Effects of Perioperative Probiotics and Synbiotics on Pancreaticoduodenectomy Patients: A Meta-Analysis of Randomized Controlled Trials
What this study found
Probiotic or synbiotic supplementation did not reduce perioperative mortality but significantly reduced postoperative infection rates, delayed gastric emptying, hospital stay length, and antibiotic usage durations. These findings suggest potential clinical benefits of probiotics and synbiotics in improving recovery after pancreaticoduodenectomy.
- Study & population
- Six randomized controlled trials (RCTs) involving 294 participants were analyzed.
- Intervention
- Evaluation of probiotics and synbiotics during pancreaticoduodenectomy to assess their efficacy in preventing postoperative infections and improving surgical outcomes.
- Key limitation
- Limited number of studies and participants; varied types of probiotics and synbiotics used; concerns about potential bias due to lack of double-blinding in some studies.
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Open PDFOriginal abstract
Post-pancreaticoduodenectomy infections cause mortality, morbidity, and prolonged antibiotic use. Probiotics or synbiotics may be advantageous for preventing postoperative infections, but their benefits on pancreaticoduodenectomy outcomes are controversial. This study evaluated the efficacy of probiotics and synbiotics in pancreaticoduodenectomy. The Embase, Web of Science, PubMed, and Cochrane Library databases were comprehensively searched for randomized controlled trials (RCTs) that evaluated the effects of probiotics or synbiotics on pancreaticoduodenectomy as of April 16, 2021. Outcomes included perioperative mortality, postoperative infectious complications, delayed gastric emptying, hospital stay length, and antibiotic-use duration. The results were reported as mean differences (MDs) and relative risks (RRs) with 95% confidence intervals (CI). Six RCTs involving 294 subjects were included. Probiotic or synbiotic supplementation did not reduce the perioperative mortality (RR, 0.34; 95% CI, 0.11, 1.03), but reduced the incidences of postoperative infection (RR, 0.49; 95% CI, 0.34, 0.70) and delayed gastric emptying (RR, 0.27; 95% CI, 0.09, 0.76) and also reduced the hospital stay length (MD, −7.87; 95% CI, −13.74, −1.99) and antibiotic-use duration (MD, −6.75; 95% CI, −9.58, −3.92) as compared to the controls. Probiotics or synbiotics can prevent infections, reduce delayed gastric emptying, and shorten the hospital stay and antibiotic-use durations in patients undergoing pancreaticoduodenectomy. These findings are clinically important for promoting recovery from pancreaticoduodenectomy, reducing the incidences of antibiotic resistance and iatrogenic infections, and reducing the medical burden.