External stenting of pancreaticojejunostomy anastomosis and pancreatic duct after pancreaticoduodenectomy. 2012

Lileswar Kaman, and Syed Nusrath, and Divya Dahiya, and Ajay Duseja, and Sameer Vyas, and Vikas Saini
Department of General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India. kamanlil@yahoo.com

Pancreatic fistula is a major cause of morbidity and mortality after pancreaticoduodenectomy. External drainage of pancreaticojejunostomy anastomosis with a stent is used to reduce the rate of pancreatic fistula. This study compares the rates of pancreatic fistula between external stent drainage versus no-stent drainage for pancreaticojejunal anastomosis following pancreaticoduodenectomy. A total of 53 patients undergoing pancreaticoduodenectomy for various benign and malignant pathologies were included in the study. An external stent was inserted across the anastomosis to drain the pancreatic duct in 26 patients and 27 patients received no stent. The primary end point was pancreatic fistula. All surgeries were done by a single surgeon with expertise in hepatobiliary pancreatic surgery at a single institute. The two groups were comparable in demographic data, underlying pathologies, presenting complaints, presence of comorbid illnesses and proportion of patients with preoperative biliary drainage, pancreatic consistency and duct diameter. The pancreatic fistula rates were similar in both the groups (11.5 vs. 14.8 %, P = 0.725). The morbidity and surgical re-exploration rate were statistically not significant between the two groups (65.4 vs. 51.9 %, P = 0.318 and 11.5 vs. 7.4 %, P = 0.60). Postoperative stay was also similar with a mean of 14 days in both the groups (P = 0.66). The mortality rate was statistically not significant in the two groups (3.8 vs. 7.4 %, P = 0.575). External drainage of pancreaticojejunostomy anastomosis and the pancreatic duct with a stent does not decrease the rate of postoperative pancreatic fistula after pancreaticoduodenectomy.

UI MeSH Term Description Entries
D007194 India A country in southern Asia, bordering the Arabian Sea and the Bay of Bengal, between Burma and Pakistan. The capitol is New Delhi. Republic of India
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010183 Pancreatic Ducts Ducts that collect PANCREATIC JUICE from the PANCREAS and supply it to the DUODENUM. Duct of Santorini,Duct of Wirsung,Duodenal Papilla, Minor,Wirsung's Duct,Accessory Pancreatic Duct,Accessory Pancreatic Duct of Santorini,Main Pancreatic Duct,Santorini's Duct,Accessory Pancreatic Ducts,Duct, Accessory Pancreatic,Duct, Main Pancreatic,Duct, Pancreatic,Duct, Santorini's,Duct, Wirsung's,Ducts, Pancreatic,Main Pancreatic Ducts,Minor Duodenal Papilla,Minor Duodenal Papillas,Pancreatic Duct,Pancreatic Duct, Accessory,Pancreatic Duct, Main,Pancreatic Ducts, Accessory,Papilla, Minor Duodenal,Santorini Duct,Wirsung Duct,Wirsungs Duct
D010185 Pancreatic Fistula Abnormal passage communicating with the PANCREAS. Fistula, Pancreatic,Fistulas, Pancreatic,Pancreatic Fistulas
D010193 Pancreaticojejunostomy Surgical anastomosis of the pancreatic duct, or the divided end of the transected pancreas, with the jejunum. (Dorland, 28th ed) Pancreatojejunostomy,Pancreaticojejunostomies,Pancreatojejunostomies
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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