A systemic review and an updated meta-analysis: minimally invasive vs open pancreaticoduodenectomy

Abstract The feasible of minimally invasive pancreaticoduodenectomy (MIPD) remains controversial when compared with open pancreaticoduodenectomy (OPD). We conducted a systemic review and meta-analysis to summarise the available evidence to compare MIPD vs OPD. We systemically searched PubMed, EMBASE...

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Autores principales:	Zhanwei Zhao, Zifang Yin, Zhenning Hang, Gang Ji, Quanxin Feng, Qingchuan Zhao
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/9ef86debbae24a34821e28ec89e6fcd2
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spelling	oai:doaj.org-article:9ef86debbae24a34821e28ec89e6fcd22021-12-02T12:30:35ZA systemic review and an updated meta-analysis: minimally invasive vs open pancreaticoduodenectomy10.1038/s41598-017-02488-42045-2322https://doaj.org/article/9ef86debbae24a34821e28ec89e6fcd22017-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-02488-4https://doaj.org/toc/2045-2322Abstract The feasible of minimally invasive pancreaticoduodenectomy (MIPD) remains controversial when compared with open pancreaticoduodenectomy (OPD). We conducted a systemic review and meta-analysis to summarise the available evidence to compare MIPD vs OPD. We systemically searched PubMed, EMBASE and Web of Science for studies published through February 2016. The primary endpoint was postoperative pancreatic fistula (POPF, grade B/C). A total of 27 studies involving 14,231 patients (2,377 MIPD and 11,854 OPD) were included. MIPD was associated with longer operative times (P < 0.01) and increased mortality (P < 0.01), but decreased estimated blood loss (P < 0.01), decreased delayed gastric emptying (P < 0.01), increased R0 resection rate (P < 0.01), decreased wound infection (P = 0.03) and shorter hospital stays (P < 0.01). There were no significant differences in BMI (P = 0.43), tumor size (P = 0.17), lymph nodes harvest (P = 0.57), POPF (P = 0.84), reoperation (P = 0.25) and 5-year survival rates (P = 0.82) for MIPD compared with OPD. Although there was an increased operative cost (P < 0.01) for MIPD compared with OPD, the postoperative cost was less (P < 0.01) with the similar total costs (P = 0.28). MIPD can be a reasonable alternative to OPD with the potential advantage of being minimally invasive. However, MIPD should be performed in high-volume centers and more randomized-controlled trials are needed to evaluate the appropriate indications of MIPD.Zhanwei ZhaoZifang YinZhenning HangGang JiQuanxin FengQingchuan ZhaoNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-8 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Zhanwei Zhao Zifang Yin Zhenning Hang Gang Ji Quanxin Feng Qingchuan Zhao A systemic review and an updated meta-analysis: minimally invasive vs open pancreaticoduodenectomy
description	Abstract The feasible of minimally invasive pancreaticoduodenectomy (MIPD) remains controversial when compared with open pancreaticoduodenectomy (OPD). We conducted a systemic review and meta-analysis to summarise the available evidence to compare MIPD vs OPD. We systemically searched PubMed, EMBASE and Web of Science for studies published through February 2016. The primary endpoint was postoperative pancreatic fistula (POPF, grade B/C). A total of 27 studies involving 14,231 patients (2,377 MIPD and 11,854 OPD) were included. MIPD was associated with longer operative times (P < 0.01) and increased mortality (P < 0.01), but decreased estimated blood loss (P < 0.01), decreased delayed gastric emptying (P < 0.01), increased R0 resection rate (P < 0.01), decreased wound infection (P = 0.03) and shorter hospital stays (P < 0.01). There were no significant differences in BMI (P = 0.43), tumor size (P = 0.17), lymph nodes harvest (P = 0.57), POPF (P = 0.84), reoperation (P = 0.25) and 5-year survival rates (P = 0.82) for MIPD compared with OPD. Although there was an increased operative cost (P < 0.01) for MIPD compared with OPD, the postoperative cost was less (P < 0.01) with the similar total costs (P = 0.28). MIPD can be a reasonable alternative to OPD with the potential advantage of being minimally invasive. However, MIPD should be performed in high-volume centers and more randomized-controlled trials are needed to evaluate the appropriate indications of MIPD.
format	article
author	Zhanwei Zhao Zifang Yin Zhenning Hang Gang Ji Quanxin Feng Qingchuan Zhao
author_facet	Zhanwei Zhao Zifang Yin Zhenning Hang Gang Ji Quanxin Feng Qingchuan Zhao
author_sort	Zhanwei Zhao
title	A systemic review and an updated meta-analysis: minimally invasive vs open pancreaticoduodenectomy
title_short	A systemic review and an updated meta-analysis: minimally invasive vs open pancreaticoduodenectomy
title_full	A systemic review and an updated meta-analysis: minimally invasive vs open pancreaticoduodenectomy
title_fullStr	A systemic review and an updated meta-analysis: minimally invasive vs open pancreaticoduodenectomy
title_full_unstemmed	A systemic review and an updated meta-analysis: minimally invasive vs open pancreaticoduodenectomy
title_sort	systemic review and an updated meta-analysis: minimally invasive vs open pancreaticoduodenectomy
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/9ef86debbae24a34821e28ec89e6fcd2
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A systemic review and an updated meta-analysis: minimally invasive vs open pancreaticoduodenectomy

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