SynthesisThe Cochrane database of systematic reviews2013
Stents for the prevention of pancreatic fistula following pancreaticoduodenectomy.
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 12 papers, 3 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
12 citing papers in PubMed, 3 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- Pooled it
- Risk factors and preventive strategies for post-operative pancreatic fistula after pancreatic surgery: a comprehensive review.Scandinavian journal of gastroenterology · 2016Pooled it
- Stents for the prevention of pancreatic fistula following pancreaticoduodenectomy.The Cochrane database of systematic reviews · 2016Pooled it
- Clinical Analysis of C-Shaped Embedded Pancreaticojejunostomy in Pancreaticoduodenectomy.Journal of oncology · 2022Article
- The prognostic value of external vs internal pancreatic duct stents after pancreaticoduodenectomy in patients with FRS ≥ 4: a retrospective cohort study.BMC surgery · 2021Article
- Article
- Pancreatic Duct Holder and Mucosa Squeeze-out Technique for Duct-to-Mucosa Pancreatojejunostomy After Pancreatoduodenectomy: Propensity Score Matching Analysis.World journal of surgery · 2016Article
- Surgery for Pancreatic and Periampullary Carcinoma.The Indian journal of surgery · 2015Article
- [Management of postoperative pancreatic fistula].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2015Review
- Pancreatoduodenectomy - preventing complications.Indian journal of surgical oncology · 2015Article
- Pancreatic surgery: evolution and current tailored approach.Hepatobiliary surgery and nutrition · 2014Review
- Techniques for prevention of pancreatic leak after pancreatectomy.Hepatobiliary surgery and nutrition · 2014Review
Corrections and comments
- Updated by
Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSeveral studies have demonstrated that the use of pancreatic duct stents following pancreaticoduodenectomy is associated with a lower risk of pancreatic fistula. However, to date, there is a lack of accord in the literature on whether the use of stents is beneficial and, if so, whether internal or external stenting is preferable.
objectivesTo determine the efficacy of pancreatic stents in preventing pancreatic fistula after pancreaticoduodenectomy. SEARCH
methodsThe Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, ISI Web of Science and four major Chinese biomedical databases were searched up to February 2011. We also searched four major trials registers. SELECTION CRITERIA: Randomized controlled trials (RCTs) comparing the use of stents (either internal or external) versus no stents, and comparing internal stents versus external stents following pancreaticoduodenectomy. DATA COLLECTION AND ANALYSIS: Two authors extracted the data independently. The outcomes studied were incidence of pancreatic fistula, need for reoperation, length of hospital stay, overall complications, and in-hospital mortality. The results were shown as relative risk (RR) with 95% confidence interval (CI). MAIN
resultsA total of 656 patients were included in the systematic review. Overall, the use of stents (both external and internal) was not associated with a statistically significant change in any of the studied outcomes. In a subgroup analysis, it was found that the use of external, but not internal, stents is associated with a significant reduction in the incidence of pancreatic fistulae (RR 0.33; 95% CI 0.11 to 0.98, P = 0.04), the incidence of complications (RR 0.48; 95% CI 0.25 to 0.92, P = 0.03) and length of hospital stay (RR -0.57; 95% CI -0.94 to -0.21, P = 0.002). In RCTs on the use of internal versus external stents, no statistically significant difference was found in terms of any of the studied outcomes. AUTHORS'
conclusionsThis systematic review suggests that the use of external stents following pancreaticoduodenectomy may be beneficial. However, only a limited number of RCTs with rather small sample sizes were available. Further RCTs on the use of stents after pancreaticoduodenectomy are warranted.
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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.