Abstract: Objective:To compare the incidence of pancreatic fistula after hand and stapler suture in preventing pancreatic fistula after distal pancreatectomy.
Methods:The literatures published before December 2011 were retrieved from SinoMed and electronic database. Prospective controlled trials and retrospective reports were screened out for Meta analysis. The diagnostic criteria of pancreatic fistula were based on the criteria formulated by the International Study group of Pancreatic Fistula. The heterogeneity of the studies was analyzed using the I2 test. The data were integrated using the fixed or random effect model. The results of the Meta analysis were pre- sented with odds ratio (OR) and 95% confidence interval (95%CI).
Results:According to the selection criteria, 10 literatures were selected which included 1 prospective randomized controlled study, 3 prospective non-randomized controlled studies and 6 retrospective studies. There were 1 441 cases in the hand suture group and 612 cases in the stapler suture group. There was no significant difference in the incidences of the pancreatic fistula between the hand suture group and the stapler suture group (OR=1.10, 95%CI: 0.86-1.88, P>0.05). Six studies compared the incidences of severe pancreatic fistula (grade B or C) between the hand suture group and the stapler suture group. There were 1 182 cases in the hand suture group and 383 cases in the stapler suture group. There was no significant difference in the incidence of severe pancreatic fistula between the hand suture group and the stapler suture group ( OR=1.33, 95%CI: 0.94-1.88, P>0.05)Conclusion:The efficacies of hand suture and stapler suture in preventing pancreatic fistula after distal pancreatectomy are comparable. Stapler suture provides an another option in distal pancreatectomy.