Evidence map›Paper›PMID 39915344›Full record

ArticleLangenbeck's archives of surgery2025

Risk stratification of postoperative pancreatic fistula and other complications following pancreatoduodenectomy. How far are we? A scoping review.

Zahraa M Alhulaili, Rick G Pleijhuis, Frederik J H Hoogwater, Maarten W Nijkamp, Joost M Klaase

Abstract readScoping Review
PubMed Full text at PMC Publisher
In one paragraph

Article 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. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing 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

6 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Article
  5. EUS pancreatic rendezvous to rescue failed ERCP for postoperative pancreatic fistula after pancreaticoduodenectomy.VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy · 2025
    Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Zahraa M AlhulailiDepartment of Hepato-Pancreato- Biliary Surgery and Liver Transplantation University Medical Center Groningen, University of Groningen, 30001 9700 RB, Groningen, Netherlands.
Rick G PleijhuisDepartment of Internal Medicine University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
Frederik J H HoogwaterDepartment of Hepato-Pancreato- Biliary Surgery and Liver Transplantation University Medical Center Groningen, University of Groningen, 30001 9700 RB, Groningen, Netherlands.
Maarten W NijkampDepartment of Hepato-Pancreato- Biliary Surgery and Liver Transplantation University Medical Center Groningen, University of Groningen, 30001 9700 RB, Groningen, Netherlands.
Joost M KlaaseDepartment of Hepato-Pancreato- Biliary Surgery and Liver Transplantation University Medical Center Groningen, University of Groningen, 30001 9700 RB, Groningen, Netherlands. j.m.klaase@umcg.nl.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePancreatoduodenectomy (PD) is a challenging procedure which is associated with high morbidity rates. This study was performed to make an overview of risk factors included in risk stratification methods both logistic regression models and models based on artificial intelligence algorithms to predict postoperative pancreatic fistula (POPF) and other complications following PD and to provide insight in the extent to which these tools were validated.

methodsFive databases were searched to identify relevant studies. Calculators, equations, nomograms, and artificial intelligence models that addressed POPF and other complications were included. Only PD resections were considered eligible. There was no exclusion of the minimally invasive techniques reporting PD resections. All other pancreatic resections were excluded.

results90 studies were included. Thirty-five studies were related to POPF, thirty-five studies were related to other complications following PD and twenty studies were related to artificial intelligence predication models after PD. Among the identified risk factors, the most used factors for POPF risk stratification were the main pancreatic duct diameter (MPD) (80%) followed by pancreatic texture (51%), whereas for other complications the most used factors were age (34%) and ASA score (29.4%). Only 26% of the evaluated risk stratification tools for POPF and other complications were externally validated. This percentage was even lower for the risk models using artificial intelligence which was 20%.

conclusionThe MPD was the most used factor when stratifying the risk of POPF followed by pancreatic texture. Age and ASA score were the most used factors for the stratification of other complications. Insight in clinically relevant risk factors could help surgeons in adapting their surgical strategy and shared decision-making. This study revealed that the focus of research still lies on developing new risk models rather than model validation, hampering clinical implementation of these tools for decision support.

Indexed as

Pancreatic FistulaPancreaticoduodenectomyPostoperative ComplicationsArtificial IntelligenceHumansRisk AssessmentRisk FactorsComplicationsMortalityPancreaticoduodenectomyPOPFRisk models.Risk stratification

Identifiers

PMID39915344
PMCPMC11802655

What Socratic holds

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LicenceCC BY
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Registered trials

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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 Socratic graph.