{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T18:18:42Z","timestamp":1791397122935,"version":"4.3.3"},"reference-count":171,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T00:00:00Z","timestamp":1702598400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3390\/cancers15245865","type":"journal-article","created":{"date-parts":[[2023,12,18]],"date-time":"2023-12-18T10:04:47Z","timestamp":1702893887000},"page":"5865","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Non-Surgical Interventions for the Prevention of Clinically Relevant Postoperative Pancreatic Fistula\u2014A Narrative Review"],"prefix":"10.3390","volume":"15","author":[{"given":"Nadya","family":"Rykina-Tameeva","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, Australia"},{"name":"Kolling Institute of Medical Research, University of Sydney, St Leonards, NSW 2065, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaswinder S.","family":"Samra","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, Australia"},{"name":"Upper GI Surgical Unit, Royal North Shore Hospital, St Leonards, NSW 2065, Australia"},{"name":"Upper GI Surgical Unit, North Shore Private Hospital, St Leonards, NSW 2065, Australia"},{"name":"Australian Pancreatic Centre, St Leonards, NSW 2065, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2900-8845","authenticated-orcid":false,"given":"Sumit","family":"Sahni","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, Australia"},{"name":"Kolling Institute of Medical Research, University of Sydney, St Leonards, NSW 2065, Australia"},{"name":"Australian Pancreatic Centre, St Leonards, NSW 2065, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anubhav","family":"Mittal","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, Australia"},{"name":"Upper GI Surgical Unit, Royal North Shore Hospital, St Leonards, NSW 2065, Australia"},{"name":"Upper GI Surgical Unit, North Shore Private Hospital, St Leonards, NSW 2065, Australia"},{"name":"Australian Pancreatic Centre, St Leonards, NSW 2065, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"8535","DOI":"10.3748\/wjg.v20.i26.8535","article-title":"Novel diagnostics for aggravating pancreatic fistulas at the acute phase after pancreatectomy","volume":"20","author":"Kanda","year":"2014","journal-title":"World J. 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