title: Does preoperative pancreatic duct stenting prevent pancreatic fistula after surgery? A cohort study.
abstract: 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.
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, Izumihoncho 4-11-1, Komae-shi, Tokyo 201-8601, Japan. tomoka@jikei.ac.jp
authors.forename: Tomoyoshi
authors.initials: T
authors.lastname: Okamoto
authors.forename: Takeshi
authors.initials: T
authors.lastname: Gocho
authors.forename: Yasuro
authors.initials: Y
authors.lastname: Futagawa
authors.forename: Shuichi
authors.initials: S
authors.lastname: Fujioka
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yanaga
authors.forename: Keiichi
authors.initials: K
authors.lastname: Ikeda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kakutani
authors.forename: Hisao
authors.initials: H
authors.lastname: Tajiri
mesh_terms: D000328:Adult; D000368:Aged; D000681:Amylases / Q000097:blood; D015331:Cohort Studies; D004322:Drainage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000601:surgery; D010183:Pancreatic Ducts / Q000601:surgery*; D010185:Pancreatic Fistula / Q000517:prevention & control*; D010195:Pancreatitis / Q000209:etiology; D011183:Postoperative Complications / Q000517:prevention & control*; D011300:Preoperative Care; D015607:Stents
chemical_list: D000681:Amylases