title: Pancreatic duct patency after pancreaticoduodenectomy for dilated pancreatic ducts.
abstract: OBJECTIVE
  It is important to prevent pancreatic leakage and maintain pancreatic duct patency after pancreaticoduodenectomy (PD). We used an implantation method and a pancreatic stent in pancreaticogastrostomy (PG) and achieved good results without pancreatic leakage; however, PG strictures were observed in some cases. Using a pancreatic stent, we evaluated the early postoperative changes in the remnant pancreatic duct diameter in patients with a mildly dilated pancreatic duct.
  
  
  METHODS
  We retrospectively analyzed 46 patients with a mildly dilated pancreatic duct (diameter 4-7mm) who underwent PD with PG. They were divided into 2 groups on the basis of the surgical treatment they received for pancreatic stump: Group C included patients who underwent complete ligation of the pancreatic duct with a pancreatic stent (complete external drainage of the pancreatic juice), and Group I included patients who underwent pancreatic duct-to-mucosa anastomosis with a pancreatic stent (incomplete external drainage of the pancreatic juice).
  
  
  RESULTS
  The postoperative mean diameter of the remnant pancreatic duct was significantly smaller in Group I (6.22±0.81mm) than in Group C (6.80±1.10mm) (p<0.0466).
  
  
  CONCLUSIONS
  To prevent pancreatic leakage and maintain pancreatic duct patency, duct-to-mucosa anastomosis with a pancreatic stent is useful for patients with a dilated pancreatic duct.
authors.affiliation: Department of Surgery, Yokohama Central Hospital, Yokohama, Japan. ooida.takatsugu@yokochu.jp
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Oida
authors.forename: Hisao
authors.initials: H
authors.lastname: Kano
authors.forename: Kenji
authors.initials: K
authors.lastname: Mimatsu
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawasaki
authors.forename: Youichi
authors.initials: Y
authors.lastname: Kuboi
authors.forename: Nobutada
authors.initials: N
authors.lastname: Fukino
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Kida
authors.forename: Sadao
authors.initials: S
authors.lastname: Amano
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D057868:Anastomotic Leak / Q000209:etiology / Q000517:prevention & control; D001650:Bile Duct Neoplasms / Q000473:pathology / Q000601:surgery*; D016009:Chi-Square Distribution; D004108:Dilatation, Pathologic; D005260:Female; D005774:Gastrostomy / Q000009:adverse effects / Q000295:instrumentation; D006801:Humans; D007564:Japan; D008026:Ligation; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000473:pathology / Q000601:surgery*; D010189:Pancreatic Juice / Q000378:metabolism; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000295:instrumentation; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome