PMID- 36902534
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230313
IS  - 2077-0383 (Print)
IS  - 2077-0383 (Electronic)
IS  - 2077-0383 (Linking)
VI  - 12
IP  - 5
DP  - 2023 Feb 22
TI  - Perioperative Drug Treatment in Pancreatic Surgery-A Systematic Review and 
      Meta-Analysis.
LID - 10.3390/jcm12051750 [doi]
LID - 1750
AB  - INTRODUCTION: Pancreatic resections for malignant or benign diseases are 
      associated with major morbidity and changes in physiology. To reduce 
      perioperative complications and enhance recovery, many types of perioperative 
      medical management have been introduced. The aim of this study was to provide an 
      evidence-based overview on the best perioperative drug treatment. METHODS: The 
      electronic bibliographic databases Medline, Embase, CENTRAL, and Web of Science 
      were systematically searched for randomized controlled trials (RCT) evaluating 
      perioperative drug treatments in pancreatic surgery. The investigated drugs were 
      somatostatin analogues, steroids, pancreatic enzyme replacement therapy (PERT), 
      prokinetic therapy, antidiabetic drugs, and proton pump inhibitors (PPI). 
      Targeted outcomes in each drug category were meta-analyzed. RESULTS: A total of 
      49 RCT were included. The analysis of somatostatin analogues showed a 
      significantly lower incidence of postoperative pancreatic fistula (POPF) in the 
      somatostatin group compared to the control group (OR 0.58, 95% CI: 0.45 to 0.74). 
      The comparison of glucocorticoids versus placebo showed significantly less POPF 
      in the glucocorticoid group (OR 0.22, 95% CI: 0.07 to 0.77). There was no 
      significant difference in DGE when erythromycin was compared to placebo (OR 0.33, 
      95% CI: 0.08 to 1.30). The other investigated drug regimens could only be 
      analyzed qualitatively. CONCLUSION: This systematic review provides a 
      comprehensive overview on perioperative drug treatment in pancreatic surgery. 
      Some often-prescribed perioperative drug treatments lack high quality evidence 
      and further research is needed.
FAU - Rompen, Ingmar F
AU  - Rompen IF
AD  - Department of General, Visceral and Transplantation Surgery, Heidelberg 
      University Hospital, 69120 Heidelberg, Germany.
FAU - Merz, Daniela C
AU  - Merz DC
AUID- ORCID: 0000-0001-7977-0275
AD  - Department of General, Visceral and Transplantation Surgery, Heidelberg 
      University Hospital, 69120 Heidelberg, Germany.
FAU - Alhalabi, Karam T
AU  - Alhalabi KT
AD  - Department of General, Visceral and Transplantation Surgery, Heidelberg 
      University Hospital, 69120 Heidelberg, Germany.
FAU - Klotz, Rosa
AU  - Klotz R
AD  - Department of General, Visceral and Transplantation Surgery, Heidelberg 
      University Hospital, 69120 Heidelberg, Germany.
AD  - Study Center of the German Society of Surgery, 69120 Heidelberg, Germany.
FAU - Kalkum, Eva
AU  - Kalkum E
AD  - Study Center of the German Society of Surgery, 69120 Heidelberg, Germany.
FAU - Pausch, Thomas M
AU  - Pausch TM
AUID- ORCID: 0000-0001-6145-3263
AD  - Department of General, Visceral and Transplantation Surgery, Heidelberg 
      University Hospital, 69120 Heidelberg, Germany.
FAU - Strothmann, Hendrik
AU  - Strothmann H
AD  - Department of Surgery, Cantonal Hospital Thurgau, 8596 Munsterlingen, 
      Switzerland.
FAU - Probst, Pascal
AU  - Probst P
AUID- ORCID: 0000-0002-0895-4015
AD  - Department of Surgery, Cantonal Hospital Thurgau, 8596 Munsterlingen, 
      Switzerland.
AD  - Department of Surgery, Cantonal Hospital Thurgau, 8501 Frauenfeld, Switzerland.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20230222
PL  - Switzerland
TA  - J Clin Med
JT  - Journal of clinical medicine
JID - 101606588
PMC - PMC10003556
OTO - NOTNLM
OT  - glucocorticoid
OT  - insulin
OT  - pancreas
OT  - pancreatic enzyme replacement
OT  - proton pump inhibitors
OT  - somatostatin
OT  - surgery
COIS- No conflict of interest were stated by the authors.
EDAT- 2023/03/12 06:00
MHDA- 2023/03/12 06:01
PMCR- 2023/02/22
CRDT- 2023/03/11 01:20
PHST- 2023/01/04 00:00 [received]
PHST- 2023/02/17 00:00 [revised]
PHST- 2023/02/20 00:00 [accepted]
PHST- 2023/03/11 01:20 [entrez]
PHST- 2023/03/12 06:00 [pubmed]
PHST- 2023/03/12 06:01 [medline]
PHST- 2023/02/22 00:00 [pmc-release]
AID - jcm12051750 [pii]
AID - jcm-12-01750 [pii]
AID - 10.3390/jcm12051750 [doi]
PST - epublish
SO  - J Clin Med. 2023 Feb 22;12(5):1750. doi: 10.3390/jcm12051750.