Cochrane · systematic review · CD008914

Stents for the prevention of pancreatic fistula following pancreaticoduodenectomy

Dong, Z, Xu, J, Wang, Z, et al. · Cochrane Database of Systematic Reviews · 2016 · Cochrane Library

Gut2 versionsAMSTAR 2: not assessed

SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.

Questions

current version

GRADE rated

No studies

Included studies

No studies 0 · 0%Ungraded 1 · 5.3%Very low 0 · 0%Low 12 · 63.2%Moderate 6 · 31.6%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

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Stents versus no stents for the prevention of pancreatic fistula following pancreaticoduodenectomy

Population: people undergoing pancreaticoduodenectomy

7 questions

Outcome	Effect	Evidence	Status / GRADE
Pancreatic fistulas Stents vs no stents	RR 0.67 [0.39, 1.14]	4 studies · 605 participants	Low Downgraded: imprecision, inconsistency
In‐hospital mortality Stents vs no stents	RR 0.73 [0.28, 1.94]	4 studies · 605 participants	Moderate Downgraded: imprecision
Reoperation Stents vs no stents	RR 0.67 [0.36, 1.22]	3 studies · 512 participants	Moderate Downgraded: imprecision
Total hospital stay Stents vs no stents	no estimate extracted	4 studies · 605 participants	Moderate Downgraded: imprecision
Delayed gastric emptying Stents vs no stents	RR 0.75 [0.24, 2.35]	3 studies · 371 participants	Moderate Downgraded: imprecision
Intra‐abdominal abscess Stents vs no stents	RR 1.38 [0.49, 3.85]	1 study · 234 participants	Low Downgraded: imprecision
Wound infection Stents vs no stents	RR 0.73 [0.4, 1.32]	4 studies · 605 participants	Moderate Downgraded: imprecision

Internal stents versus external stents for the prevention of pancreatic fistula following pancreaticoduodenectomy

Population: people undergoing pancreaticoduodenectomy

8 questions

Outcome	Effect	Evidence	Status / GRADE
Pancreatic fistulas Internal stents vs external stents	RR 1.44 [0.94, 2.21]	3 studies · 362 participants	Low Downgraded: risk of bias
In‐hospital mortality Internal stents vs external stents	RR 0.33 [0.01, 7.99]	3 studies · 362 participants	Low Downgraded: imprecision
Reoperation Internal stents vs external stents	RR 2.02 [0.38, 10.79]	2 studies · 319 participants	Low Downgraded: imprecision
Total hospital stay Internal stents vs external stents	no estimate extracted	2 studies · 262 participants	Low Downgraded: risk of bias, imprecision
Delayed gastric emptying Internal stents vs external stents	RR 1.65 [0.66, 4.09]	3 studies · 362 participants	Low Downgraded: risk of bias, imprecision
Pancreatitis Internal stents vs external stents	RR 0.15 [0.01, 2.73]	2 studies · 262 participants	Low Downgraded: risk of bias, imprecision
Intra‐abdominal abscess Internal stents vs external stents	RR 1.91 [0.8, 4.58]	3 studies · 362 participants	Low Downgraded: risk of bias, imprecision
Wound infection Internal stents vs external stents	RR 1.41 [0.44, 4.48]	2 studies · 319 participants	Moderate Downgraded: imprecision

No replacement versus replacement for the prevention of pancreatic fistula following pancreaticoduodenectomy

Population: people undergoing pancreaticoduodenectomy

4 questions

Outcome	Effect	Evidence	Status / GRADE
Pancreatic fistulas No replacement vs replacement	RR 1.6 [0.84, 3.07]	1 study · 46 participants	Low Downgraded: imprecision
In‐hospital mortality No replacement vs replacement	no estimate extracted	1 study · 46 participants	Ungraded
Total hospital stay No replacement vs replacement	no estimate extracted	1 study · 46 participants	Low Downgraded: imprecision
Delayed gastric emptying No replacement vs replacement	RR 1.05 [0.46, 2.41]	1 study · 46 participants	Low Downgraded: imprecision