Table 2.
Meta-analysis of intraoperative and perioperative results
| Outcome of interest | No. of studies |
Sample size |
Heterogeneity |
Model | Overall effect size | 95%CI of overall effect | P-value | ||
| TLPD | OPD | P | I2 | ||||||
| Operative time | 11 | 642 | 1129 | < 0.00001 | 99% | R | WMD = 77.92 | 40.89, 114.95 | < 0.0001 |
| EBL | 10 | 612 | 1324 | < 0.00001 | 98% | R | WMD = -260.08 | -336.02, -184.14 | < 0.00001 |
| Transfusion rate | 12 | 1254 | 15964 | 0.003 | 60% | R | OR = 0.51 | 0.36, 0.72 | 0.0001 |
| Overall morbidity | 12 | 1407 | 22126 | 0.10 | 37% | F | OR = 0.82 | 0.73, 0.92 | 0.0008 |
| Major morbidity | 16 | 886 | 1704 | 0.05 | 41% | F | OR = 0.88 | 0.70, 1.10 | 0.25 |
| POPF | 17 | 954 | 7629 | 0.42 | 3% | F | OR = 0.95 | 0.79, 1.15 | 0.62 |
| POPF (grade B/C) | 18 | 942 | 1821 | 0.47 | 0 | F | OR = 0.96 | 0.76, 1.22 | 0.75 |
| DGE | 13 | 890 | 7452 | 0.98 | 0 | F | OR = 0.99 | 0.78, 1.24 | 0.90 |
| DGE (grade B/C) | 7 | 479 | 994 | 0.60 | 0 | F | OR = 0.63 | 0.45, 0.88 | 0.006 |
| PPH | 13 | 771 | 7363 | 0.74 | 0 | F | OR = 1.12 | 0.89, 1.42 | 0.34 |
| PPH (grade B/C) | 7 | 454 | 966 | 0.91 | 0 | F | OR = 1.02 | 0.65, 1.60 | 0.95 |
| Bile leak | 8 | 289 | 522 | 0.96 | 0 | F | OR = 1.11 | 0.57, 2.16 | 0.76 |
| Gastroente-ric anastomosis fistula | 4 | 201 | 423 | 0.77 | 0 | F | OR = 0.62 | 0.16, 2.40 | 0.49 |
| Wound infection | 10 | 612 | 7033 | 0.38 | 7% | F | OR = 0.48 | 0.34, 0.67 | < 0.0001 |
| Intra-abdominal abscess | 6 | 455 | 6676 | 0.32 | 14% | F | OR = 0.97 | 0.71, 1.31 | 0.82 |
| Bowel obstruction | 2 | 73 | 73 | 0.33 | 0 | F | OR = 1.00 | 0.14, 7.31 | 1.00 |
| Fluid collection | 3 | 142 | 367 | 0.20 | 37% | F | OR = 1.50 | 0.90, 2.48 | 0.12 |
| Pneumonia | 13 | 1489 | 22399 | 0.99 | 0 | F | OR = 0.72 | 0.60, 0.85 | 0.0002 |
| Cardiac event | 6 | 1200 | 21877 | 0.75 | 0 | F | OR = 1.04 | 0.82, 1.32 | 0.75 |
| Reoperation | 14 | 881 | 7616 | 0.40 | 5% | F | OR = 1.10 | 0.83, 1.47 | 0.51 |
| ICU admission | 2 | 171 | 283 | 0.40 | 0 | F | OR = 0.90 | 0.53, 1.54 | 0.71 |
| ICU stay | 2 | 65 | 227 | 0.62 | 0 | F | WMD = -2.08 | -2.88, -1.29 | < 0.00001 |
| Diet Start Time | 3 | 175 | 284 | <0.0001 | 90% | R | WMD = -1.75 | -3.38, -0.12 | 0.04 |
| LOS | 10 | 1544 | 11922 | < 0.00001 | 78% | R | WMD = -3.05 | -3.93, -2.17 | < 0.00001 |
| Discharge to a new facility | 4 | 498 | 6826 | 0.74 | 0 | F | OR = 0.55 | 0.39, 0.78 | 0.0008 |
| 30-d readmission | 10 | 2006 | 19786 | 0.30 | 15% | F | OR = 0.81 | 0.68, 0.95 | 0.010 |
| 90-d readmission | 4 | 136 | 279 | 0.70 | 0 | F | OR = 1.07 | 0.62, 1.84 | 0.81 |
| 30-d mortality | 18 | 2870 | 35337 | 0.70 | 0 | F | OR = 1.00 | 0.81, 1.24 | 1.00 |
| 90-d mortality | 11 | 1273 | 9159 | 0.77 | 0 | F | OR = 0.77 | 0.58, 1.01 | 0.06 |
EBL: Estimated blood loss; Major morbidity: Clavien-Dindo classification ≥ III; POPF: Postoperative pancreatic fistula; DGE: Delayed gastric emptying; PPH: Postpancreatectomy hemorrhage; LOS: Length of hospital stay; ICU: Intensive care unit; WMD: Weighted mean difference; OR: Odds ratio; CI: Confidence interval; F: Fixed-effects model; R: Random-effects model; TLPD: Total laparoscopic pancreaticoduodenectomy; OPD: Open pancreaticoduodenectomy.