Do Transanastomotic Pancreatic Ductal Stents After Pancreatic Resections Improve Outcomes?

P Shukla, Savio Barreto, Abe Fingerhut

    Research output: Contribution to journalReview article

    18 Citations (Scopus)

    Abstract

    Objectives: Despite strategies aimed at reducing a postoperative pancreatic fistula (POPF) after pancreatectomies, the overall incidence remains unchanged. One such procedure, until now incompletely explored, is transanastomotic pancreatic (TAP) ductal stenting. Methods: We conducted a systematic search using MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials from 1983-2008 to determine if TAP ductal stents provide any benefit and, if so, in which clinical scenarios they can be recommended. Results: Stents can be internal or external, intraoperative only, or temporary (several days). One randomized trial on internal stents across pancreaticojejunostomy (PJ) suggested a higher POPF rate in the stented group. One nonrandomized study using an internal stent for pancreaticogastrostomy (PG) revealed a 0% POPF rate. Results from studies where external stents were used across PJ/PG reported a lower incidence of POPF. No statistically significant difference was reported in a POPF incidence when internal stents were compared with externalized stents. Available data suggest improved outcomes of pancreatoenteric anastomosis when TAP ductal stent is inserted in small ducts (≤3 mm). Conclusions: There is insufficient evidence to support or refute improved outcomes after TAP ductal stent insertion in patients with PJ/PG with small ducts (≤3 mm) or soft pancreata. More evidence of benefit is needed before use of external stents can be recommended.

    Original languageEnglish
    Pages (from-to)561-566
    Number of pages6
    JournalPancreas
    Volume39
    Issue number5
    DOIs
    Publication statusPublished - Jul 2010

    Keywords

    • anastomosis
    • fistula
    • leak
    • outcomes
    • pancreas
    • resection

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