USE of Biodegradable STENTS in Pancreaticoduodenectomy: Initial Experience

Abstract

Background. Plastic stents have been used to avoid postoperative pancreatic fistula (POPF) following Whipple’s Pancreaticoduodenectomy (WPD), but they may cause some stent-related complications. Biodegradable stents have been recently introduced and might be a safe alternative. Here we present our initial experience with their use. Methods. Between March 1, 2020, and September 30, 2020, ten (10) consecutive patients underwent WPD. They all had conventional two-layer pancreaticojejunostomy with the placement of an internal biodegradable stent. They were assessed for technical feasibility, pancreatic leak, and stent-related complications. Results. The use of biodegradable stents was technically feasible in all patients, despite some difficulties in insertion due to stent stiffness and design. After a median follow-up period of 124 days, none of the patients suffered POPF. One patient had a biochemical pancreatic leak with no clinical significance. The median hospital stay was 7 days, and there were no stent-related complications. Conclusion. Biodegradable stents are technically feasible and safe in WPD with good short-term outcomes. They might provide a better alternative to plastic stents and their potential complications. Larger long-term studies are needed to validate efficacy and safety. Few modifications of the stent’s design might be needed to facilitate use in open surgery.

Surgical Options to Mitigate the Consequences of Pancreatic Anastomosis Leak after Pancreaticoduodenectomy

“…Anastomosis was then completed using anterior row sutures. A similar use of an uncovered coronary artery stent with positioning under X-ray guidance was recently reported by Huscher et al [26], and the use of biodegradable stents in 10 patients was reported by Sulieman et al [27]. Although the use of expandable internal PJA stents is still in its infancy, the initial results of their use are promising in terms of reducing the clinically relevant POPF rate and major morbidity with no stent-related complications [26, 27].…”