Postoperative Fluid Collections Following Left Pancreatectomy: Urgent Need for a Standardized Definition. A Systematic Review and Meta‐Analysis

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ABSTRACT Background Postoperative fluid collections (PFCs) are common after left pancreatectomy (LP), but their definition and incidence remain unclear. Methods A systematic search was performed for studies published up to April 2025 reporting the incidence of PFCs after LP. PFCs were defined as radiologically detected collections within 90 days after surgery; symptomatic PFCs were those associated with clinical symptoms, infections, or requiring intervention. The primary outcome was the pooled incidence of overall and symptomatic PFCs. Results Twenty‐six studies (5 RCTs and 21 observational cohorts) were analyzed. Three RCTs reported overall PFCs and the pooled incidence was 47.9% (95% CI 32.2–64.1; I 2 = 94.0%). All five RCTs reported symptomatic PFCs, with a pooled incidence of 9.6% (95% CI 7.6–12.0; I 2 = 35.5%). Eighteen observational studies analyzed overall PFCs with a pooled incidence of 58.3% (95% CI 44.2–71.2; I 2 = 97.7%), while symptomatic PFCs were reported in 19 cohorts with a pooled incidence of 15.0% (95% CI 11.7–19.1; I 2 = 91.7%). Conclusion PFCs incidence after LP approaches 50% overall and 10%–15% for symptomatic collections. Consistency was observed only in RCTs reporting symptomatic PFCs. Standardized, radiology‐based definitions are urgently needed to improve comparability across studies and to guide.

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