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Predicting pancreatic fistula risk after splenectomy in cirrhotic splenomegaly: Surgical anatomy and implications
Ismail Abdul Sattar Burud, Suneet Sood, Sherreen Elhariri, Department of Surgery, School of Medicine, IMU University, Seremban, Negeri Sembilan 70300, Malaysia
Nabil Eid, Department of Human Biology, School of Medicine, IMU University, Kuala Lumpur 57000, Malaysia
Author contributions: Burud IAS, Sood S, Elhariri S, and Eid N wrote the primary draft of the manuscript; Eid N edited and approved the final draft of the manuscript; All authors have read and approved the final manuscript.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
Corresponding author: Nabil Eid, MD, PhD, Associate Professor, Department of Human Biology, School of Medicine, IMU University, Bukit Jalil, Kuala Lumpur 57000, Malaysia.
Received: February 6, 2026
Revised: February 12, 2026
Accepted: February 26, 2026
Published online: September 27, 2026
Processing time: 223 Days and 5.9 Hours
Revised: February 12, 2026
Accepted: February 26, 2026
Published online: September 27, 2026
Processing time: 223 Days and 5.9 Hours
Core Tip
Core Tip: Clinically relevant postoperative pancreatic fistula (CR-POPF) is an underrecognized complication after splenectomy in cirrhotic patients with splenomegaly. A retrospective study of 186 patients identified body mass index and splenic thickness as independent predictors of CR-POPF and proposed a nomogram-based model; 21 patients developed biochemical leaks, and six developed CR-POPF. This editorial highlights these findings, briefly reviews CR-POPF mana