Cochrane · systematic review · CD013462
Duct‐to‐mucosa versus other types of pancreaticojejunostomy for the prevention of postoperative pancreatic fistula following pancreaticoduodenectomy
Hai, H, Li, Z, Zhang, Z, et al. · Cochrane Database of Systematic Reviews · 2022 · 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
16
current version
GRADE rated
12
No studies
4
Included studies
NR
No studies 4 · 25%Ungraded 0 · 0%Very low 12 · 75%Low 0 · 0%Moderate 0 · 0%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
Duct‐to‐mucosa compared to invagination pancreaticojejunostomy for the prevention of postoperative pancreatic fistula following pancreaticoduodenectomy
Population: adults undergoing open pancreaticoduodenectomy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Rate of POPF (grade B or C defined according to the 2005 ISGPF definition) Duct‐to‐mucosa vs invagination pancreaticojejunostomy | RR 1.45 [0.64, 3.26] | 7 studies · 1122 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Postoperative mortality Duct‐to‐mucosa vs invagination pancreaticojejunostomy | RR 0.77 [0.39, 1.49] | 10 studies · 1472 participants | Very low Downgraded: risk of bias, imprecision, indirectness, publication bias |
Adverse events Duct‐to‐mucosa vs invagination pancreaticojejunostomy | no estimate extracted | NR | No studies |
Rate of surgical reintervention Duct‐to‐mucosa vs invagination pancreaticojejunostomy | RR 1.12 [0.65, 1.95] | 10 studies · 1472 participants | Very low Downgraded: risk of bias, imprecision, indirectness, publication bias |
Rate of postoperative bleeding Duct‐to‐mucosa vs invagination pancreaticojejunostomy | RR 0.85 [0.51, 1.42] | 9 studies · 1275 participants | Very low Downgraded: risk of bias, imprecision, indirectness, publication bias |
Overall rate of surgical complications Duct‐to‐mucosa vs invagination pancreaticojejunostomy | RR 1.12 [0.92, 1.36] | 5 studies · 750 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Length of hospital stay (days) Duct‐to‐mucosa vs invagination pancreaticojejunostomy | no estimate extracted | 4 studies · 658 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Quality of life Duct‐to‐mucosa vs invagination pancreaticojejunostomy | no estimate extracted | NR | No studies |
Duct‐to‐mucosa pancreaticojejunostomy using the modified Blumgart technique compared to duct‐to‐mucosa pancreaticojejunostomy using the traditional interrupted technique for the prevention of postoperative pancreatic fistula following pancreaticoduodenectomy
Population: adults undergoing open pancreaticoduodenectomy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Rate of POPF (grade B or C defined according to the 2016 ISGPS definition) Duct‐to‐mucosa pancreaticojejunostomy using the modified Blumgart technique vs duct‐to‐mucosa pancreaticojejunostomy using the traditional interrupted technique | 1.51 [0.61, 3.75] | 1 study · 210 participants | Very low Downgraded: risk of bias, imprecision |
Postoperative mortality Duct‐to‐mucosa pancreaticojejunostomy using the modified Blumgart technique vs duct‐to‐mucosa pancreaticojejunostomy using the traditional interrupted technique | no estimate extracted | 1 study · 210 participants | Very low Downgraded: risk of bias, imprecision |
Adverse events Duct‐to‐mucosa pancreaticojejunostomy using the modified Blumgart technique vs duct‐to‐mucosa pancreaticojejunostomy using the traditional interrupted technique | no estimate extracted | NR | No studies |
Rate of surgical reintervention Duct‐to‐mucosa pancreaticojejunostomy using the modified Blumgart technique vs duct‐to‐mucosa pancreaticojejunostomy using the traditional interrupted technique | RR 1.93 [0.18, 20.91] | 1 study · 210 participants | Very low Downgraded: risk of bias, imprecision |
Rate of postoperative bleeding Duct‐to‐mucosa pancreaticojejunostomy using the modified Blumgart technique vs duct‐to‐mucosa pancreaticojejunostomy using the traditional interrupted technique | RR 2.89 [0.12, 70.11] | 1 study · 210 participants | Very low Downgraded: risk of bias, imprecision |
Overall rate of surgical complications Duct‐to‐mucosa pancreaticojejunostomy using the modified Blumgart technique vs duct‐to‐mucosa pancreaticojejunostomy using the traditional interrupted technique | RR 1.1 [0.8, 1.51] | 1 study · 210 participants | Very low Downgraded: risk of bias, imprecision |
Length of hospital stay (days) Duct‐to‐mucosa pancreaticojejunostomy using the modified Blumgart technique vs duct‐to‐mucosa pancreaticojejunostomy using the traditional interrupted technique | no estimate extracted | 1 study · 210 participants | Very low Downgraded: risk of bias, imprecision |
Quality of life Duct‐to‐mucosa pancreaticojejunostomy using the modified Blumgart technique vs duct‐to‐mucosa pancreaticojejunostomy using the traditional interrupted technique | no estimate extracted | NR | No studies |