Clinical characteristics and outcomes of acute pancreatitis following spinal surgery: a systematic review

OBJECTIVE: This study reviewed the current evidence on the clinical characteristics and outcome of acute pancreatitis (AP) following spinal surgery. METHODS: A systematic search was performed to identify English articles published through May 2020 in PubMed, Scopus, EMBASE, Latin American & Caribbean Health Sciences Literature, and Cochrane Library. Data on clinical characteristics, risk factors, and outcomes were analyzed. RESULTS: Eleven papers (including six case reports) were included, with 306 patients (incidence, 23.0%) developing AP after spinal surgery (mean age, 14.2 years). Of the studies that specified symptoms (55 patients), abdominal pain (43.6%), nausea and vomiting (32.7%), and abdominal distension (7.27%) were most prevalent. The mean duration from surgery to symptom onset was 6.15 days (range, 1–7). The most common complications of AP were glucose intolerance (25%), peritonitis (2%), pseudocyst formation (2%), and fluid collection (2%) were most prevalent. Prolonged fasting time (13.6%), intraoperative blood loss (9.09%), gastroesophageal reflux disease (9.1%), age >14 years (9.1%), and low BMI (9.1%) were most commonly associated with AP. Two deaths (0.6%) were reported. CONCLUSION: AP remains an important complication of spinal surgery because of its morbidity and mortality. Avoiding major risk factors can reduce the incidence of AP following spinal surgery.