Changes in incretin hormone concentrations after pancreaticoduodenectomy: a systematic review and exploratory meta-analysis
Abstract
Background: Pancreaticoduodenectomy (PD) removes the duodenum and proximal jejunum, alters nutrient transit, and may modify secretion of incretin hormones involved in glucose homeostasis.
Objective: To systematically review clinical evidence on postoperative changes in glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) after PD, together with co-reported hormonal and metabolic outcomes, and to perform a strictly exploratory meta-analysis where sufficiently comparable numerical data were available.
Methods: Following PRISMA 2020, we reviewed human studies identified in PubMed, Embase, and Scopus from 1 January 2000 to 27 March 2026, with screening and full-text selection performed in Rayyan. Eligible studies reported GLP-1 and/or GIP after PD, after different PD reconstructions, or during post-PD nutrient-delivery interventions. Because outcome reporting was heterogeneous, quantitative pooling was restricted to exploratory random-effects syntheses of two clinically comparable post-PD reconstruction studies. Because only two studies contributed to each pooled comparison, estimates of effect size and heterogeneity were considered highly fragile and were not interpreted as confirmatory.
Results: Six studies involving 134 participants met the eligibility criteria. Postprandial GLP-1 generally increased after PD or was higher in settings associated with faster gastric emptying or greater distal nutrient exposure. By contrast, GIP was reported in…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 134 participants or records.
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