title: Internal pancreatic ductal stenting to reduce leakage rate of pancreaticojejunostomy after pancreaticoduodenectomy: a comparative study.
abstract: OBJECTIVE
  This is a non-randomized comparative trial designed to compare the results of pancreaticoduodenectomy with internal pancreatic stenting versus no stenting for pancreaticojejunal (PJ) anastomosis after pancreaticoduodenectomy.
  
  
  METHODS
  Between January 1999 and March 2008, a total of 49 consecutive patients undergoing pancreaticoduodenectomy with duct-to-mucosa PJ anastomosis with, or without an internal stent were evaluated.
  
  
  RESULTS
  The 2 groups were comparable in demographic data, underlying pathologies, and pancreatic stump condition. Four patients (16.7%) in the stented group, and four patients (16%) in the non-stented anastomosis group had pancreatic fistula. There was no significant difference in pancreatic fistula rate between two groups. No surgical reintervention was necessary in all the patients with pancreatic fistulas. There were also no significant differences in operating time (mean, 270.5 minutes vs. 263.6 minutes), intra-operative blood loss (mean, 772.9 ml vs. 665.3 ml), overall morbidity (45.8% vs. 40%) and hospital mortality (4.2% vs. 4.0%). The mean hospital stay after surgery was 34 days in stented group and 21.5 days in non-stented group.
  
  
  CONCLUSIONS
  Internal stenting of pancreatic duct could not reduce pancreatic fistula rate after pancreaticoduodenectomy.
authors.affiliation: Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong SAR, China. ericlai@alumni.cuhk.edu.hk
authors.forename: Eric C H
authors.initials: EC
authors.lastname: Lai
authors.forename: Ngai Tang
authors.initials: NT
authors.lastname: Chung
authors.forename: George P C
authors.initials: GP
authors.lastname: Yang
authors.forename: Michael K W
authors.initials: MK
authors.lastname: Li
mesh_terms: D000714:Anastomosis, Surgical; D016063:Blood Loss, Surgical; D016009:Chi-Square Distribution; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000601:surgery*; D010183:Pancreatic Ducts; D010185:Pancreatic Fistula / Q000209:etiology / Q000517:prevention & control*; D016577:Pancreaticoduodenectomy; D010193:Pancreaticojejunostomy; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome