Stapler vs suture closure of pancreatic remnant after distal pancreatectomy: a meta-analysis.

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.

• Authors: Wei Zhou, Ran Lv, Xianfa Wang, Yiping Mou, Xiujun Cai, Ingrid Herr
• Journal: American journal of surgery (Am J Surg) Vol. 200 Issue 4 Pg. 529-36 (Oct 2010) ISSN: 1879-1883 [Electronic] United States
• PMID: 20538249 (Publication Type: Journal Article, Meta-Analysis, Review)
• Copyright: Copyright © 2010 Elsevier Inc. All rights reserved.

Topics

• Equipment Design
• Humans
• Pancreas (surgery)
• Pancreatectomy (methods)
• Surgical Staplers
• Suture Techniques (instrumentation)
• Sutures