胰十二指肠切除术后应用胰胃吻合与胰空肠吻合的Meta分析

发布时间：2018-03-22 10:26

本文选题：胰十二指肠切除术　切入点：胰管空肠吻合术　出处：《肝胆胰外科杂志》2014年06期 　论文类型：期刊论文

【摘要】：目的评价胰十二指肠切除术后胰胃吻合术与胰空肠吻合术的疗效。方法计算机检索Cochrane Library(2014年第5期)、Pub Med(1978年1月至2014年5月)、EMBASE(1966年1月至2014年5月)、SCI(1961年1月至2014年5月)、中国生物医学数据库(CBM)(1978年1月至2014年5月)、相关期刊论文(CNKI)(1994年1月至2014年5月),维普(1989年1月至2014年5月)和万方数据库(1998年1月至2014年5月),同时在Google搜索引擎进行检索,并追查纳入研究参考文献,收集胰十二指肠切除术后胰胃吻合术与胰空肠吻合术的所有随机对照试验。根据Cochrane协作网推荐的"风险评估工具"进行偏倚风险评估,用Rev Man5.2软件进行统计学分析。结果纳入7项随机对照试验,共1 121例患者。Meta分析结果显示,与胰空肠吻合组相比,胰胃吻合组能降低胰十二指肠切除术后胰瘘发生率(RR=0.56;95%CI:0.41~0.75;P=0.0001)、胆漏发生率(RR=0.43;95%CI:0.19~0.95;P=0.04)腹腔内多发并发症(OR=0.26;95%CI:0.12~0.56;P=0.0007)和腹腔内积液的发生(OR=0.54;95%CI:0.38~0.77;P=0.0005),但两者在术后并发症、胃排空延迟、围手术期病死率方面差异均无统计学意义。结论目前随机对照试验研究显示胰十二指肠切除术后消化道重建胰胃吻合术优于胰空肠吻合术。
[Abstract]:Objective to evaluate the efficacy of pancreaticogastrostomy and pancreaticojejunostomy after pancreaticoduodenectomy. Methods Cochrane Library (issue 5, 2014) was searched by computer for EMBASE (January 1966-May 2014). China Biomedical Database (January 1978-May 2014), CNKI (January 1994-May 2014), Weip (January 1989-May 2014) and Wanfang Database (January 1998-May 2014). The Google search engine searches, All randomized controlled trials of pancreaticojejunostomy and pancreaticojejunostomy after pancreaticoduodenectomy were collected. The bias risk was assessed according to the "risk assessment tool" recommended by Cochrane. Rev Man5.2 software was used to carry out statistical analysis. Results 1 121 patients were included in 7 randomized controlled trials. Meta-analysis showed that compared with pancreaticojejunostomy group, In the pancreaticostomy group, the incidence of pancreatic fistula after pancreaticoduodenectomy was reduced by 0.5695% CI: 0.441% 0.75% P 0.0001, and the incidence of bile leakage was 0.4395CI0.199.5% 0.195% P0.04). The complications were 0.2695% CI 0.120.56 P 0.0007) and the incidence of intraperitoneal effusion was 0.5495% 0.3895% 0.77P0.0005.However, the postoperative complications were delayed gastric emptying. Conclusion the results of randomized controlled trial showed that the pancreaticogastric anastomosis after pancreaticoduodenectomy was superior to that of pancreaticojejunostomy.
【作者单位】：上海交通大学医学院附属仁济医院胆胰外科;
【分类号】：R735

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