Mortality and complications in patients with obesity after open, robotic or laparoscopic pancreaticoduodenectomy: A systematic review and meta-analysis
Pooled result · 30-day mortalityResult — go to the resultOdds ratio 1.68 95% CI 1.35–2.08Authors' conclusion
Patients with obesity undergoing PD are at increased risk for 30-day mortality and major complications. OPD carries the highest overall risk, while RPD and LPD are linked to a greater POPF risk. These findings highlight the need for careful perioperative management in this high-risk population.
Study context
- Population
- Patients with resectable pancreatic cancer undergoing pancreaticoduodenectomy (PD) by open (OPD), robotic (RPD) or laparoscopic (LPD) technique13 observational studies
- Comparison
- Patients with obesity vs without obesity undergoing PD
- Outcome
- 30-day mortality
- Follow-up
- 30 days
Pooled result
As reported in the abstract
Odds ratio
1.68
95% CI 1.35–2.08
P < 0.00001
By group
Obesityvs No obesity
OR 1.68 (95% CI 1.35–2.08); P < 0.00001
Further pooled results
| Outcome | Obesity | No obesity | OR (95% CI) | P value | |
|---|---|---|---|---|---|
| Major complications (Clavien-Dindo)I² = 52% | 23.3% | 17.12% | 1.77 (1.27–2.46) | P = 0.0007 | |
| POPFI² = 26% | 21.9% | 13.76% | 2.04 (1.69–2.46) | P < 0.00001 | |
| PPHI² = 0% | 7.31% | 6.26% | 1.44 (1.07–1.94) | P = 0.02 | |
| DGEI² = 89% | 20.23% | 15.5% | 1.98 (1.3–3.03) | P < 0.00001 | |
| SSII² = 90%; not statistically significant | 28.17% | 20.39% | 1.80 (0.93–3.5) | P = 0.08 | |
| OPD subgroup: 30-day mortality, major complications, POPF | 1.59 (1.26–2.00) | P < 0.0001 | |||
| OPD subgroup: 30-day mortality, major complications, POPFMajor complications | 1.63 (1.17–2.28) | P = 0.004 | |||
| OPD subgroup: 30-day mortality, major complications, POPFPOPF | 1.98 (1.59–2.47) | P < 0.00001 | |||
| RPD subgroup: 30-day mortality, POPF | 2.68 (1.12–6.39) | P = 0.03 | |||
| RPD subgroup: 30-day mortality, POPFPOPF | 3.32 (1.68–6.57) | P = 0.0006 | |||
| LPD subgroup: POPF | 2.06 (1.69–3.32) | P = 0.003 | |||
| 0.10.31310Odds ratio (log scale) |
Original publication
Mortality and complications in patients with obesity after open, robotic or laparoscopic pancreaticoduodenectomy: A systematic review and meta-analysis. Int J Obes (Lond). Published 28 July 2025. doi:10.
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