What do systematic reviews say?

Stapler vs scalpel resection followed by hand‐sewn closure of the pancreatic remnant

Stapler showed no clear difference in mortality compared with scalpel resection followed by hand‐sewn closure of the pancreatic… (moderate certainty).

• Stapler versus scalpel resection followed by hand‐sewn closure of the pancreatic remnant for distal pancreatectomy 2015 · Cochrane Headline outcomes only
  RR 0.49 [0.05, 5.4]
  2 studies · 381 participants
  Moderate

Drain use vs No drain

Drain use showed no clear difference in mortality compared with no drain use following pancreatic surgery (low certainty).

• Prophylactic abdominal drainage for pancreatic surgery 2021 · Cochrane Headline outcomes only
  RR 0.78 [0.31, 1.99]
  4 studies · 1055 participants
  Low
• Prophylactic abdominal drainage for pancreatic surgery 2021 · Cochrane Headline outcomes only
  RR 0.23 [0.06, 0.9]
  2 studies · 478 participants
  Low

Early vs late drain removal following pancreatic surgery

It is very uncertain whether early changes mortality compared with late drain removal following pancreatic surgery (very low certainty).

• Prophylactic abdominal drainage for pancreatic surgery 2021 · Cochrane Headline outcomes only
  RR 0.99 [0.06, 15.45]
  3 studies · 399 participants
  Very low
• Prophylactic abdominal drainage for pancreatic surgery 2021 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Active drain vs passive drain

It is very uncertain whether active drain changes mortality compared with passive drain following pancreatic surgery (very low certainty).

• Prophylactic abdominal drainage for pancreatic surgery 2021 · Cochrane Headline outcomes only
  RR 1.23 [0.3, 5.06]
  2 studies · 382 participants
  Very low
• Prophylactic abdominal drainage for pancreatic surgery 2021 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

High vs non‐high (medium or low) dose regimen

High showed no clear difference in mortality compared with non‐high (medium or low) dose regimen (low certainty).

• Comparison of different regimens of proton pump inhibitors for acute peptic ulcer bleeding 2013 · Cochrane Headline outcomes only
  RR 0.85 [0.47, 1.54]
  12 studies · 1667 participants
  Low

Percutaneous endoscopic gastrostomy vs nasogastric tube feeding

It is very uncertain whether percutaneous endoscopic gastrostomy changes mortality irrespective of compared with nasogastric tube feeding (very low certainty).

• Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for adults with swallowing disturbances 2015 · Cochrane Headline outcomes only
  RR 0.86 [0.58, 1.28]
  9 studies · 644 participants
  Very low

Perioperative chemotherapy vs primary surgery

• Perioperative chemo(radio)therapy versus primary surgery for resectable adenocarcinoma of the stomach,… 2013 · Cochrane Headline outcomes only
  no estimate extracted
  11 studies · 1606 participants
  Moderate

Higher threshold (500 mL per six hours or greater) vs lower threshold (less than 500 mL per six hours) at time of aspiration

It is very uncertain whether higher threshold (500 mL per six hours or greater) changes mortality (at the end of compared with lower threshold (less than 500 mL per six hours) at time of aspiration (very low certainty).

• Monitoring of gastric residual volume during enteral nutrition 2021 · Cochrane Headline outcomes only
  RR 1.01 [0.74, 1.38]
  1 study · 322 participants
  Very low

No replacement vs replacement

• Stents for the prevention of pancreatic fistula following pancreaticoduodenectomy 2016 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 46 participants
  GRADE not reported

Stents vs no stents

Stents showed no clear difference in in‐hospital mortality compared with no stents (moderate certainty).

• Stents for the prevention of pancreatic fistula following pancreaticoduodenectomy 2016 · Cochrane Headline outcomes only
  RR 0.73 [0.28, 1.94]
  4 studies · 605 participants
  Moderate

Internal stents vs external stents

Internal stents showed no clear difference in in‐hospital mortality compared with external stents (low certainty).

• Stents for the prevention of pancreatic fistula following pancreaticoduodenectomy 2016 · Cochrane Headline outcomes only
  RR 0.33 [0.01, 7.99]
  3 studies · 362 participants
  Low

Duct‐to‐mucosa pancreaticojejunostomy using the modified Blumgart technique vs duct‐to‐mucosa pancreaticojejunostomy using the traditional interrupted technique

• Duct‐to‐mucosa versus other types of pancreaticojejunostomy for the prevention of postoperative pancreatic fistula… 2022 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 210 participants
  Very low

Duct‐to‐mucosa vs invagination pancreaticojejunostomy

It is very uncertain whether duct‐to‐mucosa changes postoperative mortality compared with invagination pancreaticojejunostomy (very low certainty).

• Duct‐to‐mucosa versus other types of pancreaticojejunostomy for the prevention of postoperative pancreatic fistula… 2022 · Cochrane Headline outcomes only
  RR 0.77 [0.39, 1.49]
  10 studies · 1472 participants
  Very low

Pancreaticojejunostomy vs pancreatogastrostomy after pancreatoduodectomy

Pancreaticojejunostomy showed no clear difference in postoperative mortality compared with pancreatogastrostomy after pancreatoduodectomy (moderate certainty).

• Pancreaticojejunostomy versus pancreaticogastrostomy reconstruction for the prevention of postoperative pancreatic… 2017 · Cochrane Headline outcomes only
  RR 0.84 [0.53, 1.34]
  10 studies · 1629 participants
  Moderate