Preoperative endoscopic pancreatic stenting: a novel prophylactic measure against pancreatic fistula after distal pancreatectomy.
OBJECTIVE
The prevention of pancreatic fistula is still a major problem in distal pancreatectomy (DP). We have recently adopted preoperative endoscopic pancreatic stenting with the aim of preventing the leakage of pancreatic juice from the resection plane of the remnant pancreas after DP. We reviewed ten patients who underwent this intervention.


METHODS
One to 6 days before surgery, the patients underwent an endoscopic transpapillary pancreatic stent (7 Fr., 3 cm) placement. The perioperative short-term outcomes were assessed.


RESULTS
Preoperative endoscopic pancreatic stenting was successfully performed in all ten patients. Two (20%) patients, both with intraductal papillary mucinous tumor, developed mild acute pancreatitis after the stent placement. None of the ten patients developed pancreatic fistula. The pancreatic stent was removed 8-28 days (mean, 11 days) postoperatively.


CONCLUSIONS
Preoperative endoscopic pancreatic stenting may be an effective prophylactic measure against pancreatic fistula development following DP.
Abe
Nobutsugu
N
Department of Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan.
Sugiyama
Masanori
M
Suzuki
Yutaka
Y
Yamaguchi
Takashi
T
Mori
Toshiyuki
T
Atomi
Yutaka
Y
D000230:Adenocarcinoma / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004384:Duodenoscopy; D016145:Endoscopy, Digestive System; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects*; D010185:Pancreatic Fistula / Q000517:prevention & control*; D010190:Pancreatic Neoplasms / Q000601:surgery; D011300:Preoperative Care; D015607:Stents