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Systematic review and meta-analysis of prophylactic abdominal drainage after pancreatic resection
  • ISSN号:1007-9327
  • 期刊名称:《世界胃肠病学杂志:英文版》
  • 时间:0
  • 分类:R657.5[医药卫生—临床医学;医药卫生—外科学]
  • 作者机构:[1]Department of Hepatobiliary Surgery, The First Affiliated Hospital of the Medical College of Xi’an Jiaotong University
  • 相关基金:Supported by National Natural Scientific Foundation of China(No.81272645 and No.81072052 to Liu QG,and No.81301743 to Zheng X);Research Fund for the Doctoral Program of High Education of China from Ministry of Education,(No.20120201120090 to Zheng X)
中文摘要:

AIM: To investigate whether prophylactic abdominal drainage is necessary after pancreatic resection. METHODS: Pub Med, Web of Science, and the Cochrane Library were systematically searched to obtain relevant articles published before January 2014. Publications were retrieved if they met the selection criteria. The outcomes of interest included: mortality, morbidity, postoperative pancreatic fistula(POPF), clinically relevant pancreatic fistula(CRPF), abdominal abscess, reoperation rate, the rate of interventional radiology drainage, and the length of hospital stay. Subgroup analyses were also performed for pancreaticoduodenectomy(PD) and for distal pancreatectomy. Begg’s funnel plot and the Egger regression test were employed to assess potential publication bias.RESULTS: Nine eligible studies involving a total of 2794 patients were identified and included in this meta-analysis. Of the included patients, 1373 received prophylactic abdominal drainage. A fixedeffects model meta-analysis showed that placement of prophylactic drainage did not have beneficial effects on clinical outcomes, including morbidity, POPF, CRPF, reoperation, interventional radiology drainage, and length of hospital stay(Ps 】 0.05). In addition, prophylactic drainage did not significantly increase the risk of abdominal abscess. Overall analysis showed that omitting prophylactic abdominal drainage resulted in higher mortality after pancreatectomy(OR = 1.56; 95%CI: 0.93-2.92). Subgroup analysis of PD showed similar results to those in the overall analysis. Elimination of prophylactic abdominal drainage after PD led to a significant increase in mortality(OR = 2.39; 95%CI: 1.22-4.69; P = 0.01).CONCLUSION: Prophylactic abdominal drainage after pancreatic resection is still necessary, though more evidence from randomized controlled trials assessing prophylactic drainage after PD and distal pancreatectomy are needed.

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  • 《世界胃肠病学杂志:英文版》
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  • 主办单位:百世登出版集团有限公司
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  • 邮编:100023
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  • 电话:0351-4078656
  • 国际标准刊号:ISSN:1007-9327
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  • 被引量:12408