Usefulness of performing a pancreaticojejunostomy with an internal stent after a pancreatoduodenectomy

Kamoda, Yasuhisa; Fujino, Yasuhiro; Matsumoto, Ippei; Shinzeki, Makoto; Sakai, Tetsuya; Kuroda, Yoshikazu

doi:10.1007/s00595-007-3662-x

Cited by 59 publications

(35 citation statements)

References 16 publications

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“…Six trials [2,37,39,40,41,42] had adequate allocation concealment with a blind envelope, except for one trial [38]. Two trials [2,40] reported that opening of the envelope was performed during the operation by a third person who was not involved in the procedure after the resection was completed and immediately before pancreaticojejunostomy anastomosis, so we considered that they had lower risks of error.…”

Section: Resultsmentioning

confidence: 99%

“…Four [2,37,38,41] of them were conducted in Japan, and three studies took place in Hong Kong [40], France [39] and the USA [42]. The interventions of the four studies [2,38,39,40] were comparisons between external duct stent and nonstent, and two studies [37,41] compared external with internal stents. Only one group [42] studied the effect of the internal stent.…”

Section: Resultsmentioning

confidence: 99%

“…By a detailed full-text read, seven RCTs [2,37,38,39,40,41,42] were ultimately identified in 793 patients. Figure 1 shows the PRISMA statement of the search flow in detail.…”

Section: Resultsmentioning

confidence: 99%

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Pancreatic Duct Stents at Pancreaticoduodenectomy: A Meta-Analysis

Wang

Tian

et al. 2013

Dig Surg

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Background and Objective: Several studies suggested that pancreatic stents had some benefit during pancreatoduodenectomy (PD), but others disagree. Whether pancreatic duct stents could prevent postoperative pancreatic fistula (POPF) is still under controversy. Methods: Randomized controlled trials published before November 2012 were all aggregated, focusing on the evaluation of pancreatic duct stents during PD. Trial data was reviewed and extracted independently by two reviewers. The quality of the including studies was assessed by the Cochrane handbook 5.1.0. Results: Seven studies were included, with a total of 793 patients. The results showed that compared with nonstents, stents during PD was associated with a significant difference on overall POPF rate (OR = 0.65, 95% CI 0.45-0.95, p = 0.02), POPF grades B and C (OR = 0.45, 95% CI 0.27-0.76, p = 0.003), and hospital stay (MD = -4.28, 95% CI -6.81, -1.75, p = 0.0009). Subgroup analyses showed that the external stent had a significant difference in the incidence of overall POPF (OR = 0.46, 95% CI 0.29-0.73, p = 0.0009), POPF grades B and C (OR = 0.49, 95% CI 0.30-0.79, p = 0.003), postoperative morbidity (OR = 0.63, 95% CI 0.42-0.96, p = 0.03), as well as hospital stay. Conclusions: Based upon this meta-analysis, there might be potential benefit in reducing POPF thanks to the use of pancreatic duct stents.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Pancreatic Duct Stents at Pancreaticoduodenectomy: A Meta-Analysis

Wang

Tian

et al. 2013

Dig Surg

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“…Age, gender, diabetes mellitus, diameter of the main pancreatic duct, pancreatic texture, pathological diagnosis, amount of blood loss, and operative time are independent risk factors in multivariate analyses [3,[8][9][10][11][12][13][14]. It has been shown BMI body mass index, CEA carcinoembryonic antigen, CA19-9 carbohydrate antigen 19-9, dMPD the diameter of the main pancreatic duct † independent two-sample t test † † Fisher's exact test that the occurrence of POPF seems to be intricately associated with preoperative, intraoperative, and postoperative variables.…”

Section: Discussionmentioning

confidence: 99%

A Rapid Predictive System for Pancreatic Fistula after Pancreaticoduodenectomy: A Report from a Low-Volume Center

Takeshima¹,

Kubochi²

2017

J Univer Surg

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“…w badaniu z randomizacją ocenili bezpieczeństwo i skuteczność zespolenia trzustkowo-jelitowego z drenażem zewnętrznym w porówna-niu z drenażem wewnętrznym. Pankreatojejunostomia z drenażem wewnętrznym okazała się lepszą metodą, cechującą się mniejszym odsetkiem powikłań i zerową śmiertelnością [19]. W licznych doniesieniach potwierdza się korzyści wynikające z drenowania przewodu trzustkowego podczas wykonywania zespolenia trzustkowo-jelitowego, ale ustalenie najkorzystniejszej techniki wymaga dalszych badań.…”

