Advances in Predicting, Preventing, and Managing High-Impact Complications After Major Pancreatic Resection

Major pancreatic resection, including pancreaticoduodenectomy, remains the cornerstone of surgical treatment for a range of pancreatic and periampullary diseases. Despite considerable progress in operative technique, perioperative care, and patient selection, postoperative morbidity remains high, with postoperative pancreatic fistula (POPF) representing one of the most critical challenges. Standardized definitions such as those proposed by the International Study Group on Pancreatic Surgery (ISGPS) have improved the consistency of reporting and management, yet the pathophysiology and risk factors underlying many high-impact complications -including postoperative hemorrhage, pancreatitis, delayed gastric emptying, and thrombosis- are still being elucidated. The field continues to search for models and strategies that can improve preoperative prediction, guide intraoperative decisions, and enhance postoperative recovery.

This Research Topic aims to consolidate current evidence and emerging concepts to refine the prediction, prevention, and management of high-impact complications following major pancreatic resection. Its overarching objectives include identifying validated risk stratification tools, refining operative and anastomotic techniques to lower morbidity, and exploring innovative approaches for mitigation and early detection. The Topic also aims to encourage comparative studies across surgical approaches (open, minimally invasive, and robotic), evaluate the role of stents and drains, and promote standardized management algorithms to improve outcomes. Studies introducing novel intraoperative technologies, perioperative optimization protocols, and the use of artificial intelligence or biomarkers in complication risk assessment are particularly welcomed.

To gather further insights into the comprehensive management of patients undergoing pancreaticoduodenectomy or major pancreatic resections, we welcome articles addressing, but not limited to, the following themes:

• Prediction models for postoperative pancreatic fistula and other major complications;
• Surgical and perioperative strategies to reduce anastomotic failure and leakage risk;
• Prevention and management of postoperative hemorrhage and pancreatitis;
• Evidence-based use of stents, drains, and duct management techniques;
• Development and validation of standardized management algorithms for POPF;
• Implementation of artificial intelligence and biomarkers in outcome prediction;
• Comparative studies across open, laparoscopic, and robotic approaches;
• Enhanced recovery, thrombosis prevention, and perioperative protocol optimization.

This Research Topic welcomes the following article types: Original Research, Review, Mini Review, Systematic Review, Clinical Trial, Case Report, Perspective, Brief Research Report, Hypothesis & Theory, and Methods articles.

Article types and fees

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Clinical Trial
• Curriculum, Instruction, and Pedagogy
• Editorial
• FAIR² Data
• General Commentary
• Hypothesis and Theory
• Methods
• ... View all formats

Articles that are accepted for publication by our external editors following rigorous peer review incur a publishing fee charged to Authors, institutions, or funders.

Article types

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Clinical Trial
• Curriculum, Instruction, and Pedagogy
• Editorial
• FAIR² Data
• General Commentary
• Hypothesis and Theory
• Methods
• Mini Review
• Opinion
• Original Research
• Perspective
• Review
• Study Protocol
• Systematic Review
• Technology and Code

Keywords: Major Pancreatic Resection, Pancreaticoduodenectomy, Postoperative Pancreatic Fistula, POPF, Postoperative Complications, Surgical Morbidity, Risk Stratification Models, Pancreatic Anastomosis, Postpancreatectomy Hemorrhage, Delayed Gastric Emptying

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.