Clinical efficacy of spleen-preserving distal pancreatectomy with or without splenic vessel preservation: A Meta-analysis. Issue 48 (December 2017)

• Record Type: Journal Article
• Authors: Sun, Ningning; Lu, Guangjun; Zhang, Likun; Wang, Xiaoling; Gao, Chunmin; Bi, Jieliang; Wang, Xiaoyi
• Other Names: Cirocchi. Roberto section editor.
• Is Part Of: Medicine. Volume 96:Issue 48(2017)
• Publication Date: 2017-12
• Subjects: meta-analysis -- splenic vessel preservation -- splenic vessel resection; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000008600
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Objective: The meta-analysis was performed to investigate the clinical efficacy of spleen-preserving distal pancreatectomy with splenic vessel preservation (SPDP-SVP) and spleen-preserving distal pancreatectomy with splenic vessel resection (SPDP-SVR). Methods: Potential articles were searched on the databases of Pubmed, Embase, and Chinese National Knowledge Infrastructure (CNKI) from January 1988 until March 2017. Weight mean difference (WMD) with 95% confidence interval (CI) was applied to compare the efficacy of SPDP-SVP and SPDP-SVR. Odds ratio (OR) with 95% CI was calculated to figure out the risks for complications. P < .05 or I 2 >50% indicated significant heterogeneity. The random-effects model is used to pool data if significant heterogeneity exists; otherwise, the fixed-effects model is used. Publication bias was evaluated by Begg's funnel plot. Results: Thirteen eligible articles were obtained in the meta-analysis. SPDP-SVP seemed to relate with reduced operative time and blood loss, prolonged hospital stay, and less complications; however, the effects were not statistically significant. Meanwhile, we found that SPDP-SVP was closely related with the reduced rate of splenic infarction and gastric varices (OR = 0.16, 95% CI = 0.09–0.29; OR = 0.08, 95% CI = 0.02–0.35). No publication bias was observed in the analysis ( P = .636). Conclusions: SPDP-SVP seems to show superiority than SPDP-SVR in reducing the rate of splenic infarction and gastric varices.