Perioperative interventions to reduce pancreatic fistula following pancreatoduodenectomy: meta-analysis.

PARANOIA Study Group.

Br J Surg 2022; 109: 812–821.

This paper included 55 studies concerning 7512 patients. Most studies were small and underpowered. External drainage, Ulinastatin treatment, and invagination pancreaticojejunostomy were associated with reduced rates of clinical postoperative pancreatic fistula.

Comment: The authors conclude bigger studies needed, but several therapies are worthwhile.