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

• Published in: Surgery today (Tokyo, Japan) Vol. 52; no. 7; pp. 1115 - 1119
• Main Authors: Mazzola, Michele, Bertoglio, Camillo Leonardo, Giani, Alessandro, Zironda, Andrea, Carnevali, Pietro, Lombardi, Pietro Maria, De Martini, Paolo, Magistro, Carmelo, Ferrari, Giovanni
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01-07-2022
• Subjects: How To Do It; Medicine; Medicine & Public Health; Surgery; Surgical Oncology; Mitigation strategy; Postoperative pancreatic fistula; Internal stent
• ISSN: 0941-1291; 1436-2813; 1436-2813
• DOI: 10.1007/s00595-022-02488-6

Clinically relevant postoperative pancreatic fistula (CR-POPF) is the most feared complication after pancreaticoduodenectomy (PD), as it can lead to extremely poor outcomes. We herein report the preliminary results of an anastomotic technique based on the use of a novel internal biodegradable stent (IBS) to mitigate POPF sequelae. Between October 2020 and May 2021, all patients undergoing PD with high-risk pancreatic anastomosis received a pancreato-jejunal (PJ) anastomosis with an Archimedes
™
IBS placement. Fifteen patients comprised our study cohort. In 11 cases, a 2-mm Archimedes
™
stent was used, and in the remaining four patients, a 2.6-mm stent was used. Overall postoperative complications occurred in eight patients, with four cases being severe. Two patients developed CR-POPF, with one of them dying. In our small preliminary series, PJ anastomosis with an Archimedes™ IBS showed encouraging results in terms of CR-POPF incidence. Further studies are needed to confirm these findings.