Pancreatic fistula rates after internal and external stenting of the pancreatojejunostomy anastomosis following pancreatoduodenectomy.
Background: This retrospective comparative case series study aims to analyze the pancreatic fistula rates of internal and external stenting of the pancreatojejunostomy (PJ) anastomosis in patients who underwent pancreatoduodenectomy (PD) for periampullary tumors.Methods: Ninety-eight patients with periampullary tumors who were operated between 2010 and 2017 were enrolled in this study. A classic open PD with Roux-en-Y PJ reconstruction was performed in all cases.Results: The PJ anastomosis of 53 patients (54%) were stented internally whereas in 45 patients (46%) external stenting was preferred. Pancreatic fistula was observed in 29 patients (29.6%). Internal stenting and soft pancreatic tissue were found to be related to higher pancreatic fistula rates with odds ratios of 3.27 (p = .024) and 3.4 (p = .017), respectively. When only grade B and grade C fistulas were taken into account, the type of stenting has lost its significance but the texture of the remnant pancreas was still associated with 'clinically important' pancreatic fistula.Conclusions: We concluded that the external stenting of the PJ anastomosis may be considered as an effective approach for reducing postoperative pancreatic leaks in PD-planned patients for periampullary tumors. Although our study was retrospectively designed, we used standard charts to gather patient data and compared two stenting methods among homogeneous patient groups.
['Aksel|Bülent|B|http://orcid.org/0000-0002-2498-664X', 'Güven|Hikmet Erhan|HE|http://orcid.org/0000-0001-6200-0506']
D000368:Aged D014670:Ampulla of Vater D000713:Anastomosis, Roux-en-Y D003138:Common Bile Duct Neoplasms D004379:Duodenal Neoplasms D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D010185:Pancreatic Fistula D010190:Pancreatic Neoplasms D016577:Pancreaticoduodenectomy D010193:Pancreaticojejunostomy D011183:Postoperative Complications D012189:Retrospective Studies D015607:Stents
pancreatic fistula stents pancreatojejunostomy Pancreatoduodenectomy