Novel biodegradable internal stent as a mitigation strategy in high-risk pancreaticojejunostomy: technical notes and preliminary results

Mazzola, Michele; Bertoglio, Camillo Leonardo; Giani, Alessandro; Zironda, Andrea; Carnevali, Pietro; Lombardi, Pietro Maria; Martini, Paolo De; Magistro, Carmelo; Ferrari, Giovanni

doi:10.1007/s00595-022-02488-6

Cited by 4 publications

(5 citation statements)

References 19 publications

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“…The incidence of POPF in this series is 44.4%. One early series using differently designed biodegradable stent in pancreatoduodenectomy reported 3% POPF rate 9,10 . Theoretically, the incidence of POPF could be reduced.…”

Section: Discussionmentioning

confidence: 99%

“…One early series using differently designed biodegradable stent in pancreatoduodenectomy reported 3% POPF rate. 9,10 Theoretically, the incidence of POPF could be reduced. The helical channel design of Archimedes stent allows the flow of pancreatic juice on the outer surface, while the lumen of pancreatic anastomosis is splinted and supported by the stent.…”

Section: Discussionmentioning

confidence: 99%

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Initial experience with a novel biodegradable pancreatic stent in pancreatoduodenectomy

Yuen

Chan²,

Luk³

et al. 2022

Surgical Practice

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The application of biodegradable pancreatic stent in pancreatoduodenectomy has rarely been studied. Archimedes biodegradable stent is a newly designed CE‐approved biodegradable stent. We conducted a retrospective cohort study to evaluate the performance of this stent in patients undergoing pancreatoduodenectomy. Clinical outcomes of these patients were reviewed. Among nine patients in this study, six (66.7%) slow‐degrading, two (22.2%) medium‐degrading, and one (11.1%) fast‐degrading stents were used. Technical success rate was 100%. There was no hospital mortality. Four patients (44.4%) developed clinically relevant post‐operative pancreatic fistula (POPF). Proximal migration of stent occurred in two patients (22%) who were managed conservatively. Five stents (55.5%) degraded within the expected degradation period. In conclusion, the use of Archimedes biodegradable stent in pancreatoduodenectomy is technically feasible. Future study is needed to evaluate its potential efficacy of reducing POPF.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Initial experience with a novel biodegradable pancreatic stent in pancreatoduodenectomy

Yuen

Chan²,

Luk³

et al. 2022

Surgical Practice

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“…The Archimedes stent is a novel biodegradable stent that shows promise for use in a range of surgical procedures, including liver transplantation and pancreaticoduodenectomy. Its use can help prevent bile leakage and improve patient outcomes[ 120 , 121 ]. A drug-eluting stent is a stent that has been coated with a medication that slowly releases over time.…”

Section: The Treatment Of Oj: Medication and Surgerymentioning

confidence: 99%

Pathophysiological consequences and treatment strategy of obstructive jaundice

Liu¹,

Sun²,

Xu³

et al. 2023

World J Gastrointest Surg

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Obstructive jaundice (OJ) is a common problem in daily clinical practice. However, completely understanding the pathophysiological changes in OJ remains a challenge for planning current and future management. The effects of OJ are widespread, affecting the biliary tree, hepatic cells, liver function, and causing systemic complications. The lack of bile in the intestine, destruction of the intestinal mucosal barrier, and increased absorption of endotoxins can lead to endotoxemia, production of proinflammatory cytokines, and induce systemic inflammatory response syndrome, ultimately leading to multiple organ dysfunction syndrome. Proper management of OJ includes adequate water supply and electrolyte replacement, nutritional support, preventive antibiotics, pain relief, and itching relief. The surgical treatment of OJ depends on the cause, location, and severity of the obstruction. Biliary drainage, surgery, and endoscopic intervention are potential treatment options depending on the patient's condition. In addition to modern medical treatments, Traditional Chinese medicine may offer therapeutic benefits for OJ. A comprehensive search was conducted on PubMed for relevant articles published up to August 1970. This review discusses in detail the pathophysiological changes associated with OJ and presents effective strategies for managing the condition.

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“…In addition, both internal and external stents can develop stent dysfunction, such as migration, occlusion, or fracture 104,105 . Recently, pancreatic duct stent placement has been intensively investigated (Table 4), 51,104–131 and the procedure remains controversial 103,110,132–134 . The International Study Group of Pancreatic Surgery has noted that the benefit of stenting the pancreaticointestinal anastomosis is not supported by high‐quality evidence, 135 and there has been no consensus on whether an internal or external stent should be placed during surgery.…”

Section: Stent Placement In Surgerymentioning

confidence: 99%

“…Since the first report in 2000, several studies have investigated the efficacy and safety of BD-SESs for the prevention of selfdigestion and intra-abdominal inflammatory diseases caused by pancreatic juice leakage and stricture after pancreaticointestinal anastomosis, which have shown that most newly designed BD-SESs have promising potential 51,131,136. Interestingly, Park et al designed acetazolamide-eluting biodegradable tubular stents and evaluated them in a porcine model.…”

mentioning

confidence: 99%

Pancreatic duct stents

Yi¹,

Li²,

Hu³

2022

J of Digest Diseases

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Pancreatic duct stenting using endoscopy or surgery is widely used for the management of benign and malignant pancreatic diseases. Endoscopic pancreatic stents are mainly used to relieve pain caused by chronic pancreatitis and pancreas divisum, and to treat pancreatic duct disruption and stenotic pancreaticointestinal anastomosis after surgery. They are also used to prevent postendoscopic retrograde cholangiopancreatography pancreatitis and postoperative pancreatic fistula, treat pancreatic cancer, and locate radiolucent stones. Recent advances in endoscopic techniques, such as endoscopic ultrasonography and balloon enteroscopy, and newly designed stents have broadened the indications for pancreatic duct stenting. In this review we outlined the types, insertion procedures, efficacy, and complications of endoscopic pancreatic duct stent placement, and summarized the applications of pancreatic duct stents in surgery.

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Novel biodegradable internal stent as a mitigation strategy in high-risk pancreaticojejunostomy: technical notes and preliminary results

Cited by 4 publications

References 19 publications

Initial experience with a novel biodegradable pancreatic stent in pancreatoduodenectomy

Initial experience with a novel biodegradable pancreatic stent in pancreatoduodenectomy

Pathophysiological consequences and treatment strategy of obstructive jaundice

Pancreatic duct stents

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