Distal pancreatectomy with

backgroundPancreatic cancer frequently results in celiac artery invasion, resulting in an unresectable disease that generally has a median survival period of 6-11 months. Efforts to achieve curative resection of such tumors have been made by conducting distal pancreatectomy with

methodsThis meta-analysis was conducted to systematically assess the clinical efficacy of the DP-CAR treatment of unresectable tumors of the pancreatic body or tail (registered with PROSPERO: CRD42019129612). The PubMed, EMBASE, the Cochrane Library, and Web of Science databases were searched to identify relevant retrospective studies pertaining to such treatment.

resultsOverall, 12 retrospective cohort analyses incorporating 213 total DP-CAR cases and 911 DP cases were incorporated into the present meta-analysis. Pooled analyses demonstrated that relative to DP, DP-CAR was related to a longer operative duration [mean difference (MD) -73.69, 95% confidence interval (CI): -112.99 to -34.38, P=0.0002] and higher blood transfusion rates [odds ratio (OR) 0.29, 95% CI: 0.10 to 0.87; P=0.03]. DP-CAR was also linked to increased rates of PV resection (OR 0.17, 95% CI: 0.07 to 0.39; P<0.001) and delayed gastric emptying (DGE) (OR 0.37, 95% CI: 0.15 to 0.93, P=0.03). In contrast, R0 resection rates were higher in the DP group (OR 2.79, 95% CI: 1.90 to 4.09, P<0.001), and these patients also had a significantly improved prognosis (median survival time, 27.0

conclusionsThis analysis indicates that DP-CAR is not an effective means of improving R0 rates. However, available studies suggest that it is nonetheless a potentially valuable treatment option for pancreatic cancer patients with celiac axis involvement, and it is associated with a reasonable median survival duration of 17.7 months.