Evidence-based guidelines for the management of exocrine pancreatic insufficiency after pancreatic surgery

Luis Sabater, Fabio Ausania, Olaf J. Bakker, Jaume Boadas, J. Enrique Dominguez-Munoz, Massimo Falconi, L. Fernández-Cruz, Luca Frulloni, Victor González-Sánchez, José Larino-Noia, Björn Lindkvist, Félix Luis, Francisco Morera-Ocón, Elena Martin-Pérez, Marra López, Ángel Moya-Herraiz, John P. Neoptolemos, Isabel Pascual, Angeles Pérez-Aisa, Raffaele PezzilliJosé M. Ramia, Belinda Sánchez, Enrique De-Madaria

Research output: Contribution to journalReview articlepeer-review

Abstract

Objective: To provide evidence-based recommendations for the management of exocrine pancreatic insufficiency (EPI) after pancreatic surgery. Background: EPI is a common complication after pancreatic surgery but there is certain confusion about its frequency, optimal methods of diagnosis, and when and how to treat these patients. Methods: Eighteen multidisciplinary reviewers performed a systematic review on 10 predefined questions following the GRADE methodology. Six external expert referees reviewed the retrieved information. Members from Spanish Association of Pancreatology were invited to suggest modifications and voted for the quantification of agreement. Results: These guidelines analyze the definition of EPI after pancreatic surgery, (one question), its frequency after specific techniques and underlying disease (four questions), its clinical consequences (one question), diagnosis (one question), when and how to treat postsurgical EPI (two questions) and its impact on the quality of life (one question). Eleven statements answering those 10 questions were provided: one (9.1%) was rated as a strong recommendation according to GRADE, three (27.3%) as moderate and seven (63.6%) as weak. All statements had strong agreement.

Original languageEnglish
Pages (from-to)949-958
Number of pages10
JournalAnnals of Surgery
Volume264
Issue number6
DOIs
Publication statusPublished - Nov 28 2016

ASJC Scopus subject areas

  • Surgery

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