What does this research mean for the field?

Pancreaticogastrostomy and pancreaticojejunostomy yield comparable overall outcomes, including mortality and complication rates, after pancreatoduodenectomy, and can be considered equivalent options. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate and compare the clinical outcomes of pancreaticogastrostomy versus pancreaticojejunostomy in partial pancreatoduodenectomy.

June 5, 2026

Meta-Analysis of Randomised Clinical Trials Comparing Pancreaticogastrostomy vs Pancreaticojejunostomy in Partial Pancreatoduodenectomy

Puntos clave

To evaluate and compare the clinical outcomes of pancreaticogastrostomy versus pancreaticojejunostomy in partial pancreatoduodenectomy.
Conducted a systematic literature search in major databases for randomized controlled trials comparing PG with PJ.
Analyzed outcomes including mortality, complications, POPF, PPH, operation time, and hospital stay using a random-effects model.
Assessed risk of bias using the Cochrane RoB 2.0 tool and rated evidence certainty with the GRADE approach.
No significant differences in mortality (OR 0.98, 95%-CI: 0.61 to 1.59, p=0.94) and overall complications (OR 1.13, 95%-CI: 0.70 to 1.80, p=0.62).
POPF occurred less frequently after PG (OR 0.69, 95%-CI: 0.50 to 0.95, p=0.02).
PPH occurred less frequently after PJ (OR 1.52, 95%-CI: 1.13 to 2.05, p<0.01).

Resumen

Abstract Background In pancreatic surgery, morbidity and mortality remain high. Major complications include postoperative pancreatic fistula (POPF) and postpancreatectomy haemorrhage (PPH), among others. One of the few modifiable factors is the reconstruction technique used to anastomose the pancreatic remnant to the gastrointestinal tract. Aims To compare the outcomes of pancreaticogastrostomy (PG) and pancreaticojejunostomy (PJ) after pancreatoduodenectomy. Methods A systematic literature search was performed in PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials to identify randomised controlled trials (RCTs) comparing PG with PJ. Outcomes included mortality, overall complications, POPF, PPH, operation time, and length of hospital stay. Pooled estimates were calculated using a random-effects model. Risk of bias was assessed using the Cochrane RoB 2.0 tool. Certainty of evidence for each outcome was subsequently rated according to the GRADE approach. Results Thirteen RCTs including 2030 patients were included. There was no difference in mortality (OR 0.98, 95%-CI: 0.61 to 1.59, p=0.94, moderate certainty of evidence) or overall complications (OR 1.13, 95%-CI: 0.70 to 1.80, p=0.62, low certainty of evidence). POPF was less frequent after PG (OR 0.69, 95%-CI: 0.50 to 0.95, p=0.02, very low certainty of evidence). In contrast, PPH occurred less frequently after PJ (OR 1.52, 95%-CI: 1.13 to 2.05, p0.01, low certainty of evidence). There was no difference in operation time (MD 4.2 min, 95%-CI: −4.8 to 13.1, p=0.36, low certainty of evidence) or length of hospital stay (MD 4.0 days, 95%-CI: −2.1 to 10.1, p=0.20, very low certainty of evidence). Conclusion Pancreaticogastrostomy and pancreaticojejunostomy yield overall comparable outcomes after pancreatoduodenectomy. Given the similar mortality and overall complication rates, both techniques can be considered equivalent options and should be performed according to surgeon expertise and institutional preference.

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Cite This Study

Gllareva et al. (Mon,) studied this question.

synapsesocial.com/papers/6a2267f6763171746d5468cf https://doi.org/https://doi.org/10.1093/bjs/znag055.035

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