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dc.contributor.authorSøreide, Kjetilen_US
dc.contributor.authorLabori, Knut Jørgenen_US
dc.date.accessioned2017-04-04T13:45:15Z
dc.date.available2017-04-04T13:45:15Z
dc.date.issued2016-03
dc.PublishedScandinavian Journal of Gastroenterology 2016, 51(10):1147-1154eng
dc.identifier.issn0036-5521
dc.identifier.urihttps://hdl.handle.net/1956/15669
dc.description.abstractBackground: Pancreas surgery has developed into a fairly safe procedure in terms of mortality, but is still hampered by considerable morbidity. Among the most frequent and dreaded complications are the development of a post-operative pancreatic fistula (POPF). The prediction and prevention of POPF remains an area of debate with several questions yet to be firmly addressed with solid answers. Methods: A systematic review of systematic reviews/meta-analyses and randomized trials in the English literature (PubMed/MEDLINE, Cochrane library, EMBASE) covering January 2005 to December 2015 on risk factors and preventive strategies for POPF. Results: A total of 49 systematic reviews and meta-analyses over the past decade discussed patient, surgeon, pancreatic disease and intraoperative related factors of POPF. Non-modifiable factors (age, BMI, comorbidity) and pathology (histotype, gland texture, duct size) that indicates surgery are associated with POPF risk. Consideration of anastomotic technique and use of somatostatin-analogs may slightly modify the risk of fistula. Sealant products appear to have no effect. Perioperative bleeding and transfusion enhance risk, but is modifiable by focus on technique and training. Drains may not prevent fistulae, but may help in early detection. Early drain-amylase may aid in detection. Predictive scores lack uniform validation, but may have a role in patient information if reliable pre-operative risk factors can be obtained. Conclusions: Development of POPF occurs through several demonstrated risk factors. Anastomotic technique and use of somatostatin-analogs may slightly decrease risk. Drains may aid in early detection of leaks, but do not prevent POPF.en_US
dc.language.isoengeng
dc.publisherTaylor & Franciseng
dc.rightsAttribution CC BY NC NDeng
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/eng
dc.subjectClassificationeng
dc.subjectConsensuseng
dc.subjectDefinitioneng
dc.subjectMorbidityeng
dc.subjectpancreas fistulaeng
dc.subjectPancreas surgeryeng
dc.subjectPredictioneng
dc.titleRisk factors and preventive strategies for post-operative pancreatic fistula after pancreatic surgery: a comprehensive reviewen_US
dc.typePeer reviewed
dc.typeJournal article
dc.date.updated2016-12-14T09:47:00Z
dc.description.versionpublishedVersionen_US
dc.rights.holderCopyright 2016 the authors
dc.identifier.doihttps://doi.org/10.3109/00365521.2016.1169317


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Attribution CC BY NC ND
Except where otherwise noted, this item's license is described as Attribution CC BY NC ND