A Meta-analysis Of Duodenum-preserving Pancreatic Head Resection Treatment For Chronic Pancreatitis With An Inflammatory Mass In The Head Of Pancreas

Objectives: Nowadays there are mainly two kinds of surgicalprocedures for the treatment of chronic pancreatitis with an inflammatorymass in the head of pancreas, pylorus-preserving pancreatoduodenectomy(including pancreatoduodenectomy, PPPD/PD) and duodenum-preservingpancreatic head resection(DPPHR). The present meta-analysis aims tocompare the safety and effectiveness of DPPHR with PPPD/PD for treatingchronic pancreatitis with an inflammatory mass in the head of pancreas.Methods: We searched the relative data bases systematically, such as IM,EM, The Cochrane Library, SCI, CBM, VIP, CNKI, Wanfang Data and soon. We selected randomized controlled trials (RCT) and prospectiveclinical controlled trials (CCT). The assessment of the bias risk of theincluded trials was according to the assessing tools suggested by CochraneHandbook5.1.We used the Review Manager5.2to perform statisticalanalysis. Results: In total,5RCTs and2CCTs were included,381patientsinvolved. Comparing with PPPD/PD procedure, there is no significantdifference in terms of the mortality of perioperative period, the incidence of bleeding, the incidence of pancreatic fistula and delayed gastricemptying(DGE) after the operations, the ration of complete pain relief afteroperation and the score of global quality of life with DPPHR procedure.While DPPHR has significant superiority in terms of the total morbidity ofperioperative period, the duration of the operations, the hospitalizationduration after operations, weight gain, occupational rehabilitation after theoperations. The sensitivity analysis shows that the DPPHR procedure haslower incidence of new onset diabetes mellitus and pancreatic exocrinedysfunction after operation. Conclusion: In terms of abdominal pain reliefand treating the relative complications, both of the procedures are safe andeffective. While the DPPHR is more favorable for improving patients’ lifequalities and should be recommended.