Comparison of long-term clinical outcomes of external and internal pancreatic stents in pancreaticoduodenectomy: randomized controlled study. Issue 1 (January 2019)

• Record Type: Journal Article
• Authors: Shin, Yong Chan; Jang, Jin-Young; Chang, Ye Rim; Jung, Woohyun; Kwon, Wooil; Kim, Hongbeom; Kim, Eunjung; Kim, Sun-Whe
• Is Part Of: HPB. Volume 21:Issue 1(2019)
• Page Start: 51
• Page End: 59
• Publication Date: 2019-01
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 616.362005
• DOI: 10.1016/j.hpb.2018.06.1795
• Languages: English
• ISSNs: 1365-182X

Abstract

Abstract: Background: To determine the most appropriate pancreatic drainage method, by investigating differences in 12-month clinical outcomes in patients implanted with external and internal pancreatic stents as an extension to a previous study on short-term outcome. Methods: This prospective randomized controlled trial enrolled 213 patients who underwent pancreaticoduodenectomy with duct to mucosa pancreaticojejunostomy between August 2010 and January 2014 (NCT01023594). Of the 185 patients followed-up for 12 months, 97 underwent external and 88 underwent internal stenting. Their long-term clinical outcomes were compared. Results: Overall late complication rates were similar in the external and internal stent groups ( P = 0.621). The percentage of patients with >50% atrophy of the remnant pancreatic volume after 12 months was similar in both groups ( P = 0.580). Factors associated with pancreatic exocrine or endocrine function, including stool elastase level ( P = 0.571) and rate of new-onset diabetes ( P = 0.179), were also comparable. There were no significant between-group differences in quality of life, as evaluated by the EORTC QLQ-C30 and QLQ PAN26 questionnaires. Conclusion: External and internal stents showed comparable long-term, as well as short-term clinical outcomes, including late complication rates, preservation of pancreatic duct diameters, pancreatic volume changes with functional derangements, and quality of life after surgery.