腹腔镜胰体尾切除术与开腹手术同样安全可行：一项荟萃分析。
Laparoscopic distal pancreatectomy is as safe and feasible as open procedure: a meta-analysis.
机构信息
Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China.
出版信息
World J Gastroenterol. 2012 Apr 28;18(16):1959-67. doi: 10.3748/wjg.v18.i16.1959.
AIM
To evaluate the feasibility and safety of laparoscopic distal pancreatectomy (LDP) compared with open distal pancreatectomy (ODP).
METHODS
Meta-analysis was performed using the databases, including PubMed, the Cochrane Central Register of Controlled Trials, Web of Science and BIOSIS Previews. Articles should contain quantitative data of the comparison of LDP and ODP. Each article was reviewed by two authors. Indices of operative time, spleen-preserving rate, time to fluid intake, ratio of malignant tumors, postoperative hospital stay, incidence rate of pancreatic fistula and overall morbidity rate were analyzed.
RESULTS
Nine articles with 1341 patients who underwent pancreatectomy met the inclusion criteria. LDP was performed in 501 (37.4%) patients, while ODP was performed in 840 (62.6%) patients. There were significant differences in the operative time, time to fluid intake, postoperative hospital stay and spleen-preserving rate between LDP and ODP. There was no difference between the two groups in pancreatic fistula rate [random effects model, risk ratio (RR) 0.996 (0.663, 1.494), P = 0.983, I² = 28.4%] and overall morbidity rate [random effects model, RR 0.81 (0.596, 1.101), P = 0.178, I² = 55.6%].
CONCLUSION
LDP has the advantages of shorter hospital stay and operative time, more rapid recovery and higher spleen-preserving rate as compared with ODP.
目的
评估腹腔镜胰体尾切除术（LDP）与开腹胰体尾切除术（ODP）相比的可行性和安全性。
方法
使用包括PubMed、Cochrane 对照试验中心注册库、Web of Science 和 BIOSIS Previews 在内的数据库进行荟萃分析。文章应包含 LDP 和 ODP 比较的定量数据。由两位作者对每篇文章进行评价。分析手术时间、保脾率、开始摄入液体时间、恶性肿瘤比例、术后住院时间、胰瘘发生率和总发病率等指标。
结果
符合纳入标准的 9 篇文章共纳入 1341 例接受胰腺切除术的患者。501 例（37.4%）患者行 LDP，840 例（62.6%）患者行 ODP。LDP 与 ODP 组间在手术时间、开始摄入液体时间、术后住院时间和保脾率方面存在显著差异。两组在胰瘘发生率[随机效应模型，风险比（RR）0.996（0.663，1.494），P=0.983，I²=28.4%]和总发病率[随机效应模型，RR 0.81（0.596，1.101），P=0.178，I²=55.6%]方面无差异。
结论
与 ODP 相比，LDP 具有住院时间和手术时间更短、恢复更快、保脾率更高的优势。
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