Non-Surgical Interventions for the Prevention of Clinically Relevant Postoperative Pancreatic Fistula—A Narrative Review
Clinically relevant postoperative pancreatic fistula (CR-POPF) is the leading cause of morbidity and mortality after pancreatic surgery. Post-pancreatectomy acute pancreatitis (PPAP) has been increasingly understood as a precursor and exacerbator of CR-POPF. No longer believed to be the consequence...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-12-01
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| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/15/24/5865 |
| _version_ | 1797381670428475392 |
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| author | Nadya Rykina-Tameeva Jaswinder S. Samra Sumit Sahni Anubhav Mittal |
| author_facet | Nadya Rykina-Tameeva Jaswinder S. Samra Sumit Sahni Anubhav Mittal |
| author_sort | Nadya Rykina-Tameeva |
| collection | DOAJ |
| description | Clinically relevant postoperative pancreatic fistula (CR-POPF) is the leading cause of morbidity and mortality after pancreatic surgery. Post-pancreatectomy acute pancreatitis (PPAP) has been increasingly understood as a precursor and exacerbator of CR-POPF. No longer believed to be the consequence of surgical technique, the solution to preventing CR-POPF may lie instead in non-surgical, mainly pharmacological interventions. Five databases were searched, identifying eight pharmacological preventative strategies, including neoadjuvant therapy, somatostatin and its analogues, antibiotics, analgesia, corticosteroids, protease inhibitors, miscellaneous interventions with few reports, and combination strategies. Two further non-surgical interventions studied were nutrition and fluids. New potential interventions were also identified from related surgical and experimental contexts. Given the varied efficacy reported for these interventions, numerous opportunities for clarifying this heterogeneity remain. By reducing CR-POPF, patients may avoid morbid sequelae, experience shorter hospital stays, and ensure timely delivery of adjuvant therapy, overall aiding survival where prognosis, particularly in pancreatic cancer patients, is poor. |
| first_indexed | 2024-03-08T20:54:46Z |
| format | Article |
| id | doaj.art-78ea1b31ba9845e19b30e87e97ac2b89 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-08T20:54:46Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-78ea1b31ba9845e19b30e87e97ac2b892023-12-22T13:59:06ZengMDPI AGCancers2072-66942023-12-011524586510.3390/cancers15245865Non-Surgical Interventions for the Prevention of Clinically Relevant Postoperative Pancreatic Fistula—A Narrative ReviewNadya Rykina-Tameeva0Jaswinder S. Samra1Sumit Sahni2Anubhav Mittal3Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, AustraliaFaculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, AustraliaFaculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, AustraliaFaculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, AustraliaClinically relevant postoperative pancreatic fistula (CR-POPF) is the leading cause of morbidity and mortality after pancreatic surgery. Post-pancreatectomy acute pancreatitis (PPAP) has been increasingly understood as a precursor and exacerbator of CR-POPF. No longer believed to be the consequence of surgical technique, the solution to preventing CR-POPF may lie instead in non-surgical, mainly pharmacological interventions. Five databases were searched, identifying eight pharmacological preventative strategies, including neoadjuvant therapy, somatostatin and its analogues, antibiotics, analgesia, corticosteroids, protease inhibitors, miscellaneous interventions with few reports, and combination strategies. Two further non-surgical interventions studied were nutrition and fluids. New potential interventions were also identified from related surgical and experimental contexts. Given the varied efficacy reported for these interventions, numerous opportunities for clarifying this heterogeneity remain. By reducing CR-POPF, patients may avoid morbid sequelae, experience shorter hospital stays, and ensure timely delivery of adjuvant therapy, overall aiding survival where prognosis, particularly in pancreatic cancer patients, is poor.https://www.mdpi.com/2072-6694/15/24/5865clinically relevant postoperative pancreatic fistulaneoadjuvant therapysomatostatinsomatostatin analoguesantibioticsanalgesia |
| spellingShingle | Nadya Rykina-Tameeva Jaswinder S. Samra Sumit Sahni Anubhav Mittal Non-Surgical Interventions for the Prevention of Clinically Relevant Postoperative Pancreatic Fistula—A Narrative Review Cancers clinically relevant postoperative pancreatic fistula neoadjuvant therapy somatostatin somatostatin analogues antibiotics analgesia |
| title | Non-Surgical Interventions for the Prevention of Clinically Relevant Postoperative Pancreatic Fistula—A Narrative Review |
| title_full | Non-Surgical Interventions for the Prevention of Clinically Relevant Postoperative Pancreatic Fistula—A Narrative Review |
| title_fullStr | Non-Surgical Interventions for the Prevention of Clinically Relevant Postoperative Pancreatic Fistula—A Narrative Review |
| title_full_unstemmed | Non-Surgical Interventions for the Prevention of Clinically Relevant Postoperative Pancreatic Fistula—A Narrative Review |
| title_short | Non-Surgical Interventions for the Prevention of Clinically Relevant Postoperative Pancreatic Fistula—A Narrative Review |
| title_sort | non surgical interventions for the prevention of clinically relevant postoperative pancreatic fistula a narrative review |
| topic | clinically relevant postoperative pancreatic fistula neoadjuvant therapy somatostatin somatostatin analogues antibiotics analgesia |
| url | https://www.mdpi.com/2072-6694/15/24/5865 |
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