title: A prospective randomized controlled trial of internal versus external drainage with pancreaticojejunostomy for pancreaticoduodenectomy.
abstract: BACKGROUND
  A stent often is placed across the pancreaticojejunostomy. However, there is no report compared between internal drainage and external drainage.
  
  
  METHODS
  We conducted a prospective randomized trial (NCT00628186 registered at http://ClinicalTrials.gov) with 100 patients who underwent pancreaticoduodenectomy and we compared the effects on postoperative course.
  
  
  RESULTS
  The incidence of pancreatic fistula according to the International Study Group on Pancreatic Fistula criteria was not different (external, 20%; vs internal, 26%), and the incidence of the other complications was similar between stent types. The median postoperative hospital stay was 21 days (range, 8-163 d) in the internal drainage group, which was shorter than the median stay of 24 days (range, 21-88 d) in the external drainage group (P = .016).
  
  
  CONCLUSIONS
  Both internal drainage and external drainage were safety devices for pancreaticojejunostomy. Internal drainage simplifies postoperative managements and it might shorten postoperative stay for pancreaticoduodenectomy.
authors.affiliation: Second Department of Surgery, Wakayama Medical University, School of Medicine, 811-1 Kimiidera, Wakayama 641-8510, Japan.
authors.forename: Masaji
authors.initials: M
authors.lastname: Tani
authors.forename: Manabu
authors.initials: M
authors.lastname: Kawai
authors.forename: Seiko
authors.initials: S
authors.lastname: Hirono
authors.forename: Shinomi
authors.initials: S
authors.lastname: Ina
authors.forename: Motoki
authors.initials: M
authors.lastname: Miyazawa
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shimizu
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yamaue
mesh_terms: D000038:Abscess / Q000209:etiology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000601:surgery*; D010185:Pancreatic Fistula / Q000209:etiology / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D010193:Pancreaticojejunostomy; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D015607:Stents; D016896:Treatment Outcome