Does external pancreatic duct stent decrease pancreatic fistula rate after pancreatic resection?: a meta-analysis.

Abstract

OBJECTIVES:

The use of an external pancreatic duct stent to prevent fistula formation of pancreatic anastomosis remains a matter of debate. This study is a meta-analysis of the available evidence.

METHODS:

Articles published until the end of March 2011 comparing external stenting and non-stenting in pancreatic anastomosis were included. Pooled odds ratios (ORs) and weighted mean differences (WMDs) with 95% confidence intervals (95% CI) were calculated using either the fixed effects model or random effects model.

RESULTS:

Six articles were identified for inclusion: 3 randomized controlled trials and 3 observational clinical studies. The meta-analysis revealed that the use of an external pancreatic duct stent was associated with a statistically significant reduction in overall postoperative morbidity (OR 0.56; 95% CI 0.39-0.81; p = 0.002), pancreatic fistula (OR 0.34; 95% CI 0.23-0.15; p < 0.001), severity of pancreatic fistula (OR 0.70; 95% CI 0.32-1.57; p = 0.04), delayed gastric emptying (OR 0.44; 95% CI 0.25-0.80; p = 0.007), and length of hospital stay (WMD -3.95; 95% CI -6.38 to -1.52; p = 0.001).

CONCLUSIONS:

The current literature suggests that the use of an external pancreatic duct stent reduced the leakage rate of pancreatic anastomosis after pancreatic resection. and IAP.

• Authors: Yanming Zhou, Chunlian Yang, Shuangjia Wang, Jingxi Chen, Bin Li
• Journal: Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] (Pancreatology) Vol. 11 Issue 3 Pg. 362-70 ( 2011) ISSN: 1424-3911 [Electronic] Switzerland
• PMID: 21876365 (Publication Type: Journal Article, Meta-Analysis)
• Copyright: Copyright © 2011 S. Karger AG, Basel.

Topics

• Adult
• Aged
• Aged, 80 and over
• Anastomosis, Surgical (adverse effects, methods)
• Female
• Humans
• Length of Stay
• Male
• Middle Aged
• Pancreas (surgery)
• Pancreatic Ducts (surgery)
• Pancreatic Fistula (prevention & control)
• Postoperative Period
• Stents