Cochrane · systematic review · CD009621

Fibrin sealants for the prevention of postoperative pancreatic fistula following pancreatic surgery

Lai, M, Zhou, S, He, S, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library

Colorectal4 versionsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
22
current version
GRADE rated
18
No studies
4
Included studies
NR
No studies 4 · 18.2%Ungraded 0 · 0%Very low 10 · 45.5%Low 8 · 36.4%Moderate 0 · 0%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

Show all 4 versions

Application of fibrin sealants to pancreatic stump closure reinforcement for the prevention of postoperative pancreatic fistula following distal pancreatectomy

Population: people undergoing distal pancreatectomy
7 questions
OutcomeEffectEvidenceStatus / GRADE
Postoperative pancreatic fistula (grade B or C)
RR 0.94 [0.73, 1.21]5 studies · 1002 participantsLow
Downgraded: risk of bias, imprecision
Postoperative mortality
Peto OR 0.39 [0.12, 1.29]7 studies · 1051 participantsVery low
Downgraded: risk of bias, imprecision
Overall postoperative morbidity
RR 1.2 [0.98, 1.48]4 studies · 893 participantsLow
Downgraded: risk of bias, imprecision
Reoperation rate
RR 0.4 [0.18, 0.9]3 studies · 623 participantsLow
Downgraded: risk of bias, imprecision
Serious adverse events
no estimate extracted5 studies · 732 participantsLow
Downgraded: risk of bias, imprecision
Cost‐effectiveness
no estimate extractedNRNo studies
Total length of hospital stay (days)
MD 0.992 studies · 371 participantsVery low
Downgraded: risk of bias, imprecision, inconsistency

Application of fibrin sealants to pancreatic anastomosis reinforcement for the prevention of postoperative pancreatic fistula following pancreaticoduodenectomy

Population: people undergoing pancreaticoduodenectomy
7 questions
OutcomeEffectEvidenceStatus / GRADE
Postoperative pancreatic fistula (grade B or C)
1.34 [0.72, 2.48]3 studies · 323 participantsVery low
Downgraded: risk of bias, imprecision
Postoperative mortality
Peto OR 0.24 [0.05, 1.06]5 studies · 517 participantsVery low
Downgraded: risk of bias, imprecision
Overall postoperative morbidity
1.02 [0.87, 1.19]4 studies · 447 participantsLow
Downgraded: risk of bias, imprecision
Reoperation rate
RR 0.74 [0.33, 1.66]3 studies · 323 participantsVery low
Downgraded: risk of bias, imprecision
Serious adverse events
no estimate extracted2 studies · 194 participantsVery low
Downgraded: risk of bias, imprecision
Total hospital cost (US dollars)
no estimate extracted1 study · 124 participantsVery low
Downgraded: risk of bias, imprecision
Total length of hospital stay (days)
no estimate extracted4 studies · 447 participantsLow
Downgraded: risk of bias, imprecision

Application of fibrin sealants to pancreatic duct occlusion for the prevention of postoperative pancreatic fistula following pancreaticoduodenectomy

Population: people undergoing pancreaticoduodenectomy
8 questions
OutcomeEffectEvidenceStatus / GRADE
Postoperative pancreatic fistula (grade B or C)
no estimate extractedNRNo studies
Postoperative mortality
Peto OR 1.41 [0.63, 3.13]2 studies · 351 participantsVery low
Downgraded: risk of bias, imprecision
Overall postoperative morbidity
RR 1.16 [0.67, 2.02]2 studies · 351 participantsVery low
Downgraded: risk of bias, imprecision, inconsistency
Reoperation rate
RR 0.85 [0.52, 1.41]2 studies · 351 participantsVery low
Downgraded: risk of bias, imprecision
Serious adverse events (diabetes mellitus)
no estimate extracted1 study · 169 participantsLow
Downgraded: risk of bias, imprecision
Quality of life
no estimate extractedNRNo studies
Cost‐effectiveness
no estimate extractedNRNo studies
Total length of hospital stay (days)
no estimate extracted2 studies · 351 participantsLow
Downgraded: risk of bias, imprecision