title: [Meta-analysis of pylorus-preserving pancreaticoduodenectomy in the treatment of periampullary adenocarcinoma].
abstract: OBJECTIVE
  To evaluate the efficacy and safety of pylorus-preserving pancreatico-duodenectomy(PPPD) in the treatment of periampullary adenocarcinoma by using Meta-analysis.
  
  
  METHODS
  From January 1, 1980 to November 8, 2013, the articles of randomized controlled trials (RCTs) about PPPD versus PD in the treatment of periampullary adenocarcinoma were collected from Cochrane Libriary, Embase, PubMed, Ovid, Web of science and CBM etc. The methodological quality of the included studies was evaluated according to Cochrane system review valuator handbook of risk of bias standards. Meta-analysis was performed by RevMan 5.2 software.
  
  
  RESULTS
  Seven RCTs were enrolled in the meta-analysis. Compared to PD group, PPPD group was associated with significantly less intraoperative blood loss (MD=-200.10, 95% CI:-400.66 to 0.46, P=0.05), shorter operation time (MD=-46.55, 95% CI:-91.02 to -2.07, P=0.04), and less postoperative blood transfusion (MD=-0.89, 95% CI:-1.59 to -0.19, P=0.01). There were no significant differences between the PPPD and PD group in pancreatic fistula, biliary fistula, intestinal fistula, abdominal abscess, postoperative bleeding, wound infection, relaparotomy, mortality and survival rate(all P>0.05).
  
  
  CONCLUSIONS
  PPPD in the treatment of the periampullary adenocarcinoma is safe and effective with similar survival of PD surgery. PPPD can reduce operative time, intraoperative blood loss, transfusion and does not increase the surgery complications as compared to PD.
authors: Department of General Surgery, The Second Affiliated Hospital, Nanchang University, Jiangxi Provincial Key Laboratory of Molecular Medicine, Nanchang 330006, China. shao5022@163.com.
authors: Junxiang
authors: J
authors: Yin
authors: Chao
authors: C
authors: Qu
authors: Jun
authors: J
authors: Huang
authors: Zixi
authors: Z
authors: Huang
authors: Junwen
authors: J
authors: Hu
authors: Jianghua
authors: J
authors: Shao
mesh_terms: D000230:Adenocarcinoma; D014670:Ampulla of Vater; D004379:Duodenal Neoplasms; D006801:Humans; D007412:Intestinal Fistula; D061646:Operative Time; D010185:Pancreatic Fistula; D010190:Pancreatic Neoplasms; D016577:Pancreaticoduodenectomy; D011708:Pylorus; D016032:Randomized Controlled Trials as Topic; D015996:Survival Rate