Evidence map›Paper›PMID 29464346›Full record

SynthesisWorld journal of surgery2018

Systematic Review and Meta-analysis of Restrictive Perioperative Fluid Management in Pancreaticoduodenectomy.

Brian P Chen, Marian Chen, Sean Bennett, Kristina Lemon, Kimberly A Bertens, Fady K Balaa, Guillaume Martel

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in World journal of surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
1.4field-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

12 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Observational
  5. Optimal Perioperative Fluid Therapy Associates with Fewer Complications After Pancreaticoduodenectomy.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023
    Article
  6. Review
  7. Risk-Stratified Pancreatectomy Clinical Pathway Implementation and Delayed Gastric Emptying.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021
    Article
  8. Review
  9. Article
  10. Article
  11. Article
  12. 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

7 authors at 2 institutions in 1 country.

Brian P ChenLiver and Pancreas Unit, Department of Surgery, The Ottawa Hospital - General Campus, University of Ottawa, 501 Smyth Road, CCW 1667, Ottawa, ON, K1H 8L6, Canada.
Marian ChenFaculty of Medicine, University of Toronto, Toronto, ON, Canada.
Sean BennettLiver and Pancreas Unit, Department of Surgery, The Ottawa Hospital - General Campus, University of Ottawa, 501 Smyth Road, CCW 1667, Ottawa, ON, K1H 8L6, Canada.
Kristina LemonLiver and Pancreas Unit, Department of Surgery, The Ottawa Hospital - General Campus, University of Ottawa, 501 Smyth Road, CCW 1667, Ottawa, ON, K1H 8L6, Canada.
Kimberly A BertensLiver and Pancreas Unit, Department of Surgery, The Ottawa Hospital - General Campus, University of Ottawa, 501 Smyth Road, CCW 1667, Ottawa, ON, K1H 8L6, Canada.
Fady K BalaaLiver and Pancreas Unit, Department of Surgery, The Ottawa Hospital - General Campus, University of Ottawa, 501 Smyth Road, CCW 1667, Ottawa, ON, K1H 8L6, Canada.
Guillaume MartelLiver and Pancreas Unit, Department of Surgery, The Ottawa Hospital - General Campus, University of Ottawa, 501 Smyth Road, CCW 1667, Ottawa, ON, K1H 8L6, Canada. gumartel@ottawahospital.on.ca.
University of Ottawa · CAUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is significant interest and controversy surrounding the effect of restrictive fluid management on outcomes in major gastrointestinal surgery. This has been most studied in colorectal surgery, although the literature relating to pancreaticoduodenectomy (PD) patients is growing. The aim of this paper was to generate a comprehensive review of the available evidence for restrictive perioperative fluid management strategies and outcomes in PD.

methodsMEDLINE/PubMed, Embase, and the Cochrane Library were searched from inception to April 2017. A review protocol was utilized and registered with PROSPERO. Primary citations that evaluated perioperative fluid management in PD, including those as part of a clinical pathway, were considered. The primary outcome was postoperative pancreatic fistula (POPF). Secondary outcomes included delayed gastric emptying (DGE), complication rate, length of stay (LOS), mortality, and readmission.

resultsA total of six studies involving 846 patients were included (2009-2015), of which four were RCTs. Pooled analysis of RCTs and high-quality observational studies found no effect of restrictive intraoperative fluid management on POPF, DGE, complication rate, LOS, mortality, and readmission. Only one study assessed postoperative fluid management exclusively and found prolonged LOS in patients in the restricted fluid group.

conclusionBased on results of RCTs and high-quality observational studies, intraoperative fluid restriction in PD has not been shown to significantly affect postoperative outcomes. There are too few studies assessing postoperative fluid management to draw conclusions at this time.

Indexed as

Anastomosis, SurgicalGastric EmptyingGastroparesisHumansLength of StayPancreatectomyPancreatic FistulaPancreaticoduodenectomyPatient ReadmissionPostoperative ComplicationsRandomized Controlled Trials as TopicTreatment Outcome

Identifiers

PMID29464346
OpenAlexW2790204068

What OpenQuestion holds

Textmetadata
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.