Risk Factors For Pancreatic Fistula After Pancreaticoduodenectomy:a Meta-analysis

Objective:Reviewing and summarizing the relative elements of the postoperative pancreatic fistula(POPF) after pancreaticoduodenectomy(PD) provides the statistical evidence for recognizing correctly the relative risk factors of the POPF, and provides theory basis for the clinic. Methods:Using the Meta analytical method made by PRISM A statement, search the documents about the relative factors of the POPF after PD published between January 2009 and December 2013. According to the inclusion and exclusion criteria, fourteen materials were studied. Use the RevMan 5.2 software to extract and analyze the data. Result:The incidence rate of POPF after PD are quite between pancreaticogastrostomy(PG) and pancreaticojejunostomy(PJ), pylorus-preserving pancreaticoduodenectomy(PPPD) and standard pancreaticoduodenectomy (SPD); Operation time, with or without diabetes is associated with the occurrence of POPF has no obvious (P>0.05). If the body mass index (BMI) is greater than or equal to 25kg/m2, the POPF will rise (OR=3.52,95%CI:2.31-5.36,P<0.05). The main pancreatic duct(MPD) greater or equal to 3mm has lower POPF rate than less than 3mm group (OR=0.24,95%CI:0.17-0.35,P< 0.05); POPF rate of pancreatic texture soft group was obviously higher than the hard group (OR= 6.03,95% CI:3.72-9.77,P<0.05); POPF rate of pathologic diagnosis of pancreatic cancer group was obviously lower than the pancreatic cancer group (OR= 0.32,95%CI:0.24-0.44,P< 0.05); POPF intraoperative blood loss than without POPF group (P= 0.004). Conclusion:The incidence rate of POPF after PD is quite between PG and PJ, PPPD and SPD; Operation time, with or without diabetes is associated with the occurrence of POPF has no obvious. The risk factors of the POPF after PD are BMI, MPD, pancreatic texture, operative blood loss and whether for pancreatic cancer.