Global Trends in Postoperative Sepsis After Pancreatoduodenectomy: A Bibliometric Analysis.

INTRODUCTION

Postoperative sepsis after pancreatoduodenectomy (PSPD) remains a major determinant of morbidity and mortality. Although extensive clinical studies have explored its risk factors and management, the global research landscape and evolving priorities of PSPD have not been systematically characterized.

METHODS

Publications related to PSPD from 1980 to July 2025 were retrieved from the Web of Science Core Collection. CiteSpace, VOSviewer, and R-based bibliometrix were used to analyze publication trends, collaborative networks, influential journals and references, research hotspots, and emerging trends.

RESULTS

A total of 297 studies were included. Global PSPD research has grown steadily over the past 45 years, with rapid acceleration since 2020. The United States, Japan, Germany, Italy, and China were the leading contributors, supported by high-output institutions such as the University of Verona, Vita-Salute San Raffaele University, and Mayo Clinic. Research hotspots centered on risk stratification, surgical technique optimization, prevention of postoperative pancreatic fistula, and perioperative infection control. Emerging frontiers include surgical site infection prevention, microbiome-gut barrier and bacterial translocation mechanisms, precision risk prediction using machine learning models, and individualized perioperative strategies.

CONCLUSIONS

Global PSPD research has evolved from descriptive clinical studies toward mechanistic, predictive, and precision-oriented investigations. Future progress will likely depend on integrating surgical innovation with microbiological, immunological, and data-driven approaches to enable earlier identification and targeted prevention of PSPD.