Prevention of Incisional Hernia after Open Hepato-Pancreato-Biliary Surgery: A Systematic Review.

Most hepato-pancreato-biliary (HPB) procedures are still performed through open approach. Incisional hernia (IH) is one of the most common complications after open surgery. To date, published data on IH after HPB surgery are scarce; therefore, the aim of this study was to assess the current evidence regarding incidence, risk factors, and prevention. Medline/PubMed (1946-2020), EMBASE (1947-2020), and the Cochrane library (1995-2020) were searched for studies on IH in open HPB surgery. Animal studies, editorials, letters, reviews, comments, short case series and liver transplant, laparoscopic, or robotic procedures were excluded. The protocol was registered with PROSPERO (CRD42020163296). A total of 5,079 articles were retrieved. Eight studies were finally included for the analysis. The incidence of IH after HPB surgery ranges from 7.7% to 38.8%. The identified risk factors were body mass index, surgical site infection, ascites, Mercedes or reversed T incisions, and previous IH. Prophylactic mesh might be safe and effective. IH after open HPB surgery is still an important matter. Some of the risk factors are specific for the HPB operations and the incision type should be carefully considered. Randomized controlled trials are required to confirm the role of prophylactic mesh after HPB operations. © 2021 S. Karger AG, Basel.

Citation

Robert Memba, Olga Morató, Laia Estalella, Mihai C Pavel, Erik Llàcer-Millán, Mar Achalandabaso, Elisabet Julià, Erlinda Padilla, Carles Olona, Donal O'Connor, Rosa Jorba. Prevention of Incisional Hernia after Open Hepato-Pancreato-Biliary Surgery: A Systematic Review. Digestive surgery. 2022;39(1):6-16

Mesh Tags

PMID: 34875657

search → result