Evidence map›Paper›PMID 41212234›Full record

SynthesisLangenbeck's archives of surgery2025

Clinical relevance of intraoperative blood loss in pancreatic surgery: a systematic review and meta-analysis to reappraise the impact on post operative pancreatic fistula.

Giampaolo Perri, Danhui Heo, Rayner Peyser Cardoso, Swizel Ann Cardoso, Antonio Facciorusso, Riccardo Pellegrini, Domenico Bassi, Umberto Cillo, Giovanni Marchegiani

Erratum issuedAbstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis 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. An erratum has been issued. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Giampaolo PerriHepato Pancreato Biliary (HPB) and Liver Transplant Surgery, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Via Giustiniani 2, Padova, 35128, Italy.ORCID http://orcid.org/0000-0002-2072-7114
Danhui HeoDoctoral School of Experimental and Preventive Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary.ORCID http://orcid.org/0009-0006-0218-3842
Rayner Peyser CardosoAll India Institute of Medical Sciences, Jodhpur, India.ORCID http://orcid.org/0009-0006-8726-7550
Swizel Ann CardosoUniversity Hospital of Birmingham NHS Foundation Trust, Birmingham, UK.ORCID http://orcid.org/0000-0003-1536-6040
Antonio FacciorussoGastroenterology Unit, Department of Experimental Medicine, Università del Salento, Lecce, 73100, Italy.ORCID http://orcid.org/0000-0002-2107-2156
Riccardo PellegriniHepato Pancreato Biliary (HPB) and Liver Transplant Surgery, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Via Giustiniani 2, Padova, 35128, Italy.ORCID http://orcid.org/0009-0006-0597-9360
Domenico BassiHepato Pancreato Biliary (HPB) and Liver Transplant Surgery, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Via Giustiniani 2, Padova, 35128, Italy.
Umberto CilloHepato Pancreato Biliary (HPB) and Liver Transplant Surgery, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Via Giustiniani 2, Padova, 35128, Italy.ORCID http://orcid.org/0000-0002-2310-0245
Giovanni MarchegianiHepato Pancreato Biliary (HPB) and Liver Transplant Surgery, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Via Giustiniani 2, Padova, 35128, Italy. giovanni.marchegiani@unipd.it.ORCID http://orcid.org/0000-0002-6824-4533

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPostoperative pancreatic fistula (POPF) is the major complication following pancreatic surgery, significantly impacting patient outcomes. Intraoperative blood loss (IBL) represents a modifiable risk factor for POPF, but its actual clinical relevance is not clearly defined. This study explores the available literature to reappraise the association of IBL and the development of POPF.

methodsA systematic review and meta-analysis of original studies published between January 2006 and August 2025, reporting IBL in patients undergoing pancreatic resections and its association with POPF were performed. Studies that used the International Study Group on Pancreatic Surgery (ISGPS) or the International Study Group on Pancreatic Fistula Definition (ISGPF) definitions for POPF were included. Qualitative synthesis included all eligible studies; quantitative meta-analysis was conducted for studies reporting IBL in both POPF and no-POPF groups.

resultsA total of 26 studies were included in the qualitative review and 12 in the meta-analysis. Among 13,108 patients who underwent pancreatic resections, the overall POPF rate was 20%. IBL was identified as an independent risk-factor of POPF in 17 studies. The meta-analysis, which included 10,008 patients, showed that IBL was significantly higher in the POPF group compared to the no-POPF group [Mean difference (MD): 112.46 ml (30.39, 194.53), p = 0.01].

conclusionsIBL is an independent predictor of POPF. Intraoperative measures to minimize its occurrence and magnitude are key to ameliorate the outcomes of pancreas surgery.

Indexed as

Blood Loss, SurgicalPancreatectomyPancreatic FistulaPostoperative ComplicationsHumansRisk FactorsIntraoperative bleedingIntraoperative blood lossPancreatic fistulaPancreatic surgeryPOPF

Identifiers

PMID41212234
PMCPMC12602675

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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.