta-analysis of the volume–outcome relationship in pancreatic surgery. Br J Surg 2011; 98: 485–494.
Kawai M, Tani M, Terasawa H, Ina S, Hirono S, Nishioka R et al. Early removal of prophylactic drains reduces the risk of intra-abdominal infections in patients with pancreatic head resection: prospective study for 104 consecutive patients. Ann Surg 2006; 244: 1–7.
Grobmyer SR, Pieracci FM, Allen PJ, Brennan MF, Jaques DP. Defining morbidity after pancreaticoduodenectomy: use of a prospective complication grading system. J Am Coll Surg 2007; 204:356–64
Whipple AO, Parsons WB, Mullins CR. Treatment of carcinoma of the ampulla of Vater. Ann Surg 1935; 102: 763–779
Wente MN, Shrikhande SV, Müller MW, Diener MK, Seiler CM, Friess H et al. Pancreaticojejunostomy versus pancreaticogastrostomy: systematic review and meta-analysis. Am J Surg 2007; 193: 171–183.
Topal B, Fieuws S, Aerts R, Weerts J, Feryn T, Roeyen G et al.; Belgian Section of Hepatobiliary and Pancreatic Surgery. Pancreaticojejunostomy versus pancreaticogastrostomy reconstruction after pancreaticoduodenectomy for pancreatic or periampullary tumours: a multicentre randomised trial. Lancet Oncol 2013; 14: 655–662.
Madiba TE, Thomson SR: Restoration of continuity following pancreatoduodenectomy. Br J Surg 1995; 82:158–165.
Sikora SS, Posner MC: Management of pancreatic stump following pancreaticoduodenectomy. Br J Surg 1995;82:1590–1597
Xiong JJ, Altaf K, Mukherjee R, HuangW, HuWM, Li A et al. Systematic review and meta-analysis of outcomes after intraoperative pancreatic duct stent placement during pancreaticoduodenectomy. Br J Surg 2012; 99: 1050–1061
Sakamoto Y, Yamamoto Y, Hata S, et al. Analysis of risk factors for delayed gastric emptying (DGE) after 387 pancreaticoduodenectomies with usage of 70 stapled reconstructions. J Gastrointest Surg. 2011; 15: 1789–1797.
Fischer CP, Hong JC. Method of pyloric reconstruction and impact upon delayed gastric emptying and hospital stay after pylorus-preserving pancreaticoduodenectomy. J Gastrointest Surg. 2006; 10:215–219.
Yeo CJ, Barry MK, Sauter PK, et al. Erythromycin accelerates gastric emptying after pancreaticoduodenectomy. A prospective, randomized, placebo controlled trial. Ann Surg. 1993; 218:229–237; discussion 237–238.
Kurosaki I, Hatakeyama K. Preservation of the left gastric vein in delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy. J Gastrointest Surg. 2005; 9:846–852.
Tani M, Terasawa H, Kawai M, et al. Improvement of delayed gastric emptying in pylorus-preserving pancreaticoduodenectomy: results of a prospective, randomized, controlled trial. Ann Surg. 2006; 243:316–320.
Kurahara H, Shinchi H, Maemura K, et al. Delayed Gastric Emptying after pancreatoduodenectomy. J Surg Res. 2011; 171:e187–192
SR. Grobmyer, ST Hollenbeck, DP Jaques et al., Roux-en-Y Reconstruction After Pancreaticoduodenectomy, Arch Surg. 2008;143(12):1184–1188
Kawamoto M, Konomi H, Kobayashi K, et al. Type of gastrointestinal reconstruction affects postoperative recovery after pancreatic head resection. J Hepatobiliary Pancreat Surg. 2006; 13:336–343
Ballas K, Symeonidis N, Rafailidis S, Pavlidis T, Marakis G, Mavroudis N et al. Use of isolated Roux loop for pancreaticojejunostomy reconstruction after pancreaticoduodenectomy. World J Gastroenterol, 2010, 16:3178–3182.
