CRD Summary: This review concluded that perioperative octreotide was associated with a significant reduction in the incidence of pancreatic fistula after elective pancreatic surgery. However, the risk reduction was not associated with a similar difference in postoperative mortality. This was a well-conducted review and the authors' conclusions appear to be reliable.

CRD Commentary: This review had clear inclusion and exclusion criteria. A number of relevant sources were searched. It was unclear if there were any language restrictions, so some relevant studies may have been missed. However, the authors assessed publication bias and concluded that this was not an issue. Systematic review methods were performed in duplicate. Trial quality was assessed, although only a total score was given. Further details of the aspects covered by this scale and reporting of the complete data for each trial would have been helpful for readers to judge the reliability of the evidence. The methods used in the meta-analysis were appropriate. The authors gave careful consideration in the discussion to any differences between the trials. The methods and reporting of this review were good and the authors' conclusions appear to be reliable.