Comparison Between External And Internal Drainage Of The Pancreatic Duct In Pancreaticoduodenectomy:a META-analysis

Objective: To evaluate the clinical effect of external and internal drai nage of pancreatic duct in pancreaticoduodenectomy.Methods: PubMe d,The Cochrane Library,Embase,CNKI,vip data,wanfang data,Ch inese biomedical literature database(CBM)and other relevant databas es were searched to find relevant studies on The comparison of exter nal and internal drainage of The pancreatic duct in pancreaticoduoden ectomy from January 2009 to August 2019,and relevant data were e xtracted for analysis.Results: a total of 832 cases were included in 4randomized controlled studies(RCTS),including 421 cases in the ex ternal drainage group and 411 cases in the internal drainage group.M eta-analysis results showed that external drainage of the pancreatic du ct in pancreaticoduodenectomy group had a lower incidence of postop erative pancreatic fistula than internal drainage group(OR=0.70,95%ci =0.52~0.94,P=0.02),but subgroup analysis suggested that there was no statistical difference between the two drainage methods in reduci ng the incidence of grade B/C pancreatic fistula(OR=0.92,95%ci =0.44~1.94,P=0.83).There was no significant statistical difference between the external drainage group and the internal drainage group in abdo minal hemorrhage(OR=1.78,P=0.17),postoperative overall complicatio ns(OR=1.13,P=0.69),and postoperative mortality(OR=0.81,P=0.74).C onclusion: the effect of external and internal drainage of the pancreati c duct on postoperative complications in pancreaticoduodenectomy is not significantly different.