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Short and long-term post-operative outcomes of duodenum preserving pancreatic head resection for chronic pancreatitis affecting the head of pancreas: a systematic review and meta-analysis.
HPB (Oxford). 2016 Feb; 18(2):121-128.H

Abstract

BACKGROUND

To evaluate the short and long term outcomes of duodenum preserving pancreatic head resection (DPPHR) procedures in the treatment of painful chronic pancreatitis.

METHODS

A systematic literature search was performed to identify all comparative studies evaluating long and short term postoperative outcomes (pain relief, morbidity and mortality, pancreatic exocrine and endocrine function).

RESULTS

Five published studies fulfilled the inclusion criteria including 1 randomized controlled trial comparing the Beger and Frey procedure. In total, 323 patients underwent surgical procedures for chronic pancreatitis, including Beger (n = 138) and Frey (n = 99), minimal Frey (n = 32), modified Frey (n = 25) and Berne's modification (n = 29). Two studies comparing the Beger and Frey procedure were entered into a meta-analysis and showed no difference in post-operative pain (RD = -0.06; CI -0.21 to 0.09), mortality (RD = 0.01; CI -0.03 to 0.05), morbidity (RD = 0.12; CI -0.00 to 0.24), exocrine insufficiency (RD = 0.04; CI -0.10 to 0.18) and endocrine insufficiency (RD = -0.14 CI -0.28 to 0.01).

CONCLUSION

All procedures are equally effective for the management of pain for chronic pancreatitis. The choice of procedure should be determined by other factors including the presence of secondary complications of pancreatitis and intra-operative findings. Registration number CRD42015019275. Centre for Reviews and Dissemination, University of York, 2009.

Authors+Show Affiliations

Hepato-Pancreato-Biliary Surgical Unit, Department of Surgery and Cancer Imperial College, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, UK.Hepato-Pancreato-Biliary Surgical Unit, Department of Surgery and Cancer Imperial College, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, UK.Hepato-Pancreato-Biliary Surgical Unit, Department of Surgery and Cancer Imperial College, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, UK.Department of Gastroenterology, Hammersmith Hospital, Du Cane Road, London, W12 0HS, UK.Department of Gastroenterology, Hammersmith Hospital, Du Cane Road, London, W12 0HS, UK.Department of Gastroenterology, Hammersmith Hospital, Du Cane Road, London, W12 0HS, UK.Hepato-Pancreato-Biliary Surgical Unit, Department of Surgery and Cancer Imperial College, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, UK. Electronic address: l.jiao@imperial.ac.uk.

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

Language

eng

PubMed ID

26902130

Citation

Jawad, Zaynab A R., et al. "Short and Long-term Post-operative Outcomes of Duodenum Preserving Pancreatic Head Resection for Chronic Pancreatitis Affecting the Head of Pancreas: a Systematic Review and Meta-analysis." HPB : the Official Journal of the International Hepato Pancreato Biliary Association, vol. 18, no. 2, 2016, pp. 121-128.
Jawad ZAR, Tsim N, Pai M, et al. Short and long-term post-operative outcomes of duodenum preserving pancreatic head resection for chronic pancreatitis affecting the head of pancreas: a systematic review and meta-analysis. HPB (Oxford). 2016;18(2):121-128.
Jawad, Z. A. R., Tsim, N., Pai, M., Bansi, D., Westaby, D., Vlavianos, P., & Jiao, L. R. (2016). Short and long-term post-operative outcomes of duodenum preserving pancreatic head resection for chronic pancreatitis affecting the head of pancreas: a systematic review and meta-analysis. HPB : the Official Journal of the International Hepato Pancreato Biliary Association, 18(2), 121-128. https://doi.org/10.1016/j.hpb.2015.10.003
Jawad ZAR, et al. Short and Long-term Post-operative Outcomes of Duodenum Preserving Pancreatic Head Resection for Chronic Pancreatitis Affecting the Head of Pancreas: a Systematic Review and Meta-analysis. HPB (Oxford). 2016;18(2):121-128. PubMed PMID: 26902130.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Short and long-term post-operative outcomes of duodenum preserving pancreatic head resection for chronic pancreatitis affecting the head of pancreas: a systematic review and meta-analysis. AU - Jawad,Zaynab A R, AU - Tsim,Nicole, AU - Pai,Madhava, AU - Bansi,Dev, AU - Westaby,David, AU - Vlavianos,Panagiotis, AU - Jiao,Long R, Y1 - 2015/11/17/ PY - 2015/10/19/received PY - 2015/10/21/accepted PY - 2016/2/24/entrez PY - 2016/2/24/pubmed PY - 2016/12/15/medline SP - 121 EP - 128 JF - HPB : the official journal of the International Hepato Pancreato Biliary Association JO - HPB (Oxford) VL - 18 IS - 2 N2 - BACKGROUND: To evaluate the short and long term outcomes of duodenum preserving pancreatic head resection (DPPHR) procedures in the treatment of painful chronic pancreatitis. METHODS: A systematic literature search was performed to identify all comparative studies evaluating long and short term postoperative outcomes (pain relief, morbidity and mortality, pancreatic exocrine and endocrine function). RESULTS: Five published studies fulfilled the inclusion criteria including 1 randomized controlled trial comparing the Beger and Frey procedure. In total, 323 patients underwent surgical procedures for chronic pancreatitis, including Beger (n = 138) and Frey (n = 99), minimal Frey (n = 32), modified Frey (n = 25) and Berne's modification (n = 29). Two studies comparing the Beger and Frey procedure were entered into a meta-analysis and showed no difference in post-operative pain (RD = -0.06; CI -0.21 to 0.09), mortality (RD = 0.01; CI -0.03 to 0.05), morbidity (RD = 0.12; CI -0.00 to 0.24), exocrine insufficiency (RD = 0.04; CI -0.10 to 0.18) and endocrine insufficiency (RD = -0.14 CI -0.28 to 0.01). CONCLUSION: All procedures are equally effective for the management of pain for chronic pancreatitis. The choice of procedure should be determined by other factors including the presence of secondary complications of pancreatitis and intra-operative findings. Registration number CRD42015019275. Centre for Reviews and Dissemination, University of York, 2009. SN - 1477-2574 UR - https://www.unboundmedicine.com/medline/citation/26902130/Short_and_long_term_post_operative_outcomes_of_duodenum_preserving_pancreatic_head_resection_for_chronic_pancreatitis_affecting_the_head_of_pancreas:_a_systematic_review_and_meta_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1365-182X(15)00004-0 DB - PRIME DP - Unbound Medicine ER -