中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 36 Issue 8
Aug.  2020
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2020  >  36(8): 1811-1815

Clinical effect of pancreaticoduodenectomy with total mesopancreas excision versus traditional pancreaticoduodenectomy in treatment of pancreatic head carcinoma and periampullary cancer:A Meta-analysis

DOI: 10.3969/j.issn.1001-5256.2020.08.026

  • The Affiliated Hospital of Southwest Medical University

Research funding:

 

  • Published Date: 2020-08-20
    Abstract

  • Objective To investigate the safety and clinical effect of pancreaticoduodenectomy with total mesopancreas excision(TMpE)versus traditional pancreaticoduodenectomy(PD) in the treatment of pancreatic head carcinoma and periampullary cancer.Methods PubMed,Web of Science,Cochrane Library,CBM,CNKI,Wanfang Data,and VIP were searched for the Chinese and English articles on the clinical effect of TMpE and PD in the treatment of pancreatic head carcinoma and periampullary cancer published from January 2007 to February 2020.Quality assessment was performed for the articles included,and Revman 5.3 software was used to perform the Meta-analysis.Results Five retrospective cohort studies were included after screening,with a total of 358 patients,among whom 188 underwent TMpE and 170 underwent PD.The results of the meta-analysis showed that compared with the PD group,the TMpE group had a significant increase in the incidence rate of pancreatic fistula(odds ratio [OR]=1.69,95% confidence interval [CI]:1.03-2.78,P=0.04),while there was no significant difference in the incidence rate of postoperative complications between the two groups(OR=1.51,95% CI:0.76-2.98,P=0.24).In addition,TMpE improved R0 resection rate(OR=2.89,95% CI:1.30-6.43,P=0.009),number of dissected lymph nodes(mean difference [MD]=5.14,95% CI:4.16-6.13,P<0.001),and 1-year survival rate after surgery(OR=2.60,95% CI:1.45-4.69,P=0.001),without increasing the time of operation(MD=7.74,95% CI:-42.84 to 58.33,P=0.76),intraoperative blood loss(MD=-45.89,95% CI:-198.19 to 106.41,P=0.55),and the length of postoperative hospital stay(MD=-4.62,95% CI:-16.60 to 7.36,P=0.45).Conclusion TMpE is safe and feasible in the treatment of pancreatic head carcinoma and periampullary cancer and has the advantages of high R0 resection rate and 1-year survival rate after surgery,and therefore,it may become a preferred treatment method for pancreatic head carcinoma and periampullary cancer.

     

