title: Usefulness of pancreatic duct stenting prior to surgery as a guide to decide the feasibility of limited pancreatic resection.
abstract: OBJECTIVE
  The purpose of this study was to introduce our procedure of limited pancreatic resection with preoperative pancreatic duct stenting to prevent complications.
  
  
  METHODS
  Subjects comprised 6 patients with neoplasm who underwent preoperative pancreatic stenting. Pancreatic stents were placed within 7 days before elective surgery. After intraoperative ultrasonography, the relationship between the main pancreatic duct (MPD) and the lesion was confirmed by measuring the distance. Partial resection was surrendered if a sufficient margin of excised tumor was not obtained or injury to the MPD was likely to occur. Branches of pancreatic duct recognized were ligated as much as possible.
  
  
  RESULTS
  Mild pancreatitis was present after stenting in 2 patients. Three patients actually underwent partial resection. In patients with partial resection, enhanced visualization of the MPD was useful for deciding the operative procedure and prevented iatrogenic injury to the MPD during dissection.
  
  
  CONCLUSIONS
  Pancreatic duct stenting prior to pancreatic surgery seems useful as a guide for determining the feasibility of limited pancreatic resection and to prevent missing injury to the MPD.
authors.affiliation: Department of Surgery, The Jikei University, School of Medicine, Tokyo, 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: D000368:Aged; D016145:Endoscopy, Digestive System; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods*; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging / Q000601:surgery*; D011300:Preoperative Care / Q000379:methods; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome; D014463:Ultrasonography