• Dong Qian, Zipeng Lu, Richard Jackson, Junli Wu, Xinchun Liu, Baobao Cai, Pengfei Wu, Jie Yin, Qingcheng Xu, Dong Xu, Yunpeng Peng, Kuirong Jiang, and Yi Miao.
• Pancreas Center, Department of General Surgery, the First Affiliated Hospital With Nanjing Medical University, Nanjing, China.
• Pancreatology. 2016 Jan 1; 16 (1): 142-50.

BackgroundDelayed gastric emptying (DGE) is one of the most troublesome complications after classical pancreaticoduodenectomy (PD) or pylorus-preserving PD. Whether the route of gastroenteric reconstruction has any influence on DGE remains controversial. The aim of this study was to investigate the influence of different types of gastroenteric anastomosis on DGE after PD/PPPD.MethodsA systematic search of literature databases (Cochrane Library, PubMed, EMBASE, and Web of Science) was performed to identify eligible studies. Cochrane collaboration's tool for assessing risk of bias was utilized to evaluate the quality of included studies. The primary outcome was DGE incidence rate. Further outcomes included mortality, morbidity, and other operation related events. Random-effect or fix-effect models were used as appropriate.ResultsFive randomized controlled trials (RCTs) including a total of 530 patients were identified and included in the analysis. Based on these studies, no difference was found in DGE incidence between antecolic and retrocolic groups (relative risk [RR], 0.82; 95% confidence interval [CI], 0.51-1.32; P = 0.41). Mortality, morbidity, and operation related events were not significantly different between groups.ConclusionsResults of the meta-analysis reveal that DGE occurrence is not affected by route of gastroenteric anastomosis. Anastomosis approach should be chosen according to the surgeons' preference.Copyright © 2015 IAP and EPC. Published by Elsevier India Pvt Ltd. All rights reserved.

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