Section: Techniki Zespolenia Trzustkowo--jelitowegounclassified

Surgical treatment of pancreatic cancer – randomized controlled trials

Andrén‐Sandberg¹,

Hedberg²,

Jurałowicz³

et al. 2011

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Słowa kluczowe: rak trzustki, leczenie chirurgiczne, badania z randomizacją. Keys words: pancreatic cancer, surgical treatment, randomized trials.Adres do korespondencji: prof. dr hab. n. med. Ewa Małecka-Panas, Klinika Chorób Przewodu Pokarmowego, Uniwersytet Medyczny, ul. Kopcińskiego 22, 90-153 Łódź, tel./faks +48 42 678 64 80, e-mail: ewuncia@poczta.onet.pl Artykuł poglądowy/Review paper StreszczeniePodejmowanie decyzji klinicznych w każdej dziedzinie medycyny powinno być oparte na evidence-based medicine, czyli dowodach płynących z dużych, dobrze zaprojektowanych i przeprowadzonych badań klinicznych. W naukowej hierarchii ważności najwyższe miejsce zajmują metaanalizy, zwłaszcza te oparte na ocenie badań klinicznych z randomizacją. W artykule tym autorzy zebrali wyniki wszystkich metaanaliz i klinicznych badań z randomizacją dotyczących chirurgicznego leczenia raka części zewnątrzwydzielniczej trzustki. Przeszukano bazę PubMed, używając słów pancreatic cancer i randomized controlled trials, a następnie przeanalizowano wszystkie dostępne w pełnej wersji artykuły odpowiadające słowom kluczowym, często znajdując w nich odniesienia do kolejnych badań. Niniejsza publikacja jest próbą zebrania wyników istotnych badań dotyczących postępowania okołooperacyjne-go u chorych na raka trzustki, w tym skuteczności przedoperacyjnego drenażu dróg żółciowych, technik zespolenia trzustkowo-jelitowego i rozszerzonej limfadenektomii. Oceniono także skuteczność i bezpieczeństwo pankreatoduodenektomii sposobem Whipple'a w porównaniu z zabiegiem oszczę-dzającym odźwiernik oraz paliatywnymi zabiegami chirurgicznymi i endoskopowymi w nieresekcyjnym raku trzustki. AbstractThe practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research. In the medical scientific hierarchy, meta-analyses and randomized controlled trials have the highest rank and their results are discussed as evidence-based medicine. We have collected all the randomized controlled trials in our clinical and research area: exocrine pancreatic cancer. We have used PubMed systematically with the key words: pancreatic cancer and randomized controlled trials, and from reading those articles we have found a few more. The present review is an attempt to make it easier for clinical pancreatologists to keep updated our knowledge about preoperative biliary stenting, techniques of pancreaticojejunostomy and extended lymphadenectomy. We also compared the results of studies concerning standard Whipple versus pylorus-preserving pancreatoduodenectomy, retrocolic or antecolic gastroenterostomy, as well as surgery versus stenting in laparoscopically unresectable pancreatic cancer. WstępW nowoczesnej medycynie podejmowanie decyzji klinicznych powinno być oparte na evidence-based medicine (EBM), czyli dowodach płynących z dużych, dobrze zaprojektowanych i przeprowadzonych badań klinicznych z randomizacją (randomized controlled trials -RCTs) [1]. W naukowej hierarchii ważności najwyższe mi...

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Usefulness of performing a pancreaticojejunostomy with an internal stent after a pancreatoduodenectomy

Abstract: Pancreaticojejunostomy with an internal stent is therefore considered to be an effective treatment alternative after PD, with an acceptable morbidity and no mortality.

Cited by 59 publications

References 16 publications

Pancreatic Duct Stents at Pancreaticoduodenectomy: A Meta-Analysis

Pancreatic Duct Stents at Pancreaticoduodenectomy: A Meta-Analysis

A Rapid Predictive System for Pancreatic Fistula after Pancreaticoduodenectomy: A Report from a Low-Volume Center

Surgical treatment of pancreatic cancer – randomized controlled trials

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