AI Article Synopsis

  • The study focused on preventing pancreatic fistulas after pancreaticoduodenectomy by examining 80 patients and their surgical outcomes.
  • The researchers found that pancreatic fistulae occurred in 26.3% of patients, with a notably higher incidence in those with soft pancreases compared to hard ones.
  • The use of external stents for pancreatic drainage significantly reduced the occurrence of fistulas in patients with soft pancreases, suggesting that external drainage may be a better option to minimize complications.

Article Abstract

Background/aims: We evaluated the prevention of pancreatic fistula after pancreaticoduodenectomy in a retrospective clinical study.

Methodology: Eighty patients undergoing pancreaticoduodenectomy between April 2007 and August 2011 were recruited.In all patients, the pancreas was reconstructed first,followed by reconstruction of the hepatic duct and the duodenum or stomach.

Results: Pancreatic fistulae were observed in 21 of 80 patients (26.3%; Grade A/B/C: 9/12/0). The incidence of pancreatic fistula in patients with soft pancreas was higher than that inpatients with hard pancreas (p<0.01). We investigated 54 patients with soft pancreas and pancreatic fistulae were diagnosed in 19 patients (35.2%; Grade A/B/C: 8/11/0). We evaluated pancreatic drainage methods (internal stent/external stent: 20/34) and in patients with soft pancreata, pancreatic fistulae were observed in 11 patients (55%) with internal stents vs. eight patients (23.5%) with external stents(p<0.05).

Conclusions: We evaluated the management of pancreatic drainage methods and external stents were associated with a significantly lower incidence of pancreatic fistula compared with internal stents.We expect that external drainage of soft pancreas will decrease pancreatic juice leakage into the abdominal cavity. Many randomised control trials on pancreatic drainage have been reported recently; we plan to study them.

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Source
http://dx.doi.org/10.5754/hge12171DOI Listing

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