Stapler vs suture closure of pancreatic remnant after distal pancreatectomy: a meta-analysis - 19/08/11
Abstract |
Background |
Suture closure and stapler closure of the pancreatic remnant after distal pancreatectomy are the techniques used most often. The ideal choice remains a matter of debate.
Methods |
Five bibliographic databases covering 1970 to July 2009 were searched.
Results |
Sixteen articles met the inclusion criteria. Stapler closure was performed in 671 patients, while suture closure was conducted in 1,615 patients. The pancreatic fistula rate ranged from 0% to 40.0% for stapler closure of the pancreatic stump and from 9.3% to 45.7% for the suture closure technique. There were no significant difference between the stapler and suture closure groups with respect to the pancreatic fistula formation rate (22.1% vs 31.2%; odds ratio, .85; 95% confidence interval, .66–1.08), although there was a trend toward favoring stapler closure. In 4 studies including 437 patients, stapler closure was associated with a trend (not statistically significant) toward a reduction in intra-abdominal abscess (odds ratio, .53; 95% confidence interval, .24–1.15).
Conclusions |
No significant differences occur between suture and stapler closure with respect to the pancreatic fistula or intra-abdominal abscess after distal pancreatectomy, though there is a trend favoring stapler closure.
Le texte complet de cet article est disponible en PDF.Keywords : Pancreatic fistula, Distal pancreatectomy, Suture, Stapler, Meta-analysis, Systematic review
Plan
Vol 200 - N° 4
P. 529-536 - octobre 2010 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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