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Central pancreatectomy: a comprehensive, up-to-date meta-analysis

  • Mihnea P. Dragomir
  • Alexandru A. Sabo
  • George E. D. Petrescu
  • Yongfeng Li
  • Traian DumitrascuEmail author
original article
  • 86 Downloads

Abstract

Background

Central pancreatectomy (CP) is the alternative to distal pancreatectomy (DP) for specific pathologies of the mid-pancreas. However, the benefits of CP over DP remain controversial. This study aims to compare the two procedures by conducting a meta-analysis of all published papers.

Methods

A systematic search of original studies comparing CP vs. DP was performed using PubMed, Scopus, and Cochrane Library databases up to June 2018. The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) checklist was followed.

Results

Twenty-one studies were included (596 patients with CP and 1070 patients with DP). Compared to DP, CP was associated with significantly higher rates of overall and severe morbidity (p < 0.0001), overall and clinically relevant pancreatic fistula (p < 0.0001), postoperative hemorrhage (p = 0.02), but with significantly lower incidences of new-onset (p < 0.0001) and worsening diabetes mellitus (p = 0.004). Furthermore, significantly longer length of hospital stay (p < 0.0001) was observed for CP patients.

Conclusions

CP is superior to DP regarding the preservation of pancreatic functions, but at the expense of significantly higher complication rates and longer hospital stay. Proper selection of patients is of utmost importance to maximize the benefits and mitigate the risks of CP.

Keywords

Central pancreatectomy Distal pancreatectomy Morbidity Exocrine pancreatic insufficiency Diabetes mellitus 

Notes

Acknowledgments

The authors thank Mr. William Ruixian He for critically reading the manuscript.

Authors’ contribution

Study design: Traian Dumitrascu. Acquisition of data: Mihnea P. Dragomir, Alexandru A. Sabo, George E.D. Petrescu, Traian Dumitrascu. Analysis and interpretation of data: Mihnea P. Dragomir, Alexandru A. Sabo, George E.D. Petrescu, Yongfeng Li, Traian Dumitrascu. Drafting the manuscript: Mihnea P. Dragomir, Alexandru A. Sabo, George E.D. Petrescu, Traian Dumitrascu. Critical revision of the work for important intellectual content: Mihnea P. Dragomir, Alexandru A. Sabo, George E.D. Petrescu, Yongfeng Li, Traian Dumitrascu. Final approval of the version to be published: Mihnea P. Dragomir, Alexandru A. Sabo, George E.D. Petrescu, Yongfeng Li, Traian Dumitrascu. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: Mihnea P. Dragomir, Alexandru A. Sabo, George E.D. Petrescu, Yongfeng Li, Traian Dumitrascu.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Supplementary material

423_2019_1829_MOESM1_ESM.docx (3.9 mb)
ESM 1 (DOCX 4020 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Mihnea P. Dragomir
    • 1
    • 2
    • 3
  • Alexandru A. Sabo
    • 4
  • George E. D. Petrescu
    • 1
  • Yongfeng Li
    • 5
  • Traian Dumitrascu
    • 1
    • 2
    Email author
  1. 1.Carol Davila University of Medicine and PharmacyBucharestRomania
  2. 2.Department of General Surgery and Liver Transplantation, Division of Surgical Oncology, Fundeni Clinical InstituteCarol Davila University of Medicine and PharmacyBucharestRomania
  3. 3.Department of Experimental TherapeuticsUniversity of Texas MD Anderson Cancer CenterHoustonUSA
  4. 4.Department of Pediatrics“Marie S. Curie” Emergency Clinical Hospital for ChildrenBucharestRomania
  5. 5.Department of Breast SurgeryZhejiang Cancer HospitalHangzhouPeople’s Republic of China

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