Abstract：
BACKGROUND: Central pancreatectomy is a surgical procedure for benign and low-grade malignant tumors which located in the neck and proximal body of the pancreas that facilitates the preservation of pancreatic endocrine and exocrine functions but has a high morbidity rate, especially postoperative pancreatic fistula (POPF). The aim of this systematic review and meta-analysis was to evaluate the safety and effectiveness between minimally invasive central pancreatectomy (MICP) and open central pancreatectomy (OCP) basing on perioperative outcomes.
METHODS: An extensive literature search to compare MICP and OCP was conducted from October 2003 to October 2023 on PubMed, Medline, Embase, Web of Science, and the Cochrane Library. Fixed-effect models or random effects were selected based on heterogeneity, and pooled odds ratios (ORs) or mean differences (MDs) with 95% confidence intervals (CIs) were calculated.
RESULTS: A total of 10 studies with a total of 510 patients were included. There was no significant difference in POPF between MICP and OCP (OR = 0.95; 95% CI [0.64, 1.43]; P = 0.82), whereas intraoperative blood loss (MD = - 125.13; 95% CI [- 194.77, -55.49]; P < 0.001) and length of hospital stay (MD = - 2.86; 95% CI [- 5.00, - 0.72]; P = 0.009) were in favor of MICP compared to OCP, and there was a strong trend toward a lower intraoperative transfusion rate in MICP than in OCP (MD = 0.34; 95% CI [0.11, 1.00]; P = 0.05). There was no significant difference in other outcomes between the two groups.
CONCLUSIONS: MICP was as safe and effective as OCP and had less intraoperative blood loss and a shorter length of hospital stay. However, further studies are needed to confirm the results.
METHODS: An extensive literature search to compare MICP and OCP was conducted from October 2003 to October 2023 on PubMed, Medline, Embase, Web of Science, and the Cochrane Library. Fixed-effect models or random effects were selected based on heterogeneity, and pooled odds ratios (ORs) or mean differences (MDs) with 95% confidence intervals (CIs) were calculated.
RESULTS: A total of 10 studies with a total of 510 patients were included. There was no significant difference in POPF between MICP and OCP (OR = 0.95; 95% CI [0.64, 1.43]; P = 0.82), whereas intraoperative blood loss (MD = - 125.13; 95% CI [- 194.77, -55.49]; P < 0.001) and length of hospital stay (MD = - 2.86; 95% CI [- 5.00, - 0.72]; P = 0.009) were in favor of MICP compared to OCP, and there was a strong trend toward a lower intraoperative transfusion rate in MICP than in OCP (MD = 0.34; 95% CI [0.11, 1.00]; P = 0.05). There was no significant difference in other outcomes between the two groups.
CONCLUSIONS: MICP was as safe and effective as OCP and had less intraoperative blood loss and a shorter length of hospital stay. However, further studies are needed to confirm the results.
摘要：
背景：中央胰腺切除术是一种良性和低度恶性肿瘤的手术方法，位于胰腺的颈部和近端，有利于保存胰腺内分泌和外分泌功能，但发病率高，尤其是术后胰瘘（POPF）。本系统评价和荟萃分析的目的是根据围手术期结果评估微创中央胰腺切除术（MICP）和开放式中央胰腺切除术（OCP）之间的安全性和有效性。
方法：2003年10月至2023年10月在PubMed上进行了广泛的文献检索，以比较MICP和OCP，Medline,Embase,WebofScience,还有Cochrane图书馆.基于异质性选择固定效应模型或随机效应，并计算了具有95%置信区间(CI)的合并比值比(OR)或平均差(MD)。
结果：共纳入10项研究，共510名患者。MICP和OCP的POPF差异无统计学意义(OR=0.95;95%CI[0.64,1.43];P=0.82),术中失血量(MD=-125.13;95%CI[-194.77,-55.49];P<0.001)和住院时间(MD=-2.86;95%CI[-5.00,-0.72];P=0.009)与OCP相比,MICP是有利的,MICP的术中输血率明显低于OCP(MD=0.34;95%CI[0.11,1.00];P=0.05)。两组之间的其他结局没有显着差异。
结论：MICP与OCP一样安全有效，术中出血量少，住院时间短。然而,需要进一步的研究来确认结果。
方法：2003年10月至2023年10月在PubMed上进行了广泛的文献检索，以比较MICP和OCP，Medline,Embase,WebofScience,还有Cochrane图书馆.基于异质性选择固定效应模型或随机效应，并计算了具有95%置信区间(CI)的合并比值比(OR)或平均差(MD)。
结果：共纳入10项研究，共510名患者。MICP和OCP的POPF差异无统计学意义(OR=0.95;95%CI[0.64,1.43];P=0.82),术中失血量(MD=-125.13;95%CI[-194.77,-55.49];P<0.001)和住院时间(MD=-2.86;95%CI[-5.00,-0.72];P=0.009)与OCP相比,MICP是有利的,MICP的术中输血率明显低于OCP(MD=0.34;95%CI[0.11,1.00];P=0.05)。两组之间的其他结局没有显着差异。
结论：MICP与OCP一样安全有效，术中出血量少，住院时间短。然而,需要进一步的研究来确认结果。
