Abstract
Background: The rate of clinically relevant postoperative pancreatic fistula (CR-POPF) after distal pancreatectomy ranges from 15-35% in the literature. Many risk factors have been reported with no consensus on their predictive value. Prior studies have observed an association between increased postoperative opioid use and fistula formation, secondary to increased sphincter of Oddi tone that leads to impaired emptying and increased pancreatic duct pressure. Our group has implemented perioperative care pathways, with each iteration increasingly using non-opioid medication bundles and reducing administered opioids. The aim of this study was to determine the association between perioperative variables, including early postoperative opioid use, and CR-POPF.
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