Comparison of efficacy between manual suture and stapler suture in preventing pancreatic fistula after distal pancreatectomy: a Meta analysis

doi:10.3877/cma.j.issn.2095-3232.2020.05.013

Abstract

Abstract:

Objective

To systematically evaluate the preventive effect between manual suture and stapler suture on pancreatic fistula after distal pancreatectomy.

Methods

Case-control and cohort studies about the preventive effect of manual suture and stapler suture for pancreatic fistula after distal pancreatectomy in China were searched in the databases of CNKI, Wanfang data, VIP, CBM, PubMed, Web of Science, Embase and Cochrane Library from the database establishment until February 29^th, 2020. The Chinese and English keywords mainly included distal pancreatectomy, pancreatic fistula, suture and stapler. Meta-analysis was conducted with data of pancreatic fistula incidence and other data in two groups.

Results

A total of 13 studies including 1 198 patients were included. Among them, there were 652 cases in the manual suture group, and 546 cases in the stapler suture group. Meta-analysis showed that the incidence of pancreatic fistula did not significantly differ between the manual and stapler suture groups (OR=1.13, 95%CI: 0.66-1.94; P>0.05). However, the incidence of clinical pancreatic fistula in the stapler suture group was significantly decreased (OR=1.48, 95%CI:1.00-2.18; P<0.05).

Conclusions

Compared with the manual suture, stapler suture can lower the incidence of clinical pancreatic fistula after distal pancreatectomy.

Key words: Pancreatectomy, Suture techniques, Pancreatic fistula, Meta analysis

Shanshan Meng, Rui Liu, Hao Wu, Feng Wei, Xiaolei Wang. Comparison of efficacy between manual suture and stapler suture in preventing pancreatic fistula after distal pancreatectomy: a Meta analysis[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2020, 09(05): 453-456.

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References 21

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作者	年份	分组		手术方式	NOS评分（分）
作者	年份	手工缝合组（例）	闭合器闭合组（例）	手术方式	NOS评分（分）
赵玉沛等^[4]	2008	53	56	胰体尾切除术	8
邹德平^[5]	2012	32	11	胰体尾切除术	7
陈金水等^[6]	2012	80	30	胰体尾切除术	7
哈振坤^[7]	2013	30	27	胃癌联合胰体尾切除术	7
包蔚雷等^[8]	2014	34	23	开腹胰腺远端切除术	7
程合等^[9]	2014	97	61	胰体尾切除术	7
芮建锐^[10]	2016	50	44	开腹胰腺远端切除术	7
欧阳柳等^[11]	2016	57	99	开腹胰腺远端切除术	7
卢斌等^[12]	2016	67	89	胰体尾切除术	7
刘一君^[13]	2017	19	17	胰体尾切除术	7
张杰^[14]	2017	79	33	开腹胰腺远端切除术	7
张永辉^[15]	2018	24	26	腹腔镜胰腺远端切除术	7
李纯坚等^[16]	2019	30	30	腹腔镜胰腺远端切除术	7

作者	年份	分组		手术方式	NOS评分（分）
作者	年份	手工缝合组（例）	闭合器闭合组（例）	手术方式	NOS评分（分）
赵玉沛等^[4]	2008	53	56	胰体尾切除术	8
邹德平^[5]	2012	32	11	胰体尾切除术	7
陈金水等^[6]	2012	80	30	胰体尾切除术	7
哈振坤^[7]	2013	30	27	胃癌联合胰体尾切除术	7
包蔚雷等^[8]	2014	34	23	开腹胰腺远端切除术	7
程合等^[9]	2014	97	61	胰体尾切除术	7
芮建锐^[10]	2016	50	44	开腹胰腺远端切除术	7
欧阳柳等^[11]	2016	57	99	开腹胰腺远端切除术	7
卢斌等^[12]	2016	67	89	胰体尾切除术	7
刘一君^[13]	2017	19	17	胰体尾切除术	7
张杰^[14]	2017	79	33	开腹胰腺远端切除术	7
张永辉^[15]	2018	24	26	腹腔镜胰腺远端切除术	7
李纯坚等^[16]	2019	30	30	腹腔镜胰腺远端切除术	7

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