Systematic review and meta-analysis of risk factors of postoperative pancreatic fistula after distal pancreatectomy in the era of 2016 International Study Group pancreatic fistula definition

Chong, E; Ratnayake, B; Lee, S; French, JJ; Wilson, C; Roberts, KJ; Loveday, BPT; Manas, D; Windsor, J; White, S; Pandanaboyana, S

Author(s): Chong, E; Ratnayake, B; Lee, S; French, JJ; Wilson, C; Roberts, KJ; Loveday, BPT; Manas, D; Windsor, J; White, S; Pandanaboyana, S;
Details: Publication Year 2021-08,Volume 23,Issue #8,Page 1139-1151
Journal Title: HPB
Publication Type: Review
Abstract: BACKGROUND: Risk factors for the development of clinically relevant POPF (CR-POPF) following distal pancreatectomy (DP) need clarification particularly following the 2016 International Study Group of Pancreatic Fistula (ISGPF) definition. METHODS: A systemic search of MEDLINE, Pubmed, Scopus, and EMBASE were conducted using the PRISMA framework. Studies were evaluated for risk factors for the development CR-POPF after DP using the 2016 ISGPF definition. Further subgroup analysis was undertaken on studies >/=10 patients in exposed and non-exposed subgroups. RESULTS: Forty-three studies with 8864 patients were included in the meta-analysis. The weighted rate of CR-POPF was 20.4% (95%-CI: 17.7-23.4%). Smoking (OR 1.29, 95%-CI: 1.08-1.53, p = 0.02) and open DP (OR 1.43, 95%-CI: 1.02-2.01, p = 0.04) were found to be significant risk factors of CR-POPF. Diabetes (OR 0.81, 95%-CI: 0.68-0.95, p = 0.02) was a significant protective factor against CR-POPF. Substantial heterogeneity was observed in the comparisons of pancreatic texture and body mass index. Seventeen risk factors achieved significance in a univariate or multivariate comparison as reported by individual studies in the narrative synthesis, however, they remain difficult to interpret as statistically significant comparisons were not uniform. CONCLUSION: This meta-analysis found smoking and open DP to be risk factors and diabetes to be protective factor of CR-POPF in the era of 2016 ISGPF definition.
Keywords: Humans; Pancreas/surgery; *Pancreatectomy/adverse effects; *Pancreatic Fistula/diagnosis/epidemiology/etiology; Postoperative Complications/epidemiology/etiology; Retrospective Studies; Risk Factors
Department(s): Surgical Oncology
PubMed ID: 33820687
Publisher's Version: https://doi.org/10.1016/j.hpb.2021.02.015
Open Access at Publisher's Site: https://doi.org/10.1016/j.hpb.2021.02.015
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2025-06-20 08:03:20

Last Modified: 2025-06-20 08:04:25