| [Objective]To analyze the 1-year,2-year,3-year,and 5-year survival rate,complications,mortality,and tumor recurrence rate of hepatopancreaticoduodenectomy(HPD)in the treatment of gallbladder cancer,and explore the role and efficacy of pancreatoduodenectomy in the treatment of gallbladder cancer.[Methods]The relevant researches on the postoperative survival rate and tumor recurrence rate of patients with gallbladder cancer who underwent this surgical method were searched in the China Knowledge Network,Wanfang,PubMed,Embase and other databases.The retrieval time of each database is from the time of building the database to December 2019.The eligible research literatures were screened for inclusion and data were extracted for meta-analysis using Statal5 software.[Results]The results showed that:(1)The one-year survival rate was 56.3%,95%CI:35.9-75.9%.The 2-year survival rate combined rate was 26.4%,95%CI:6.2?51.8.The 3-year survival rate combined rate was 9.3%,95%CI:1.5?20.6%.The combined 5-year survival rate was 6.6%,95%CI:2.2 to 12.4%.(2)Analysis of the R0 subgroup:the 1-year survival rate was 55.4%in the group(I2=64.852%,P=0.006,95%CI:23.4?86.7);it was 57.7%(I2=60.665%,P=0.038,95%CI:33.8?80.2),P=0.898,the difference was not statistically significant.The 2-year survival rate was 22.0%in the non-group(I2=69.045%,P=0.002,95%CI:0.2 to 56.7);it was 33.9%(I2=80.134%,P=0.002,95%CI:4.3 to 71.4),P=0.727,the difference was not statistically significant.The 3-year survival rate was 10.5%in the non-group(I2=60.632%,P=0.013,95%CI:0.0 to 32.0);it was 9.7%in the group(I2=29.011%,P=0.217,95%CI:1.6 to 21.6),P=0.578,the difference was not statistically significant.The 5-year survival rate was 3.3%in the group(I2=16.080%,P=0.29995%CI:0.0?12.3);it was 9.0%in the group(I2=0.000%,P=0.534,95%CI:1.2?20.6),P=0.792,the difference was not statistically significant.According to the merger rate,the 1-year and 2-year survival rates of R0 resection and non-R0 resection are basically the same,but the 5-year survival rate of R0 resection is much higher than non-R0 resection.(3)Pathology ? and V subgroup analysis:1-year survival rate was 46.8%in stage ?(I2=0.000%,95%CI:5.4?90.8);80.5%in stage V(I2=0.000%,95%CI:54.8?98.1),P=0.204,the difference was not statistically significant.2-year survival rate was 6.4%in stage ?(I2=0.000%,95%CI:0.0?38.8);66.9%in stage V(I2=0.000%,95%CI:39.7?89.9),P=0.006,and stage ? was lower than At stage V,the difference was statistically significant.The 3-year survival rate was 6.5%in stage ?(I2=0.000%,95%CI:0.0?40.9);8.6%in stage ?(I2=0.000%,95%CI 0.0?30.9),P=0.891,and the difference was not statistically significant.significance The 5-year survival rate was 3.5%in stage ?(I2=0.000%,95%CI:0.6?7.8);28.6%in stage V(I2=0.000%,95%CI:3.7?71.0),P=0.167,and there was no statistical difference.significance.(4)Analysis of total recurrence rate and subgroup analysis of recurrence rate:analysis of total recurrence rate was 71.2%,95%CI 44.1?93.1%.The subgroup analysis showed that the recurrence rate was 49.9%in the non-group(I2=0.000%,95%CI:17.6?82.2);80.2%(I2=0.000%,95%CI:44.2?100.0)in the group,P=0.187,and there was no difference.Statistical significance.There was only one article in each stage of recurrence by pathological stage.According to the merger rate,the postoperative recurrence rate is higher.(5)Analysis of perioperative complications:According to the statistics of the 16 included studies,there are 12 studies with complication data records,7 of which can accurately extract data from 57 patients,and complications occurred.A total of 50 patients.A total of 4 studies involving perioperative deaths included a total of 47 patients,and a total of 9 patients experienced perioperative deaths.The most common types of complications were pancreatic leakage,abdominal infection,liver failure,etc.The causes of perioperative death were different,and the perioperative complications and mortality were higher.[Conclusion]Hepatopancreaticoduodenectomy for patients with gallbladder cancer has a 1-year survival rate of 56.3%,a 2-year survival rate of 26.4%,a 3-year survival rate of 9.3%,and a 5-year survival rate of 6.6%.Significantly longer,and the 5-year survival rate of surgical R0 resection was significantly higher than non-R0 resection.However,the perioperative complications and death rates are higher and the recurrence rate is higher.Hepatopancreaticoduodenectomy can prolong the survival of patients with gallbladder cancer,but preoperative and postoperative proactive measures are expected to reduce complications and reduce mortality,and strive for surgical R0 resection to reduce postoperative recurrence.In general,hepatopancreaticoduodenectomy can prolong the survival of patients with gallbladder cancer,which is of certain value for the treatment of gallbladder cancer. |
PDF Full Text Request