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| Preoperative diabetes as a protective factor for pancreatic fistula after pancreaticoduodenectomy: a meta-analysis |
| Xiang Xia, Chen Huang, Gang Cen and Zheng-Jun Qiu |
Shanghai, China
Author Affiliations: Department of General Surgery, Shanghai Jiaotong University Affiliated First People's Hospital, Shanghai 200080, China (Xia X, Huang C, Cen G and Qiu ZJ)
Corresponding Author: Zheng-Jun Qiu, MD, PhD, Department of General Surgery, Shanghai Jiaotong University Affiliated First People's Hospital, 100 Haining Road, Shanghai 200080, China (Tel: +86-21-63240825; Fax: +86-21-63240090; Email: qiuzjdoctor@sina.com) |
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Abstract BACKGROUND: The role of diabetes mellitus (DM) in pancreatic fistula (PF) or clinical relevant PF (CR-PF) after pancreaticoduodenectomy (PD) or pylorus-preserving pancreaticoduodenectomy (PPPD) is unclear. We conducted a meta-analysis to investigate the relationship between DM and PF or CR-PF.
DATA SOURCES: Embase, MEDLINE and Cochrane databases were searched systematically for relevant articles from January 2005 to June 2013. The selected studies that examined clinical risk factors of PF or CR-PF were included. We created pooled estimates for our outcomes using the random-effects model.
RESULTS: Sixteen observational clinical studies were included. Pooling of PF rates from ten studies revealed that DM was associated with a decreased risk of PF (P=0.01). CR-PF rates from 8 studies showed no significant difference between DM and control group (P=0.14).
CONCLUSIONS: DM is not a risk factor for PF in patients undergoing PD or PPPD. On the contrary, patients without DM are at a higher risk of PF because the pancreases in these patients have more fatty tissue and the pancreas is soft.
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2015, Vol. 14 
