A Network Meta-analysis of Surgery for Chronic Pancreatitis: Impact on Pain and Quality of Life
Background The surgical operation associated with improved pain and quality of life (QoL) in patients with chronic pancreatitis (CP) is unknown. Method The Scopus, EMBASE, Medline and Cochrane databases were systematically searched until May 2019, and all randomised trials (RCTs) comparing surgical...
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| Veröffentlicht in: | Journal of gastrointestinal surgery 2020-12, Vol.24 (12), p.2865-2873 |
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| creator | Ratnayake, Chathura B. B. Kamarajah, Sivesh K. Loveday, Benjamin P. T. Nayar, Manu Oppong, Kofi White, Steve French, Jeremy J. Windsor, John A. Pandanaboyana, Sanjay |
| description | Background
The surgical operation associated with improved pain and quality of life (QoL) in patients with chronic pancreatitis (CP) is unknown.
Method
The Scopus, EMBASE, Medline and Cochrane databases were systematically searched until May 2019, and all randomised trials (RCTs) comparing surgical operations for CP pain were included in a network meta-analysis (NMA).
Results
Four surgical operations for treating CP were directly compared in eight RCTs including 597 patients. Patients were mainly male (79%, 474/597) with alcoholic CP (85%, 382/452). Surgical operations included were pancreatoduodenectomy (224, 38%), Berne procedure (168, 28%), Beger procedure (133, 22%) and Frey procedure (72, 12%). The NMA revealed that the Beger procedure ranked best for pain relief, whilst the Frey procedure ranked best for postoperative QoL, postoperative pancreatic fistula rate and postoperative exocrine insufficiency rate during a median follow-up of 26 months (reported range 6–58 months). Overall the Frey procedure ranked best for the combination of primary outcome measures based on surface under cumulative ranking curve scores.
Conclusions
Overall the Frey procedure may perform the best for both pain relief and postoperative QoL in patients with CP. Further trials are warranted in defining the role of surgery in relation to endotherapy. |
| doi_str_mv | 10.1007/s11605-020-04718-z |
| format | Article |
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The surgical operation associated with improved pain and quality of life (QoL) in patients with chronic pancreatitis (CP) is unknown.
Method
The Scopus, EMBASE, Medline and Cochrane databases were systematically searched until May 2019, and all randomised trials (RCTs) comparing surgical operations for CP pain were included in a network meta-analysis (NMA).
Results
Four surgical operations for treating CP were directly compared in eight RCTs including 597 patients. Patients were mainly male (79%, 474/597) with alcoholic CP (85%, 382/452). Surgical operations included were pancreatoduodenectomy (224, 38%), Berne procedure (168, 28%), Beger procedure (133, 22%) and Frey procedure (72, 12%). The NMA revealed that the Beger procedure ranked best for pain relief, whilst the Frey procedure ranked best for postoperative QoL, postoperative pancreatic fistula rate and postoperative exocrine insufficiency rate during a median follow-up of 26 months (reported range 6–58 months). Overall the Frey procedure ranked best for the combination of primary outcome measures based on surface under cumulative ranking curve scores.
