title: [A prospective randomized controlled trial of pancreatic duct stent internal versus external drainage with pancreaticojejunostomy for the early curative effect after pancreaticoduodenectomy].
abstract: OBJECTIVE
  To investigate the effect of pancreatic duct stent internal versus external drainage with pancreaticojejunostomy on the early curative effect after pancreaticoduodenectomy (PD).
  
  
  METHODS
  The study was a prospective controlled trial. A total of 219 patients undergoing PD from January 2010 to March 2013 were randomly divided into external drainage group (n = 110) and internal drainage group (n = 109). The pancreatic duct stent was put in the jejunum during the operation in the internal drainage group, while that in the external drainage group was placed outside the body through the jejunum and abdominal wall. The intra-operative blood loss, operative duration, post-operative hospital stay, mortality rate, and the morbidity of pancreatic fistula as well as other complications were compared between the two groups.
  
  
  RESULTS
  Compared with internal drainage group, pancreatic duct stent external drainage obviously reduced the morbidity of pancreatic fistula (13.6% vs. 22.6%), delayed gastric emptying (10.0% vs. 27.5%), abdominal infection (6.4% vs. 19.3%), intestinal obstruction (8.2% vs. 20.2%) along with the overall complications (24.5% vs. 41.3%) after PD (χ(2) = 5.735 8 to 11.047 7, P < 0.05), and shortened the healing duration of pancreatic fistula ((11.5 ± 2.9) d vs. (20.1 ± 5.7) d, t = 5.07, P < 0.01), while there was no significant difference in the intra-operative blood loss, operative duration, post-operative hospital stay and mortality rate, etc between the two groups (P > 0.05).
  
  
  CONCLUSIONS
  Pancreatic duct stent external drainage can effectively reduce the morbidity of pancreatic fistula and the overall complications after PD, which is safe and feasible. The method is worthy of popularization and application clinically.
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Harbin Medical University, Harbin 150001, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Harbin Medical University, Harbin 150001, China. Email: sunbei70@tom.com.
authors.forename: Bei
authors.initials: B
authors.lastname: Sun
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Harbin Medical University, Harbin 150001, China.
authors.forename: Hongchi
authors.initials: H
authors.lastname: Jiang
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Harbin Medical University, Harbin 150001, China.
authors.forename: Le
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Harbin Medical University, Harbin 150001, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Ma
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Harbin Medical University, Harbin 150001, China.
authors.forename: Linfeng
authors.initials: L
authors.lastname: Wu
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Harbin Medical University, Harbin 150001, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Harbin Medical University, Harbin 150001, China.
authors.forename: Panquan
authors.initials: P
authors.lastname: Li
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Harbin Medical University, Harbin 150001, China.
authors.forename: Xiangsong
authors.initials: X
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000601:surgery*; D010185:Pancreatic Fistula / Q000209:etiology / Q000517:prevention & control; D016577:Pancreaticoduodenectomy; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D016896:Treatment Outcome