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Review Article | | Peer-Reviewed

Impact of Surgical Technique on Reducing the Incidence of Postoperative Pancreatic Fistula: A Systematic Review and Meta-Analysis

Lama Alzelfawi*,  Ebtesam Almajed,  Alya Al Zabin,  Norah Alqntash,  Ayidh Alqantash,  Abdullah Al Shamrani,  Saleh Al Bishri
Published in International Journal of Gastroenterology (Volume 8, Issue 2)
Received: 27 August 2024     Accepted: 21 September 2024     Published: 30 September 2024
Views:       Downloads:
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Abstract

Background: Postoperative pancreatic fistula (POPF), a complication frequently encountered following pancreaticoduodenectomy. Pancreaticojejunostomy (PJ) and pancreaticogastrostomy (PG) are the most frequently utilized reconstructive strategies with different anastomosis techniques. This study was conducted to evaluate the optimal surgical technique to prevent POPF. Methods: The study was conducted using PRISMA guidelines with PROSPERO registration No. CRD42023494393. Patients undergoing pancreaticoduodenectomy includes the use of PJ or PG with different anastomoses techniques and developed POPF were included. We conducted a systematic literature review from January 2019 to December 2023 using a comprehensive search strategy, through Web of Science, ProQuest, Science Direct, PubMed, and Google Scholar databases. Meta-analysis was utilized to analyze the outcomes. The risk of bias was assessed using the Newcastle-Ottawa scale. Results: Eighteen studies with 3343 patients who underwent various anastomoses (including the Modified DuVal, Heidelberg PJ, and Blumgart methods) were included. Postoperative pancreatic fistula (POPF) occurred in 27% of patients. Techniques such as modified Heidelberg, Peng, shark mouth PJ, and Kiguchi PJ were associated with lower POPF rates, whereas modified and classical Blumgart techniques exhibited higher rates. While mortality rates varied among surgical techniques, overall mortality was low. Conclusions: Data from this study can be used to shape future studies and direct physicians to develop strategies to reduce the risk of POPF and thereby reduce morbidity and mortality, leading to improved patient outcomes. Furthermore, this data can inform clinical decision-making and guide the development of evidence-based practice guidelines to optimize surgical outcomes.

Published in International Journal of Gastroenterology (Volume 8, Issue 2)
DOI 10.11648/j.ijg.20240802.12
Page(s) 50-66
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

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Copyright © The Author(s), 2024. Published by Science Publishing Group
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Keywords

Pancreatic Fistula, Pancreatoduodenectomy, POPF, Systematic Review and Meta-Analysis

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    Alzelfawi, L., Almajed, E., Zabin, A. A., Alqntash, N., Alqantash, A., et al. (2024). Impact of Surgical Technique on Reducing the Incidence of Postoperative Pancreatic Fistula: A Systematic Review and Meta-Analysis. International Journal of Gastroenterology, 8(2), 50-66. https://doi.org/10.11648/j.ijg.20240802.12

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    ACS Style

    Alzelfawi, L.; Almajed, E.; Zabin, A. A.; Alqntash, N.; Alqantash, A., et al. Impact of Surgical Technique on Reducing the Incidence of Postoperative Pancreatic Fistula: A Systematic Review and Meta-Analysis. Int. J. Gastroenterol. 2024, 8(2), 50-66. doi: 10.11648/j.ijg.20240802.12

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    AMA Style

    Alzelfawi L, Almajed E, Zabin AA, Alqntash N, Alqantash A, et al. Impact of Surgical Technique on Reducing the Incidence of Postoperative Pancreatic Fistula: A Systematic Review and Meta-Analysis. Int J Gastroenterol. 2024;8(2):50-66. doi: 10.11648/j.ijg.20240802.12

