Effect of Billroth II or Roux-en-Y Reconstruction for the Gastrojejunostomy After Pancreaticoduodenectomy: Meta-analysis of Randomized Controlled Trials

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• 作者：Ji Yang ; Chao Wang ; Qiang Huang
• 关键词：Billroth II reconstruction ; Delayed gastric emptying ; Gastrojejunostomy ; Pancreatic fistula ; Pancreaticoduodenectomy ; Roux ; en ; Y reconstruction
• 刊名：Journal of Gastrointestinal Surgery
• 出版年：2015
• 出版时间：May 2015
• 年：2015
• 卷：19
• 期：5
• 页码：955-963
• 全文大小：594 KB
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• 作者单位：Ji Yang (1) (2)
  Chao Wang (1) (2)
  Qiang Huang (1) (2)
  
  1. Department of General Surgery, Affiliated Provincial Hospitalof Anhui Medical University, Hefei, 230001, China
  2. Hepatobiliary and Pancreatic Laboratory of Anhui Province, Hefei, 230001, China
  
• 刊物主题：Surgery; Gastroenterology;
• 出版者：Springer US
• ISSN：1873-4626

文摘

Background and Objectives This study aimed to compare Billroth II with Roux-en-Y reconstruction after pancreaticoduodenectomy (PD). Methods A literature search was carried out to identify all randomized controlled trials (RCTs) comparing postoperative complications of Billroth II versus Roux-en-Y reconstruction following PD published from 1 January 1990 to 31 August 2014. Pooled risk ratios (RRs) with 95?% confidence intervals (CIs) were calculated using fixed effects or random effects models Results In total, three RCTs with 470 patients were included. Using International Study Group of Pancreatic Surgery (ISGPS) definitions, incidences of delayed gastric emptying (DGE) [grades B and C (3.9 versus 12.9?%; RR 0.30, 95?% CI 0.11-.79; P--.01), DGE grade C (0.7 versus 9.6?%; RR 0.11, 95?% CI 0.02-.61; P--.01)] were significantly lower in the Billroth II group than in the Roux-en-Y group, as was the length of hospital stay (weighted mean difference ?.72, 95?% CI ?.91, ?.53; P--.03). Conclusions Meta-analysis revealed that the incidence of DGE (grades B and C) after PD can be decreased by using Billroth II rather than Roux-en-Y reconstruction.