Postoperative Fluid Collections Following Left Pancreatectomy: Urgent Need for a Standardized Definition. A...

Area of Science:

• Gastrointestinal Surgery
• Surgical Oncology
• Abdominal Imaging

Background:

• Postoperative fluid collections (PFCs) are frequent complications following left pancreatectomy (LP).
• The precise definition and incidence of PFCs after LP remain inconsistently reported in existing literature.
• This variability hinders accurate assessment and management strategies.

Purpose of the Study:

• To systematically evaluate and pool the reported incidence of overall and symptomatic PFCs after left pancreatectomy (LP).
• To identify the current state of evidence regarding PFCs following LP through a meta-analysis.
• To highlight the need for standardized definitions in future research.

Main Methods:

• A comprehensive systematic literature search was conducted for studies up to April 2025.
• Studies reporting PFC incidence post-LP were included, defining PFCs as radiologic collections within 90 days.
• Pooled incidence rates for overall and symptomatic PFCs were calculated using data from randomized controlled trials (RCTs) and observational cohorts.

Main Results:

• Analysis of 26 studies (5 RCTs, 21 observational cohorts) revealed significant heterogeneity.
• Pooled incidence of overall PFCs was 47.9% in RCTs and 58.3% in observational studies.
• Pooled incidence of symptomatic PFCs was 9.6% in RCTs and 15.0% in observational studies, with notable variability (I² > 35%).

Conclusions:

• PFCs occur in approximately 50% of patients undergoing LP, with symptomatic collections in 10-15%.
• Limited consistency was found across studies, particularly in observational cohorts, emphasizing the need for standardized definitions.
• Standardized, radiology-based definitions are crucial for improving study comparability and guiding clinical practice for PFCs after LP.