Evidence map›Paper›PMID 42456034›Full record

SynthesisBJS open2026

Hospital costs associated with complications following pancreatoduodenectomy: systematic review.

Michiel F G Francken, Joey de Hondt, Faridi S Jamaludin, Martijn W J Stommel, Bert A Bonsing, Hjalmar C van Santvoort, Bas Groot Koerkamp, Olivier R Busch, Marcel G W Dijkgraaf, Marc G Besselink

Abstract readSystematic Review
In one paragraph

Synthesis in BJS open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

10 authors.

Michiel F G FranckenDepartment of Surgery, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands.
Joey de HondtDepartment of Surgery, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands.
Faridi S JamaludinAmsterdam UMC, Location University of Amsterdam, Medical Library AMC, Amsterdam, the Netherlands.
Martijn W J StommelDepartment of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands.ORCID 0000-0002-4257-5254
Bert A BonsingDepartment of Surgery, Leiden University Medical Center, Leiden, the Netherlands.
Hjalmar C van SantvoortDepartment of Surgery, St Antonius Hospital, Nieuwegein, the Netherlands.
Bas Groot KoerkampDepartment of Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.ORCID 0000-0003-1917-6973
Olivier R BuschDepartment of Surgery, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands.ORCID 0000-0001-9605-6831
Marcel G W DijkgraafDepartment of Epidemiology and Data Science, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands.ORCID 0000-0003-0750-8790
Marc G BesselinkDepartment of Surgery, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands.ORCID 0000-0003-2650-9350

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPancreatoduodenectomy is associated with postoperative complications in nearly half of all patients. Understanding the financial burden of these complications is relevant to supporting initiatives to improve patient outcome and resource allocation. A contemporary systematic review evaluating the costs of complications following pancreatoduodenectomy is lacking.

methodsA systematic review was conducted following PRISMA 2020 guidelines in PubMed, Embase, and Cochrane Central Register of Controlled Trials from inception to September 2024. Studies reporting on the hospital costs (primary outcome) of complications following pancreatoduodenectomy were included. Costs were adjusted for inflation and purchasing power parity to 2023 Dutch euros (€). Data extraction and risk-of-bias assessments were conducted independently by two reviewers.

resultsOverall, 46 studies with 111 215 patients undergoing pancreatoduodenectomy from 13 countries were included. Postoperative pancreatic fistula grade B increased costs by €1998 to €25 228, and grade C by €21 268 to €112 824 versus no clinically relevant postoperative pancreatic fistula (mean or median values). Delayed gastric emptying grade B increased costs by €10 836 to €22 571 and grade C by €28 707 to €61 818 versus no clinically relevant delayed gastric emptying. Postpancreatectomy haemorrhage (various definitions) increased costs by €29 447 to €48 380. Biliary leak grade B increased costs by €7616 and grade C by €22 727. Clavien-Dindo complication grade III added €2785 to €20 294 compared with grade II, and grade IV added €25 190 to €63 644 compared with grade III.

conclusionComplications following pancreatoduodenectomy increase costs substantially, exceeding €100 000 for a single postoperative pancreatic fistula grade C. These costs can now be used to design cost-effective prophylactic and therapeutic interventions aiming to improve patient outcomes together with optimal use of healthcare resources.

Indexed as

Hospital CostsPancreaticoduodenectomyPostoperative ComplicationsHumansPancreatic Fistulacomplicationscostspancreatoduodenectomy

Identifiers

PMID42456034
PMCPMC13372025

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.