Effect of preoperative pancreatic duct stent placement in enucleation of pancreatic tumor adjacent to the main pancreatic duct
10.3760/cma.j.cn113884-20241022-00313
- VernacularTitle:术前置入胰管支架在邻近主胰管的胰腺肿瘤剜除术中的应用分析
- Author:
Haotian YU
1
;
Shubin ZHANG
1
;
Jianhua LIU
1
;
Jianzhang QIN
1
;
Chengxu DU
1
;
Xinda YANG
1
;
Weihong ZHAO
1
;
Haitao LYU
1
Author Information
1. 河北医科大学第二医院肝胆外科，石家庄 050000
- Publication Type:Journal Article
- Keywords:
Pancreatic neoplasms;
Pancreatic tumor enucleation;
Main pancreatic duct;
Pancreatic duct stent;
Pancreatic fistula
- From:
Chinese Journal of Hepatobiliary Surgery
2025;31(1):43-48
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the effect of preoperative pancreatic duct stent placement in enucleation (EN) of pancreatic tumor adjacent to the main pancreatic duct (MPD).Methods:Clinical data of 56 patients with benign or borderline pancreatic tumor adjacent to the MPD undergoing EN in the Department of Hepatobiliary Surgery of the Second Hospital of Hebei Medical University from January 2022 to September 2024 were retrospectively analyzed, including 25 males and 31 females, aged (32.0±5.5) years. Among the patients, 35 (62.5%) were solid pseudopapillary neoplasm, 15 (26.8%) were neuroendocrine tumor, and 6 (10.7%) were serous cystic tumor. According to whether the pancreatic duct stent was placed through encoscopic retrograde cholangiopancreatography preoperatively, patients were divided into the stent group ( n=20, observation group) and no-stent group ( n=36, control group). The operation time, intraoperative pancreatic duct injury, tumor enucleation time and blood loss, grade B/C pancreatic fistula and postoperative hospital stay were compared between the two groups. Results:All patients underwent EN successfully. The operation time in the observation group was shorter than that in the control group [150.0 (143.5, 159.0) vs 158.0 (150.0, 180.0) min, Z=-2.08, P=0.031], and the rate of intraoperative MPD injury in the observation group was lower than that in the control group [10.0% (2/20) vs 38.9% (14/36), χ2=5.26, P=0.022]. The tumor enucleation time and blood loss were comparable between the two groups (both P>0.05). The rate of postoperative grade B/C pancreatic fistula in the observation group was lower than that in the control group [15.0% (3/20) vs 41.7% (15/36), χ2=4.19, P=0.041], and the postoperative hospital stay was also shorter in the observation group [(7.9±1.6) vs (9.3±2.1) d, t=-2.57, P=0.014]. Conclusion:Under the premise of matured endoscopic operation, preoperative pancreatic duct stent placement through ERCP in the EN of pancreatic tumor adjacent to the MPD can protect the MPD during operation, reduce the occurrence of postoperative grade B/C pancreatic fistula, and shorten the postoperative hospital stay.
