Evidence map›Paper›PMID 35236667›Full record

ArticleCanadian journal of surgery. Journal canadien de chirurgie

Prevention of postoperative pancreatic fistula after pancreatectomy: results of a Canadian RAND/UCLA appropriateness expert panel.

Julie Hallet, Evangelia Theodosopoulos, Jad Abou-Khalil, Kimberley Bertens, Jean-Sébastien Pelletier, Maja Segedi, Jean-François Ouellet, Jeffrey Barkun, Natalie Coburn, Canadian Hepato-Pancreato-Biliary Association working group

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In one paragraph

Article in Canadian journal of surgery. Journal canadien de chirurgie. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.6field-weighted citation impact, top 31% 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

4 citing papers in PubMed, 7 citations in OpenAlex.

  1. Review
  2. Review
  3. Article
  4. Appropriate scenarios for the prevention of postoperative pancreatic fistula.Canadian journal of surgery. Journal canadien de chirurgie
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 1 country.

Julie HalletFrom the Department of Surgery, University of Toronto, Toronto, Ont. (Hallet, Theodosopoulos, Coburn); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Abou-Khalil, Bertens); the Department of Surgery, McGill University, Montréal, Que. (Pelletier, Barkun); the Department of Surgery, University of British-Columbia, Vancouver, BC (Segedi); and the Department of Surgery, Université Laval, Québec, Que. (Ouellet) julie.hallet@sunnybrook.ca.
Evangelia TheodosopoulosFrom the Department of Surgery, University of Toronto, Toronto, Ont. (Hallet, Theodosopoulos, Coburn); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Abou-Khalil, Bertens); the Department of Surgery, McGill University, Montréal, Que. (Pelletier, Barkun); the Department of Surgery, University of British-Columbia, Vancouver, BC (Segedi); and the Department of Surgery, Université Laval, Québec, Que. (Ouellet).
Jad Abou-KhalilFrom the Department of Surgery, University of Toronto, Toronto, Ont. (Hallet, Theodosopoulos, Coburn); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Abou-Khalil, Bertens); the Department of Surgery, McGill University, Montréal, Que. (Pelletier, Barkun); the Department of Surgery, University of British-Columbia, Vancouver, BC (Segedi); and the Department of Surgery, Université Laval, Québec, Que. (Ouellet).
Kimberley BertensFrom the Department of Surgery, University of Toronto, Toronto, Ont. (Hallet, Theodosopoulos, Coburn); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Abou-Khalil, Bertens); the Department of Surgery, McGill University, Montréal, Que. (Pelletier, Barkun); the Department of Surgery, University of British-Columbia, Vancouver, BC (Segedi); and the Department of Surgery, Université Laval, Québec, Que. (Ouellet).
Jean-Sébastien PelletierFrom the Department of Surgery, University of Toronto, Toronto, Ont. (Hallet, Theodosopoulos, Coburn); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Abou-Khalil, Bertens); the Department of Surgery, McGill University, Montréal, Que. (Pelletier, Barkun); the Department of Surgery, University of British-Columbia, Vancouver, BC (Segedi); and the Department of Surgery, Université Laval, Québec, Que. (Ouellet).
Maja SegediFrom the Department of Surgery, University of Toronto, Toronto, Ont. (Hallet, Theodosopoulos, Coburn); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Abou-Khalil, Bertens); the Department of Surgery, McGill University, Montréal, Que. (Pelletier, Barkun); the Department of Surgery, University of British-Columbia, Vancouver, BC (Segedi); and the Department of Surgery, Université Laval, Québec, Que. (Ouellet).
Jean-François OuelletFrom the Department of Surgery, University of Toronto, Toronto, Ont. (Hallet, Theodosopoulos, Coburn); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Abou-Khalil, Bertens); the Department of Surgery, McGill University, Montréal, Que. (Pelletier, Barkun); the Department of Surgery, University of British-Columbia, Vancouver, BC (Segedi); and the Department of Surgery, Université Laval, Québec, Que. (Ouellet).
Jeffrey BarkunFrom the Department of Surgery, University of Toronto, Toronto, Ont. (Hallet, Theodosopoulos, Coburn); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Abou-Khalil, Bertens); the Department of Surgery, McGill University, Montréal, Que. (Pelletier, Barkun); the Department of Surgery, University of British-Columbia, Vancouver, BC (Segedi); and the Department of Surgery, Université Laval, Québec, Que. (Ouellet).
Natalie CoburnFrom the Department of Surgery, University of Toronto, Toronto, Ont. (Hallet, Theodosopoulos, Coburn); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Abou-Khalil, Bertens); the Department of Surgery, McGill University, Montréal, Que. (Pelletier, Barkun); the Department of Surgery, University of British-Columbia, Vancouver, BC (Segedi); and the Department of Surgery, Université Laval, Québec, Que. (Ouellet).
Canadian Hepato-Pancreato-Biliary Association working group
Université Laval · CAUniversity of Ottawa · CAMcGill University · CAUniversity of British Columbia · CAUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe aimed to define the appropriateness of interventions for the prevention of postoperative pancreatic fistulas (POPF) after pancreatectomy, given the lack of consistent data on this topic.

methodsUsing the RAND/UCLA appropriateness method, we assembled an expert panel to rate clinical scenarios for interventions to prevent POPF after pancreaticoduodenectomy (PD) and distal pancreatectomy (DP).

resultsThe following interventions were rated appropriate: individualized risk prediction for all patients; perioperative pasireotide administration for patients undergoing PD who have a soft pancreatic gland and a pancreatic duct size of less 3 mm and for patients undergoing DP; pancreaticogastrostomy for patients undergoing PD who have a soft pancreatic gland and pancreaticojejunostomy for PD for patients with a pancreatic duct size of 6 mm or greater regardless of pancreatic gland texture; duct-to-mucosa anastomosis for all patients undergoing PD and dunking anastomosis for patients undergoing PD who have a pancreatic duct size of less than 3 mm with a firm pancreatic gland; simple stapled and reinforced stapled transection for all DP; surgical drains for PD and DP in patients with a soft pancreatic gland; and open and minimally invasive surgery for DP and open surgery for PD. The following were rated inappropriate: gastrointestinal anastomosis for stump closure in all DP and omission of surgical drain in PD for patients with a pancreatic duct diameter less than 3 mm and a soft pancreatic gland.

conclusionThe expert panel identified appropriate and inappropriate scenarios for POPF prevention following pancreatectomy, to provide guidance to clinicians. However, the appropriateness of the interventions in the majority of the clinical scenarios was rated as uncertain, demonstrating equipoise.

Indexed as

PancreatectomyPancreatic FistulaCanadaHumansPancreasPancreaticoduodenectomyPostoperative Complications

Identifiers

PMID35236667
PMCPMC8900740
OpenAlexW4214911646

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.