Central pancreatectomy: a comprehensive, up-to-date meta-analysis

Area of Science:

• Gastroenterology and Hepatology
• Surgical Oncology
• Gastrointestinal Surgery

Background:

• Central pancreatectomy (CP) is an alternative to distal pancreatectomy (DP) for mid-pancreas pathologies.
• The comparative benefits of CP versus DP remain a subject of debate in surgical literature.

Purpose of the Study:

• To conduct a meta-analysis comparing central pancreatectomy (CP) and distal pancreatectomy (DP).
• To evaluate the outcomes, including morbidity and functional preservation, of CP versus DP.

Main Methods:

• Systematic literature search of PubMed, Scopus, and Cochrane Library databases up to June 2018.
• Inclusion of original studies comparing CP and DP, adhering to the PRISMA checklist.
• Meta-analysis of data from 21 studies involving 596 patients undergoing CP and 1070 patients undergoing DP.

Main Results:

• CP demonstrated significantly higher rates of overall and severe morbidity, pancreatic fistula, and postoperative hemorrhage compared to DP.
• CP was associated with significantly lower incidences of new-onset and worsening diabetes mellitus.
• Patients undergoing CP experienced a significantly longer hospital stay than those undergoing DP.

Conclusions:

• Central pancreatectomy (CP) offers superior pancreatic function preservation compared to distal pancreatectomy (DP).
• However, CP is associated with increased complication rates and prolonged hospital stays.
• Careful patient selection is essential to maximize the benefits and minimize the risks associated with CP.