AI Article Synopsis
- The study aimed to assess the effectiveness and safety of pylorus-preserving pancreatico-duodenectomy (PPPD) for treating periampullary adenocarcinoma using a meta-analysis of randomized controlled trials.
- Seven trials were included, showing that patients undergoing PPPD experienced significantly less intraoperative blood loss, shorter operation time, and required fewer blood transfusions compared to those who had traditional pancreatico-duodenectomy (PD).
- Overall, PPPD proved to be a safe and effective treatment option, with outcomes similar to PD in terms of survival and complications.
Article Abstract
Objective: To evaluate the efficacy and safety of pylorus-preserving pancreatico-duodenectomy(PPPD) in the treatment of periampullary adenocarcinoma by using Meta-analysis.
Methods: From January 1, 1980 to November 8, 2013, the articles of randomized controlled trials (RCTs) about PPPD versus PD in the treatment of periampullary adenocarcinoma were collected from Cochrane Libriary, Embase, PubMed, Ovid, Web of science and CBM etc. The methodological quality of the included studies was evaluated according to Cochrane system review valuator handbook of risk of bias standards. Meta-analysis was performed by RevMan 5.2 software.
Results: Seven RCTs were enrolled in the meta-analysis. Compared to PD group, PPPD group was associated with significantly less intraoperative blood loss (MD=-200.10, 95% CI:-400.66 to 0.46, P=0.05), shorter operation time (MD=-46.55, 95% CI:-91.02 to -2.07, P=0.04), and less postoperative blood transfusion (MD=-0.89, 95% CI:-1.59 to -0.19, P=0.01). There were no significant differences between the PPPD and PD group in pancreatic fistula, biliary fistula, intestinal fistula, abdominal abscess, postoperative bleeding, wound infection, relaparotomy, mortality and survival rate(all P>0.05).
Conclusions: PPPD in the treatment of the periampullary adenocarcinoma is safe and effective with similar survival of PD surgery. PPPD can reduce operative time, intraoperative blood loss, transfusion and does not increase the surgery complications as compared to PD.
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