摘要
目的本研究通过Meta分析的方法,探讨胰十二指肠切除术/保留幽门胰十二指肠切除术(pancreaticoduodenectomy/pylorus-preserving pancreaticoduodenectomy,PD/PPPD)和保留十二指肠胰头切除术(duodenum-preserving pancreatic head resection,DPPHR)治疗慢性胰腺炎(chronic pancreatitis,CP)的安全性和有效性。方法在Medline、EMBASE、Cochrane library等医学数据库检索已发表的关于比较DPPHR和PD/PPPD治疗CP的随机对照试验,据纳入标准有5项临床试验(包括8篇文献)纳入本研究,使用Revman 5.3进行统计分析。结果在手术时间(P=0.007)、新发糖尿病(P=0.11)、外分泌功能不全(P=0.18)、术后疼痛的缓解(P=0.36)、术后死亡(P=0.18)、术后并发症发生情况(P=0.35)、短期生活质量评分(P=0.14)及长期生活质量评分(P=0.16)、住院时间(P=0.69)、胰瘘发生情况(P=0.78)等方面差异无统计学意义;术后体重增加(P<0.000 01)、恢复工作(P=0.03)方面DPPHR优于PD/PPPD,但PD/PPPD术后因胰腺相关疾病再入院率低于DPPHR。结论 DPPHR更有利于改善患者术后生活质量,但未来尚需更多高质量临床研究验证。
Objective To carry out a meta-analysis, in order to evaluate the effectiveness and safety of the duodenum-preserving pancreatic head resection (DPPHR) and pancreaticoduodenectomy (PD) or pylorus-preserving pancreaticoduodenectomy (PPPD) for surgical treatment of chronic pancreatitis. Methods Medline, EMBASE, Cochrane library and other medical databases were searched for the clinical trials (randomized controlled trials) of comparing DPPHR Versus PD/PPPD. A total of 5 clinical trials (8 references) met the inclusion criteria. The data were analyzed using the RevMan 5.3 software. Results The two methods don’t have statistical difference in terms of operation time (P=0.007), postoperative morbidity (P=0.35) and mortality (P=0.18), pain relief (P=0.36), new onset of diabetes (P=0.11), exocrine insufficiency (P=0.18), short-term (P=0.14) and long-term (P=0.16) quality of life score, the length of hospital stay (P=0.69), and pancreatic fistula (P=0.78). Weight gain (P<0.000 01) and occupational rehabilitation (P=0.03) were significantly improved in the DPPHR group. However, PD/PPPD group was associated with fewer readmission due to pancreatic diseases. Conclusions DPPHR offers more advantages with regard to the quality of life. However, it needs more high-quality clinical trials to verify the results.
作者
孙永辉
张晓晶
林海
龚新利
闫丙政
徐佳琪
陈启龙
Sun Yonghui;Zhang Xiaojing;Lin Hai;Gong Xinli;Yan Bingzheng;Xu Jiaqi;Chen Qilong(Digestion and Vascular Center, Department of Pancreas Surgery, the First Affiliated Hospital to Xinjiang Medical University, Urumqi 830054, China;Department of Anesthhesiology, the First Affiliated Hospital to Xinjiang Medical University, Urumqi 830054, China)
出处
《中华内分泌外科杂志》
CAS
2019年第3期249-255,共7页
Chinese Journal of Endocrine Surgery
