{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T01:14:33Z","timestamp":1768439673476,"version":"3.49.0"},"reference-count":40,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,10,18]],"date-time":"2020-10-18T00:00:00Z","timestamp":1602979200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,10,18]],"date-time":"2020-10-18T00:00:00Z","timestamp":1602979200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2020,10,18]],"date-time":"2020-10-18T00:00:00Z","timestamp":1602979200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cirrhosis has been considered a contraindication to major abdominal surgeries, due to increased risk for postoperative morbidity and mortality. The aim of this study was to assess the safety of pancreatectomy in cirrhotic versus non\u2010cirrhotic patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The present systematic review and meta\u2010analysis was performed according to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta\u2010Analyses) guidelines. All meta\u2010analyses were performed using the random effects model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eight studies were eventually included, enrolling 1229 patients (cirrhotics: 722; and Child\u2013Pugh A: 593; Child\u2013Pugh B\/C: 129) who underwent surgery for pancreatic cancer. The overall postoperative morbidity rate was 66% (51%\u201380%). Infections (26%) and ascites formation\/worsening (23%) were the most common postoperative complications, followed by anastomotic leak\/fistula (17%). Non\u2010cirrhotic patients were less likely to suffer from anastomotic leak\/fistula (OR: 0.39; 95% CI: 0.23\u20130.65) and infections (OR: 0.41; 95% CI: 0.25\u20130.67). Postoperative mortality rate was statistically significantly lower in non\u2010cirrhotic versus cirrhotic patients (OR: 0.18; 95% CI:0.18\u20130.39). The odds ratios of 1 year (OR: 0.62; 95% CI: 0.30\u20131.30), 2 year (OR: 0.67; 95% CI: 0.25\u20131.83) and 3 year all\u2010cause mortality (OR: 0.32; 95% CI: 20.03\u20132.99) were not significantly different between cirrhotic versus non\u2010cirrhotic patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study demonstrated that non\u2010cirrhotic patients were less likely to undergo any type of re\u2010intervention and had statistically significant lower postoperative mortality rates compared to patients with cirrhosis.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-020-05821-7","type":"journal-article","created":{"date-parts":[[2020,10,18]],"date-time":"2020-10-18T20:02:37Z","timestamp":1603051357000},"page":"562-570","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The Impact of Cirrhosis on Pancreatic Cancer Surgery: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"45","author":[{"given":"Dimitrios","family":"Schizas","sequence":"first","affiliation":[{"name":"First Department of Surgery, Laikon General Hospital National and Kapodistrian University of Athens Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Spyridon","family":"Peppas","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Athens Naval Hospital Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefanos","family":"Giannopoulos","sequence":"additional","affiliation":[{"name":"Department of Surgery 251 VA and Hellenic Air Force Hospital Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vasiliki","family":"Lagopoulou","sequence":"additional","affiliation":[{"name":"Department of Surgery 251 VA and Hellenic Air Force Hospital Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos S.","family":"Mylonas","sequence":"additional","affiliation":[{"name":"First Department of Surgery, Laikon General Hospital National and Kapodistrian University of Athens Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Spyridon","family":"Giannopoulos","sequence":"additional","affiliation":[{"name":"First Department of Surgery, Laikon General Hospital National and Kapodistrian University of Athens Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitrios","family":"Moris","sequence":"additional","affiliation":[{"name":"Department of Surgery Duke University Medical Center Durham NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evangelos","family":"Felekouras","sequence":"additional","affiliation":[{"name":"First Department of Surgery, Laikon General Hospital National and Kapodistrian University of Athens Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos","family":"Toutouzas","sequence":"additional","affiliation":[{"name":"First Propedeutic Department of Surgery, Hippocration General Hospital National and Kapodistrian University of Athens Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,10,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(14)60121\u20105"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(08)60383\u20109"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.26682"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010003\u20106794\u20101"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2003.08.011"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2008.10.013"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010004\u20108823\u2010z"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0039\u20106060(97)90080\u20105"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2013.11.009"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2004.07.034"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510280404"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0b013e3282f4489f"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2010.10.014"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/pl00013170"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gassur.2006.08.018"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000246856.03918.9a"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2006.11.017"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v19.i41.7129"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.5754\/hge10509"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.630"},{"key":"e_1_2_9_22_1","first-page":"82","article-title":"Pancreaticoduodenectomy with radical lymphadenectomy is not contraindicated for patients with established chronic liver disease and portal hypertension","volume":"7","author":"Sethi H","year":"2008","journal-title":"HepatobiliaryPancreat Dis Int"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpb.2018.08.002"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.23856"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1159\/000323961"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28677"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2017.5"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v20.i32.11182"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.24936"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/PPO.0b013e3182756803"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055\u20109965.EPI\u201008\u20100880"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.22535"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021423"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000201"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2012.03.037"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1542\u20103565(04)00296\u20104"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.14.1774"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001299"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.140.7.650"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ciresp.2016.01.002"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-020-05821-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00268-020-05821-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-020-05821-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-020-05821-7","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,7]],"date-time":"2024-01-07T17:44:23Z","timestamp":1704649463000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-020-05821-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,18]]},"references-count":40,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,2]]}},"alternative-id":["10.1007\/s00268-020-05821-7"],"URL":"https:\/\/doi.org\/10.1007\/s00268-020-05821-7","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,18]]},"assertion":[{"value":"4 October 2020","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 October 2020","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"All authors have nothing to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}