    • FullText(HTML)
  • loading
    • References(19)
  • [1] TANG WH,TANG JX,YUAN ZR. Several issues that need to be taken seriously in the surgical treatment of pancreatic head carcinoma[J]. Int J Surg,2019,46(1):13-16.(in Chinese)唐文皓，唐健雄，袁祖荣．胰头癌外科治疗中应注意的几个问题[J]．国际外科学杂志，2019,46(1):13-16.
    [2] ZHAO C,DAI CL. Methods and significance for improving the preoperative qualitative diagnosis of periampullary cancer[J].J Hepatobiliary Surg,2018,26(4):245-250.(in Chinese)赵闯，戴朝六．提高壶腹周围癌术前定性诊断的方法及意义[J]．肝胆外科杂志，2018,26(4):245-250.
    [3] ADHAM M,SINGHIRUNNUSORN J. Surgical technique and results of total mesopancreas excision(TMpE)in pancreatic tumors[J]. Eur J Surg Oncol,2012,38(4):340-345.
    [4] WU WG,WANG XA,WU XS,et al. Total mesopancreas excision for pancreatic head cancer:Analysis of 120 cases[J].Chin J Cancer Res,2016,28(4):423-428.
    [5] LUCHINI C,STUBBS B,SOLMI M,et al. Assessing the quality of studies in Meta-analyses:Advantages and limitations of the Newcastle Ottawa Scale[J]. World J of Meta-Analysis,2017,5(4):80.
    [6] KAWABATA Y,TANAKA T,NISHI T,et al. Appraisal of a total meso-pancreatoduodenum excision with pancreaticoduodenectomy for pancreatic head carcinoma[J]. Eur J Surg Oncol,2012,38(7):574-579.
    [7] AIMOTO T,MIZUTANI S,KAWANO Y,et al. Left posterior approach pancreaticoduodenectomy with total mesopancreas excision and circumferential lymphadenectomy around the superior mesenteric artery for pancreatic head carcinoma[J]. J Nippon Med Sch,2013,80(6):438-445.
    [8] XU JY,TIAN XD,CHEN YR,et al. Total mesopancreas excision for the treatment of pancreatic head cancer[J]. J Cancer,2017,8(17):3575-3584.
    [9] XU YK,SU S,GAN Y,et al. Safety and efficacy of total mesopancreas excision with pancreaticoduodenectomy in treatment of periampullary carcinoma and pancreatic head carcinoma[J]. Chin J Bases Clin Gen Surg,2018,25(12):1464-1468.(in Chinese)徐云柯，苏松，淦宇，等．胰腺全系膜切除的胰十二指肠切除术治疗壶腹周围癌及胰头癌的安全性及疗效分析[J]．中国普外基础与临床杂志，2018,25(12):1464-1468.
    [10] ZHANG D. The value of total mesopancreas excision in pancreatoduodenectomy[D]. Fuzhou:Fujian Medical University,2017.(in Chinese)张迪．胰腺全系膜切除在胰十二指肠切除术中应用价值[D]．福州:福建医科大学，2017.
    [11] LI B,GUO SW,JIANG H,et al. Resection margin of pancreatic cancer:Consensus and controversy[J]. Chin J Pract Surg,2019,39(9):983-987.(in Chinese)李勃，郭世伟，蒋慧，等．胰腺癌手术切缘共识与争议[J]．中国实用外科杂志，2019,39(9):983-987.
    [12] DU L,XU XJ,GENG C,et al. Efficacy of pancreaticoduodenectomy combined with portal vein/superior mesenteric vein resection for pancreatic head cancer[J]. Chin J Gen Surg,2016,25(3):381-386.(in Chinese)杜露，徐新建，耿城，等．联合门静脉/肠系膜上静脉切除的胰十二指肠术治疗胰头癌的疗效[J]．中国普通外科杂志，2016,25(3):381-386.
    [13] LIU YB,LI YS,WANG XA. Application and progress of total mesopancrease excision in radical resection of pancreatic head cancer[J]. J Abdominal Surg,2019,32(5):315-318,323.(in Chinese)刘颖斌，李永盛，王许安．全系膜切除理念在胰头癌根治术中的应用与研究进展[J]．腹部外科，2019,32(5):315-318,323.
    [14] YAO HC. Analysis of risk factors for recurrence after pancreatoduodenectomy[D]. Changchun:Jilin University,2018.(in Chinese)姚浩琛．胰头癌胰十二指肠切除术后复发危险因素分析[D]．长春:吉林大学，2018.
    [15] BAGHMAR S,AGRAWAL N,KUMAR G,et al. Prognostic factors and the role of adjuvant treatment in periampullary carcinoma:A single-centre experience of 95 patients[J]. J Gastrointest Cancer,2019,50(3):361-369.
    [16] SUN WB. Detailed measures to reduce the incidence and severity of pancreatic fistula after pancreaticoduodenectomy[J]. Chin J Hepatobiliary Surg,2019,25(7):481-486.(in Chinese)孙文兵．降低胰十二指肠切除切除术后胰瘘发生率和严重性的细节性措施[J]．中华肝胆外科杂志，2019,25(7):481-486.
    [17] YI B,WU X,YANG J,et al. Risk factor for delayed gastric emptying after pancreaticoduodenectomy[J]. Chin J Gen Surg,2018,33(3):248-249.(in Chinese)易彬，伍星，杨健，等．胰十二指肠切除术后胃排空障碍的危险因素分析[J]．中华普通外科杂志，2018,33(3):248-249.
    [18] LI GZ,ZHU ZW,WANG SP,et al. Predictive value of procalcitonin for early abdominal infection after pancreatoduodenectomy[J]. Chin J Pancreatol,2018,18(5):313-317.(in Chinese)李广洲，朱宗文，王水平，等．降钙素原对胰十二指肠切除术后腹腔感染早期的预测价值[J]．中华胰腺病杂志，2018,18(5):313-317.
    [19] QIN RY. Reflection on and improvement of digestive tract reconstruction after pancreatoduodenectomy[J]. Chin J Dig Surg,2011,10(5):335-337.(in Chinese)秦仁义．胰十二指肠切除后消化道重建方式的思考与改进[J]．中华消化外科杂志，2011,10(5):335-337.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索
    Get Citation
    PDF
    XML

    Article Metrics

    Article views (1533) PDF downloads(165) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return