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Pancreatic Duct Stents at Pancreaticoduodenectomy: A Meta-Analysis.
MedLine Citation:
PMID:  24217416     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background and Objective: Several studies suggested that pancreatic stents had some benefit during pancreatoduodenectomy (PD), but others disagree. Whether pancreatic duct stents could prevent postoperative pancreatic fistula (POPF) is still under controversy. Methods: Randomized controlled trials published before November 2012 were all aggregated, focusing on the evaluation of pancreatic duct stents during PD. Trial data was reviewed and extracted independently by two reviewers. The quality of the including studies was assessed by the Cochrane handbook 5.1.0. Results: Seven studies were included, with a total of 793 patients. The results showed that compared with nonstents, stents during PD was associated with a significant difference on overall POPF rate (OR = 0.65, 95% CI 0.45-0.95, p = 0.02), POPF grades B and C (OR = 0.45, 95% CI 0.27-0.76, p = 0.003), and hospital stay (MD = -4.28, 95% CI -6.81, -1.75, p = 0.0009). Subgroup analyses showed that the external stent had a significant difference in the incidence of overall POPF (OR = 0.46, 95% CI 0.29-0.73, p = 0.0009), POPF grades B and C (OR = 0.49, 95% CI 0.30-0.79, p = 0.003), postoperative morbidity (OR = 0.63, 95% CI 0.42-0.96, p = 0.03), as well as hospital stay. Conclusions: Based upon this meta-analysis, there might be potential benefit in reducing POPF thanks to the use of pancreatic duct stents. © 2013 S. Karger AG, Basel.
Authors:
Quan Wang; Xi-Ran He; Jin-Hui Tian; Ke-Hu Yang
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-11-6
Journal Detail:
Title:  Digestive surgery     Volume:  30     ISSN:  1421-9883     ISO Abbreviation:  Dig Surg     Publication Date:  2013 Nov 
Date Detail:
Created Date:  2013-11-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8501808     Medline TA:  Dig Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  415-424     Citation Subset:  -    
Affiliation:
The First Clinical Medical College of Lanzhou University, Lanzhou, PR China.
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