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  • @article{10.11648/j.ijg.20240802.12,
  author = {Lama Alzelfawi and Ebtesam Almajed and Alya Al Zabin and Norah Alqntash and Ayidh Alqantash and Abdullah Al Shamrani and Saleh Al Bishri},
  title = {Impact of Surgical Technique on Reducing the Incidence of Postoperative Pancreatic Fistula: A Systematic Review and Meta-Analysis
},
  journal = {International Journal of Gastroenterology},
  volume = {8},
  number = {2},
  pages = {50-66},
  doi = {10.11648/j.ijg.20240802.12},
  url = {https://doi.org/10.11648/j.ijg.20240802.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijg.20240802.12},
  abstract = {Background: Postoperative pancreatic fistula (POPF), a complication frequently encountered following pancreaticoduodenectomy. Pancreaticojejunostomy (PJ) and pancreaticogastrostomy (PG) are the most frequently utilized reconstructive strategies with different anastomosis techniques. This study was conducted to evaluate the optimal surgical technique to prevent POPF. Methods: The study was conducted using PRISMA guidelines with PROSPERO registration No. CRD42023494393. Patients undergoing pancreaticoduodenectomy includes the use of PJ or PG with different anastomoses techniques and developed POPF were included. We conducted a systematic literature review from January 2019 to December 2023 using a comprehensive search strategy, through Web of Science, ProQuest, Science Direct, PubMed, and Google Scholar databases. Meta-analysis was utilized to analyze the outcomes. The risk of bias was assessed using the Newcastle-Ottawa scale. Results: Eighteen studies with 3343 patients who underwent various anastomoses (including the Modified DuVal, Heidelberg PJ, and Blumgart methods) were included. Postoperative pancreatic fistula (POPF) occurred in 27% of patients. Techniques such as modified Heidelberg, Peng, shark mouth PJ, and Kiguchi PJ were associated with lower POPF rates, whereas modified and classical Blumgart techniques exhibited higher rates. While mortality rates varied among surgical techniques, overall mortality was low. Conclusions: Data from this study can be used to shape future studies and direct physicians to develop strategies to reduce the risk of POPF and thereby reduce morbidity and mortality, leading to improved patient outcomes. Furthermore, this data can inform clinical decision-making and guide the development of evidence-based practice guidelines to optimize surgical outcomes.
},
 year = {2024}
}

    Copy | Download 

  • TY  - JOUR
T1  - Impact of Surgical Technique on Reducing the Incidence of Postoperative Pancreatic Fistula: A Systematic Review and Meta-Analysis

AU  - Lama Alzelfawi
AU  - Ebtesam Almajed
AU  - Alya Al Zabin
AU  - Norah Alqntash
AU  - Ayidh Alqantash
AU  - Abdullah Al Shamrani
AU  - Saleh Al Bishri
Y1  - 2024/09/30
PY  - 2024
N1  - https://doi.org/10.11648/j.ijg.20240802.12
DO  - 10.11648/j.ijg.20240802.12
T2  - International Journal of Gastroenterology
JF  - International Journal of Gastroenterology
JO  - International Journal of Gastroenterology
SP  - 50
EP  - 66
PB  - Science Publishing Group
SN  - 2640-169X
UR  - https://doi.org/10.11648/j.ijg.20240802.12
AB  - Background: Postoperative pancreatic fistula (POPF), a complication frequently encountered following pancreaticoduodenectomy. Pancreaticojejunostomy (PJ) and pancreaticogastrostomy (PG) are the most frequently utilized reconstructive strategies with different anastomosis techniques. This study was conducted to evaluate the optimal surgical technique to prevent POPF. Methods: The study was conducted using PRISMA guidelines with PROSPERO registration No. CRD42023494393. Patients undergoing pancreaticoduodenectomy includes the use of PJ or PG with different anastomoses techniques and developed POPF were included. We conducted a systematic literature review from January 2019 to December 2023 using a comprehensive search strategy, through Web of Science, ProQuest, Science Direct, PubMed, and Google Scholar databases. Meta-analysis was utilized to analyze the outcomes. The risk of bias was assessed using the Newcastle-Ottawa scale. Results: Eighteen studies with 3343 patients who underwent various anastomoses (including the Modified DuVal, Heidelberg PJ, and Blumgart methods) were included. Postoperative pancreatic fistula (POPF) occurred in 27% of patients. Techniques such as modified Heidelberg, Peng, shark mouth PJ, and Kiguchi PJ were associated with lower POPF rates, whereas modified and classical Blumgart techniques exhibited higher rates. While mortality rates varied among surgical techniques, overall mortality was low. Conclusions: Data from this study can be used to shape future studies and direct physicians to develop strategies to reduce the risk of POPF and thereby reduce morbidity and mortality, leading to improved patient outcomes. Furthermore, this data can inform clinical decision-making and guide the development of evidence-based practice guidelines to optimize surgical outcomes.

VL  - 8
IS  - 2
ER  -

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