Incidence of Leakage in Pancreatic Anastomosis with External Stent after Whipple Operation

Document Type : Original Article


The Department of General Surgery, Faculty of Medicine, Ain Shams University


Abstract Background: Pancreaticojejunal anastomotic leakage (PJAL) and subsequent pancreatic fistula are the most serious problems associated with pancreatic remnant. Reoperation as a pancreaticogastrostomy, repeat pancreaticojejunostomy, or total pancreatectomy is necessary in the case of severe PJAL, and it relies on the patient's clinical status. Aim of Study: To identify the risk factors for pancreatic fistula after pancreaticoduodenectomy (PD), and the incidence and prediction of PJALthrough a comparison between using external pancreatic duct stent and no stent. Material and Methods: Acomparative cohort studywas conducted on 20 patients who were enrolled and divided into two equal groups, group 1 included 10 patients with pancreatic external stent and group II included 10 patients without pancreatic stent. Results: No statistically significant differences were noted between study groups regarding all study parameters such as interventions and outcomes. Also, no differences were noted between study groups regarding main study outcomes as the incidence of postoperative pancreatic fistula was 1 case (10.0%) vs. 3 cases (30.0%); p=0.264, bile leak was 1 case (10.0%) vs. 2 cases (20.0%); p=0.531 and there was no mortality in group 1 (0.0%) and only 1 case in group 2 (10.0%); p=0.305. Conclusions: External pancreatic duct stenting has no significant effect on decreasing the rate of Post-Operative Pancreatic Fistula (POPF) suggests that external stenting of the pancreatic duct to drain pancreatic juice shouldn't be used as a routine in preventing the complications of pancreatic leakage.