Conclusions
Overall the Frey procedure may perform the best for both pain relief and postoperative QoL in patients with CP. Further trials are warranted in defining the role of surgery in relation to endotherapy.</description><identifier>ISSN: 1091-255X</identifier><identifier>EISSN: 1873-4626</identifier><identifier>DOI: 10.1007/s11605-020-04718-z</identifier><identifier>PMID: 32705610</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Gastroenterology ; Humans ; Male ; Medicine ; Medicine & Public Health ; Network Meta-Analysis ; Pain ; Pancreatectomy - adverse effects ; Pancreatitis, Chronic - surgery ; Quality of Life ; Review Article ; Surgery ; Treatment Outcome</subject><ispartof>Journal of gastrointestinal surgery, 2020-12, Vol.24 (12), p.2865-2873</ispartof><rights>The Society for Surgery of the Alimentary Tract 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c347t-a8c4e9bb9c792928baf7f06e49da774666229ebf508f62e0c9a9ad6393383c6b3</citedby><cites>FETCH-LOGICAL-c347t-a8c4e9bb9c792928baf7f06e49da774666229ebf508f62e0c9a9ad6393383c6b3</cites><orcidid>0000-0002-5188-9124</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11605-020-04718-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11605-020-04718-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32705610$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ratnayake, Chathura B. B.</creatorcontrib><creatorcontrib>Kamarajah, Sivesh K.</creatorcontrib><creatorcontrib>Loveday, Benjamin P. T.</creatorcontrib><creatorcontrib>Nayar, Manu</creatorcontrib><creatorcontrib>Oppong, Kofi</creatorcontrib><creatorcontrib>White, Steve</creatorcontrib><creatorcontrib>French, Jeremy J.</creatorcontrib><creatorcontrib>Windsor, John A.</creatorcontrib><creatorcontrib>Pandanaboyana, Sanjay</creatorcontrib><title>A Network Meta-analysis of Surgery for Chronic Pancreatitis: Impact on Pain and Quality of Life</title><title>Journal of gastrointestinal surgery</title><addtitle>J Gastrointest Surg</addtitle><addtitle>J Gastrointest Surg</addtitle><description>Background
The surgical operation associated with improved pain and quality of life (QoL) in patients with chronic pancreatitis (CP) is unknown.
Method
The Scopus, EMBASE, Medline and Cochrane databases were systematically searched until May 2019, and all randomised trials (RCTs) comparing surgical operations for CP pain were included in a network meta-analysis (NMA).
Results
Four surgical operations for treating CP were directly compared in eight RCTs including 597 patients. Patients were mainly male (79%, 474/597) with alcoholic CP (85%, 382/452). Surgical operations included were pancreatoduodenectomy (224, 38%), Berne procedure (168, 28%), Beger procedure (133, 22%) and Frey procedure (72, 12%). The NMA revealed that the Beger procedure ranked best for pain relief, whilst the Frey procedure ranked best for postoperative QoL, postoperative pancreatic fistula rate and postoperative exocrine insufficiency rate during a median follow-up of 26 months (reported range 6–58 months). Overall the Frey procedure ranked best for the combination of primary outcome measures based on surface under cumulative ranking curve scores.
Conclusions
Overall the Frey procedure may perform the best for both pain relief and postoperative QoL in patients with CP. Further trials are warranted in defining the role of surgery in relation to endotherapy.</description><subject>Gastroenterology</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Network Meta-Analysis</subject><subject>Pain</subject><subject>Pancreatectomy - adverse effects</subject><subject>Pancreatitis, Chronic - surgery</subject><subject>Quality of Life</subject><subject>Review Article</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><issn>1091-255X</issn><issn>1873-4626</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1PGzEQhq2qqAToH-gB-cjF7djetdfcoqhQpPAlQOJmeR27ddisU3tXKPx6TBM49jSjmed9Dw9C3yh8pwDyR6ZUQE2AAYFK0oa8fEIT2khOKsHE57KDooTV9eM-Osh5CUAl0OYL2udMQi0oTJCe4is3PMf0hC_dYIjpTbfJIePo8d2Yfru0wT4mPPuTYh8svjG9Tc4MYQj5FF-s1sYOOPblHnps-gW-HU0Xhs1bfh68O0J73nTZfd3NQ_Rw9vN-9ovMr88vZtM5sbySAzGNrZxqW2WlYoo1rfHSg3CVWhgpKyEEY8q1vobGC-bAKqPMQnDFecOtaPkhOtn2rlP8O7o86FXI1nWd6V0cs2YVkxwYr1lB2Ra1KeacnNfrFFYmbTQF_SZWb8XqIlb_E6tfSuh41z-2K7f4iLybLADfArm8-uJNL-OYis38v9pXKHyDpQ</recordid><startdate>20201201</startdate><enddate>20201201</enddate><creator>Ratnayake, Chathura B. B.</creator><creator>Kamarajah, Sivesh K.