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| 保留幽门的胰十二指肠切除术与胰十二指肠切除术治疗壶腹周围癌及胰头癌的Meta分析 | |
| 引用本文： | 卡哈尔·吐尔逊|吴源泉|王晓嵘|白磊|买买提吐尔孙·吐尔迪|赵晋明.保留幽门的胰十二指肠切除术与胰十二指肠切除术治疗壶腹周围癌及胰头癌的Meta分析[J].中国普通外科杂志,2013,22(9):1114-1121. |
| 作者姓名： | 卡哈尔·吐尔逊|吴源泉|王晓嵘|白磊|买买提吐尔孙·吐尔迪|赵晋明 |
| 作者单位： | （1. 新疆喀什地区第一人民医院 肝胆·包虫外科|新疆 喀什 844000；2. 新疆军区六九〇〇九部队卫生队|新疆 乌鲁木齐 830011；3. 新疆医科大学第一附属医院 肝脏·腹腔镜外科|新疆 乌鲁木齐 830011） |
| 摘 要： | 目的：系统评价保留幽门的胰十二指肠切除术（PPPD）与胰十二指肠切除术（PD）治疗壶腹周围癌及胰头癌的效果。方法：全面检索国内外关于PPPD与PD治疗壶腹周围癌及胰头癌的相关文献。按Cochrane系统评价的方法评价纳入研究的质量，用RevMan 5.0软件对资料进行统计分析。结果：纳入6个随机对照试验，共468例患者，PPPD组232例，PD组236例对照。Meta分析结果显示，两组间术后1，2，3年生存率（RR=1.20，95%CI=0.73-1.97；RR=1.02，95%CI=0.78-1.32；RR=0.99，95% CI=0.84-1.16）以及术后并发症与胃排空延迟的发生率（RR=0.86，95% CI=0.66-1.14；RR=1.30，95% CI=0.69-2.45）差异均无统计学意义（均P>0.05）；PPPD组术中出血量与手术时间少于PD组，差异有统计学意义（WMD=-527.21，95% CI=-1044.05--10.36，P=0.05；WMD=-29.82，95% CI=-48.05--11.59，P=0.001）。结论：如果把握手术适应征，PPPD与PD比较，前者并不增加并发症发生率，并能减少术中出血量和缩短手术时间。 |
| 关 键 词： | 胰腺肿瘤 胰十二指肠切除术/方法 Meta分析 |
| 收稿时间： | 2013/6/25 0:00:00 |
| 修稿时间： | 2013/8/27 0:00:00 |
PPPD versus PD for periampullary and pancreatic head carcinoma: a systematic review |
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| KAHAER?Tuersun,WU Yuanquan,WANG Xiaorong,BAI Lei,MAIMAITITUERSUN?Tuerdi.PPPD versus PD for periampullary and pancreatic head carcinoma: a systematic review[J].Chinese Journal of General Surgery,2013,22(9):1114-1121. | |
| Authors: | KAHAER?Tuersun WU Yuanquan WANG Xiaorong BAI Lei MAIMAITITUERSUN?Tuerdi |
| Institution: | (1. Department of Hepabiliary and Hydatid Surgery, Kashi Prefecture People’s Hospital, Kashi, Xinjiang 844000, China|2. Health Team, 69009th Force of Xinjiang Military Region, Urumqi 830011, China|3. Department of Liver and Larparoscopic Surgery, the First Affiliated Hospital, Xinjiang Medical University, Urumqi 830011, China) |
| Abstract: | Objective: To assess the clinical efficacy of the pylorus preserving pancreaticoduodenectomy (PPPD) and pancreaticoduodenectomy (PD) for carcinoma of the periampullary region and pancreatic head by means of systematic review. Methods: The studies both at home and abroad concerning PPPD versus PD for carcinoma of the periampullary region and pancreatic head were thoroughly searched. The quality of included studies was assessed according to the Cochrane systematic review method and statistical analysis of data was performed using RevMan 5.0 software. Results: Six randomized controlled studies were included, with a total of 468 patients, of whom, 232 cases underwent PPPD and 236 cases underwent PD. The results of Meta-analysis indicated that there were no significant differences between the two groups in 1-, 2- and 3-year survival rate (RR=1.20, 95% CI=0.73–1.97; RR=1.02, 95% CI=0.78–1.32; RR=0.99, 95% CI=0.84–1.16), and incidence of postoperative complications and delayed gastric emptying (RR=0.86, 95% CI=0.66–1.14; RR=1.30, 95% CI=0.69–2.45) (all P>0.05). The intraoperative blood loss and operative time in PPPD group were significantly reduced compared with PD group (WMD=–527.21, 95% CI=–1044.05––10.36, P=0.05; WMD=–29.82, 95% CI=–48.05––11.59, P=0.001). Conclusion: Compared with PD, PPPD does not increase the incidence of postoperative complications, and furthermore, it reduces the intraoperative blood loss and operative time on the basis of appropriate indications |
| Keywords: | Pancreatic Neoplasms Pancreaticoduodenectomy/methods Meta-Analysis |
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