Systematic Reviews
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 6, 2021; 9(13): 3024-3037
Published online May 6, 2021. doi: 10.12998/wjcc.v9.i13.3024
Systematic review and meta-analysis of the impact of deviations from a clinical pathway on outcomes following pancreatoduodenectomy
Monish Karunakaran, Pavan Kumar Jonnada, Savio George Barreto
Monish Karunakaran, Department of Gastrointestinal Surgery, Gastrointestinal Oncology, and Bariatric Surgery, Medanta Institute of Digestive and Hepatobiliary Sciences, Gurgaon 122001, Haryana, India
Monish Karunakaran, Department of Liver Transplantation and Regenerative Medicine, Medanta-The Medicity, Gurgaon 122001, Haryana, India
Pavan Kumar Jonnada, Surgical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru 560029, Karnataka, India
Savio George Barreto, Division of Surgery and Perioperative Medicine, Flinders Medical Center, Bedford Park 5042, South Australia, Australia
Savio George Barreto, College of Medicine and Public Health, Flinders University, Bedford Park 5042, South Australia, Australia
Author contributions: Karunakaran M was responsible for the conceptualization of the study, selection of studies, interpretation of data and drafting of the manuscript; Jonnada PK was responsible for the selection of studies, statistical analysis and interpretation of data; Barreto SG was responsible for the conceptualization and design of the study, interpretation of data and critical review of the manuscript and final approval.
Conflict-of-interest statement: All the authors have no conflicts of Interest to declare.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Savio George Barreto, FAIS, FRACS, PhD, Doctor, Senior Lecturer, College of Medicine and Public Health, Flinders University, Bedford Park 5042, South Australia, Australia. georgebarreto@yahoo.com
Received: December 7, 2020
Peer-review started: December 7, 2020
First decision: December 31, 2020
Revised: January 6, 2021
Accepted: March 12, 2021
Article in press: March 12, 2021
Published online: May 6, 2021
Processing time: 136 Days and 7.3 Hours
Core Tip

Core Tip: Compliance to post-pancreatoduodenectomy clinical pathways remains low. Deviations are associated with an increased risk of complications and length of hospital stay. Understanding the relevance of deviations to clinical pathways post-pancreato-duodenectomy presents us with opportunities to actively pursue an enhanced-recovery of our patients.