Dimitri Dorcaratto1, Niamh M Hogan2, Elena Muñoz3, Marina Garcés3, Paolo Limongelli4, Luis Sabater3, Joaquin Ortega3. 1. Hepatobiliary and Pancreatic Unit, General and Digestive Surgery Department, Hospital Clõnico Universitario de Valencia, Valencia, Spain. Electronic address: dorcaratto.dimitri@gmail.com. 2. Royal College of Surgeons in Ireland, Dublin, Ireland. 3. Hepatobiliary and Pancreatic Unit, General and Digestive Surgery Department, Hospital Clõnico Universitario de Valencia, Valencia, Spain. 4. Department of Medical, Surgical, Neurologic, Metabolic and Aging Sciences, Second University of Naples, Naples, Italy.
Abstract
PURPOSE: To compare postoperative complications in patients who underwent pancreatoduodenectomy after either endoscopic or percutaneous biliary drain (BD). MATERIAL AND METHODS: Data from studies comparing the rate of postoperative complications in patients who underwent endoscopic BD or percutaneous BD before pancreatoduodenectomy were extracted independently by 2 investigators. The primary outcome compared in the meta-analysis was the risk of postoperative complications. Secondary outcomes were the risks of procedure-related complications, postoperative mortality, postoperative pancreatic fistula, severe complications, and wound infection. For dichotomous variables, the odds ratio (OR) with 95% confidence interval (CI) was calculated. RESULTS: Thirteen studies, including 2334 patients (501 in the percutaneous BD group and 1833 in the endoscopic group), met the inclusion criteria. Postoperative and procedure-related complication rates were significantly lower in the percutaneous BD group (OR = .7, 95% CI = .52-.94, P = .02 and OR = .44, 95% CI = .23-.84, P = .01, respectively). No significant differences were observed when severe postoperative complications, postoperative mortality, postoperative pancreatic fistula, and wound infection rates were compared. CONCLUSIONS: In patients awaiting pancreatoduodenectomy, preoperative percutaneous BD is associated with fewer procedure-related or postoperative complications than endoscopic drain.
PURPOSE: To compare postoperative complications in patients who underwent pancreatoduodenectomy after either endoscopic or percutaneous biliary drain (BD). MATERIAL AND METHODS: Data from studies comparing the rate of postoperative complications in patients who underwent endoscopic BD or percutaneous BD before pancreatoduodenectomy were extracted independently by 2 investigators. The primary outcome compared in the meta-analysis was the risk of postoperative complications. Secondary outcomes were the risks of procedure-related complications, postoperative mortality, postoperative pancreatic fistula, severe complications, and wound infection. For dichotomous variables, the odds ratio (OR) with 95% confidence interval (CI) was calculated. RESULTS: Thirteen studies, including 2334 patients (501 in the percutaneous BD group and 1833 in the endoscopic group), met the inclusion criteria. Postoperative and procedure-related complication rates were significantly lower in the percutaneous BD group (OR = .7, 95% CI = .52-.94, P = .02 and OR = .44, 95% CI = .23-.84, P = .01, respectively). No significant differences were observed when severe postoperative complications, postoperative mortality, postoperative pancreatic fistula, and wound infection rates were compared. CONCLUSIONS: In patients awaiting pancreatoduodenectomy, preoperative percutaneous BD is associated with fewer procedure-related or postoperative complications than endoscopic drain.
Authors: José María Huguet; Miriam Lobo; José Mir Labrador; Carlos Boix; Cecilia Albert; Luis Ferrer-Barceló; Ana B Durá; Patricia Suárez; Isabel Iranzo; Mireia Gil-Raga; Celia Baez de Burgos; Javier Sempere Journal: World J Clin Cases Date: 2019-07-26 Impact factor: 1.337
Authors: Keith B Quencer; Anthony S Tadros; Keyan B Marashi; Ziga Cizman; Eric Reiner; Ryan O'Hara; Rahmi Oklu Journal: J Clin Med Date: 2018-05-01 Impact factor: 4.241
Authors: Anna Tavakkoli; B Joseph Elmunzer; Akbar K Waljee; Caitlin C Murphy; Sandi L Pruitt; Hong Zhu; Rong Rong; Richard S Kwon; James M Scheiman; Joel H Rubenstein; Amit G Singal Journal: Gastrointest Endosc Date: 2020-06-09 Impact factor: 9.427