Journal of Minimal Access Surgery

REVIEW ARTICLE
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Year : 2022  |  Volume : 18  |  Issue : 3  |  Page : 338--345

The outcome of bioabsorbable staple line reinforcement versus standard stapler for distal pancreatectomy: A systematic review and meta-analysis

Beshoy Effat Elkomos1, Philopateer Effat Elkomos2, Amir Ali Salem1, Philobater Bhgat Adly1 
1 Department of General Surgery, Faculty of Medicine, Ain Shams University Hospital, Cairo, Egypt
2 Faculty of Medicine, Ain Shams University, Cairo, Egypt

Correspondence Address:
Dr. Beshoy Effat Elkomos
109, Tomanbia Street, Cairo
Egypt

Background and Aim: In the era of minimally invasive procedures and as a way to decrease the incidence of post-operative pancreatic fistula (POPF), the use of staplers for distal pancreatectomy (DP) has increased dramatically. Our aim was to investigate whether reinforced staplers decrease the incidence of clinically relevant PF after DP compared with staplers without reinforcement. Methods: PubMed, Scopus, Web of Science and Cochrane Library were searched for eligible studies from inception to 1 November 2021, and a systematic review and a meta-analysis were done to detect the outcomes after using reinforced staplers versus standard stapler for DP. Results: Seven studies with a total of 681 patients were included. The overall incidence of POPF and the incidence of Grade A POPF after DP are similar for the two groups (overall POPF, risk ratio [RR] = 0.85, 95% confidence interval [CI] = 0.71–1.01, P = 0.06; I2 = 38% and Grade A POPF, RR = 1.15, 95% CI = 0.78–1.69, P = 0.47; I2 = 49%). However, the incidence of clinically significant POPF (Grades B and C) is significantly lower in DP with reinforced staplers than DP with bare staplers (Grades B and C, RR = 0.45, 95% CI = 0.29–0.71, P = 0.0005; I2 = 17%). Nevertheless, the time of the operation, the blood loss during surgical procedure, the hospital stay after the surgery and the thickness of the pancreas are similar for both techniques. Conclusion: Although staple line reinforcement after DP failed to prevent biochemical PF, it significantly reduced the rate of clinically relevant POPF in comparison to standard stapling.


How to cite this article:
Elkomos BE, Elkomos PE, Salem AA, Adly PB. The outcome of bioabsorbable staple line reinforcement versus standard stapler for distal pancreatectomy: A systematic review and meta-analysis.J Min Access Surg 2022;18:338-345


How to cite this URL:
Elkomos BE, Elkomos PE, Salem AA, Adly PB. The outcome of bioabsorbable staple line reinforcement versus standard stapler for distal pancreatectomy: A systematic review and meta-analysis. J Min Access Surg [serial online] 2022 [cited 2022 Jul 4 ];18:338-345
Available from: https://www.journalofmas.com/article.asp?issn=0972-9941;year=2022;volume=18;issue=3;spage=338;epage=345;aulast=Elkomos;type=0