Pancreatic duct stents at pancreaticoduodenectomy: a meta-analysis.
OBJECTIVE
Several studies suggested that pancreatic stents had some benefit during pancreatoduodenectomy (PD), but others disagree. Whether pancreatic duct stents could prevent postoperative pancreatic fistula (POPF) is still under controversy.


METHODS
Randomized controlled trials published before November 2012 were all aggregated, focusing on the evaluation of pancreatic duct stents during PD. Trial data was reviewed and extracted independently by two reviewers. The quality of the including studies was assessed by the Cochrane handbook 5.1.0.


RESULTS
Seven studies were included, with a total of 793 patients. The results showed that compared with nonstents, stents during PD was associated with a significant difference on overall POPF rate (OR = 0.65, 95% CI 0.45-0.95, p = 0.02), POPF grades B and C (OR = 0.45, 95% CI 0.27-0.76, p = 0.003), and hospital stay (MD = -4.28, 95% CI -6.81, -1.75, p = 0.0009). Subgroup analyses showed that the external stent had a significant difference in the incidence of overall POPF (OR = 0.46, 95% CI 0.29-0.73, p = 0.0009), POPF grades B and C (OR = 0.49, 95% CI 0.30-0.79, p = 0.003), postoperative morbidity (OR = 0.63, 95% CI 0.42-0.96, p = 0.03), as well as hospital stay.


CONCLUSIONS
Based upon this meta-analysis, there might be potential benefit in reducing POPF thanks to the use of pancreatic duct stents.
The First Clinical Medical College of Lanzhou University, Lanzhou, PR China.
Quan
Q
Wang
Xi-Ran
XR
He
Jin-Hui
JH
Tian
Ke-Hu
KH
Yang
D000714:Anastomosis, Surgical; D006801:Humans; D007902:Length of Stay; D010183:Pancreatic Ducts / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000295:instrumentation* / Q000379:methods / Q000401:mortality; D012107:Research Design; D015607:Stents; D016019:Survival Analysis; D016896:Treatment Outcome