SynthesisDer Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen2010
[Survival, mortality and quality of life after pylorus-preserving or classical Whipple operation. A systematic review with meta-analysis].
Synthesis in Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 14 citations in OpenAlex.
- Patient expectations about the oncologic benefit of pancreatectomy for pancreatic ductal adenocarcinoma.HPB : the official journal of the International Hepato Pancreato Biliary Association · 2025Article
- Cholangiocarcinoma.Nature reviews. Disease primers · 2021Review
- Comparison of Quality of Life before and after pancreaticoduodenectomy: a prospective study.Electronic physician · 2018Article
- Impact of pancreatectomy on long-term patient-reported symptoms and quality of life in recurrence-free survivors of pancreatic and periampullary neoplasms.Journal of surgical oncology · 2017Article
- Quality of life and impact of bile reflux after retro colic retro gastric gastrojejunostomy in Whipple surgery.BMC gastroenterology · 2017Article
- Pylorus preservation pancreatectomy or not.Translational gastroenterology and hepatology · 2017Review
- Evidence-Based Surgical Treatments for Chronic Pancreatitis.Deutsches Arzteblatt international · 2016Review
- The estimation of metaloproteinases and their inhibitors blood levels in patients with pancreatic tumors.World journal of surgical oncology · 2013Article
- Ductal adenocarcinoma of the pancreatic head: a focus on current diagnostic and surgical concepts.World journal of gastroenterology · 2012Review
- The Study Centre of the German Surgical Society: current trials and results.Langenbeck's archives of surgery · 2012Review
- [Contribution of the Study Center of the German Surgical Society to evidence based surgery].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2011Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTwo surgical procedures are mainly performed for the treatment of pancreatic head cancer and periampullary carcinoma: the classical Whipple operation and the pylorus-preserving Whipple operation.
methodsThis manuscript represents an extension of a systematic review and meta-analysis previously published in the Annals of Surgery. A systematic literature search was performed in MEDLINE, EMBASE and the Cochrane Library (central) to identify randomized controlled trials (RCTs) and observational studies. A meta-analysis based on a random-effects model was performed for the hazard ratios (HR) of survival and the odds ratios (OR) of postoperative mortality. The results of the different studies on quality of life (QoL) could not be summarized quantitatively in a meta-analysis and were therefore summarized qualitatively. Subgroup analyses were performed by study type, RCTs, prospective cohort studies (PSs), retrospective cohort studies (RSs), study quality and tumor localization (pancreatic head cancer versus periampullary carcinoma).
resultsThe systematic literature search retrieved 4,503 studies of which 4,460 did not fulfill the inclusion criteria. The remaining 43 studies (6 RCTs, 12 PSs and 25 RSs) representing 3,893 patients were finally included in the review. There was neither a significant survival difference for patients with pancreatic head cancer in the pooled estimate of the RCTs (HR 0.80; 95% CI 0.53-1.22; p=0.16) nor in the pooled estimate of the PSs (HR 0.84; 95% CI 0.7-1.0; p=0.95) or the RSs (HR 0.84; 95% CI 0.7-1.01; p=0.21). Survival of patients with periampullary carcinoma was not significantly different in the RCTs (HR 1.02; 95% CI 0.49-2.13; p=0.3), the PSs (HR 1.26; 95% CI 0.46-3.42; p=0.65) or the RSs (HR 0.86; 95% CI 0.6-1.24; p=0.33). Postoperative mortality was not significantly different after both types of operations (RCTs: HR 0.49; 95% CI 0.17-1.4; p=0.18; PSs: HR 0.63; 95% CI 0.34-1.18; p=0.15; RSs: HR 0.7; 95% CI 0.37-1.31; p=0.27). QoL was reported as either the same in both groups or in favor of the pylorus-preserving Whipple operation.
conclusionsMortality, survival and QoL were not significantly different between the classical Whipple and the pylorus-preserving Whipple operations. Given the poor quality of the underlying trials a pragmatic RCT is recommended to prove the findings of this systematic review.
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