Original ResearchClinical effect of pancreaticojejunostomy with a long-internal stent during pancreaticoduodenectomy in patients with a main pancreatic duct of small diameter

•The aim of this study was to evaluate the clinical effect of a long-internal stent for pancreatojejunostomy (PJ).•54 patients had undergone PJ with a long-internal stent compared with 54 patients who undergone PJ without a stent.•There was no significant difference between two groups in the incidence of postoperative pancreatic fistula.

BackgroundPost-operative pancreatic fistula (POPF) is one of the most common causes of death following pancreaticoduodenectomy (PD). The aim of this study was to evaluate the clinical effect of a long-internal stent on the development of POPF in patients with a main pancreatic duct diameter of 3 mm or less.Study designPatients (N = 108) with a main pancreatic duct (≤3 mm) who underwent PD were included in this single-institution historical control study. Between January 2012 and December 2013, 54 patients had undergone PJ with a long-internal stent across the duct-to-mucosa anastomosis (long-stent group), and between February 2009 and December 2011, 54 patients had undergone PJ without a stent (control).ResultsThere was no significant difference between groups (long-stent vs control) in the incidence of POPF (70% vs. 56%, p = 0.110) and grade B/C POPF (26% vs. 26%, p = 1.000). Univariate analysis identified body mass index, extent of blood loss and soft pancreatic parenchyma as risk factors related to POPF. Multivariate analysis identified extent of blood loss and soft pancreatic parenchyma as significant risk factors.ConclusionPlacement of a long-internal stent during PJ did not reduce POPF after PD in patients with a main pancreatic duct of small diameter.