Evidence map›Paper›PMID 27102322›Full record

SynthesisLangenbeck's archives of surgery2016

Pancreaticojejunostomy is comparable to pancreaticogastrostomy after pancreaticoduodenectomy: an updated meta-analysis of randomized controlled trials.

Stefano Crippa, Roberto Cirocchi, Justus Randolph, Stefano Partelli, Giulio Belfiori, Alessandra Piccioli, Amilcare Parisi, Massimo Falconi

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Langenbeck's archives of surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 4 pooled it
–field-weighted citation impact
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

27 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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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

8 authors.

Stefano CrippaDepartment of Surgery, Division of Pancreatic Surgery, San Raffaele Scientific Institute, Vita e Salute University, Via Olgettina 60, 20132, Milan, Italy.
Roberto CirocchiDepartment of General and Oncologic Surgery, St. Maria Hospital, University of Perugia, Terni, Italy.
Justus RandolphMercer University, Tift College of Education, Atlanta, GA, USA.
Stefano PartelliDepartment of Surgery, Division of Pancreatic Surgery, San Raffaele Scientific Institute, Vita e Salute University, Via Olgettina 60, 20132, Milan, Italy.
Giulio BelfioriDepartment of Surgery, Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy.
Alessandra PiccioliDepartment of Surgery, Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy.
Amilcare ParisiDepartment of Digestive and Liver Surgery Unit, St. Maria Hospital, Terni, Italy.
Massimo FalconiDepartment of Surgery, Division of Pancreatic Surgery, San Raffaele Scientific Institute, Vita e Salute University, Via Olgettina 60, 20132, Milan, Italy. falconi.massimo@hsr.it.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo perform an up-to-date meta-analysis of randomized controlled trials (RCTs) comparing pancreaticojejunostomy (PJ) and pancreaticogastrostomy (PG) in order to determine the safer anastomotic technique. Compared to existing meta-analysis, new RCTs were evaluated and subgroup analyses of different anastomotic techniques were carried out.

methodsWe conducted a bibliographic research using the National Library of Medicine's PubMed database from January 1990 to July 2015 of RCTs. Only RCTs, in English, that compared PG versus all types of PJ were selected. Data were independently extracted by two authors. We performed a quantitative systematic review following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. A random-effect model was applied. Statistical heterogeneity was assessed using the I (2) and χ (2) tests. Primary outcomes were rate of overall and clinically significant pancreatic fistula (POPF).

resultsTen RCTs were identified including 1629 patients, 826 undergoing PG and 803 undergoing PJ. RCTs showed significant heterogeneity regarding definitions of POPF, perioperative management, and characteristics of pancreatic gland. No significant differences were found in the rate of overall and clinically significant POPF, morbidity, mortality, reoperation, and intra-abdominal sepsis when PG was compared with all types PJ or when subgroup analysis (double-layer PG with or without anterior gastrotomy versus duct to mucosa PJ and single-layer PG versus single-layer end-to-end/end-to-side PJ) were analyzed.

conclusionsPG is not superior to PJ in the prevention of POPF. Current RCTs have major methodological limitations with significant heterogeneity in regard to surgical techniques, definition of POPF/complications, and perioperative management.

Indexed as

GastrostomyHumansPancreatic FistulaPancreaticoduodenectomyPancreaticojejunostomyPostoperative ComplicationsRandomized Controlled Trials as TopicMeta-analysisPancreatic fistulaPancreaticogastrostomyPancreaticojejunostomyRandomized trial

Identifiers

PMID27102322

What OpenQuestion holds

Textmetadata
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.