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The role of central pancreatectomy in pancreatic surgery: a systematic review and meta-analysis


BACKGROUND:

The aim of this systematic review and meta-analysis was to compare the clinical outcomes of central pancreatectomy (CP) with distal pancreatectomy (DP) and pancreaticoduodenectomy (PD).

METHODS:

A systematic literature research in PubMed/Medline, Embase and Cochrane Library was performed to identify articles reporting CP from January 1983 to November 2017.

RESULTS:

Fifty studies with 1305 patients undergoing CP were identified. The overall morbidity, mortality, pancreatic fistula (PF) rate and reoperation rate was 51%, 0.5%, 35% and 4% respectively. Endocrine and exocrine insufficiency were occurred in 4% and 5% of patients after CP.
Meta-analysis of CP versus DP favored CP with regard to less blood loss (WMD = −143.4, P = 0.001), lower rates of endocrine (OR = 0.13, P < 0.001) and exocrine insufficiency (OR = 0.38, P < 0.001). CP was associated with higher morbidity and PF rate. In comparison with PD, CP had a lower risk of endocrine (OR = 0.14, P < 0.001) and exocrine insufficiency (OR = 0.14, P < 0.001), but a higher PF rate (OR = 1.6, P = 0.015).

CONCLUSIONS:

CP maintains pancreatic endocrine and exocrine function better than DP and PD, but is associated with a higher PF rate.

HPB (Oxford). 2018 Jun 6
pii: S1365−182X (18)30801−3
doi: 10.1016/j.hpb.2018.05.001
Xiao W, Zhu J, Peng L, Hong L, Sun G, Li Y

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