Systematic review and meta-analysis of technique for closure of the pancreatic remnant after distal pancreatectomy.

摘要: Background: Appropriate closure of the pancreatic remnant after distal pancreatectomy is still debated. A variety procedures have been recommended to reduce frequency fistula. This review quantitatively compares available techniques. Methods: Original articles and abstracts published up end June 2004 were searched without language restriction in Cochrane Controlled Trials Register, Medline Embase. Three reviewers independently assessed each study's eligibility quality, extracted data. random effects model was performed using weighted odds ratios. Results: Only ten 262 could be included, two randomized clinical trials eight observational studies. Reported postoperative morbidity varied from 13·3 64 per cent. The primary outcome measure, fistula rate, occurred within range 0–60·9 Meta-analysis six studies comparing stapler versus hand-sutured showed a non-significant combined ratio for occurrence 0·66 (95 cent confidence interval 0·35 1·26, P = 0·21) favour closure. Conclusions: The quality quantity information are insufficient enable any firm conclusion drawn on optimal surgical technique stump closure; there trend stapling technique. Copyright © 2005 British Journal Surgery Society Ltd. Published by John Wiley & Sons,