Detailed Abstract
[BP Best Oral Presentation - Biliary & Pancreas (Biliary Disease/Surgery)]
[BP BO-S3] Impact of Internal Stent for Pancreatic Anastomosis on Long-term Pancreatic Function after Pancreatoduodenectomy
Jinju KIM 1, Ho-Seong HAN 1, Jai Young CHO 1, Hae Won LEE 1, Boram LEE 1, MeeYoung KANG 1, Yeshong PARK 1, Yoo-Seok YOON 1
1 General Surgery, Seoul National University Bundang Hospital, REPUBLIC OF KOREA
Background : Placement of internal pancreatic stents is a common practice to reduce the risk of postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD). This study aimed to evaluate the incidence of retained internal stents and their association with long-term pancreatic functional outcomes.
Methods : Among 264 patients who underwent PD between 2015 and 2020, 173 patients without pre-existing diabetes mellitus (DM) and with pancreatic stent were included. Preoperative and 1-year postoperative CT scans were checked to assess the pancreatic atrophic change and the location of pancreatic stent. The patients were classified into two groups based on stent retention: group A (removed stent, n=151) and group B (retained stent, n=22). The pancreatic atrophic change and new-onset DM were compared between the two groups.
Results : The incidence of retained stents in the pancreatic duct was 12.7 %. The mean stent migration time from the anastomosis was 6.1 months. Group B exhibited a higher rate of pancreatic atrophy (>30 % decrease in thickness of the remnant pancreas) (4.6 vs. 18.2 %, P = 0.049) and a more increase in pancreatic duct size (0.9±2.1 vs. 3.4±2.6 mm, P < 0.001) compared with Group A. Moreover, the onset of DM was significantly earlier in Group B (22.5 vs. 14.8 months P = 0.010).
Conclusions : Prolonged retention of internal stents in the pancreatic duct following PD may lead to pancreatic atrophy and ductal dilatation, resulting in early-onset DM. The use of internal pancreatic stents should be decided with caution to minimize adverse effects on the long-term pancreatic function.
Methods : Among 264 patients who underwent PD between 2015 and 2020, 173 patients without pre-existing diabetes mellitus (DM) and with pancreatic stent were included. Preoperative and 1-year postoperative CT scans were checked to assess the pancreatic atrophic change and the location of pancreatic stent. The patients were classified into two groups based on stent retention: group A (removed stent, n=151) and group B (retained stent, n=22). The pancreatic atrophic change and new-onset DM were compared between the two groups.
Results : The incidence of retained stents in the pancreatic duct was 12.7 %. The mean stent migration time from the anastomosis was 6.1 months. Group B exhibited a higher rate of pancreatic atrophy (>30 % decrease in thickness of the remnant pancreas) (4.6 vs. 18.2 %, P = 0.049) and a more increase in pancreatic duct size (0.9±2.1 vs. 3.4±2.6 mm, P < 0.001) compared with Group A. Moreover, the onset of DM was significantly earlier in Group B (22.5 vs. 14.8 months P = 0.010).
Conclusions : Prolonged retention of internal stents in the pancreatic duct following PD may lead to pancreatic atrophy and ductal dilatation, resulting in early-onset DM. The use of internal pancreatic stents should be decided with caution to minimize adverse effects on the long-term pancreatic function.
SESSION
BP Best Oral Presentation
Room A 3/22/2024 1:30 PM - 2:50 PM