Somatostatin

One of the most important features of an evidence map is the cataloging of the large number and variety of outcomes reported in the published literature. This step typically occurs after data extraction since the scope of an evidence-map database is large. Thus, it is often difficult to pre-define all outcome categories of interest. The research team worked with the stakeholder panel to classify outcomes into clinically and biologically meaningful outcome categories that could be used in evidence-map analyses. The research team recorded outcomes reported in each publication and took the first attempt in identifying clinically and biologically relevant groups. Standardized coding was then developed for each outcome category. Feedback was sought from the stakeholder panel, and the outcome categories and coding were modified based on the final consensus of the stakeholder panel. Table 2 shows the final list of outcomes for each outcome category that are reported in the studies included in the LCS evidence-map database. Specifically, outcomes related to appetite or satiety ratings such as hunger score and desire to eat were often rated by a visual analog scale (VAS) and were classified under the ‘Appetite’ category. Outcomes focused on neurological measurements and sensing signals by the brain were classified under the ‘Energy Sensing’ category. Body weight, body composition and changes in weight-related outcomes were classified under the ‘Body Weight or Composition’ category. The ‘Dietary Intake’ category included outcomes such as energy intake, dietary intake, food intake and carbohydrate intake, and finally the ‘Glycemic’ category included glucose, insulin and gastric hormones. Our stakeholder panel did not identify additional outcomes that were not reported in the literature. Both outcome categories and full outcome lists were included in the evidence-map database, which can be used in future analyses with current or new outcome category coding.Table 2

Outcomes of interest by outcome groups in the LCS evidence-map database

Outcome groups	Outcomes of interest
Appetite	Appetite ratings using a visual analog scale (VAS), hunger, desire to eat, fullness, prospective consumption, thirst, motivational and behavioral factors reported through questionnaire
Energy sensing by brain	Neurological measurements (fMRI, EEG), sensory rating (sweetness, intensity, pleasantness, sensory specific satiation), taste, perception and preference, taste reaction time
Body weight or body composition	Body weight, body composition, BMI, waist circumferences, weight or BMI changes
Dietary intake	Energy intake, dietary intake, food intake, carbohydrate intake, sugar intake, salt intake, water intake
Glycemic	Glucose, Hemoglobin A1c (HbA1c), insulin concentration, insulin sensitivity, hypoglycemia, glucagon, glucose-dependent insulinotropic peptide (GIP), glucagon-like peptide-1 (GLP-1), peptide tyrosine tyrosine (PYY), cholecystokinin (CCK), enterostatin, ghrelin, leptin, somatostatin, oxyntomodulin

If the patient's preoperative total bilirubin was >300 mmol/L, percutaneous transhepatic cholangial drainage (PTCD) should be performed for two weeks to reduce jaundice or preoperative total bilirubin to <51 mmol/L. On the 3rd day after operation, when the flow of nasogastric tube was less than 200 mL/D, nasogastric tube was removed. On the 3rd day after operation, the drainage fluid of abdominal drainage tube was collected, and the concentration of amylase was detected. When the drainage volume was less than 20 mL, drainage tube was removed. On the 5th day after operation, routine computed tomography (CT) scanning was performed on the upper abdomen to understand abdominal abscess and effusion. On the 3rd day after operation, patients began to eat liquid food. All patients were treated with somatostatin analogues.
International Study Group of Pancreatic Surgery (ISGPF) classification was used for the definition of postoperative complications (POPF, delayed gastric emptying, and postpancreatectomy hemorrhage (PPH)) [30 (link)–32 (link)], while POPF grades B and C were regarded as clinically relevant. Postoperative bleeding was defined as a PPH grade B or C according to the ISGPF [32 (link)]. Acute pancreatitis was chemically defined as an elevated serum amylase and/or lipase level (at least three times of the normal level) for at least 3 consecutive days on the 3rd day after operation. Acute pancreatitis was confirmed by CT. The classification of postoperative complications was the Clavien-Dindo classification [33 (link)]. The FRS is a 10-point scale that relies on weighted effect of four variables including gland texture, pathology, duct size, and estimated blood loss [34 (link), 35 (link)]. The weighted aggregate of these risk factors was used to calculate the individual FRS score (0-10) for each patient.

Experiments were performed on male and female C57/Bl6 mice aged 4–8 weeks. Slc6a4-cre::Rosa-TdTomato (SERT-Cre) and Sst-cre::Rosa-TdTomato transgenic lines were used to fluorescently label DRN 5-HT and somatostatin (SOM) GABA neurons, respectively. Animals were group-housed and kept on a 12:12 hr light/dark cycle with access to food and water ad libitum. All experiments were carried out in accordance with procedures approved by the University of Ottawa Animal Care and Veterinary Services (protocol numbers CMM-164, CMM-176, CMM-1711, CMM-1743, and CMM-2737).