Journal
WORLD JOURNAL OF SURGERY
Volume 45, Issue 6, Pages 1929-1939Publisher
SPRINGER
DOI: 10.1007/s00268-021-06039-x
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Funding
- Alma Mater Studiorum Universita` di Bologna within the CRUI-CARE Agreement
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Blumgart anastomosis appears to be superior to non-BA duct to mucosa in avoiding CR-POPF. Additionally, BA is also favored over DtoM in overall morbidity, PPH, and length of stay.
Background The superiority of Blumgart anastomosis (BA) over non-BA duct to mucosa (non-BA DtoM) still remains under debate. Methods We performed a systematic search of studies comparing BA to non-BA DtoM. The primary endpoint was CR-POPF. Postoperative morbidity and mortality, post-pancreatectomy hemorrhage (PPH), delayed gastric emptying (DGE), reoperation rate, and length of stay (LOS) were evaluated as secondary endpoints. The meta-analysis was carried out using random effect. The results were reported as odds ratio (OR), risk difference (RD), weighted mean difference (WMD), and number needed to treat (NNT). Results Twelve papers involving 2368 patients: 1075 BA and 1193 non-BA DtoM were included. Regarding the primary endpoint, BA was superior to non-BA DtoM (RD = 0.10; 95% CI: -0.16 to -0.04; NNT = 9). The multivariate ORs' meta-analysis confirmed BA's protective role (OR 0.26; 95% CI: 0.09 to 0.79). BA was superior to DtoM regarding overall morbidity (RD = -0.10; 95% CI: -0.18 to -0.02; NNT = 25), PPH (RD = -0.03; 95% CI -0.06 to -0.01; NNT = 33), and LOS (- 4.2 days; -7.1 to -1.2 95% CI). Conclusion BA seems to be superior to non-BA DtoM in avoiding CR-POPF.
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