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Biliary self-expandable metal stents do not adversely affect pancreaticoduodenectomy.

Publication ,  Journal Article
Cavell, LK; Allen, PJ; Vinoya, C; Eaton, AA; Gonen, M; Gerdes, H; Mendelsohn, RB; D'Angelica, MI; Kingham, TP; Fong, Y; Dematteo, R; Kurtz, RC ...
Published in: Am J Gastroenterol
July 2013

OBJECTIVES: Controversy exists regarding whether to place a plastic or a metal endobiliary stent in patients with resectable pancreatic cancer who require biliary drainage. Although self-expandable metal stents (SEMS) provide better drainage compared with plastic stents, concerns remain that SEMS may compromise resection and increase postoperative complications. Our objective was to compare surgical outcomes of patients undergoing pancreaticoduodenectomy (PD) with SEMS in place vs. plastic endoscopic stents (PES) and no stents (NS). METHODS: We performed a retrospective analysis from a prospective database of all patients undergoing either attempted or successful PD with SEMS, PES, or NS in place at the time of operation. Patients were compared with regard to perioperative complications, margin status, and the rate of intraoperative determination of unresectability. RESULTS: A total of 593 patients underwent attempted PD. Of these, 84 patients were locally unresectable intraoperatively and 509 underwent successful PD, of which 71 had SEMS, 149 had PES, and 289 had NS. Among patients who had a preoperative stent, SEMS did not increase overall or serious postoperative complications, 30-day mortality, length of stay, biliary anastomotic leak, or positive margin, but was associated with more wound infections and longer operative times. In those with adenocarcinoma, intraoperative determination of local unresectability was similar in the SEMS group compared with other groups, with 16 (19.3%) in SEMS compared with 29 (17.7%) in PES (P=0.862), and 31 (17.5%) in NS (P=0.732). CONCLUSIONS: Placement of SEMS is not contraindicated in patients with resectable pancreatic cancer who require preoperative biliary drainage.

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Published In

Am J Gastroenterol

DOI

EISSN

1572-0241

Publication Date

July 2013

Volume

108

Issue

7

Start / End Page

1168 / 1173

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Stents
  • Retrospective Studies
  • Preoperative Period
  • Plastics
  • Pancreaticoduodenectomy
  • Pancreatic Neoplasms
  • Neoplasm, Residual
  • Middle Aged
 

Citation

APA
Chicago
ICMJE
MLA
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Cavell, L. K., Allen, P. J., Vinoya, C., Eaton, A. A., Gonen, M., Gerdes, H., … Schattner, M. A. (2013). Biliary self-expandable metal stents do not adversely affect pancreaticoduodenectomy. Am J Gastroenterol, 108(7), 1168–1173. https://doi.org/10.1038/ajg.2013.93
Cavell, Lianne K., Peter J. Allen, Cjloe Vinoya, Anne A. Eaton, Mithat Gonen, Hans Gerdes, Robin B. Mendelsohn, et al. “Biliary self-expandable metal stents do not adversely affect pancreaticoduodenectomy.Am J Gastroenterol 108, no. 7 (July 2013): 1168–73. https://doi.org/10.1038/ajg.2013.93.
Cavell LK, Allen PJ, Vinoya C, Eaton AA, Gonen M, Gerdes H, et al. Biliary self-expandable metal stents do not adversely affect pancreaticoduodenectomy. Am J Gastroenterol. 2013 Jul;108(7):1168–73.
Cavell, Lianne K., et al. “Biliary self-expandable metal stents do not adversely affect pancreaticoduodenectomy.Am J Gastroenterol, vol. 108, no. 7, July 2013, pp. 1168–73. Pubmed, doi:10.1038/ajg.2013.93.
Cavell LK, Allen PJ, Vinoya C, Eaton AA, Gonen M, Gerdes H, Mendelsohn RB, D’Angelica MI, Kingham TP, Fong Y, Dematteo R, Jarnagin WR, Kurtz RC, Schattner MA. Biliary self-expandable metal stents do not adversely affect pancreaticoduodenectomy. Am J Gastroenterol. 2013 Jul;108(7):1168–1173.

Published In

Am J Gastroenterol

DOI

EISSN

1572-0241

Publication Date

July 2013

Volume

108

Issue

7

Start / End Page

1168 / 1173

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Stents
  • Retrospective Studies
  • Preoperative Period
  • Plastics
  • Pancreaticoduodenectomy
  • Pancreatic Neoplasms
  • Neoplasm, Residual
  • Middle Aged