Meta-analysis Of PPPD Versus CW For Pancreatic Head Carcinoma Or Periampullary Adenocarcinoma

Objective：To evaluate the efficacy of pylorus-preserving pancreaticoduodene-ctomy (PPPD) versus classical Whipple (CW) in the treatment of pancreatic headcarcinoma or periampullary adenocarcinoma by using Meta-analysis.Method：From1978to2013,the articles of randomized controlled trial (RCT)about PPPD versus CW in the treatment of pancreatic head carcinoma orperiampullary adenocarcinoma were collected, and Meta-analysis was performed byRevMan5.2software.Results：Nine RCTs including669patients with pancreatic head carcinoma orperiampullary adenocarcinoma (335cases in PPPD group,334cases in CWgroup)were enrolled in the Meta-analysis. PPPD group was associated withsignificantly less intraoperative blood loss ［MD=-405.24，95%CI（-655.66，-154.82），P=0.002］, shorter operation time ［MD=-43.76，95%CI（-76.02，-11.50），P<0.0008］, less postoperative blood transfusion ［MD=-1.11，95%C（I-1.67，-0.56），P＜0.0001］.There were no significant differences between PPPD and CW groups inpostoperative complications, mortality and survival rate.(P>0.05).Conclusions：PPPD able to achieve considerable CW surgery survival andreduce operative time, intraoperative blood loss, transfusion.