Highlights Considerable deficiency in reliability and quality of information was noted. The majority of websites had low to moderate readability and usability. Lack for proper standardisation and monitoring are possible causes for poor quality.

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Objective This study reviewed the current evidence on the clinical characteristics and outcome of acute pancreatitis (AP) following spinal surgery. Methods A systematic search was performed to identify English articles published through May 2020 in PubMed, Scopus, EMBASE, Latin American & Caribbean Health Sciences Literature, and Cochrane Library. Data on clinical characteristics, risk factors, and outcomes were analyzed. Results Eleven papers (including six case reports) were included, with 306 patients (incidence, 23.0%) developing AP after spinal surgery (mean age, 14.2 years). Of the studies that specified symptoms (55 patients), abdominal pain (43.6%), nausea and vomiting (32.7%), and abdominal distension (7.27%) were most prevalent. The mean duration from surgery to symptom onset was 6.15 days (range, 1–7). The most common complications of AP were glucose intolerance (25%), peritonitis (2%), pseudocyst formation (2%), and fluid collection (2%) were most prevalent. Prolonged fasting time (13.6%), intraoperative blood loss (9.09%), gastroesophageal reflux disease (9.1%), age >14 years (9.1%), and low BMI (9.1%) were most commonly associated with AP. Two deaths (0.6%) were reported. Conclusion AP remains an important complication of spinal surgery because of its morbidity and mortality. Avoiding major risk factors can reduce the incidence of AP following spinal surgery.

Aims Acute pancreatitis (AP) is a rare post-operative complication of spinal surgery. This study reviews the current evidence on clinical characteristics and outcome of AP following spinal surgery. Methods A systematic search was performed on English articles published up to May 2020 using PubMed, Scopus, EMBASE, LILACS and Cochrane databases. Data on clinical characteristics, risk factors and outcomes were extracted and analysed. Results Eleven papers meeting the inclusion criteria which included a total of 306 (23.02%) patients developing AP out of 1,329 patients undergoing spinal surgery were included (mean age= 14.17 years). Of the 11 studies that specified symptoms (n = 55 patients) abdominal pain (43.6%), nausea and vomiting (32.7%) and abdominal distension (7.27%) were the commonest symptoms. The mean duration from surgery to onset of symptoms was 6.15 days (range:1-7). Almost all (n = 10, 90.9%) were treated non-operatively. Of the complications mentioned (n = 306 patients), glucose intolerance (25%), peritonitis (2%), pseudocyst (2%), and fluid collection (2%) were the commonest. Of the studies mentioning associated factors (n = 22 patients) prolonged fasting time (13.6%), intra-operative blood loss (9.09%), gastroesophageal reflux disease (9.09%), age >14 years (9.09 %), low BMI (9.09 %), and anterior/combined approach (9.09%) were the commonest associated factors for AP. A total of 2 deaths (n = 2/306, 0.65%) were reported. Conclusion Although uncommon, AP remains an important post-operative complication of spinal surgery due to its associated morbidity and mortality. Avoiding major risk factors including prolong fasting and minimizing intra-operative blood loss may help reduce the incidence of AP in patients undergoing spinal surgery.

Review question / Objective: This study reviews the current evidence on clinical characteristics and outcome of Acute Pancreatitis following spinal surgery. Condition being studied: Acute pancreatitis in spinal surgery. Information sources: All articles were searched electronically using PubMed/Medline, Scopus, EMBASE, Cochrane CENTRAL, and Latin American & Caribbean Health Sciences Literature (LILACS) before May 2020 without any restriction in the language or status of publication. Key words related to acute pancreatitis and its complications and various types of spinal surgeries were searched in the title and abstract fields.