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目的:系统评价胰胃吻合(PG)和胰肠吻合(PJ)两种胰十二指肠切除术(PD)后胰腺消化道吻合术的安全性及疗效。n 方法:检索国内外数据库中有关PD术中应用PG和PJ的前瞻性随机对照试验,由2名研究者独立进行文献数据的提取,按照Cochrane Handbook 5.1对纳入的文献进行严格的质量评价,并应用Review Manager 5.2软件进行Meta分析。n 结果:共纳入7篇文献,包括1 121例患者,其中PG组562例,PJ组559例。Meta分析结果显示,PG组在胰瘘(OR=0.60,95% CI=0.44~0.82,P=0.001)、胆瘘(OR=0.42,95% CI=0.18~0.93,P=0.03)、腹腔积液(OR=0.50,95% CI=0.34~0.74,P=0.0005)发生率方面优于PJ组;两组在胃排空障碍(OR=0.98,95% CI=0.53~1.82,P=0.95)、术后腹腔出血(OR=1.29,95% CI=0.95~1.96,P=0.24)、二次手术率(OR=0.96,95% CI=0.61~1.52,P=0.87)、病死率(OR=0.82,95% CI=0.43~1.58,P=0.56)方面差异无统计学意义。n 结论: PD在减少胰瘘、胆瘘、腹腔积液发生率方面较PJ更有优势,但两者的安全性与远期疗效尚值得进一步研究验证。“,”Objective: To systematically evaluate the safety and efficacy of pancreaticogastrostomy (PG) and pancreaticojejunostomy (PJ) for pancreatico-digestive anastomosis atfer pancreaticoduodenectomy (PD). n Methods:hTe prospective randomized controlled trials concerning application of PG and PJ in PD were collected by searching available national and international databases. Data were extracted by two independent reviewers, and the methodological quality of the included studies was evaluated according to the Cochrane handbook 5.1.Meta-analysis was performed using Manager 5.2 sotfware. n Results:A total of 7 studies were included involving 1 121 patients, with 562 cases in PG group and 559 cases in PJ group. Meta-analysis indicated that PG group was superior to PJ group with regard to the incidence of pancreatic fistula (OR=0.60, 95%CI=0.44–0.82, P=0.001), biliary fistula (OR=0.42, 95%CI=0.18–0.93, P=0.03) and intra-abdominal collection (OR=0.50, 95%CI=0.34–0.74, P=0.0005), while there was no signiifcant difference between the two groups in respect to the incidence of delayed gastric emptying (OR=0.98, 95%CI=0.53–1.82, P=0.95) and postoperative intra-abdominal hemorrhage (OR=1.29, 95%CI=0.95–1.96, P=0.24), as well as the reoperation rate (OR=0.96, 95%CI=0.61–1.52, P=0.87) and mortality (OR=0.82, 95%CI=0.43–1.58, P=0.56). n Conclusion:PG is superior to PJ in reducing the incidence of pancreatic ifstula, biliary ifstula and intra-abdominal collection, however, the safety and long-term effcacy of the two procedures still need further veriifcation.