Pedicled ligament flaps during pancreatoduodenectomy are associated with reduced hemorrhage from hepatic artery and gastroduodenal artery stump during pancreatoduodenectomy : a systematic review, meta-analysis and trial sequential analysis
Copyright © 2023 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved..
BACKGROUND: The aim of this study was to investigate whether pedicled ligament flaps (PLF) covering around the hepatic and gastroduodenal artery stump can provide better clinical outcomes in pancreatoduodenectomy (PD).
METHODS: We conducted a comprehensive search of databases (inception to January 2023) to identify studies comparing PD with or without PLF covering the skeletonized arteries. The perioperative and postoperative outcomes were compared. Pooled odds ratios (ORs) with 95 % confidence intervals (CIs) were calculated using fixed-effects models.
RESULTS: Ten studies were included in the qualitative synthesis. Six studies with 3538 patients met the inclusion criteria for the meta-analysis. Patients in the PLF group had a significantly lower rate of PPH from the hepatic artery or gastroduodenal artery stump (H/G PPH) (OR: 0.41; 95 % CI, 0.22-0.75; P < 0.01) and overall PPH (OR: 0.65; 95 % CI, 0.46-0.93; P = 0.02). There were no significant differences between the two groups in terms of morbidity, grade B/C postoperative pancreatic fistula (B/C POPF), delayed gastric emptying (DGE), reoperation, or mortality.
CONCLUSION: Prophylactic pedicled ligament flaps covering around the skeletonized arteries significantly reduced overall PPH and H/G PPH, and it seemed to have no obvious influence on other complications.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:26 |
|---|---|
| Enthalten in: |
HPB : the official journal of the International Hepato Pancreato Biliary Association - 26(2024), 4 vom: 30. Apr., Seite 476-485 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Hang, Kuan [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Completed 01.04.2024 Date Revised 01.04.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.hpb.2023.11.013 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM366859102 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM366859102 | ||
| 003 | DE-627 | ||
| 005 | 20240401232512.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240114s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.hpb.2023.11.013 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1359.xml |
| 035 | |a (DE-627)NLM366859102 | ||
| 035 | |a (NLM)38195309 | ||
| 035 | |a (PII)S1365-182X(23)02004-X | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Hang, Kuan |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Pedicled ligament flaps during pancreatoduodenectomy are associated with reduced hemorrhage from hepatic artery and gastroduodenal artery stump during pancreatoduodenectomy |b a systematic review, meta-analysis and trial sequential analysis |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 01.04.2024 | ||
| 500 | |a Date Revised 01.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved. | ||
| 520 | |a BACKGROUND: The aim of this study was to investigate whether pedicled ligament flaps (PLF) covering around the hepatic and gastroduodenal artery stump can provide better clinical outcomes in pancreatoduodenectomy (PD) | ||
| 520 | |a METHODS: We conducted a comprehensive search of databases (inception to January 2023) to identify studies comparing PD with or without PLF covering the skeletonized arteries. The perioperative and postoperative outcomes were compared. Pooled odds ratios (ORs) with 95 % confidence intervals (CIs) were calculated using fixed-effects models | ||
| 520 | |a RESULTS: Ten studies were included in the qualitative synthesis. Six studies with 3538 patients met the inclusion criteria for the meta-analysis. Patients in the PLF group had a significantly lower rate of PPH from the hepatic artery or gastroduodenal artery stump (H/G PPH) (OR: 0.41; 95 % CI, 0.22-0.75; P < 0.01) and overall PPH (OR: 0.65; 95 % CI, 0.46-0.93; P = 0.02). There were no significant differences between the two groups in terms of morbidity, grade B/C postoperative pancreatic fistula (B/C POPF), delayed gastric emptying (DGE), reoperation, or mortality | ||
| 520 | |a CONCLUSION: Prophylactic pedicled ligament flaps covering around the skeletonized arteries significantly reduced overall PPH and H/G PPH, and it seemed to have no obvious influence on other complications | ||
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 700 | 1 | |a Wei, Lijuan |e verfasserin |4 aut | |
| 700 | 1 | |a Yi, Mingchao |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Haoheng |e verfasserin |4 aut | |
| 700 | 1 | |a Huang, Yang |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Hao |e verfasserin |4 aut | |
| 700 | 1 | |a Tan, Chunlu |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Kezhou |e verfasserin |4 aut | |
| 700 | 1 | |a Xiong, Junjie |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t HPB : the official journal of the International Hepato Pancreato Biliary Association |d 2001 |g 26(2024), 4 vom: 30. Apr., Seite 476-485 |w (DE-627)NLM178147761 |x 1477-2574 |7 nnns |
| 773 | 1 | 8 | |g volume:26 |g year:2024 |g number:4 |g day:30 |g month:04 |g pages:476-485 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.hpb.2023.11.013 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 26 |j 2024 |e 4 |b 30 |c 04 |h 476-485 | ||