Comparison of clinical efficacy of laparoscopic spleen-preserving distal pancreatectomy between Kimura technique and Warshaw technique: a Meta-analysis

doi:10.3877/cma.j.issn.2095-3232.2019.03.007

Abstract

Abstract:

Objective

To compare the clinical efficacy of laparoscopic spleen-preserving distal pancreatectomy between Kimura technique and Warshaw technique.

Methods

Literature before August 1, 2018 were reviewed from PubMed, EMBASE, CNKI and Wanfang database by using the keywords laparoscopic, pancreatectomy, pancreatic neoplasms, spleen, Kimura and Warshaw in both English and Chinese. Data about operation time, intraoperative blood loss, total incidence of complications, pancreatic fistula, splenic infarction and length of hospital stay were extracted and subjected to Meta-analysis.

Results

A total of 801 patients were enrolled from 12 articles, including 514 cases treated with Kimura technique and 287 cases with Warshaw technique. Meta-analysis revealed that the incidence of postoperative splenic infarction of Kimura technique was significantly lower than that of Warshaw technique (OR=0.13, 95%CI: 0.08-0.23; P<0.05). No significant difference was observed in the length of hospital stay, intraoperative blood loss and operation time between two techniques (SMD=0.31, -0.12, -0.05; P>0.05). And no significant difference was observed in the total incidence of postoperative complications and incidence of pancreatic fistula between two techniques (OR=0.65, 0.87; P>0.05).

Conclusions

The incidence of postoperative splenic infarction in patients using Kimura technique is lower compared with those using Warshaw technique. Kimura technique is better than Warshaw technique for laparoscopic spleen-preserving pancreatectomy, which can be the primary choice for operation.

Key words: Pancreatic neoplasms, Laparoscopes, Pancreatectomy, Meta-analysis, Kimura, Warshaw

Jiajun Ji, Chaojie Liang, Jianzhu Fu, Guangming Li, Jixiang Wu. Comparison of clinical efficacy of laparoscopic spleen-preserving distal pancreatectomy between Kimura technique and Warshaw technique: a Meta-analysis[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2019, 08(03): 207-211.

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References 24

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作者	发表年份	国家	样本量（例）		平均年龄（岁）		性别（男/女）		NOS评分
作者	发表年份	国家	Kimura	Warshaw	Kimura	Warshaw	Kimura	Warshaw	NOS评分
Beane等^[10]	2011	美国	45	41	53.4	56.7	10/350	19/22	8
Butturini等^[11]	2012	意大利	36	7	47±18	44±17	7/29	1/6	7
Hwang等^[12]	2013	韩国	17	4	44±15	37±10	7/10	0/4	8
Jean-Philippe等^[13]	2013	西班牙	55	85	-	-	-	-	7
Lv等^[14]	2013	中国	12	8	38±20	43±16	2/10	3/5	8
Worhunsky等^[15]	2014	美国	19	31	56±11	54±15	10/900	24/70	8
Matsushima等^[16]	2014	日本	7	17	70(50～86)	49(30～83)	4/30	03/14	7
Zhou等^[17]	2014	中国	206	40	50±14	49±12	63/143	05/35	6
胡文迪^[18]	2014	中国	28	17	42±13	39±15	4/24	04/13	7
Lee等^[19]	2016	韩国	63	26	52(16～78)	51(20～78)	24/390	05/21	8
杨洲^[20]	2016	中国	15	5	-	-	-	-	6
Nakamura等^[21]	2016	日本	11	6	43±23	59±18	5/60	4/2	8

作者	发表年份	国家	样本量（例）		平均年龄（岁）		性别（男/女）		NOS评分
作者	发表年份	国家	Kimura	Warshaw	Kimura	Warshaw	Kimura	Warshaw	NOS评分
Beane等^[10]	2011	美国	45	41	53.4	56.7	10/350	19/22	8
Butturini等^[11]	2012	意大利	36	7	47±18	44±17	7/29	1/6	7
Hwang等^[12]	2013	韩国	17	4	44±15	37±10	7/10	0/4	8
Jean-Philippe等^[13]	2013	西班牙	55	85	-	-	-	-	7
Lv等^[14]	2013	中国	12	8	38±20	43±16	2/10	3/5	8
Worhunsky等^[15]	2014	美国	19	31	56±11	54±15	10/900	24/70	8
Matsushima等^[16]	2014	日本	7	17	70(50～86)	49(30～83)	4/30	03/14	7
Zhou等^[17]	2014	中国	206	40	50±14	49±12	63/143	05/35	6
胡文迪^[18]	2014	中国	28	17	42±13	39±15	4/24	04/13	7
Lee等^[19]	2016	韩国	63	26	52(16～78)	51(20～78)	24/390	05/21	8
杨洲^[20]	2016	中国	15	5	-	-	-	-	6
Nakamura等^[21]	2016	日本	11	6	43±23	59±18	5/60	4/2	8

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