As pancreatic surgeons, we know all too well how hard it is to carry out randomized clinical trials in our field. Therefore, in striving for the best evidence-based solutions to combat the sequelae of pancreatectomies, we are grateful to Tarvainen and colleagues1 for providing us the Hydrocortisone vs Pasireotide in Reducing Pancreatic Surgery Complications trial in this issue of JAMA Surgery. We are offered a demonstration that perioperative administration of hydrocortisone is not significantly worse compared with the more-expensive option of pasireotide in terms of overall complication burden (measured by the Comprehensive Complication Index) following different types of pancreatectomies. Pasireotide is, however, associated with a lower rate of clinically relevant postoperative pancreatic fistulas in the subgroup of distal pancreatectomies. Unfortunately, the article is unclear on which of these outcomes (overall burden vs fistula) is the real focus of the investigation.
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Casciani F, Vollmer CM. Pasireotide and Corticosteroids for Prevention of Pancreatic Fistula—Over-HYPed? JAMA Surg. Published online February 05, 2020. doi:10.1001/jamasurg.2019.6020
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: