SynthesisThe Cochrane database of systematic reviews2013
Prophylactic gastrojejunostomy for unresectable periampullary carcinoma.
Synthesis in The Cochrane database of systematic reviews, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
14 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Double Stenting for Malignant Biliary and Duodenal Obstruction: A Systematic Review and Meta-Analysis.Clinical and translational gastroenterology · 2020Pooled it
- Stent placement versus surgical palliation for adults with malignant gastric outlet obstruction.The Cochrane database of systematic reviews · 2018Pooled it
- Laparoscopic gastrojejunostomy for gastric outlet obstruction in patients with unresectable hepatopancreatobiliary cancers: A personal series and systematic review of the literature.World journal of gastroenterology · 2018Pooled it
- A systematic review and meta-analysis comparing partial stomach partitioning gastrojejunostomy versus conventional gastrojejunostomy for malignant gastroduodenal obstruction.Langenbeck's archives of surgery · 2016Pooled it
- An additional gastrojejunostomy may reduce the incidence of moderate and severe delayed gastric emptying after distal segmental duodenectomy for gastrointestinal stromal tumors.World journal of surgical oncology · 2024Article
- Outcomes and risks in palliative pancreatic surgery: an analysis of the German StuDoQ|Pancreas registry.BMC surgery · 2022Article
- Korean Surgical Practice Guideline for Pancreatic Cancer 2022: A summary of evidence-based surgical approachesAnnals of hepato-biliary-pancreatic surgery · 2022Article
- Current Clinical Strategies of Pancreatic Cancer Treatment and Open Molecular Questions.International journal of molecular sciences · 2019Review
- Palliative therapy in pancreatic cancer-palliative surgery.Translational gastroenterology and hepatology · 2019Review
- Potential therapeutic value of primary tumor resection in ampullary cancer patients with distant metastases at initial diagnosis: a population-based study.Cancer management and research · 2019Article
- Roux-en-Y duodenojejunostomy improves gastric emptying in experimental obstruction of the distal duodenum.PloS one · 2018Article
- Palliative Care for Pancreatic and Periampullary Cancer.The Surgical clinics of North America · 2016Review
- Advances in the Surgical Management of Resectable and Borderline Resectable Pancreas Cancer.Surgical oncology clinics of North America · 2016Review
- TTD consensus document on the diagnosis and management of exocrine pancreatic cancer.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2014Review
Corrections and comments
- Update of
Authors and funding
3 authors.
Funding
Abstract
backgroundThe role of prophylactic gastrojejunostomy in patients with unresectable periampullary cancer is controversial.
objectivesTo determine whether prophylactic gastrojejunostomy should be performed routinely in patients with unresectable periampullary cancer. SEARCH
methodsFor the initial version of this review, we searched the Cochrane Upper Gastrointestinal and Pancreatic Diseases Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, issue 3), MEDLINE, EMBASE and Science Citation Index Expanded until April 2010. Literature searches were re-run in August 2012. SELECTION CRITERIA: We included randomised controlled trials comparing prophylactic gastrojejunostomy versus no gastrojejunostomy in patients with unresectable periampullary cancer (irrespective of language or publication status). DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trials for inclusion and independently extracted data. We analysed data with both the fixed-effect and the random-effects models using Review Manager (RevMan). We calculated the hazard ratio (HR), risk ratio (RR), and mean difference (MD) with 95% confidence intervals (CI) based on an intention-to-treat or available case analysis. MAIN
resultsWe identified two trials (of high risk of bias) involving 152 patients randomised to gastrojejunostomy (80 patients) and no gastrojejunostomy (72 patients). In both trials, patients were found to be unresectable during exploratory laparotomy. Most of the patients also underwent biliary-enteric drainage. There was no evidence of difference in the overall survival (HR 1.02; 95% CI 0.84 to 1.25), peri-operative mortality or morbidity, quality of life, or hospital stay (MD 0.97 days; 95%CI -0.18 to 2.12) between the two groups. The proportion of patients who developed long-term gastric outlet obstruction was significantly lower in the prophylactic gastrojejunostomy group (2/80; 2.5%) compared with no gastrojejunostomy group (20/72; 27.8%) (RR 0.10; 95%CI 0.03 to 0.37). The operating time was significantly longer in the gastrojejunostomy group compared with no gastrojejunostomy group (MD 45.00 minutes; 95%CI 21.39 to 68.61). AUTHORS'
conclusionsRoutine prophylactic gastrojejunostomy is indicated in patients with unresectable periampullary cancer undergoing exploratory laparotomy (with or without hepaticojejunostomy).
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.