Review for 10.1186/s12876-025-04095-4 (2025)

Title: Long-term Quality of Life After Acute Pancreatitis: A Systematic Review and Meta-
Analysis
Version: 0 Date: 19 Feb 2025
Reviewer:  Karunia Valeriani Japar
Reviewer's report:
The manuscript addresses an important topic: the long-term impact of acute pancreatitis (AP) on
patients' quality of life (QoL). The study is well-structured, with a clear objective to elucidate the
long-term QoL outcomes following an episode of AP. The systematic review and meta-analysis
appear comprehensive, adhering to established guidelines. The inclusion of both physical and
psychological aspects of QoL is commendable.
Specific Comments
Abstract: The abstract clearly summarizes the background, methods, results, and conclusion of
the study. It highlights the significant impairment in specific QoL domains among AP patients
compared to the control group.
Introduction: The introduction provides sufficient background information on AP, its increasing
prevalence, and potential long-term complications. The authors acknowledge the conflicting
results in previous studies regarding QoL after AP, justifying the need for this comprehensive
review. The aim of the study is clearly stated.
Methods: The methods section is detailed and transparent. The authors specify the databases
searched, search terms used, and inclusion/exclusion criteria. The data extraction process and
quality assessment using the Newcastle-Ottawa Scale are well-described. The statistical analysis
methods are appropriate, with consideration for heterogeneity among studies.
Results: The results section clearly presents the findings of the meta-analysis. The authors report
significant impairments in specific QoL domains (Role physical, General health, Vitality) and
the physical component summary score in AP patients compared to controls. They also report
on the incidence of exocrine and endocrine insufficiency in AP patients.
Discussion: The discussion section should interpret the findings in the context of existing
literature and discuss the implications of the results. It should also address the limitations of the
study and suggest directions for future research.
Tables and Figures: The tables and figures should be clear, concise, and well-labeled. They
should provide essential information to support the findings presented in the text.
Suggestions for Improvement
Heterogeneity: The authors acknowledge significant heterogeneity in some of the QoL domains.
While they mention using a random-effects model to account for this, further exploration of the
sources of heterogeneity would strengthen the analysis. Subgroup analysis, if feasible with the
available data, could help identify factors contributing to heterogeneity.
Standardized QoL Assessment Tools: The authors mention the need for standardized tools
to assess QoL specific to pancreatic diseases. Expanding on this point in the discussion,
highlighting the limitations of generic QoL instruments like SF-36 in capturing the nuances of
pancreatic disease-related QoL, would be valuable.
Exocrine and Endocrine Insufficiency: The study reports on the incidence of exocrine and
endocrine insufficiency in AP patients. Exploring the relationship between these complications
and QoL would provide additional insights.
Follow-up Duration: The follow-up duration varied across the included studies. Analyzing the
impact of follow-up duration on QoL outcomes could be informative.
Overall Assessment
This is a well-conducted systematic review and meta-analysis that provides valuable insights
into the long-term impact of acute pancreatitis on patients' quality of life. The findings
highlight the need for comprehensive management strategies that address both the physical and
psychological consequences of AP. Addressing the suggestions above would further enhance
the quality and impact of the manuscript.