Summary of findings for the main comparison. Somatostatin analogues for pancreatic surgery.
| Somatostatin analogues for pancreatic surgery | ||||||
| Patient or population: people with pancreatic surgery Settings: secondary or tertiary care Intervention: somatostatin analogues | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Control | Somatostatin analogues | |||||
| Perioperative mortality | 49 per 1000 | 40 per 1000 (28 to 57) | RR 0.8 (0.56 to 1.16) | 2210 (18 studies) | ⊕⊝⊝⊝ very low1,2,3 | |
| Treatment withdrawal | 8 per 1000 | 13 per 1000 (5 to 35) | RR 1.55 (0.56 to 4.33) | 1220 (9 studies) | ⊕⊝⊝⊝ very low1,2,3,4 | |
| Re‐operation | 102 per 1000 | 108 per 1000 (70 to 166) | RR 1.06 (0.69 to 1.63) | 687 (7 studies) | ⊕⊝⊝⊝ very low1,2,3,4,5 | |
| Anastomotic leak | 48 per 1000 | 39 per 1000 (25 to 61) | RR 0.81 (0.51 to 1.27) | 1585 (9 studies) | ||
| Pancreatic fistula (clinically significant) | 151 per 1000 | 104 per 1000 (46 to 191) | RR 0.69 (0.38 to 1.29) | 292 (4 studies) | ⊕⊝⊝⊝ very low1,2,3,4 | |
| Infected abdominal collections | 61 per 1000 | 56 per 1000 (40 to 80) | RR 0.93 (0.66 to 1.32) | 1965 (13 studies) | ||
| Shock | 29 per 1000 | 29 per 1000 (14 to 63) | RR 1 (0.46 to 2.15) | 812 (4 studies) | ||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RR: risk ratio. | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1 Most trials were of high risk of bias. 2 Confidence intervals overlap 1 and 0.75 or 1.25. 3 A total of fewer than 300 events in the comparison. 4 Fewer than 10 trials were included for this outcome. So, there is a suspicion of selective outcome reporting, which can indicate publication bias. 5 There was moderate heterogeneity as indicated by I² of 30%, tau² of 0.27; and lack of overlapping of confidence intervals.