Publications

Authors:

Huscher, Cristiano; Perri, Giampaolo; Lazzarin, Gianni; Marchegiani, Giovanni; Malleo, Giuseppe; Salvia, Roberto; Bassi, Claudio

Title:

Coronary Artery Stent for Securing High-risk Pancreatico-jejunal Anastomosis After Pancreatoduodenectomy: A Pilot Series

Year:

2022

Type of item:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Language:

Inglese

Referee:

No

Name of journal:

Annals of Surgery

ISSN of journal:

0003-4932

N° Volume:

275

Number or Folder:

4

Page numbers:

e665-e668

Keyword:

coronary stent; pancreatic fistula; pancreatic stent; pancreaticoduodenectomy; pancreatico-jejunostomy

Short description of contents:

Objective: To assess the feasibility and clinical utility of coronary artery stent (CAS) in securing pancreatico-jejunal anastomosis (PJ) and avoid stent displacement after pancreatoduodenectomy (PD). Summary of Background Data: Externalized trans-anastomotic stent (ETS) is a standard mitigation strategy for postoperative pancreatic fistula (POPF) in high-risk patients. However, major morbidity remains extremely elevated, especially in case of ETS malfunction due to displacement. Methods: A pilot series of 72 patients underwent PD and PJ with CAS positioning between January 2016 and December 2019. All patients were at high-risk for POPF (soft pancreatic texture; main pancreatic duct diameter <= 3 mm) and underwent a CT-scan at postoperative day 5 and 10 to assess the correct CAS positioning. Postoperative outcomes were analyzed, and displacement rates were compared with a cohort of 141 patients with the same high-risk characteristics, undergoing PD with PJ and externalized trans-anastomotic stent (ETS). Results: No CAS-related complications were registered in the study group. In particular, no CAS displacement was registered, compared to a 28% ETS malfunction (either displacement or occlusion). The POPF rate, major morbidity, and mortality were 11%, 6%, and 0% respectively. Conclusions: The CAS positioning appears to be a feasible and safe mitigation strategy to secure PJ anastomosis after PD with high POPF risk avoiding stent displacement. Further validation and comparison with current standard of care is required in a prospective controlled setting.

Product ID:

131970

Handle IRIS:

11562/1086133

Last Modified:

February 23, 2023

Bibliographic citation:

Huscher, Cristiano; Perri, Giampaolo; Lazzarin, Gianni; Marchegiani, Giovanni; Malleo, Giuseppe; Salvia, Roberto; Bassi, Claudio, Coronary Artery Stent for Securing High-risk Pancreatico-jejunal Anastomosis After Pancreatoduodenectomy: A Pilot Series «Annals of Surgery» , vol. 275 , n. 4 , 2022 , pp. e665-e668

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