{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:02:30Z","timestamp":1791820950933,"version":"4.3.4"},"reference-count":50,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pancreaticoduodenectomy (PD) removes the duodenum and proximal jejunum, alters nutrient transit, and may modify secretion of incretin hormones involved in glucose homeostasis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To systematically review clinical evidence on postoperative changes in glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) after PD, together with co-reported hormonal and metabolic outcomes, and to perform a strictly exploratory meta-analysis where sufficiently comparable numerical data were available.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following PRISMA 2020, we reviewed human studies identified in PubMed, Embase, and Scopus from 1 January 2000 to 27 March 2026, with screening and full-text selection performed in Rayyan. Eligible studies reported GLP-1 and\/or GIP after PD, after different PD reconstructions, or during post-PD nutrient-delivery interventions. Because outcome reporting was heterogeneous, quantitative pooling was restricted to exploratory random-effects syntheses of two clinically comparable post-PD reconstruction studies. Because only two studies contributed to each pooled comparison, estimates of effect size and heterogeneity were considered highly fragile and were not interpreted as confirmatory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Six studies involving 134 participants met the eligibility criteria. Postprandial GLP-1 generally increased after PD or was higher in settings associated with faster gastric emptying or greater distal nutrient exposure. By contrast, GIP was reported in fewer studies than GLP-1 and showed attenuation or no consistent enhancement. Co-reported glucose, insulin, C-peptide, glucagon, PYY, and gastric-emptying measures indicated that endocrine adaptation after PD is heterogeneous and not uniformly beneficial despite the recurrent GLP-1 signal. Exploratory meta-analysis of Whipple versus pylorus-preserving PD comparisons suggested a direction favoring Whipple for early GLP-1 exposure, although confidence intervals were wide and the two-study pooled estimates were statistically fragile. Given the small number of heterogeneous studies, quantitative findings should be interpreted as exploratory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Available clinical evidence supports a reproducible increase in postprandial GLP-1 signaling after PD, whereas evidence for GIP is weaker, based on fewer studies, and remains sparse and inconsistent. The meta-analytic component should be regarded as exploratory and hypothesis-generating only. Larger prospective studies with standardized stimulation protocols and detailed assay reporting are needed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/prospero\/<\/jats:ext-link>\n                      , identifier 1345848.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1845925","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T12:58:59Z","timestamp":1780491539000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Changes in incretin hormone concentrations after pancreaticoduodenectomy: a systematic review and exploratory meta-analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Oliwia","family":"Grz\u0105siak-Kraj","sequence":"first","affiliation":[{"name":"Department of General and Transplant Surgery, Medical University of Lodz","place":["Lodz, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomasz","family":"Kraj","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery and Angiology, Independent Public Healthcare Institution of the Ministry of the Interior and Administration in Lodz","place":["Lodz, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krzysztof","family":"Pozna\u0144ski","sequence":"additional","affiliation":[{"name":"Department of General and Transplant Surgery, Medical University of Lodz","place":["Lodz, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aneta","family":"Szmiel","sequence":"additional","affiliation":[{"name":"Department of General and Transplant Surgery, Medical 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