Comparison between Pancreaticojejunostomy with Pancreaticogastrostomy after Panereatieoduodenectomy：A Meta Analysis

Objective To evaluate the clinical effects of Pancreaticojejunostomy(PJ) and pancreaticogastrostomy(PG) after panereatieoduodenectomy(PD) by evidence based medicine. Methods Clinical data(RCT or NRCT)of effects after panereatieoduodenectomy underwent pancreaticojejunostomy or pancreaticogastrostomy were collected from computer literature searching,which was carried out in PubMed,EMBASE,Wanfang and VIP database etc.Meta analysis recommended by Cochrane Collaboration was done for the data obtained that 866 patients who met with the six criteria of enrollment were included in this study.Publication bias was assessed by using a funnel plot. Results The results of Meta-analysis show that the pancreatic fistula（P=0.003）,complication rate（P=0.04）and intra-abdominal fluid collection(P=0.01)was lower in patients treated with pancreaticogastrostomy than in those treated with pancreaticojejunostomy.However,compared with pancreaticojejunostomy,there was no significantly statistical difference in the incidence of Bile leak(P=0.08),and perioperative mortality(P=0.14). Conclusion The results show that pancreaticogastrostomy after panereatieoduodenectomy can reduce the incidence of pancreatic fistula,complication rate and intra-abdominal fluid collection in a certain degree.But it can not effectively prevent the occurrence of Bile leak and perioperative mortality.Further more,because these RCTs and NRCTs included may have selection bias,publication bias and measurement bias which can strength strongly affect the outcome of the argument,so the further conclusion need more high-quality RCTs to deeply explore and demonstrate.