Pancreatic stump closure after distal pancreatectomy: Systematic review and meta-analysis of randomized clinical trials comparing non-autologous versus no reinforcement: Value of prediction intervals - 26/02/24
, Chadli Dziri b, ⁎ , Selman Uranues c , Abe Fingerhut c, d Abstract |
Background |
This meta-analysis of randomized trials aimed to assess the benefits and harms of non-autologous versus no reinforcement of the pancreatic stump following distal pancreatectomy (DP).
Methods |
It was performed in accordance with PRISMA 2020 and AMSTAR 2 Guidelines. (registered in PROSPERO ID: EROCRD42021286863).
Results |
Nine relevant articles (between 2009 and 2021) were retrieved, comparing non-autologous reinforcement (757 patients) with non-reinforcement (740 patients) after PD. Pooled analysis showed a statistically significant lower rate of postoperative pancreatic fistula (POPF) in the reinforcement group (RR = 0.677; 95 % CI [0.479, 0.956], p = 0.027). The 95 % predictive interval (0.267–1.718) showed heterogeneity. Non-autologous reinforcement other than with "Tachosil®" was effective (subgroup analysis). No statistically significant differences were found between the two groups with regard to secondary outcomes.
Conclusions |
This meta-analysis showed that covering the stump with non-autologous reinforcement other than Tachosil® had a preventive effect on the onset of POPF.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Postoperative pancreatic fistula (POPF) occurs in 5–50 % of patients after distal pancreatectomy (DP). |
• | Several methods have been proposed to reduce the incidence and severity of POPF after DP. |
• | Non-autologous reinforcement of the pancreatic section (except for TachoSil®) after DP reduces the relative risk of POPF. |
Keywords : Distal pancreatectomy, Postoperative pancreatic fistula, Sealant patch, Meta-analysis, Predictive interval, Subgroup analysis
Plan
Vol 229
P. 92-98 - mars 2024 Retour au numéro
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