Pancreatic fistula (according to the 2016-revised ISGPSc of POPF
) developed in 3/40 patients (7.5%) in both groups: one grade B POPF
(2.5%) and 2 (5%) grade C POPF
in the sPD group and 3 (7.5%) grade C POPF
in the nvrPD group; p = 0.55.
Given the fact that the frequency of POPF, the most notorious postpancreatoduodenectomy complication, remains as high as 40% , researchers have focused on factors that may influence this rate, with the pancreatoenteric anastomosis being one of them.
In light of these conflicting evidences, we conducted a meta-analysis, in order to provide an up-to-date comparison of PG and PJ after PD, for benign or malignant diseases of the head of the pancreas and the periampullary region, in terms of clinically significant POPF and other postoperative complications.
The results of meta-analysis show that there is no difference between internal and external drainage in the rate of POPF ([I.sup.2] = 51%, OR = 0.81; 95% CI, 0.47-1.39; P = 0.44); therefore the random model was used (Figure 3).
Three studies reported POPF in patients with soft pancreas and hard pancreas.
All the late bleeds were associated with a POPF
, with a median presentation at 12 days (range 10-25 days).
There are several studies in the literature to identify the risk factors affecting the development of POPF
. In these studies, researchers were focused more on pancreatic remnant stump closure technique, simultaneous resection of other organs (6).
Clinically relevant postoperative pancreatic fistula formation (POPF
) Grades B and C which occur in up to 21% of all patients especially have a major impact on postoperative outcome and may lead to additional complications such as delayed gastric emptying, intra-abdominal abscess formation, sepsis, or hemorrhage from major visceral vessels and may therefore contribute not just to a prolonged hospital stay but eventually to a fatal postoperative outcome [5, 7-10].
The results of meta-analysis show that there is no difference between two groups in the rate of POPF
(OR = 0.76; 95% CI, 0.35-1.69; P = 0.51; [I.sup.2] = 0% for heterogeneity).
Postoperative pancreatic fistula (POPF
) is the most common complication of pancreaticoduodenectomy.
Among these complications, postoperative pancreatic fistula (POPF
) is the most serious [2-6].
Zhang and coworkers  in their case series of 119 patients receiving enucleation (91% for PanNETs) reported that NYHA (New York Heart Association) class II or III and operative time longer than 180 min were both independent risk factors for POPF