A systemic review and an updated meta-analysis: minimally invasive vs open pancreaticoduodenectomy
Abstract The feasible of minimally invasive pancreaticoduodenectomy (MIPD) remains controversial when compared with open pancreaticoduodenectomy (OPD). We conducted a systemic review and meta-analysis to summarise the available evidence to compare MIPD vs OPD. We systemically searched PubMed, EMBASE...
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2017-05-01
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doaj-9ef86debbae24a34821e28ec89e6fcd22020-12-08T00:12:33ZengNature Publishing GroupScientific Reports2045-23222017-05-01711810.1038/s41598-017-02488-4A systemic review and an updated meta-analysis: minimally invasive vs open pancreaticoduodenectomyZhanwei Zhao0Zifang Yin1Zhenning Hang2Gang Ji3Quanxin Feng4Qingchuan Zhao5Xijing Hospital of Digestive Diseases, the Fourth Military Medical UniversityShaanxi Maternal and Child Health HospitalXijing Hospital of Digestive Diseases, the Fourth Military Medical UniversityXijing Hospital of Digestive Diseases, the Fourth Military Medical UniversityXijing Hospital of Digestive Diseases, the Fourth Military Medical UniversityXijing Hospital of Digestive Diseases, the Fourth Military Medical UniversityAbstract The feasible of minimally invasive pancreaticoduodenectomy (MIPD) remains controversial when compared with open pancreaticoduodenectomy (OPD). We conducted a systemic review and meta-analysis to summarise the available evidence to compare MIPD vs OPD. We systemically searched PubMed, EMBASE and Web of Science for studies published through February 2016. The primary endpoint was postoperative pancreatic fistula (POPF, grade B/C). A total of 27 studies involving 14,231 patients (2,377 MIPD and 11,854 OPD) were included. MIPD was associated with longer operative times (P < 0.01) and increased mortality (P < 0.01), but decreased estimated blood loss (P < 0.01), decreased delayed gastric emptying (P < 0.01), increased R0 resection rate (P < 0.01), decreased wound infection (P = 0.03) and shorter hospital stays (P < 0.01). There were no significant differences in BMI (P = 0.43), tumor size (P = 0.17), lymph nodes harvest (P = 0.57), POPF (P = 0.84), reoperation (P = 0.25) and 5-year survival rates (P = 0.82) for MIPD compared with OPD. Although there was an increased operative cost (P < 0.01) for MIPD compared with OPD, the postoperative cost was less (P < 0.01) with the similar total costs (P = 0.28). MIPD can be a reasonable alternative to OPD with the potential advantage of being minimally invasive. However, MIPD should be performed in high-volume centers and more randomized-controlled trials are needed to evaluate the appropriate indications of MIPD.https://doi.org/10.1038/s41598-017-02488-4 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Zhanwei Zhao Zifang Yin Zhenning Hang Gang Ji Quanxin Feng Qingchuan Zhao |
spellingShingle |
Zhanwei Zhao Zifang Yin Zhenning Hang Gang Ji Quanxin Feng Qingchuan Zhao A systemic review and an updated meta-analysis: minimally invasive vs open pancreaticoduodenectomy Scientific Reports |
author_facet |
Zhanwei Zhao Zifang Yin Zhenning Hang Gang Ji Quanxin Feng Qingchuan Zhao |
author_sort |
Zhanwei Zhao |
title |
A systemic review and an updated meta-analysis: minimally invasive vs open pancreaticoduodenectomy |
title_short |
A systemic review and an updated meta-analysis: minimally invasive vs open pancreaticoduodenectomy |
title_full |
A systemic review and an updated meta-analysis: minimally invasive vs open pancreaticoduodenectomy |
title_fullStr |
A systemic review and an updated meta-analysis: minimally invasive vs open pancreaticoduodenectomy |
title_full_unstemmed |
A systemic review and an updated meta-analysis: minimally invasive vs open pancreaticoduodenectomy |
title_sort |
systemic review and an updated meta-analysis: minimally invasive vs open pancreaticoduodenectomy |
publisher |
Nature Publishing Group |
series |
Scientific Reports |
issn |
2045-2322 |
publishDate |
2017-05-01 |
description |
Abstract The feasible of minimally invasive pancreaticoduodenectomy (MIPD) remains controversial when compared with open pancreaticoduodenectomy (OPD). We conducted a systemic review and meta-analysis to summarise the available evidence to compare MIPD vs OPD. We systemically searched PubMed, EMBASE and Web of Science for studies published through February 2016. The primary endpoint was postoperative pancreatic fistula (POPF, grade B/C). A total of 27 studies involving 14,231 patients (2,377 MIPD and 11,854 OPD) were included. MIPD was associated with longer operative times (P < 0.01) and increased mortality (P < 0.01), but decreased estimated blood loss (P < 0.01), decreased delayed gastric emptying (P < 0.01), increased R0 resection rate (P < 0.01), decreased wound infection (P = 0.03) and shorter hospital stays (P < 0.01). There were no significant differences in BMI (P = 0.43), tumor size (P = 0.17), lymph nodes harvest (P = 0.57), POPF (P = 0.84), reoperation (P = 0.25) and 5-year survival rates (P = 0.82) for MIPD compared with OPD. Although there was an increased operative cost (P < 0.01) for MIPD compared with OPD, the postoperative cost was less (P < 0.01) with the similar total costs (P = 0.28). MIPD can be a reasonable alternative to OPD with the potential advantage of being minimally invasive. However, MIPD should be performed in high-volume centers and more randomized-controlled trials are needed to evaluate the appropriate indications of MIPD. |
url |
https://doi.org/10.1038/s41598-017-02488-4 |
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