Impact of Neoadjuvant Chemoradiotherapy on Postoperative Clinically Significant Pancreatic Fistula – A Systemic Review and Updated Meta-analysis

Introduction: The primary aim of our analysis was to do a systemic review and updated meta-analysis literature published in the last 10 years look for association neoadjuvant chemoradiation risk subsequent clinically significant pancreatic fistula. Methods: EMBASE, MEDLINE, Cochrane Database were searched. A Metanalysis done according MOOSE PRISMA guidelines. Results: Twenty-six studies including 17021 patients finally included analysis. 339 out total 3386 developed fistula first group. 2342 13335 surgery Neoadjuvant treatment significantly reduced (p= <0.0001). number with soft pancreas higher (p Pancreatic duct diameter mentioned only two but there no difference between both groups. [p=1].Blood loss more group.[ p <0.0001]. There pancreaticoduodenectomy or distal pancreatectomy performed (p=0.82). borderline resectable tumors 0.34). overall grade 3/grade 4 complications rate 0.39). Conclusion: treatments may be responsible lower rates after surgery.