Symeonidis D, Zacharoulis D, Tzovaras G, Kissa L, Samara AA, Petsa E, Tepetes K. Stent A pancreaticojejunostomy after pancreatoduodenectomy: Is it always necessary? World J Methodol 2024; 14(3): 90164 [DOI: 10.5662/wjm.v14.i3.90164]
Corresponding Author of This Article
Athina A Samara, MD, MSc, Surgeon, Department of Surgery, University Hospital of Larissa, Mezourlo Hill, Larissa 41110, Greece. at.samara93@gmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dimitrios Symeonidis, Dimitris Zacharoulis, Georgios Tzovaras, Labrini Kissa, Athina A Samara, Eleana Petsa, Department of Surgery, University Hospital of Larissa, Larissa 41110, Greece
Konstantinos Tepetes, Department of General Surgery, University Hospital of Larissa, Larissa 41110, Greece
Author contributions: Symeonidis D, Zacharoulis D, and Samara AA contributed to study conception and design; Kissa L and Petsa E contributed to acquisition of data; Tzovaras G and Samara AA contributed to analysis and interpretation of data; Symeonidis D, Zacharoulis D, and Samara AA contributed to drafting of manuscript; Tzovaras G, Kissa L, Petsa E, and Tepetes K contributed to critical revision; All authors have approved the final version of the present manuscript.
Conflict-of-interest statement: All authors declare that there are no competing interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Athina A Samara, MD, MSc, Surgeon, Department of Surgery, University Hospital of Larissa, Mezourlo Hill, Larissa 41110, Greece. at.samara93@gmail.com
Received: November 25, 2023 Revised: February 19, 2024 Accepted: April 7, 2024 Published online: September 20, 2024 Processing time: 212 Days and 22.3 Hours
Abstract
The establishment of a postoperative pancreatic fistula (POPF) is considered the most common and, concomitantly, the most serious complication associated with pancreaticoduodenectomy (PD). The search for either technical modifications of the operative technique or pharmaceutical interventions that could possibly aid in decreasing the incidence of this often-devastating complication appears justified. The stenting of the pancreatic duct, with the use of either internal or external stents, has been evaluated in this direction. In theory, it is an approach that could eliminate many pathophysiological factors responsible for the occurrence of a POPF. The purpose of the present study was to review the current data regarding the role of pancreatic duct stenting on the incidence of POPF, after PD, by using PubMed and Reference Citation Analysis. In general, previous studies seem to highlight the superiority of external stents over their internal counterparts in regard to the incidence of POPF; this is at the cost, however, of increased morbidity associated mainly with the stent removal. Certainly, the use of an internal stent is a less invasive approach with acceptable results and is definitely deprived of the drawbacks arising through the complete diversion of pancreatic juice from the gastrointestinal tract. Bearing in mind the scarcity of high-quality data on the subject, an approach of reserving stent placement for the high-risk for POPF patients and individualizing the selection between the use of an internal or an external stent according to the distinct characteristics of each individual case scenario appears appropriate.
Core Tip: A postoperative pancreatic fistula (POPF) is considered the most common and the most serious complication associated with pancreaticoduodenectomy. Reserving stent placement for the high-risk for POPF patients and individualizing the selection between the use of an internal or an external stent according to the distinct characteristics of each individual case scenario appears appropriate.
