Yu Zhou1, Quanbo Zhou, Zhihua Li, Rufu Chen. 1. Department of Hepatobiliary Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, GuangZhou, China.
Abstract
BACKGROUND: The use of an internal pancreatic duct stent to improve postoperative outcomes of pancreatic anastomosis remains a matter of debate. METHODS: A meta-analysis including comparative studies providing data on patients with and without internal stenting during pancreaticojejunostomy anastomosis was performed. RESULTS: Seven articles including 724 patients were identified for inclusion: 1 randomized controlled trial, 1 quasi-randomized controlled trial, and 5 observational clinical studies. The meta-analysis revealed that there were no significant differences between groups regarding operative outcomes. The use of an internal pancreatic duct stent was not associated with a statistically significant reduction in pancreatic fistula (P = .31), hospital mortality (P = .64), or delayed gastric emptying (P = .17), but it was associated with a higher risk of pancreatic fistulas in soft pancreases (P = .05) and overall morbidity (P = .04). CONCLUSIONS: The current literature suggests that the use of an internal pancreatic duct stent does not help to reduce the leakage rate of pancreatic anastomosis after pancreatic resection, and it may increase the risk of pancreatic fistulas in soft pancreases.
BACKGROUND: The use of an internal pancreatic duct stent to improve postoperative outcomes of pancreatic anastomosis remains a matter of debate. METHODS: A meta-analysis including comparative studies providing data on patients with and without internal stenting during pancreaticojejunostomy anastomosis was performed. RESULTS: Seven articles including 724 patients were identified for inclusion: 1 randomized controlled trial, 1 quasi-randomized controlled trial, and 5 observational clinical studies. The meta-analysis revealed that there were no significant differences between groups regarding operative outcomes. The use of an internal pancreatic duct stent was not associated with a statistically significant reduction in pancreatic fistula (P = .31), hospital mortality (P = .64), or delayed gastric emptying (P = .17), but it was associated with a higher risk of pancreatic fistulas in soft pancreases (P = .05) and overall morbidity (P = .04). CONCLUSIONS: The current literature suggests that the use of an internal pancreatic duct stent does not help to reduce the leakage rate of pancreatic anastomosis after pancreatic resection, and it may increase the risk of pancreatic fistulas in soft pancreases.
Authors: Jasper Jan Atema; Anneke P J Jilesen; Olivier R C Busch; Thomas M van Gulik; Dirk J Gouma; Els J M Nieveen van Dijkum Journal: HPB (Oxford) Date: 2014-07-18 Impact factor: 3.647
Authors: Anneke P J Jilesen; Casper H J van Eijck; Olivier R C Busch; Thomas M van Gulik; Dirk J Gouma; Els J M Nieveen van Dijkum Journal: World J Surg Date: 2016-03 Impact factor: 3.352