SynthesisThe British journal of surgery2021
Completion pancreatectomy or a pancreas-preserving procedure during relaparotomy for pancreatic fistula after pancreatoduodenectomy: a multicentre cohort study and meta-analysis.
Synthesis in The British journal of surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed, 33 citations in OpenAlex.
- Surgical Procedures Used in the Treatment of Postoperative Acute Pancreatitis Grade C After Pancreatoduodenectomy-A Narrative Review.Medicina (Kaunas, Lithuania) · 2026Review
- Radiologically-confirmed dehiscence of the pancreaticojejunal anastomosis following pancreaticoduodenectomy: risk factors and implications for technique.Gland surgery · 2026Article
- Endoscopic management of postoperative pancreatic fistula after pancreaticoduodenectomy: a single center retrospective analysis.Surgical endoscopy · 2025Article
- Comparison of three reconstruction techniques performed after pancreaticoduodenectomy: Using external, internal, or no stent.World journal of gastrointestinal surgery · 2025Article
- Weekday effect of surgery on in-hospital outcome in pancreatic surgery: a population-based study.Langenbeck's archives of surgery · 2024Article
- Pancreatic duct occlusion with polychloroprene-based glue for the management of postoperative pancreatic fistula after pancreatoduodenectomy-an outdated approach?Frontiers in surgery · 2024Article
- Nationwide Outcome after Pancreatoduodenectomy in Patients at very High Risk (ISGPS-D) for Postoperative Pancreatic Fistula.Annals of surgery · 2023Article
- Can the Realization of an External Wirsungostomy be an Option for High-Risk Pancreatic Anastomosis After Pancreaticoduodenectomy?World journal of surgery · 2023Article
- Current Perioperative Care in Pancreatoduodenectomy: A Step-by-Step Surgical Roadmap from First Visit to Discharge.Cancers · 2023Review
- Prevention and Treatment of Grade C Postoperative Pancreatic Fistula.Journal of clinical medicine · 2022Review
- Conversion to pancreaticogastrostomy for salvage of disrupted pancreaticojejunostomy following pancreaticoduodenectomy.Annals of surgical treatment and research · 2022Article
- Comment on: "Hepatobiliary surgery and nutrition · 2022Article
- A comparison of surgical approaches in the treatment of grade C postoperative pancreatic fistula: A retrospective study.Frontiers in surgery · 2022Article
Corrections and comments
- Commented on byComment on: "2022
Authors and funding
18 authors at 9 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite the fact that primary percutaneous catheter drainage has become standard practice, some patients with pancreatic fistula after pancreatoduodenectomy ultimately undergo a relaparotomy. The aim of this study was to compare completion pancreatectomy with a pancreas-preserving procedure in patients undergoing relaparotomy for pancreatic fistula after pancreatoduodenectomy.
methodsThis retrospective cohort study of nine institutions included patients who underwent relaparotomy for pancreatic fistula after pancreatoduodenectomy from 2005-2018. Furthermore, a systematic review and meta-analysis were performed according to the PRISMA guidelines.
resultsFrom 4877 patients undergoing pancreatoduodenectomy, 786 (16 per cent) developed a pancreatic fistula grade B/C and 162 (3 per cent) underwent a relaparotomy for pancreatic fistula. Of these patients, 36 (22 per cent) underwent a completion pancreatectomy and 126 (78 per cent) a pancreas-preserving procedure. Mortality was higher after completion pancreatectomy (20 (56 per cent) versus 40 patients (32 per cent); P = 0.009), which remained after adjusting for sex, age, BMI, ASA score, previous reintervention, and organ failure in the 24 h before relaparotomy (adjusted odds ratio 2.55, 95 per cent c.i. 1.07 to 6.08). The proportion of additional reinterventions was not different between groups (23 (64 per cent) versus 84 patients (67 per cent); P = 0.756). The meta-analysis including 33 studies evaluating 745 patients, confirmed the association between completion pancreatectomy and mortality (Mantel-Haenszel random-effects model: odds ratio 1.99, 95 per cent c.i. 1.03 to 3.84).
conclusionBased on the current data, a pancreas-preserving procedure seems preferable to completion pancreatectomy in patients in whom a relaparotomy is deemed necessary for pancreatic fistula after pancreatoduodenectomy.
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