Does preoperative pancreatic duct stenting prevent pancreatic fistula after surgery? A cohort study.
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.
Okamoto
Tomoyoshi
T
Department of Surgery, The Jikei University School of Medicine, Izumihoncho 4-11-1, Komae-shi, Tokyo 201-8601, Japan. tomoka@jikei.ac.jp
Gocho
Takeshi
T
Futagawa
Yasuro
Y
Fujioka
Shuichi
S
Yanaga
Katsuhiko
K
Ikeda
Keiichi
K
Kakutani
Hiroshi
H
Tajiri
Hisao
H
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
D000681:Amylases