{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T23:29:17Z","timestamp":1786663757950,"version":"build-2736575974"},"reference-count":22,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Laparoendoscopic &amp; Advanced Surgical Techniques"],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Pancreaticoduodenectomy (PD) is a high-risk surgical procedure associated with significant postoperative morbidity. While complications such as pancreatic fistula and delayed gastric emptying are well-studied, the incidence and risk factors of incisional hernia (IH) following PD remain poorly characterized. This systematic review and meta-analysis aimed to evaluate the incidence of IH and identify associated risk factors in patients undergoing PD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We conducted a systematic search of PubMed, Embase, CENTRAL, and Web of Science databases from inception to December 2024, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies reporting IH incidence after PD were included. The primary outcome was the pooled incidence of IH. Secondary outcomes included risk factors associated with IH. A random-effects model was used for meta-analyses, and heterogeneity was assessed using\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      statistics. Risk of bias was evaluated using the ROBINS-I tool.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 6 studies comprising 1929 patients met inclusion criteria. The pooled incidence of IH following open PD was 6% (95% CI: 2%\u201315%), with substantial heterogeneity (\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 94%). Risk factors significantly associated with IH included BMI \u2265 30 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      (OR range: 1.67\u20132.6), preoperative hypoalbuminemia (OR 3.4; 95% CI: 1.2\u20139.4), chronic obstructive pulmonary disease (HR 24.4; 95% CI: 1.6\u2013391.9), elevated preoperative CRP (HR 11.4; 95% CI: 1.2\u2013103.1), postoperative fascial dehiscence (HR 14.1; 95% CI: 1.10\u2013180.4), and wound infection (OR 2.9; 95% CI: 1.8\u20134.6). Sensitivity analyses confirmed the robustness of incidence estimates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>IH is a relatively underrecognized yet significant complication following PD, with a pooled incidence of 6%. Several modifiable and non-modifiable risk factors contribute to its development. These findings underscore the need for targeted preventive strategies in high-risk patients and further research to inform surgical decision-making and postoperative care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10926429261421860","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T15:10:07Z","timestamp":1770649807000},"page":"737-743","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Incisional Hernia after Pancreaticoduodenectomy: A Systematic Review and Meta-Analysis of Incidence and Risk Factors"],"prefix":"10.1177","volume":"36","author":[{"given":"Maria Fernanda Andrade","family":"da Silva","sequence":"first","affiliation":[{"name":"Universidade Salvador (UNIFACS), Salvador, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Clara","family":"Morais","sequence":"additional","affiliation":[{"name":"Department of Surgery, Lenox Hill Hospital, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Lech","sequence":"additional","affiliation":[{"name":"Pontif\u00edcia Universidade Cat\u00f3lica do Rio Grande do Sul, Porto Alegre, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matheus","family":"Faleiro","sequence":"additional","affiliation":[{"name":"Universidade Federal de Minas Gerais, Belo Horizonte, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o","family":"Kasakewitch","sequence":"additional","affiliation":[{"name":"Department of Surgery, New York University Langone Long Island School of Medicine, Mineola, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Perim","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raquel","family":"Nogueira","sequence":"additional","affiliation":[{"name":"Department of Surgery, Montefiore Medical Center, Bronx, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego L.","family":"Lima","sequence":"additional","affiliation":[{"name":"Department of Surgery, Montefiore Medical Center, Bronx, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,9]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000217673.04165.ea"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-193510000-00023"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2016.06.040"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00534-007-1301-y"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2022.08.002"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000189124.47589.6d"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-013-2046-1"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9600"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.284.6320.931"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0138745"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/9781119536604"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"e_1_3_3_14_2","first-page":"218248","article-title":"Reoperation following pancreaticoduodenectomy","volume":"2012","author":"Reddy JR","year":"2012","unstructured":"Reddy JR, , Saxena R, , Singh RK, et al. Reoperation following pancreaticoduodenectomy. 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