The Second Clinical Medical College of Lanzhou University, Lanzhou 730030, China.
Department of General Surgery, Lanzhou University Second Hospital, Lanzhou 730030, China.
Biomed Res Int. 2020 Dec 3;2020:6131968. doi: 10.1155/2020/6131968. eCollection 2020.
To evaluate Roux-en-Y and Billroth II reconstruction following pancreaticoduodenectomy (PD).
PubMed, Embase, the Cochrane Library, and the Web of Science were searched to identify randomized controlled trials (RCTs) and controlled clinical trials that compared Roux-en-Y and Billroth II reconstruction following PD up to December 2019. RevMan 5.3 software was used for the statistical analysis.
Four RCTs and five controlled clinical trials were included, with a total of 1,072 patients (500 and 572 patients in the Roux-en-Y and Billroth II groups, respectively). No significant differences in delayed gastric emptying (DGE), A-grade DGE, B-grade DGE, or C-grade DGE were observed between the Roux-en-Y and Billroth II reconstruction groups after PD (odds ratio [OR] = 1.01, 95% confidence interval [CI]: 0.50-2.03, = 0.98; OR = 0.49, 95% CI: 0.17-1.45, = 0.20; OR = 0.63, 95% CI: 0.29-1.38, = 0.25; and OR = 2.13, 95% CI: 0.38-11.99, = 0.39). No significant difference in the incidence of postoperative pancreatic fistula, abscess, bile leaks, infection, postoperative bleeding, or the length of the postoperative hospital stay was observed between the Roux-en-Y and Billroth II groups ( > 0.05), but the operation time was significantly different (mean difference [MD] = 31.65, 95% CI: 7.14-56.17, = 0.01).
Billroth II reconstruction after PD did not significantly reduce the incidence of DGE or other complications but shortened the operation time compared to Roux-en-Y reconstruction. However, the results must be verified by further high-quality, large RCTs or controlled clinical trials.
评估胰十二指肠切除术后（PD）行 Roux-en-Y 和 Billroth II 重建的效果。
检索 PubMed、Embase、Cochrane 图书馆和 Web of Science，以确定截至 2019 年 12 月比较 PD 后 Roux-en-Y 和 Billroth II 重建的随机对照试验（RCT）和对照临床试验。使用 RevMan 5.3 软件进行统计分析。
纳入 4 项 RCT 和 5 项对照临床试验，共 1072 例患者（Roux-en-Y 组和 Billroth II 组各 500 例和 572 例）。PD 后，Roux-en-Y 和 Billroth II 重建组之间的胃排空延迟（DGE）、A级 DGE、B 级 DGE 或 C 级 DGE 无显著差异（优势比[OR] = 1.01，95%置信区间[CI]：0.50-2.03，= 0.98；OR = 0.49，95% CI：0.17-1.45，= 0.20；OR = 0.63，95% CI：0.29-1.38，= 0.25；OR = 2.13，95% CI：0.38-11.99，= 0.39）。两组术后胰腺瘘、脓肿、胆漏、感染、术后出血或术后住院时间的发生率无显著差异（>0.05），但手术时间有显著差异（平均差值[MD] = 31.65，95% CI：7.14-56.17，= 0.01）。
与 Roux-en-Y 重建相比，PD 后行 Billroth II 重建并未显著降低 DGE 或其他并发症的发生率，但缩短了手术时间。然而，这些结果还需要进一步的高质量、大样本 RCT 或对照临床试验来验证。
