| Objective: To investigate the risk factors of late biliary complications after pancreaticoduodenectomy.Methods: A literature search of Cochrane library,Pub Med,and Embase databases from inception until August 2020 was conducted.The meta-analysis was performed by the Review Manager 5.3 software.Results: A total of 479 literatures were retrieved.After screening according to quality assessment and exclusion criteria,11 literatures were finally included,involving a total of 6544 patients,of which 457 patients developed late biliary complications after pancreaticoduodenectomy,with an incidence of 6.98%.Twenty-three probable risk factors were evaluated,pooled analyses revealed that male gender(OR=1.37;95%CI: 1.12-1.69,P=0.002),lower preoperative biliary drainage(OR=0.53;95%CI: 0.30-0.92,P=0.02),preoperative albumin level(WMD=0.20;95%CI: 0.08-0.31,P=0.0008),anastomotic bile duct diameter ≤ 10 mm(OR=3.59;95%CI:1.40-9.23,P=0.008);larger amount of intraoperative bleeding(m L)(WMD= 42.75;95%CI: 5.24-80.27,P=0.03),postoperative bile leakage(OR=3.10;95%CI: 1.66-5.81,P=0.0004)were risk factors for late biliary complications after pancreaticoduodenectomy.Conclusion: Male gender,preoperative biliary drainage,lower preoperative albumin level,anastomotic bile duct diameter ≤ 10 mm,larger amount of intraoperative bleeding and postoperative bile leakage may be risk factors for late biliary complications after pancreaticoduodenectomy.while pancreatic fistula,suturing methods of bilioenteric anastomosis and other factors have no significant correlation. |
