Somatostatin analogues and the risk of post-operative pancreatic fistulas after pancreatic resection - A systematic review & meta-analysis |
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| Affiliation: | 1. Yong Loo Lin School of Medicine, National University, Singapore;2. Department of General Surgery, National University Health System, Singapore;3. Department of General Surgery, Tan Tock Seng Hospital, Singapore;1. Department of HPB Surgery, Freeman Hospital, Newcastle-upon-Tyne, UK;2. Department of Cellular Pathology, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK;1. Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation, and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan;2. Gastroenterological Surgery, National Hospital Organization Shinshu Ueda Medical Center, Ueda, Japan;3. Gastroenterological Surgery, Nagano Municipal Hospital, Nagano, Japan;1. Departement of Surgery, Institut Paoli-Calmettes, Marseille, France;2. Departement of Oncology, Institut Paoli-Calmettes, Marseille, France;3. Departement of Pathology, Institut Paoli-Calmettes, Marseille, France;4. Departement of Endoscopy, Institut Paoli-Calmettes, Marseille, France;5. Departement of Surgery, Aix-Marseille University, Institut Paoli-Calmettes, CRCM, Marseille, France;1. Department of Digestive Internal Medicine, Gannan Medical University Pingxiang Hospital, 128 Guangchang Road, Pingxiang, 337055, People''s Republic of China;2. Department of International School of Nursing, Hainan Medical University, Haikou, 571199, People''s Republic of China;3. Laboratory of Shock, Department of Pathophysiology, Xiangya School of Medicine, Central South University, Changsha, Hunan, 410008, People''s Republic of China;1. GI & HPB Service, Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India;2. Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, the Netherlands |
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| Abstract: | BackgroundPost-operative pancreatic fistula (POPF) is a common complication of pancreatic resection. Somatostatin analogues (SA) have been used as prophylaxis to reduce its incidence. The aim of this study is to appraise the current literature on the effects of SA prophylaxis on the prevention of POPF following pancreatic resection.MethodsThe review of the literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data from studies that reported the effects of SA prophylaxis on POPF following pancreatic resection were extracted, to determine the effect of SA on POPF morbidity and mortality.ResultsA total of 15 studies, involving 2221 patients, were included. Meta-analysis revealed significant reductions in overall POPF (Odds ratio: 0.65 (95% CI 0.53–0.81, p < 0.01)), clinically significant POPF (Odds ratio: 0.53 (95% CI 0.34–0.83, p < 0.01)) and overall morbidity (OR: 0.69 (95% CI: 0.50–0.95, p = 0.02)) following SA prophylaxis. There is no evidence that SA prophylaxis reduces mortality (OR: 1.10 (95%CI: 0.68–1.79, p = 0.68)).ConclusionSA prophylaxis following pancreatic resection reduces the incidence of POPF. However, mortality is unaffected. |
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| Keywords: | Octreotide Pancreaticoduodenectomy Distal pancreatectomy Whipple’s procedure Pasireotide Somatostatin analogues Post-operative Pancreatic fistula Pancreatic resection |
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