title: [Reconstruction of pancreaticogastrostomy versus pancreaticojejunostomy after pancreaticoduodenectomy: a meta-analysis of prospectively controlled trials].
abstract: OBJECTIVE
  To compare the reconstructing safety of pancreaticogastrostomy (PG) versus pancreaticojejunostomy (PJ) after pancreaticoduodenectomy (PD).
  
  
  METHODS
  The articles of prospectively controlled trials published until late December 2010 comparing PJ and PG after PD were searched by the means of MEDLINE, EMBASE, Cochrane Controlled Trials Register databases and Chinese Biomedical Database. After quality assessment of all included prospective controlled trials, a meta-analysis was performed with Review Manager 5.0 for statistic analysis.
  
  
  RESULTS
  A total of 6 prospective controlled trials were included. Among 867 patients analyzed, 440 underwent PG and 426 PJ. A meta-analysis of 6 prospective controlled trials (including randomized control trial (RCT) and non-randomized prospective trial) revealed significant differences between PJ and PG regarding the overall postoperative complication rates [OR 0.53, 95%CI (0.30, 0.95), P = 0.03], pancreatic fistula [OR 0.47, 95%CI (0.22, 0.97), P = 0.04] and intra-abdominal fluid collection [OR 0.42, 95%CI (0.25, 0.72), P = 0.001]. The differences in biliary fistula, intra-abdominal (IAC) complications and mortality were of no significance. Meta-analysis of 4 RCTs revealed significant differences between PJ and PG regarding intra-abdominal fluid collection [OR 0.46, 95%CI (0.26, 0.79), P = 0.005]. The differences in pancreatic fistula, overall postoperative complications, biliary fistula, intra-abdominal complications and mortality were of no statistical significance.
  
  
  CONCLUSIONS
  Through a meta-analysis of 6 prospective controlled trials, there are significant differences between PJ and PG regarding overall postoperative complications, pancreatic fistula and intra-abdominal fluid collection. Significant differences exist between PJ and PG regarding intra-abdominal fluid collection. The safety profiles of PG and PJ are comparable.
authors.affiliation: Department of Gastrointestinal & Pancreatic Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Jin-ping
authors.initials: JP
authors.lastname: Ma
authors.forename: Jian-wei
authors.initials: JW
authors.lastname: Lin
authors.forename: Zhi
authors.initials: Z
authors.lastname: Wang
authors.forename: Liang
authors.initials: L
authors.lastname: Wang
authors.forename: Jian-hui
authors.initials: JH
authors.lastname: Chen
authors.forename: Chuang-qi
authors.initials: CQ
authors.lastname: Chen
authors.forename: Dong-jie
authors.initials: DJ
authors.lastname: Yang
authors.forename: Jian-jun
authors.initials: JJ
authors.lastname: Peng
authors.forename: Shi-rong
authors.initials: SR
authors.lastname: Cai
authors.forename: Yu-long
authors.initials: YL
authors.lastname: He
mesh_terms: D018849:Controlled Clinical Trials as Topic; D005774:Gastrostomy; D006801:Humans; D010179:Pancreas / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D010193:Pancreaticojejunostomy; D011446:Prospective Studies