Wayne MG, Jorge IA, Cooperman AM. Alternative reconstruction after pancreaticoduodenectomy. World J Surg Oncol, 2008, 6:9.
Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009) Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med, 2009, 6(7):1–6
Adad AR, Moore RA, Carrol D, Jenkinson C, Reynolds DJ, Gavaghan DJ et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials, 1996, 17:1–12
DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials 1986; 7: 177–188.
Laird NM, Mosteller F. Some statistical methods for combining experimental results. Int J Technol Assess Health Care 1990; 6: 5–30
M. Tani, M. Kawai, S. Hirono, K.-I. Okada, M. Miyazawa, A. Shimizu, Y. Kitahata and H. Yamaue, Randomized clinical trial of isolated Roux-en-Y versus conventional reconstruction after pancreaticoduodenectomy, Br J Surg. 2014;101:1084–1091
Mitsugi Shimoda, Keiichi Kubota, Masato Katoh, Junji Kita. Effect of Billroth II or Roux-en-Y Reconstruction for the Gastrojejunostomy on Delayed Gastric Emptying After Pancreaticoduodenectomy: A Randomized Controlled Study, Ann Surg 2013;257: 938–942
Ke S, Ding XM, Gao J, Zhao AM, Deng GY, Ma RL et al. A prospective, randomized trial of Roux-en-Y reconstruction with isolated pancreatic drainage versus conventional loop reconstruction after pancreaticoduodenectomy. Surgery 2013; 153: 743–752.
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.
Wente MN, Bassi C, Dervenis C, et al. Delayed gastric emptying (DGE) after pancreatic surgery: a suggested definition by the International Study Group of Pancreatic Surgery (ISGPS). Surgery. 2007; 142:761–768.
Warshaw AL, Torchiana DL. Delayed gastric emptying after pylorus preserving pancreaticoduodenectomy. Surg Gynecol Obstet. 1985; 160:1–4.
Itani KM, Coleman RE, Meyers WC, et al. Pylorus-preserving pancreatoduodenectomy. A clinical and physiologic appraisal. Ann Surg. 1986;204:655–664.
Haddad LB, Scatton O, Randone B, Andraus W, Massault PP, Dousset B et al. Pancreatic fistula after pancreaticoduodenectomy: the conservative treatment of choice. HPB, 2009, 11:203–209.
Reid-Lombardo KM, Farnell MB, Crippa S, Barnett M, Maupin G, Bassi C et al. Pancreatic anastomotic leakage after pancreaticoduodenectomy in 1507 patients: a report from the pancreatic anastomotic leak study group. J Gastrointest Surg, 2007, 11:1451–1458.
Ramacciato G, Mercantini P, Petrucciani N, Nigri GR, Kazemi A, Muroni M et al. Risk factors of pancreatic fistula after pancreaticoduodenectomy: a collective review. ,2011, Am Surg 77:257–269.
Sugimoto M, Takahashi S, Gotohda N, Kato Y, Kinoshita T, Shibasaki H et al. Schematic pancreatic configuration: a risk assessment for postoperative pancreatic fistula after pancreaticoduodenectomy. J Gastrointest Surg, 2013, 7: 1744–1751.
Wang Q, He XR, Tian JH, Yang KH. Pancreatic duct stents at pancreaticoduodenectomy: a meta-analysis. Dis Surg, 2013, 30:415–424.
Funovics JM, Zoch G, Wenzl E, Schulz F. Progress in reconstruction after resection of the head of the pancreas. Surg Gynecol Obstet 1987; 164:545–8.
Oneil Machado N. Pancreatic fistula after pancreatectomy: definitions, risk factors, preventive measures, and management review. Int J Surg Oncol 2012; 2012:602478.
Tolin RD, Malmud LS, Stelzer F, Menin R, Makler PT Jr, Applegate G, et al. Enterogastric reflux in normal subjects and patients with Bilroth II gastroenterostomy. Measurement of enterogastric reflux. Gastroenterology 1979; 77: 1027–33.