Cochrane · systematic review · CD012257
Pancreaticojejunostomy versus pancreaticogastrostomy reconstruction for the prevention of postoperative pancreatic fistula following pancreaticoduodenectomy
Cheng, Y, Briarava, M, Lai, M, et al. · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library
GutAMSTAR 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
10
current version
GRADE rated
9
No studies
1
Included studies
NR
No studies 1 · 10%Ungraded 0 · 0%Very low 1 · 10%Low 6 · 60%Moderate 2 · 20%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
Pancreaticojejunostomy compared with pancreatogastrostomy after pancreatoduodectomy
Population: adults undergoing pancreatoduodenectomy (mainly for pancreatic cancer)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Postoperative pancreatic fistula (Grade A, B or C) Pancreaticojejunostomy vs pancreatogastrostomy after pancreatoduodectomy | RR 1.19 [0.88, 1.62] | 9 studies · 1513 participants | Low Downgraded: risk of bias |
Clinically significant pancreatic fistula (Grade B or C) Pancreaticojejunostomy vs pancreatogastrostomy after pancreatoduodectomy | RR 1.51 [0.92, 2.47] | 7 studies · 1184 participants | Very low Downgraded: risk of bias |
Postoperative mortality Pancreaticojejunostomy vs pancreatogastrostomy after pancreatoduodectomy | RR 0.84 [0.53, 1.34] | 10 studies · 1629 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Length of hospital stay Pancreaticojejunostomy vs pancreatogastrostomy after pancreatoduodectomy | MD 1.04 | 4 studies · 502 participants | Low Downgraded: risk of bias |
Surgical re‐intervention Pancreaticojejunostomy vs pancreatogastrostomy after pancreatoduodectomy | RR 1.18 [0.86, 1.61] | 7 studies · 1263 participants | Low Downgraded: risk of bias |
Surgical complications Pancreaticojejunostomy vs pancreatogastrostomy after pancreatoduodectomy | RR 1.03 [0.9, 1.18] | 9 studies · 1513 participants | Moderate Downgraded: risk of bias |
Postoperative bleeding Pancreaticojejunostomy vs pancreatogastrostomy after pancreatoduodectomy | RR 0.69 [0.51, 0.93] | 8 studies · 1386 participants | Low Downgraded: risk of bias |
Intra‐abdominal abscess Pancreaticojejunostomy vs pancreatogastrostomy after pancreatoduodectomy | RR 1.77 [1.11, 2.81] | 7 studies · 1121 participants | Low Downgraded: risk of bias |
Quality of life Pancreaticojejunostomy vs pancreatogastrostomy after pancreatoduodectomy | no estimate extracted | 1 study · 320 participants | Low Downgraded: risk of bias |
Cost analysis Pancreaticojejunostomy vs pancreatogastrostomy after pancreatoduodectomy | no estimate extracted | NR | No studies |