So Hyun Park1, Jin Hee Kim2, Seung Yeon Noh1, Jae Ho Byun1, Seung Soo Lee1, Hyoung Jung Kim1, Seong Ho Park1, Sung Koo Lee3, Dae Wook Hwang4, Song Cheol Kim4, Duck Jong Han4, Moon-Gyu Lee1. 1. Department of Radiology and Research Institute of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, 88 Olympic-ro, 43-gil, Songpa-Gu, Seoul, 138-736, South Korea. 2. Department of Radiology and Research Institute of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, 88 Olympic-ro, 43-gil, Songpa-Gu, Seoul, 138-736, South Korea. kimjhrad@amc.seoul.kr. 3. Department of Internal Medicine, Asan Medical Center, College of Medicine, University of Ulsan, 88 Olympic-ro, 43-gil, Songpa-Gu, Seoul, 138-736, South Korea. 4. Department of Surgery, Asan Medical Center, College of Medicine, University of Ulsan, 88 Olympic-ro, 43-gil, Songpa-Gu, Seoul, 138-736, South Korea.
Abstract
PURPOSE: To investigate the incidence, complications, and risk factors of the migration of internal pancreaticojejunostomy (PJ) stents into the bile ducts in patients undergoing pancreatoduodenectomy. METHODS: Postoperative computed tomography (CT) and clinical data of 802 patients with CT-detectable internal PJ stents were reviewed to assess the occurrence of stent migration into the bile ducts and stent-induced complications with their clinical significance. Risk factors for stent migration and stent-induced complications were determined. RESULTS: Stent migration into the bile ducts occurred in 135 patients (16.8 %); 40 of these (29.6 %) showed stent-induced complications including bile duct stricture, stone, and liver abscess. Clinically significant complications were identified in only eight patients. Neither the stent length nor diameter was associated with stent migration. A small stent diameter, peripheral location of the stent, absence of stent remigration from the bile ducts to the intestine, and longer stent retention time in the bile ducts were risk factors of stent-induced complications. CONCLUSIONS: The incidence of internal PJ stent migration into the bile ducts was 16.8 %. Migrated stents frequently caused complications, although they were mostly subclinical. Stent-induced complications were associated with stent diameter and location, stent remigration to the intestine, and stent retention time in the bile ducts.
PURPOSE: To investigate the incidence, complications, and risk factors of the migration of internal pancreaticojejunostomy (PJ) stents into the bile ducts in patients undergoing pancreatoduodenectomy. METHODS: Postoperative computed tomography (CT) and clinical data of 802 patients with CT-detectable internal PJ stents were reviewed to assess the occurrence of stent migration into the bile ducts and stent-induced complications with their clinical significance. Risk factors for stent migration and stent-induced complications were determined. RESULTS: Stent migration into the bile ducts occurred in 135 patients (16.8 %); 40 of these (29.6 %) showed stent-induced complications including bile duct stricture, stone, and liver abscess. Clinically significant complications were identified in only eight patients. Neither the stent length nor diameter was associated with stent migration. A small stent diameter, peripheral location of the stent, absence of stent remigration from the bile ducts to the intestine, and longer stent retention time in the bile ducts were risk factors of stent-induced complications. CONCLUSIONS: The incidence of internal PJ stent migration into the bile ducts was 16.8 %. Migrated stents frequently caused complications, although they were mostly subclinical. Stent-induced complications were associated with stent diameter and location, stent remigration to the intestine, and stent retention time in the bile ducts.
Entities:
Keywords:
Bile ducts; Internal stent; Migration; Pancreaticojejunostomy; Pancreatoduodenectomy
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