Meta-analysis Of Safety And Efficacy Of Laparoscopic Distal Pancreatectomy

Objective To assess the safety and efficacy of Laparoscopic distal pancreatectomy.Methods The Literature published before September of2013was searched in CNKI、VIP、 CBM、Wanfang Data、EMbase、PubMed、The Cochrane Library、web of science to identify the randomized controlled trials(RCTs) or quasi-RCTs about Laparoscopic versus open distal pancreatectomy.The literature was screened according to the inclusive and exclusive criteria by two reviewers independently,and the methodology quality was evaluated after abstracting the data,then the RevMan5.0software was used for Meta-analyses.Results Fourteen RCTs and five CCTs involving1721patients were included.The results of Meta-analyses showed that,compared with the open resection surgery,the laparoscopic resection surgery significantly reduced the amount of bleeding [MD=-293.35,95%CI(-502.05,-84.66), i>=0.006], blood transfusion required [OR=0.47,95%CI(0.22,0.98), P=0.04], postoperative overall morbidity [OR=0.75,95%CI(0.58,0.97), P=0.03], postoperative first flatus [MD＝-1.20,95%CI(-2.04,-0.36),P＝0.005], postoperative first oral intake [MD=-1.03, P5%C/(-1.97,-0.08), P=0.03], hospitalization duration [MD=-3.28, P5%CI(-3.97,-2.59), P<0.00001]. No significant diferences were found between the two groups in Mortality,operation time,postoperative complication rate,such as pancreatic fistula、wound infection、pulmonary complications,rate of reoperation (P>0.05).Conclusion LDP may reduce hospitalization duration and operative blood loss,with lower time to adequate oral intake and postoperative first flatus.