Preoperative Biliary Decompression Preceding Pancreaticoduodenectomy With Plastic or Self-Expandable Metallic Stent

Conclusions:
The stent failure rate was 7.4% for plastic stents and 3.4% for SEMS (p = 0.697). A bilirubin level under 50 µmol/L was reached by 80% of the patients with plastic stents and by 61% of the patients with SEMS (p = 0.058). A postoperative infection complication and/or a pancreatic fistula was found in 26% while using plastic stents and in 25% using SEMS (p = 1.000). In unstented patients with biliary obstruction, the bile juice was sterile significantly more often than in endoscopically stented patients (100% vs 1%, p < 0.001). When the stented and unstented patients were compared regarding postoperative infection complications, there was no significant difference between the groups (p = 0.365). Plastic stents did not differ from SEMS regarding the stent failure rate, bilirubin level decrease, amount of bacteria in the bile juice, or postoperative complications when used for PBD. The significantly higher price of SEMS suggests their use in selected cases only.

Source: Scandinavian Journal of Surgery - May 5, 2015 Category: Surgery Authors: Haapamaki, C., Seppanen, H., Udd, M., Juuti, A., Halttunen, J., Kiviluoto, T., Siren, J., Mustonen, H., Kylanpaa, L. Tags: Original Articles Source Type: research