SynthesisAnnals of surgery2026
A New Gold Standard? Impact of Broad-spectrum Penicillin-based Antibiotic Prophylaxis on Outcome After Pancreatoduodenectomy: Results of a Systematic Review and Meta-analysis (PROSPERO CRD42024559197).
Synthesis in Annals of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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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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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.
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Who cites it
9 citing papers in PubMed.
- 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
- Tumor Location and Preoperative Biliary Stenting Shape Gut Microbiome Diversity in Pancreatic Cancer.Cancers · 2026Article
- Pancreatic cancer.Nature reviews. Disease primers · 2026Review
- Pancreatic Cancer in the Holobiont and Therapeutic Targets: A Review.Journal of clinical medicine · 2026Review
- Perioperative antibiotic prophylaxis in pancreatoduodenectomy: toward a new standard, but questions remain.Hepatobiliary surgery and nutrition · 2026Article
- Reducing Complications in Pancreaticoduodenectomy.Cancers · 2026Review
- Turning the tide in the mitigation of clinically relevant post-operative pancreatic fistula in pancreatoduodenectomy-broad-spectrum antibiotic surgical prophylaxis is the new standard of care.Hepatobiliary surgery and nutrition · 2026Article
- Antibiotic Resistance Patterns in Pancreatic Surgery: A Tailor-Made Antibiotic Prophylaxis in a Secondary Hospital.Cureus · 2026Article
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis review evaluated whether broad-spectrum penicillin-based antibiotic prophylaxis (BS-AB) such as piperacillin-tazobactam might lead to better outcomes in pancreatoduodenectomy compared with standard care antibiotics, mainly cephalosporins (CE-AB).
backgroundPancreatoduodenectomy is commonly associated with high postoperative infectious complications, contributing to increased morbidity, mortality, and health care costs.
methodsA systemic literature search (PubMed, EMBASE, Cochrane Library, and Web of Science) was conducted to identify suitable RCTs and non-RCTs. After inclusion, the data were analyzed using a random-effects model with the Mantel-Haenszel model or inverse variance to calculate odds ratio (OR) or mean difference (MD) with 95% confidence intervals (CI).
resultsOne RCT and 11 non-RCTs were included with 12,469 patients (35.3% BS-AB, 64.7% CE-AB). Surgical site infections (SSI) were significantly lower after BS-AB when compared with CE-AB, [OR 0.53; CI (0.32 to 0.86); P =0.01; I2 =79%] as well as the occurrence of postoperative pancreatic fistula (POPF) [OR 0.62; CI (0.47 to 0.81); P <0.01; I2 =0%], days of hospitalization [MD -2.02; CI (-4.08 to 0.03); P =0.05; I2 =98%] and mortality [OR 0.56; CI (0.34 to 0.95); P =0.03; I2 =0%]. Subgroup analyses of patients with preoperative biliary drainage demonstrated an even higher effect of BS-AB in reducing SSI [OR 0.45, CI (0.45 to 0.67); P =0.01; I2 =78%], POPF [OR 0.52; CI (0.36 to 0.75); P <0.01; I2 =0%] and mortality [OR 0.34; CI (0.15 to 0.76); P <0.01; I2 =0%].
conclusionBS-AB significantly reduces the risk of infectious complications and surgical outcomes in pancreatoduodenectomy compared with CE-AB, particularly in patients with preoperative biliary drainage. These findings support the use of BS-AB as a new gold standard for patients undergoing pancreatoduodenectomy.
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