ArticleLangenbeck's archives of surgery2025
Towards a more precise definition of postoperative pancreatic fistula (POPF): should drain position be considered alongside drain amylase levels after pancreaticoduodenectomy? - a retrospective cohort study.
Article in Langenbeck's archives of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe International Study Group of Pancreatic Fistula (ISGPF) defines postoperative pancreatic fistula (POPF) based on drain fluid amylase (DFA) levels. However, drain malposition can compromise the reliability of DFA in detecting POPF. This may trigger premature drain removal, delayed recognition of clinically relevant POPF (CR-POPF), and escalation of morbidity. We evaluated how drain position modifies the diagnostic performance of DFA after PD.
methodA retrospective analysis of 334 patients who underwent PD (June 2019-December 2023). Drain position was assessed using postoperative imaging and DFA levels were measured on postoperative day3. The primary aim was the incidence of drain malposition, while secondary aims included its impact on the diagnosis of CR-POPF, SFC.
resultAmong 334 patients, the drain was well-positioned in 255 patients (76.4%) and malpositioned in 79 patients (23.6%). High DFA levels were strongly associated with proper drain positioning (152/164, 92.7%). However, low/normal DFA levels often reflected drain malposition, with 67/170 patients(39.4%) incorrectly classified, leading to potential false-negative results. Malpositioned drains patients had a significantly higher SFC(p < 0.001) and longer hospital stay (p < 0.001). Multivariable analysis confirmed drain malposition as an independent predictor of CR-POPF (OR 4.74, 95% CI: 1.86-12.06, p = 0.001), small pancreatic duct(OR 10.59, 95% CI: 3.92-28.62,p < 0.001) and low preoperative albumin (OR 0.07, 95% CI: 0.02-0.24, p < 0.001).
conclusionDrain malposition significantly impacts DFA reliability with false-negative diagnosis. Revising the ISGPS definition to incorporate drain positioning alongside DFA levels may improve diagnostic accuracy in defining POPF.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.