BioMed Research International

Review Article

Surgical Technique in Distal Pancreatectomy: A Systematic Review of Randomized Trials

Table 1

The main characteristics and results of the selected trials.


Reference	Year		Age	Sex (M/F)	Definition of pancreatic fistula	Interventions	Group size	Mortality	Morbidity	Fistula rate

Suzuki et al. [35]	1995	SC	58,7 ± 15,5* 61,5 ± 9,4*	19/7 21/9	Any amount, concentration 3x normal serum value lasting for at least 7 days	Fibrin glue control group	26 30	1,8%	N/A N/A	15,4% 40,0%	0,04

Suzuki et al. [36]	1999	SC	57,7 ± 10,9* 58,5 ± 11,9*	18/9 18/13	Any amount, concentration 3x normal serum value lasting for at least 7 days	Ultrasonic dissection Control group	27 31	N/A N/A	N/A N/A	3,7% 25,8%	0,02

Bassi et al. [37]	1999	SC	N/A	N/A	More than 10 mL/d with amylase 1000 IU/L beyond POD 7	Suture closure	15	0%	N/A	33,3%	NS
			N/A	N/A		Suture closure + fibrin glue	11	0%	N/A	27,3%
			N/A	N/A		Suture closure + polypropylene mesh	15	0%	N/A	13,3%
			N/A	N/A		Pancreaticojejunostomy	14	0%	N/A	7,1%
			N/A	N/A		Stapler closure	14	0%	N/A	14,3%

Suc et al. [38]	2003	MC	N/A	N/A	Any amount, concentration 4x normal serum value lasting for at least 3 days	Occlusion of the main duct with fibrin glue	22	0%	27,20%	18,2%	NS
Suc et al. [38]	2003	MC	N/A	N/A		Control group	19	5,3%	26,30%	15,8%	NS

Oláh et al. [39]	2009	SC	65 (52–70) 51 (42–59)	21/14 20/15	ISGPF	Stapler + seromuscular patch Stapler	35 35	0% 2,8%	11,4%⁺ 31,4%⁺	8,6% 20,0%	N/A

Diener et al. [27]	2011	MC	59,8 ± 14,1* 59,8 ± 13,6*	85/92 76/99	ISGPF	Stapler Suture	177 175	<1% 1%	49,2% 40,0%	35,6% 36,6%	0,84

Frozanpor et al. [24]	2012	SC	N/A N/A	12/15 14/12	ISGPF	Distal pancreatectomy Distal pancreatectomy + stent	27 26	0% 0%	100,0% 100,0%	37,0% 50,0%	0,122

Hamilton et al. [40]	2012	SC	58,6 ± 13,4* 57,5 ± 15,6*	25/21 20/34	More than 50 mL/d, concentration 3x normal serum value after day 3	Stapler Stapler + mesh reinforcement	46 54	0% 0%	60,9% 38,9%	56,5% 38,9%	0,001

Montorsi et al. [41]	2012	MC	60,5 ± 14,9* 61,6 ± 14,2*	64/81 39/91	ISGPF	TachoSil control group	145 130	0% 0%	28,3%⁺⁺ 29,2%⁺⁺	62,1% 68,5%	0,267

Carter et al. [21]	2013	DC	62,5 (29–84)* 65,0 (20–82)*	22/28 19/32	ISGPF	Falciform patch and fibrin glue control group	50 51	0% 0%	N/A N/A	20,0% 20,0%	1

SC: single center, MC: multicenter, DC: dual-center, N/A: not available, NS: not significant, *mean ± standard deviation, **median (interquartile range), ***median (range), ⁺pancreas-related morbidity, ⁺⁺postoperative complications excluding POPF.