Evidence map›Paper›PMID 25119463›Full record

SynthesisPloS one2014

Does minimally-invasive pancreaticoduodenectomy have advantages over its open method? A meta-analysis of retrospective studies.

Han Qin, Jianguo Qiu, Yiyang Zhao, Gang Pan, Yong Zeng

Open access · goldAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 7 pooled it
2.7field-weighted citation impact, top 9% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 7 syntheses or guidelines pooled it, 51 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Han QinDepartment of Hepatic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, P. R. China.
Jianguo QiuDepartment of Hepatobiliary Surgery, The First Affiliated Hospital, Chongqing Medical University, Chongqing, P. R. China.
Yiyang ZhaoDepartment of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, P. R. China.
Gang PanDepartment of Hepatic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, P. R. China.
Yong ZengDepartment of Hepatic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, P. R. China.
Sichuan University · CNChongqing Medical University · CNWest China Hospital of Sichuan University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWhile more and more open procedures now routinely performed using laparoscopy, minimally invasive pancreaticoduodenectomy (MIPD) remains one of the most challenging abdominal procedures. Therefore, we carried out this meta-analysis to evaluate whether MIPD is safe, feasible and worthwhile.

methodsPubMed, EMBASE, and Cochrane Library were searched to identify studies published between January 1994 and November 2013 comparing MIPD with open pancreaticoduodenectomy (OPD). Intraoperative outcomes, oncologic safety, postoperative complications, and postoperative recovery were evaluated.

results11 retrospective studies representing 869 patients (327 MIPDs, 542 OPDs) were included. MIPD was associated with a reduction in estimated blood loss (MD -361.93 ml, 95% CI -519.22 to -204.63 ml, p<0.001, I(2) = 94%), wound infection (OR 0.41, 95% CI 0.22 to 0.78, p = 0.007, I(2) = 0%), and hospital stay (MD -2.64 d, 95% CI -4.23 to -1.05 d, p = 0.001, I(2) = 78%). However, it brings longer operative time (MD 105 min, 95% CI 49.73 to 160.26 min, p<0.001, I(2) = 93%). There were no significant differences between the two procedures in likelihood of overall complications (p = 0.05), pancreatic fistula (PF) (p = 0.86), delayed gastric empting (DGE) (p = 0.96), positive surgical margins (p = 0.07), retrieval of lymph nodes (p = 0.48), reoperation (p = 0.16) and mortality (p = 0.64).

conclusionsOur results suggest that MIPD is currently safe, feasible and worthwhile. But considering the selection bias, complexity of MIPD and lack of long-term oncologic outcomes, we suggest it be performed in a high-volume pancreatic surgery center in selected patients.

Indexed as

AgedAged, 80 and overBlood Loss, SurgicalFemaleHumansLymph Node ExcisionMaleMiddle AgedMinimally Invasive Surgical ProceduresOperative TimePancreaticoduodenectomyPostoperative ComplicationsReoperationRetrospective StudiesRisk AssessmentTreatment Outcome

Identifiers

PMID25119463
PMCPMC4132100
OpenAlexW1991487591

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.