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Does preoperative pancreatic duct stenting prevent pancreatic fistula after surgery? A cohort study.

AbstractBACKGROUND/OBJECTIVE:
Postoperative pancreatic fistula remains a major complication after pancreatic surgeries. To prevent pancreatic fistula, one of the employed management strategies is pancreatic duct stenting. The purpose of this study was to evaluate the efficacy and safety of preoperative pancreatic stenting to prevent pancreatic fistula after surgery.
METHODS:
Subjects comprised 18 consecutive patients who underwent pancreatic surgeries. Patients were divided into 2 groups: stenting group (n=7); and non-stenting group (n=11). Complications after stent placement were analyzed. Compared parameters between groups included background, incidence and grading of pancreatic fistula as judged by international study group of pancreatic fistula (ISGPF) criteria, duration until drain removal, and mean maximum level of drain amylase.
RESULTS:
Two patients displayed mild pancreatitis with high serum amylase levels after stenting. No significant differences in background or any other compared parameters to assess drainage effect were identified between stenting and non-stenting groups. Complications related to placement of the stent tube occurred in 4 patients with tube occlusion or cholestasis.
CONCLUSIONS:
Although drainage effect in the stenting group was compared with that in the non-stenting group, no obvious effect was obtained. This procedure seems to require further investigation on indications for postoperative drainage to decrease the incidence of pancreatic fistula.
AuthorsTomoyoshi Okamoto, Takeshi Gocho, Yasuro Futagawa, Shuichi Fujioka, Katsuhiko Yanaga, Keiichi Ikeda, Hiroshi Kakutani, Hisao Tajiri
JournalInternational journal of surgery (London, England) (Int J Surg) Vol. 6 Issue 3 Pg. 210-3 (Jun 2008) ISSN: 1743-9159 [Electronic] England
PMID18430621 (Publication Type: Comparative Study, Journal Article)
Chemical References
  • Amylases
Topics
  • Adult
  • Aged
  • Amylases (blood)
  • Cohort Studies
  • Drainage
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreas (surgery)
  • Pancreatic Ducts (surgery)
  • Pancreatic Fistula (prevention & control)
  • Pancreatitis (etiology)
  • Postoperative Complications (prevention & control)
  • Preoperative Care
  • Stents

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