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Using a Reinforced Stapler Decreases the Incidence of Postoperative Pancreatic Fistula After Distal Pancreatectomy: A Systematic Review and Meta-Analysis

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Abstract

Background

There is no consensus on the pancreatic transection during distal pancreatectomy (DP) to reduce postoperative pancreatic fistula (POPF). This meta-analysis aimed to evaluate the effects of a reinforced stapler on the postoperative outcomes of DP.

Methods

We systematically searched electronic databases and bibliographic reference lists in The PubMed/MEDLINE, Google Scholar, Cochrane Library's Controlled Trials Registry and Database of Systematic Reviews, Embase, and Scopus. Review Manager Software was used for pooled estimates.

Results

Seven eligible studies published between 2007 and 2021 were included with 553 patients (267 patients in the reinforced stapler group and 286 patients in the standard stapler group). The reinforced stapler reduced the POPF grade B and C (OR = 0.33; 95% CI [0.19, 0.57], p < 0.01). There was no difference between the reinforced stapler group and standard stapler group in terms of mortality rate (OR = 0.39; 95% CI [0.04, 3.57], p = 0.40), postoperative haemorrhage (OR = 0.53; 95% CI [0.20, 1.43], p = 0.21), and reoperation rate (OR = 0.91; 95% CI [0.40, 2.06], p = 0.82).

Conclusions

Reinforced stapling in DP is safe and seems to reduce POPF grade B/C with similar mortality rates, postoperative bleeding, and reoperation rate. The protocol of this systematic review with meta-analysis was registered in PROSPERO (ID: CRD42021286849).

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Availability of data and materials

All data generated or analysed during this study are included in this published article.

No conflicts of interests or disclosures.

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Authors and Affiliations

  1. Department of Surgery, Medical Faculty Mannheim, Universitätsmedizin Mannheim, Heidelberg University, Mannheim, Germany

    Hani Oweira, Arianeb Mehrabi, Christoph Reissfelder, Nuh Rahbari, Alexander Betzler & Hazem Elhadedy

  2. Department of Digestive, Oncologic and Metabolic Surgery, Institute Mutualist of Montsouris, Paris, France

    Alessandro Mazotta & Olivier Soubrane

  3. Department of Visceral and Digestive Surgery, Fattouma Bourguiba University Hospital, Monastir University, Monastir, Tunisia

    Mohamed Ali Chaouch

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  1. Hani Oweira
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Contributions

All authors participated in the study on the conception, design of the research, acquisition of the data, analysis and interpretation of the data.

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Correspondence to Mohamed Ali Chaouch.

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Oweira, H., Mazotta, A., Mehrabi, A. et al. Using a Reinforced Stapler Decreases the Incidence of Postoperative Pancreatic Fistula After Distal Pancreatectomy: A Systematic Review and Meta-Analysis. World J Surg 46, 1969–1979 (2022). https://doi.org/10.1007/s00268-022-06572-3

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