Clinically relevant postoperative pancreatic fistula (CR-POPF) is the leading cause of morbidity and mortality after pancreatic surgery. Post-pancreatectomy acute pancreatitis (PPAP) has been increasingly understood as a precursor and exacerbator of CR-POPF. No longer believed to be the consequence of surgical technique, the solution to preventing CR-POPF may lie instead in non-surgical, mainly pharmacological interventions. Five databases were searched, identifying eight pharmacological preventative strategies, including neoadjuvant therapy, somatostatin and its analogues, antibiotics, analgesia, corticosteroids, protease inhibitors, miscellaneous interventions with few reports, and combination strategies. Two further non-surgical interventions studied were nutrition and fluids. New potential interventions were also identified from related surgical and experimental contexts. Given the varied efficacy reported for these interventions, numerous opportunities for clarifying this heterogeneity remain. By reducing CR-POPF, patients may avoid morbid sequelae, experience shorter hospital stays, and ensure timely delivery of adjuvant therapy, overall aiding survival where prognosis, particularly in pancreatic cancer patients, is poor.
临床上相关的术后胰瘘是胰腺手术后发病和死亡的主要原因。术后急性胰腺炎日益被视为临床上相关术后胰瘘的前兆和加重因素。预防临床上相关术后胰瘘的解决方案不再被认为是手术技术的结果，而可能在于非手术干预，主要是药物干预。检索了五个数据库，确定了八种药物预防策略，包括新辅助治疗、生长抑素及其类似物、抗生素、镇痛药、皮质类固醇、蛋白酶抑制剂、报告较少的其他干预措施以及联合策略。另外研究的两种非手术干预是营养和液体管理。从相关的外科和实验背景中也发现了新的潜在干预措施。鉴于这些干预措施报告的疗效各不相同，澄清这种异质性的机会仍然很多。通过减少临床上相关术后胰瘘，患者可以避免病态后遗症，缩短住院时间，并确保及时进行辅助治疗，总体上帮助预后较差的患者（尤其是胰腺癌患者）提高生存率。
肿瘤(癌症)患者之家