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...

Full description

Bibliographic Details
Main Authors: Zhanwei Zhao, Zifang Yin, Zhenning Hang, Gang Ji, Quanxin Feng, Qingchuan Zhao
Format: Article
Language:English
Published: Nature Publishing Group 2017-05-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-017-02488-4
id doaj-9ef86debbae24a34821e28ec89e6fcd2
record_format Article
spelling 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
work_keys_str_mv AT zhanweizhao asystemicreviewandanupdatedmetaanalysisminimallyinvasivevsopenpancreaticoduodenectomy
AT zifangyin asystemicreviewandanupdatedmetaanalysisminimallyinvasivevsopenpancreaticoduodenectomy
AT zhenninghang asystemicreviewandanupdatedmetaanalysisminimallyinvasivevsopenpancreaticoduodenectomy
AT gangji asystemicreviewandanupdatedmetaanalysisminimallyinvasivevsopenpancreaticoduodenectomy
AT quanxinfeng asystemicreviewandanupdatedmetaanalysisminimallyinvasivevsopenpancreaticoduodenectomy
AT qingchuanzhao asystemicreviewandanupdatedmetaanalysisminimallyinvasivevsopenpancreaticoduodenectomy
AT zhanweizhao systemicreviewandanupdatedmetaanalysisminimallyinvasivevsopenpancreaticoduodenectomy
AT zifangyin systemicreviewandanupdatedmetaanalysisminimallyinvasivevsopenpancreaticoduodenectomy
AT zhenninghang systemicreviewandanupdatedmetaanalysisminimallyinvasivevsopenpancreaticoduodenectomy
AT gangji systemicreviewandanupdatedmetaanalysisminimallyinvasivevsopenpancreaticoduodenectomy
AT quanxinfeng systemicreviewandanupdatedmetaanalysisminimallyinvasivevsopenpancreaticoduodenectomy
AT qingchuanzhao systemicreviewandanupdatedmetaanalysisminimallyinvasivevsopenpancreaticoduodenectomy
_version_ 1724396605582344192