| Systematic review and meta-analysis of prophylactic gastroenterostomy for unresectable advanced pancreatic cancer. | |
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MedLine Citation:
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PMID: 19526616 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The value of prophylactic gastroenterostomy (usually combined with a biliary bypass) in patients with unresectable cancer of the pancreatic head is controversial. METHODS: A systematic review of retrospective and prospective studies, and a meta-analysis of prospective studies, on the use of prophylactic gastroenterostomy for unresectable pancreatic cancer were performed. RESULTS: Analysis of retrospective studies did not reveal any advantage or disadvantage of prophylactic gastroenterostomy. Three prospective studies comparing prophylactic gastroenterostomy plus biliodigestive anastomosis with no bypass or a biliodigestive anastomosis alone were identified (altogether 218 patients). For patients who had prophylactic gastroenterostomy, the chance of gastric outlet obstruction during follow-up was significantly lower (odds ratio (OR) 0.06 (95 per cent confidence interval (c.i.) 0.02 to 0.21); P < 0.001). The rates of postoperative delayed gastric emptying were similar in both groups (OR 1.93 (95 per cent c.i. 0.57 to 6.53); P = 0.290), as were morbidity and mortality. The estimated duration of hospital stay after prophylactic gastroenterostomy was 3 days longer than for patients without bypass (weighted mean difference 3.1 (95 per cent c.i. 0.7 to 5.5); P = 0.010). CONCLUSION: Prophylactic gastroenterostomy should be performed during surgical exploration of patients with unresectable pancreatic head tumours because it reduces the incidence of long-term gastroduodenal obstruction without impairing short-term outcome. |
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Authors:
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N Hüser; C W Michalski; T Schuster; H Friess; J Kleeff |
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Publication Detail:
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Type: Journal Article; Meta-Analysis; Review |
Journal Detail:
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Title: The British journal of surgery Volume: 96 ISSN: 1365-2168 ISO Abbreviation: Br J Surg Publication Date: 2009 Jul |
Date Detail:
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Created Date: 2009-06-22 Completed Date: 2009-07-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372553 Medline TA: Br J Surg Country: England |
Other Details:
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Languages: eng Pagination: 711-9 Citation Subset: AIM; IM |
Copyright Information:
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Copyright 2009 British Journal of Surgery Society Ltd. |
Affiliation:
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Department of Surgery, Technische Universität München, Munich, Germany. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Epidemiologic Methods Gastric Outlet Obstruction / prevention & control* Gastroenterostomy / methods* Humans Length of Stay Pancreatic Neoplasms / surgery* Quality of Life Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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