A major meta-analysis looking at how patient outcomes can be improved by adding a stent to the pancreatic duct during major surgery that requires a pancreatic resection followed by a join between the pancreas and the bowel was published in August 2012.
The operation, known as a pancreaticoduodenectomy involves cutting the head of the pancreas away, normally because it contains a tumour. Both the pancreas and the pancreatic duct are then sewn into a loop made in the jejunum, which is part of the small intestine. This allows pancreatic juices to flow out of the pancreas and directly into the intestine. This join can leak in up to 15 % of patients.
This meta-analysis looked at the results obtained from six such trials, involving some 732 patients.
“The results look quite promising in that patients who are fitted with a pancreatic stent experience fewer complications – but the difference isn’t ‘significant’ when rigorous statistics are applied to the data. We need to do more research to find out which patients will definitely benefit, as opposed to those who will do better without stenting,” says Mr Imber.
The impact of pancreatic duct drainage following pancreaticojejunostomy on clinical outcome. Markar SR, Vyas S, Karthikesalingam A, Imber C, Malago M.
J Gastrointest Surg. 2012 Aug; 16(8):1610-7