The impact of externalized pancreatic stents in our practice: A comparison of outcomes after pancreaticoduodenectomy in two time periods

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2024-10-06 DOI:10.1016/j.amjsurg.2024.116004

L. Arias-Espinosa , A. Nordmann-Gomes , A. Zorrilla-Villalobos , A. Vargas-España , F. Malcher , A. Ramírez-Del Val , C. Chan , I. Domínguez-Rosado

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引用次数: 0

Abstract

Background

Postoperative pancreatic fistula is a severe complication of pancreaticoduodenectomy. Using an externalized pancreatic stent is a potential mitigation strategy not previously studied in Latin America.

Methods

Pancreaticoduodenectomies performed in a single center between 2006 and 2019 were retrospectively analyzed. Clinical variables were collected with a 90-day follow-up according to stent intervention: externalized stent (ES), internal stent (IS), or no stent. Before and after ES implementation (2016) periods were also compared.

Results

Out of 237 patients, 77 (32.5 %) had an ES, 24 (10.1 %) an IS, and 136 (57.4 %) none. No difference was found in the overall incidence of POPF. The use of an ES was associated with less type C POPF, despite having an increased risk for fistula development. PD performed after 2016 were also associated with a reduced incidence of type C POPF, surgical reintervention requirement, POPF-associated mortality, and intrahospital stay.

Conclusions

The use of an ES is a low-cost intervention that can mitigate POPF severity in high-risk patients.

Abstract Image

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外置胰腺支架对我们工作的影响：两个时期胰十二指肠切除术后疗效的比较

背景术后胰瘘是胰十二指肠切除术的一种严重并发症。方法回顾性分析了 2006 年至 2019 年期间在一个中心进行的胰十二指肠切除术。根据支架干预：外置支架（ES）、内置支架（IS）或无支架，收集了随访 90 天的临床变量。结果在 237 名患者中，77 人（32.5%）使用了 ES，24 人（10.1%）使用了 IS，136 人（57.4%）未使用。在 POPF 的总发病率方面没有发现差异。尽管瘘管发展的风险增加，但使用 ES 与较少的 C 型 POPF 相关。2016 年后进行的 PD 也与 C 型 POPF 发生率、手术再干预要求、POPF 相关死亡率和院内住院时间减少有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.