title: Binding versus Conventional Pancreaticojejunostomy in Preventing Postoperative Pancreatic Fistula: A Systematic Review and Meta-Analysis.
abstract: BACKGROUND
  The aim of this study was to compare the safety and efficacy of a new technology, binding pancreaticojejunostomy (BPJ), with conventional pancreaticojejunostomy (CPJ) after pancreaticoduodenectomy in preventing postoperative pancreatic fistula (POPF).
  
  
  METHODS
  Randomized controlled trials and observational studies were retrieved from literature searches. Pooled OR with 95% CI for dichotomous variables and weighted mean difference with 95% CI for continuous variables were calculated. Fixed-effect and random-effect models as well as subgroup analysis were used for sensitivity analysis.
  
  
  RESULTS
  No statistically significant differences were found in the incidence of POPF, delayed gastric emptying, postpancreatectomy hemorrhage, reoperation, morbidity, mortality, operation time, intraoperative blood loss, blood transfusion, and hospital stay between 2 groups. However, the total costs of hospitalization and ordinary stay were higher in BPJ group (€10,513 ± €6,536 vs. €8,238 ± €4,687, p = 0.002; €7,946 ± €5,023 vs. €5,700 ± €2,902, p = 0.015, respectively).
  
  
  CONCLUSIONS
  Our study showed BPJ was as safe as CPJ. However, no significant superiority was found in BPJ group regarding the incidence of POPF. The total costs of hospital stay were higher for patients undergoing BPJ. Surgeons can prefer to perform the digestive tract reconstruction of their choice.
authors.affiliation: Institute for Experimental Surgery, Rostock University Medical Center, Rostock, Germany.
authors.forename: Xianbin
authors.initials: X
authors.lastname: Zhang
authors.forename: Xin
authors.initials: X
authors.lastname: Dong
authors.forename: Peng
authors.initials: P
authors.lastname: Liu
authors.forename: Yumei
authors.initials: Y
authors.lastname: Yan
authors.forename: Yushan
authors.initials: Y
authors.lastname: Wei
authors.forename: Dietmar
authors.initials: D
authors.lastname: Zechner
authors.forename: Peng
authors.initials: P
authors.lastname: Gong
authors.forename: Brigitte
authors.initials: B
authors.lastname: Vollmar
mesh_terms: D016063:Blood Loss, Surgical; D005746:Gastric Emptying; D006760:Hospitalization / Q000191:economics; D006801:Humans; D061646:Operative Time; D010185:Pancreatic Fistula / Q000209:etiology / Q000517:prevention & control*; D016577:Pancreaticoduodenectomy; D010193:Pancreaticojejunostomy / Q000009:adverse effects* / Q000191:economics / Q000379:methods* / Q000401:mortality; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D019106:Postoperative Hemorrhage / Q000209:etiology*; D012086:Reoperation
keywords: Binding pancreaticojejunostomy; Pancreaticoduodenectomy; Pancreaticojejunostomy ; Postoperative pancreatic fistula