Pancreatic duct stenting and postoperative pancreatic fistula after pancreaticoduodenectomy
10.3760/cma.j.issn.1007-631X.2019.09.004
- VernacularTitle: 胰管支撑管与胰十二指肠切除术后胰瘘相关性分析
- Author:
Xingyu CHEN
1
;
Ye LI
1
;
Jian ZHOU
1
;
Dongming ZHU
1
;
Zixiang ZHANG
1
;
Dechun LI
1
Author Information
1. Department of General Surgery, Pancreatic Disease Research Centre, The First Affiliated Hospital of Soochow University, Jiangsu Province 215006, China
- Publication Type:Journal Article
- Keywords:
Pancreaticoduodenectomy;
Pancreatic fistula;
External drainage
- From:
Chinese Journal of General Surgery
2019;34(9):757-761
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the correlation between pancreatic duct stent placement and postoperative pancreatic fistula in patients undergoing pancreaticoduodenectomy.
Methods:We performed a retrospective review on 298 patients who underwent pancreaticoduodenectomy from Jan 2011 to Dec 2016. Patients were divided into none stent group, external stent group and internal stent group according to the placement and drainage of the pancreatic duct stent.
Results:There were 60 cases in none stent group, 103 cases in external stent group and 135 cases in internal stent group. Altogether there were 52 cases suffering from biochemical pancreatic fistula, 52 cases of grade B fistula and 9 cases of grade C pancreatic fistula. There were three factors with statistical significance: 1, the operative method (χ2=20.947, P=0.000), 2, the diameter of main pancreatic duct (χ2=8.662, P=0.013), and 3, the intraoperative blood loss (χ2=14.03, P=0.001). There were no statistical significance difference between no stenting group and external/ internal stent group in the incidence of pancreatic fistula (P>0.05). The difference between internal stent group and external stent group was of statistical significance (χ2=9.948, P=0.019). The incidence of clinically relevant pancreatic fistula in external stent group was lower than the internal stent group (14.5% vs. 26.6%)(χ2=9.777, P=0.002).
Conclusions:The pancreatic duct stenting is not a risk factor for pancreatic fistula. The external drainage of pancreatic juice is associated with a lower incidence of pancreatic fistula compared to the internal drainage.
