L. Arias-Espinosa , A. Nordmann-Gomes , A. Zorrilla-Villalobos , A. Vargas-España , F. Malcher , A. Ramírez-Del Val , C. Chan , I. Domínguez-Rosado
{"title":"外置胰腺支架对我们工作的影响：两个时期胰十二指肠切除术后疗效的比较","authors":"L. Arias-Espinosa , A. Nordmann-Gomes , A. Zorrilla-Villalobos , A. Vargas-España , F. Malcher , A. Ramírez-Del Val , C. Chan , I. Domínguez-Rosado","doi":"10.1016/j.amjsurg.2024.116004","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>The use of an ES is a low-cost intervention that can mitigate POPF severity in high-risk patients.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"239 ","pages":"Article 116004"},"PeriodicalIF":2.7000,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The impact of externalized pancreatic stents in our practice: A comparison of outcomes after pancreaticoduodenectomy in two time periods\",\"authors\":\"L. Arias-Espinosa , A. Nordmann-Gomes , A. Zorrilla-Villalobos , A. Vargas-España , F. Malcher , A. Ramírez-Del Val , C. Chan , I. Domínguez-Rosado\",\"doi\":\"10.1016/j.amjsurg.2024.116004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>The use of an ES is a low-cost intervention that can mitigate POPF severity in high-risk patients.</div></div>\",\"PeriodicalId\":7771,\"journal\":{\"name\":\"American journal of surgery\",\"volume\":\"239 \",\"pages\":\"Article 116004\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2024-10-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American journal of surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0002961024005567\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0002961024005567","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
The impact of externalized pancreatic stents in our practice: A comparison of outcomes after pancreaticoduodenectomy in two time periods
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.
期刊介绍：
The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.
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