</creator><creator>Loveday, Benjamin P. T.</creator><creator>Nayar, Manu</creator><creator>Oppong, Kofi</creator><creator>White, Steve</creator><creator>French, Jeremy J.</creator><creator>Windsor, John A.</creator><creator>Pandanaboyana, Sanjay</creator><general>Springer US</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5188-9124</orcidid></search><sort><creationdate>20201201</creationdate><title>A Network Meta-analysis of Surgery for Chronic Pancreatitis: Impact on Pain and Quality of Life</title><author>Ratnayake, Chathura B. B. ; Kamarajah, Sivesh K. ; Loveday, Benjamin P. T. ; Nayar, Manu ; Oppong, Kofi ; White, Steve ; French, Jeremy J. ; Windsor, John A. ; Pandanaboyana, Sanjay</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c347t-a8c4e9bb9c792928baf7f06e49da774666229ebf508f62e0c9a9ad6393383c6b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Gastroenterology</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Network Meta-Analysis</topic><topic>Pain</topic><topic>Pancreatectomy - adverse effects</topic><topic>Pancreatitis, Chronic - surgery</topic><topic>Quality of Life</topic><topic>Review Article</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ratnayake, Chathura B. B.</creatorcontrib><creatorcontrib>Kamarajah, Sivesh K.</creatorcontrib><creatorcontrib>Loveday, Benjamin P. T.</creatorcontrib><creatorcontrib>Nayar, Manu</creatorcontrib><creatorcontrib>Oppong, Kofi</creatorcontrib><creatorcontrib>White, Steve</creatorcontrib><creatorcontrib>French, Jeremy J.</creatorcontrib><creatorcontrib>Windsor, John A.</creatorcontrib><creatorcontrib>Pandanaboyana, Sanjay</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of gastrointestinal surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ratnayake, Chathura B. B.</au><au>Kamarajah, Sivesh K.</au><au>Loveday, Benjamin P. T.</au><au>Nayar, Manu</au><au>Oppong, Kofi</au><au>White, Steve</au><au>French, Jeremy J.</au><au>Windsor, John A.</au><au>Pandanaboyana, Sanjay</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Network Meta-analysis of Surgery for Chronic Pancreatitis: Impact on Pain and Quality of Life</atitle><jtitle>Journal of gastrointestinal surgery</jtitle><stitle>J Gastrointest Surg</stitle><addtitle>J Gastrointest Surg</addtitle><date>2020-12-01</date><risdate>2020</risdate><volume>24</volume><issue>12</issue><spage>2865</spage><epage>2873</epage><pages>2865-2873</pages><issn>1091-255X</issn><eissn>1873-4626</eissn><abstract>Background
The surgical operation associated with improved pain and quality of life (QoL) in patients with chronic pancreatitis (CP) is unknown.
Method
The Scopus, EMBASE, Medline and Cochrane databases were systematically searched until May 2019, and all randomised trials (RCTs) comparing surgical operations for CP pain were included in a network meta-analysis (NMA).
Results
Four surgical operations for treating CP were directly compared in eight RCTs including 597 patients. Patients were mainly male (79%, 474/597) with alcoholic CP (85%, 382/452). Surgical operations included were pancreatoduodenectomy (224, 38%), Berne procedure (168, 28%), Beger procedure (133, 22%) and Frey procedure (72, 12%). The NMA revealed that the Beger procedure ranked best for pain relief, whilst the Frey procedure ranked best for postoperative QoL, postoperative pancreatic fistula rate and postoperative exocrine insufficiency rate during a median follow-up of 26 months (reported range 6–58 months). Overall the Frey procedure ranked best for the combination of primary outcome measures based on surface under cumulative ranking curve scores.
Conclusions
Overall the Frey procedure may perform the best for both pain relief and postoperative QoL in patients with CP. Further trials are warranted in defining the role of surgery in relation to endotherapy.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>32705610</pmid><doi>10.1007/s11605-020-04718-z</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-5188-9124</orcidid></addata></record> |
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| subjects | Gastroenterology Humans Male Medicine Medicine & Public Health Network Meta-Analysis Pain Pancreatectomy - adverse effects Pancreatitis, Chronic - surgery Quality of Life Review Article Surgery Treatment Outcome |
| title | A Network Meta-analysis of Surgery for Chronic Pancreatitis: Impact on Pain and Quality of Life |
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