title: Stenting versus non-stenting in pancreaticojejunostomy: a prospective study limited to a normal pancreas without fibrosis sorted by using dynamic MRI.
abstract: OBJECTIVE
  We prospectively investigated the efficacy of an external pancreatic duct stent to prevent pancreatic fistula in the nonfibrotic pancreas after pancreaticojejunostomy, in which the degree of pancreatic fibrosis was assessed objectively by using dynamic magnetic resonance imaging (MRI).
  
  
  METHODS
  Among the 67 consecutive patients who underwent pancreatic head resection, 45 patients were judged to have a normal pancreas without fibrosis based on the preoperative assessment of pancreatic fibrosis based on MRI. The patients were randomly allocated to 1 of 2 groups with (n=23) or without (n=22) use of an external pancreatic duct stent in performing a pancreaticojejunostomy.
  
  
  RESULTS
  Pancreatic fistula developed in 8 (34.5%) patients in the stented group: 3 grade A and 5 grade B; whereas in the nonstented group, 9 (40.9%) patients developed pancreatic fistula: 3 grade A and 6 grade B. There were no significant differences in the incidence or severity of pancreatic fistula between the 2 groups.
  
  
  CONCLUSIONS
  The utility of the external pancreatic duct stent after pancreaticojejunostomy was not found in the nonfibrotic pancreases, which were sorted according to the degree of pancreatic fibrosis using the pancreatic time-signal intensity curve analysis from MRI.
authors: Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Sakamoto, Nagasaki, Japan. tkuroki-gi@umin.ac.jp
authors: Tamotsu
authors: T
authors: Kuroki
authors: Yoshitsugu
authors: Y
authors: Tajima
authors: Amane
authors: A
authors: Kitasato
authors: Tomohiko
authors: T
authors: Adachi
authors: Takashi
authors: T
authors: Kanematsu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005355:Fibrosis; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology*; D010185:Pancreatic Fistula / Q000209:etiology; D010193:Pancreaticojejunostomy / Q000009:adverse effects / Q000379:methods*; D011446:Prospective Studies; D015607:Stents