Evidence map›Paper›PMID 19630998›Full record

SynthesisTrials2009

Perioperative management in distal pancreatectomy: results of a survey in 23 European participating centres of the DISPACT trial and a review of literature.

Helge Bruns, Nuh N Rahbari, Thorsten Löffler, Markus K Diener, Christoph M Seiler, Matthias Glanemann, Giovanni Butturini, Christoph Schuhmacher, Inga Rossion, Markus W Büchler and 2 more

Open access · goldAbstract readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Trials, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 2 pooled it
1.8field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. Visceral Obesity and Open Passive Drainage Increase the Risk of Pancreatic Fistula Following Distal Pancreatectomy.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2019
    Article
  4. Article
  5. [Present situation and prospect of enhanced recovery after surgery in pancreatic surgery].Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences · 2017
    Review
  6. Article
  7. Review
  8. Article
  9. The influence of staple size on fistula formation following distal pancreatectomy.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2012
    Article
  10. Article
  11. Intraoperative Fluid Excess Is a Risk Factor for Pancreatic Fistula after Partial Pancreaticoduodenectomy.HPB surgery : a world journal of hepatic, pancreatic and biliary surgery
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 5 institutions in 2 countries.

Helge BrunsDepartment of General, Visceral and Transplantation Surgery, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany. helge.bruns@med.uni-heidelberg.de
Nuh N Rahbari
Thorsten Löffler
Markus K Diener
Christoph M Seiler
Matthias Glanemann
Giovanni Butturini
Christoph Schuhmacher
Inga Rossion
Markus W Büchler
Tido Junghans
DISPACT Trial group
Heidelberg University · DECharité - Universitätsmedizin Berlin · DEGerman Society of Surgery · DETechnical University of Munich · DEUniversity of Verona · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundConcomitant treatment in addition to intervention may influence the primary outcome, especially in complex interventions such as surgical trials. Evidence-based standards for perioperative care after distal pancreatectomy, however, have been rarely defined. This study's objective was therefore to identify and analyse the current basis of evidence for perioperative management in distal pancreatectomy.

methodsA standardised questionnaire was sent to 23 European centres recruiting patients for a randomized controlled trial (RCT) on open distal pancreatectomy that would compare suture versus stapler closure of the pancreatic remnant (DISPACT trial, ISRCTN 18452029). Perioperative strategies (e.g., bowel preparation, pain management, administration of antibiotics, abdominal incision, drainages, nasogastric tubes, somatostatin, mobilisation and feeding regimens) were assessed. Moreover, a systematic literature search in the Medline database was performed and retrieved meta-analyses and RCTs were reviewed.

resultsAll 23 centres returned the questionnaire. Consensus for thoracic epidural catheters (TECs), pain treatment and transverse incisions was found, as well as strong consensus for the placement of intra-abdominal drainages and perioperative single-shot antibiotics. Also, there was consensus that bowel preparation, somatostatin application, postoperative nasogastric tubes and intravenous feeding might not be beneficial. The literature search identified 16 meta-analyses and 19 RCTs demonstrating that bowel preparation, somatostatin therapy and nasogastric tubes can be omitted. Early mobilisation, feeding and TECs seem to be beneficial for patients. The value of drainages remains unclear.

conclusionMost perioperative standards within the centres participating in the DISPACT trial are in accordance with current available evidence. The need for drainages requires further investigation.

trial registrationCLINICAL

trial registrationISRCTN 18452029.

Indexed as

Health Care SurveysBenchmarkingEuropeHumansPancreatectomyPancreatic DiseasesPerioperative CareSurveys and Questionnaires

Identifiers

PMID19630998
PMCPMC2726965
OpenAlexW2080847837

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.