临床肝胆病杂志2024，Vol.40Issue(1)：129-137,9.DOI:10.12449/JCH240122
大网膜包裹胰肠吻合口预防胰十二指肠切除术后并发症有效性和安全性的Meta分析
Efficacy and safety of omental wrapping technique for pancreaticojejunal anastomosis in preventing complications after pancreaticoduodenectomy:A Meta-analysis
摘要
Abstract
Objective To systematically evaluate the efficacy and safety of omental wrapping technique for pancreaticojejunal anastomosis in preventing complications after pancreaticoduodenectomy.Methods This study was conducted according to the PRISMA guideline.English and Chinese databases including CNKI,Wanfang Data,VIP,CBM,the Cochrane Library,PubMed,Embase,and Web of Science were searched for clinical studies on omental wrapping technique for pancreaticojejunal anastomosis in preventing complications after pancreaticoduodenectomy published up to November 2022,and Stata 16 and Review Manager 5.4 were used to perform the meta-analysis.Results A total of 15 studies with 1 830 patients were included in this study.The meta-analysis showed that the omental wrapping group had a significantly lower overall incidence rate of postoperative pancreatic fistula(POPF)than the non-omental wrapping group(odds ratio[OR]=0.30,95%confidence interval[CI]:0.22—0.41,P<0.001),and the subgroup analysis showed that the omental wrapping group had a significantly lower incidence rate of grade B/C POPF than the non-omental wrapping group(OR=0.29,95%CI:0.21—0.39,P<0.001).Compared with the non-omental wrapping group,the omental wrapping group had significantly lower incidence rates of postoperative bile leakage(OR=0.30,95%CI:0.16—0.56,P<0.001),postoperative hemorrhage(OR=0.35,95%CI:0.24—0.53,P<0.001),delayed gastric emptying(OR=0.45,95%CI:0.31—0.64,P<0.001),abdominal infection(OR=0.55,95%CI:0.40—0.75,P<0.001),reoperation(OR=0.31,95%CI:0.18—0.54,P<0.001),and death within 30 days after surgery(OR=0.42,95%CI:0.22—0.80,P=0.009),a significantly earlier time to diet(mean difference[MD]=-0.98,95%CI:-1.84 to-0.11,P=0.03),and a significantly shorter length of postoperative hospital stay(MD=-2.44,95%CI:-4.10 to-0.77,P=0.004).There were no significant differences between the two groups in the time of operation(MD=-13.68,95%CI:-28.31 to-0.95,P=0.07)and intraoperative blood loss(MD=-17.26,95%CI:-57.55 to-23.03,P=0.40).Conclusion Omental wrapping can reduce the incidence rates of postoperative complications such as pancreatic fistula,bile leakage,postoperative hemorrhage,abdominal infection,and delayed gastric emptying,improve the prognosis of patients,and shorten the length of hospital stay,without increasing surgical difficulty or time of operation.关键词
胰十二指肠切除术/网膜/外科吻合口/手术后并发症/Meta分析Key words
Pancreaticoduodenectomy/Omentum/Surgical Stomas/Postoperative Complications/Meta-Analysis引用本文复制引用
史亚波,李扬,刘华兵,王智聪,黄长文..大网膜包裹胰肠吻合口预防胰十二指肠切除术后并发症有效性和安全性的Meta分析[J].临床肝胆病杂志,2024,40(1):129-137,9.基金项目
江西省自然科学基金面上项目(20202BABL206096) General Program of National Natural Science Foundation of Jiangxi Province(20202BABL206096) （20202BABL206096）
