American journal of surgery · 2024
The impact of externalized pancreatic stents in our practice: A comparison of outcomes after pancreaticoduodenectomy in two time periods.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Arias-Espinosa L, Nordmann-Gomes A, Zorrilla-Villalobos A, Vargas-España A, Malcher F, Ramírez-Del Val A, Chan C, Domínguez-Rosado I
Аннотация
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.
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.