SynthesisAnnals of surgery2023
A Simple Classification of Pancreatic Duct Size and Texture Predicts Postoperative Pancreatic Fistula: A classification of the International Study Group of Pancreatic Surgery.
Synthesis in Annals of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 154 papers, 7 of them syntheses that pooled it.
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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.
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Who cites it
154 citing papers in PubMed, 7 syntheses or guidelines pooled it, 210 citations in OpenAlex.
- Preventing pancreatic fistula following pancreatectomy: meta-analysis of randomized clinical trials.BJS open · 2026Pooled it
- Postoperative pancreatic fistula: a bibliometric analysis of research trends and a meta-analysis on the association with intra pancreatic fat deposition.Scientific reports · 2025Pooled it
- Duct-to-mucosa versus other types of pancreaticojejunostomy for the prevention of postoperative pancreatic fistula following pancreaticoduodenectomy.The Cochrane database of systematic reviews · 2025Pooled it
- Prophylactic abdominal drainage for pancreatic surgery.The Cochrane database of systematic reviews · 2025Pooled it
- The impact of pancreatic duct stent placement on the clinically relevant postoperative pancreatic fistula rate for high-risk anastomoses: a systematic review and meta-analysis.BMC gastroenterology · 2025Pooled it
- Safety and effectiveness of minimally invasive central pancreatectomy versus open central pancreatectomy: a systematic review and meta-analysis.Surgical endoscopy · 2024Pooled it
- Incidence and risk factors for Chyle leak after pancreatic surgery for cancer: A comprehensive systematic review.European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2022Pooled it
- Preoperative stereotactic radiotherapy to prevent pancreatic fistula in high-risk patients undergoing pancreatoduodenectomy (FIBROPANC): prospective multicentre phase II single-arm trial.The British journal of surgery · 2025Trial
- Association Between Surgeons' Consideration of Suspected Biliary Contamination and Reported Antibiotic Duration After Pancreatoduodenectomy: An Exploratory Secondary Analysis of an International Survey.Antibiotics (Basel, Switzerland) · 2026Article
- Development and internal validation of a nomogram for predicting grade B/C hemorrhage after pancreaticoduodenectomy.Clinics (Sao Paulo, Brazil) · 2026Article
- Perioperative H-FABP and Its Association with Postoperative Morbidity Following Pancreatic Resection: A Prospective Observational Study.Medicina (Kaunas, Lithuania) · 2026Observational
- Clinical Evaluation of Postoperative Day 3 Serum Lipase in Relation to Clinically Relevant Pancreatic Fistula After Distal Pancreatectomy: A Retrospective Cohort Study.Biomedicines · 2026Article
- Optimal Timing of Serum Lipase for Early Prediction of Clinically Relevant Pancreatic Fistula After Pancreaticoduodenectomy.Cancers · 2026Article
- Clinical, microbial, and experimental features associated with Grade C postoperative pancreatic fistula and pancreaticojejunostomy disruption.Gland surgery · 2026Article
- Understanding pancreatic reconstruction after pancreatoduodenectomy: lessons in technique and biology.Gland surgery · 2026Article
- Avoiding the knot: the no-knots pancreatojejunostomy for redistribution of traction forces on the pancreatic parenchyma.Updates in surgery · 2026Article
- Impact of age on safety of pancreaticoduodenectomy: a nationwide cohort study stratified by surgical approach and anastomotic technique with optimal age cut-off analysis.Science China. Life sciences · 2026Article
- Structured Adaptability in HPB Cancer Surgery: Precision Beyond Technical Uniformity.Annals of surgical oncology · 2026Article
- Comparative Severe Complications After Laparoscopic Pancreatoduodenectomy in PDAC vs Non-PDAC Periampullary Cancer: A Retrospective Cohort Study.Journal of surgical oncology · 2026Article
- Geometric simplification by ductal unification of dual pancreatic ducts during pancreaticojejunostomy.BMC surgery · 2026Article
94 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
30 authors at 18 institutions in 13 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe aim of this study was to develop a classification system for pancreas-associated risk factors in pancreatoduodenectomy (PD). SUMMARY BACKGROUND DATA: Postoperative pancreatic fistula (POPF) is the most relevant PD-associated complication. A simple standardized surgical reporting system based on pancreas-associated risk factors is lacking.
methodsA systematic literature search was conducted to identify studies investigating clinically relevant (CR) POPF (CR-POPF) and pancreas-associated risk factors after PD. A meta-analysis of CR-POPF rate for texture of the pancreas (soft vs not-soft) and main pancreatic duct (MPD) diameter was performed using the Mantel-Haenszel method. Based on the results, the International Study Group of Pancreatic Surgery (ISGPS) proposes the following classification: A, not-soft (hard) texture and MPD >3 mm; B, not-soft (hard) texture and MPD ≤3 mm; C, soft texture and MPD >3 mm; D, soft texture and MPD ≤3 mm. The classification was evaluated in a multi-institutional, international cohort.
resultsOf the 2917 articles identified, 108 studies were included in the analyses. Soft pancreatic texture was significantly associated with the development of CR-POPF [odds ratio (OR) 4.24, 95% confidence interval (CI) 3.67-4.89, P < 0.01) following PD. Similarly, MPD diameter ≤3 mm significantly increased CR-POPF risk compared with >3 mm diameter MPDs (OR 3.66, 95% CI 2.62-5.12, P < 0.01). The proposed 4-stage system was confirmed in an independent cohort of 5533 patients with CR-POPF rates of 3.5%, 6.2%, 16.6%, and 23.2% for type A-D, respectively ( P < 0.001).
conclusionFor future pancreatic surgical outcomes studies, the ISGPS recommends reporting these risk factors according to the proposed classification system for better comparability of results.
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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.