Effect of a novel pancreatic stent design on short-term pancreatic injury in a canine model.
OBJECTIVE
Attempts to address the problem of injury to the pancreas by indwelling pancreatic stents are limited by our lack of knowledge of the pathogenesis of stent-induced injury and its relationship to stent morphology and the duration of stenting. The aim of our study was to evaluate pancreatic injury induced by 1 week of stenting with a 5F indwelling pancreatic stent of novel design, the "wing stent."


METHODS
Pancreatic stents (5F) were placed surgically in eight dogs; wing stents (WS-5F) were used in four dogs and conventional stents (CS-5F) in another four. Two dogs underwent duodenotomy without stent placement (controls). The pancreas was harvested for microscopy at 1 week. A pathologist who was unaware of the source of the specimens graded the pancreatic injury.


RESULTS
Although pancreatic injury was observed in both the CS-5F and WS-5F groups after 1 week of indwelling pancreatic stenting, it was considerably less severe in the WS-5F group compared with the CS-5F group (1.01 +/- 0.10 vs. 1.63 +/- 0.14, P < 0.01). All components of pancreatic injury were affected, with the most dramatic differences noted in inflammation, fibrosis, and edema. The differences were most marked in the stented segment ( P < 0.001) and in the upstream segment of the pancreas ( P < 0.05).


CONCLUSIONS
Indwelling conventional pancreatic stents can cause significant pancreatic injury even when left in place for only 1 week. A wing design can significantly ameliorate stent-induced changes.
Raju
G S
GS
Center for Endoscopic Research, Training, and Innovation (CERTAIN), Department of Medicine, Surgery and Pathology, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555, USA.
Gomez
G
G
Xiao
S-Y
SY
Ahmed
I
I
Brining
D
D
Bhutani
M S
MS
Kalloo
A N
AN
Pasricha
P J
PJ
D000818:Animals; D004285:Dogs; D004867:Equipment Design; D010179:Pancreas / Q000293:injuries* / Q000473:pathology; D010183:Pancreatic Ducts; D015607:Stents / Q000009:adverse effects*