Pros and pitfalls of externalized trans-anastomotic stent as a mitigation strategy of POPF: a prospective risk-stratified observational series

Zhang, 2014, Pancreaticogastrostomy versus pancreaticojejunostomy reconstruction after pancreaticoduodenectomy: a meta-analysis of randomized controlled trials, Surg Today, 1 Bassi, 2005, Reconstruction by pancreaticojejunostomy versus pancreaticogastrostomy following pancreatectomy, Ann Surg, 242, 767, 10.1097/01.sla.0000189124.47589.6d Xiong, 2014, Meta-analysis of pancreaticogastrostomy versus pancreaticojejunostomy after pancreaticoduodenectomy, Br J Surg, 101, 1196, 10.1002/bjs.9553 Que, 2015, Pancreaticogastrostomy versus pancreaticojejunostomy after pancreaticoduodenectomy: a meta-analysis Of∼randomized controlled trials, Am J Surg, 209, 1074, 10.1016/j.amjsurg.2014.07.019 Alfieri, 2016, Indications and results of pancreatic stump duct occlusion after duodenopancreatectomy, Updat Surg, 10.1007/s13304-016-0384-x Chen, 2014, Chen's U-suture technique for end-to-end invaginated pancreaticojejunostomy following pancreaticoduodenectomy, Ann Surg Oncol, 21, 4336, 10.1245/s10434-014-3823-2 Peng, 2011, Binding pancreaticoenteric anastomosis: from binding pancreaticojejunostomy to binding pancreaticogastrostomy, Updat Surg, 63, 69, 10.1007/s13304-011-0067-6 Fujii, 2014, Modified blumgart anastomosis for pancreaticojejunostomy: technical improvement in matched historical control study, J Gastrointest Surg, 18, 1108, 10.1007/s11605-014-2523-3 Pessaux, 2011, External pancreatic duct stent decreases pancreatic fistula rate after pancreaticoduodenectomy: prospective multicenter randomized trial, Ann Surg, 253, 879, 10.1097/SLA.0b013e31821219af Poon, 2007, External drainage of pancreatic duct with a stent to reduce leakage rate of pancreaticojejunostomy after pancreaticoduodenectomy: a prospective randomized trial, Ann Surg, 246, 425, 10.1097/SLA.0b013e3181492c28 Kuroki, 2011, Stenting versus non-stenting in pancreaticojejunostomy: a prospective study limited to a normal pancreas without fibrosis sorted by using dynamic MRI, Pancreas, 40, 25, 10.1097/MPA.0b013e3181e861fa Hong, 2013, External stent versus No stent for pancreaticojejunostomy: a meta-analysis of randomized controlled trials, J Gastrointest Surg, 17, 1516, 10.1007/s11605-013-2187-4 Allen, 2014, Pasireotide for postoperative pancreatic fistula, N Engl J Med, 370, 2014, 10.1056/NEJMoa1313688 McMillan, 2016, Multicenter, prospective trial of selective drain management for pancreatoduodenectomy using risk stratification, Ann Surg, 265, 1209, 10.1097/SLA.0000000000001832 Bassi, 2010, Early versus late drain removal after standard pancreatic resections: results of a prospective randomized trial, Ann Surg, 252, 207, 10.1097/SLA.0b013e3181e61e88 Martin, 2012, Does fibrin glue sealant decrease the rate of anastomotic leak after a pancreaticoduodenectomy? Results of a prospective randomized trial, HPB, 15, 561, 10.1111/hpb.12018 Callery, 2013, A prospectively validated clinical risk score accurately predicts pancreatic fistula after pancreatoduodenectomy, J Am Coll Surg, 216, 1, 10.1016/j.jamcollsurg.2012.09.002 McMillan, 2016, Externalized stents for pancreatoduodenectomy provide value only in high-risk scenarios, J Gastrointest Surg, 20, 2052, 10.1007/s11605-016-3289-6 Ecker, 2018, Characterization and optimal management of high-risk pancreatic anastomoses during pancreatoduodenectomy, Ann Surg, 267, 608, 10.1097/SLA.0000000000002327 Jang, 2016, Randomized multicentre trial comparing external and internal pancreatic stenting during pancreaticoduodenectomy, Br J Surg, 103, 668, 10.1002/bjs.10160 Bassi, 2017, The 2016 update of the international study group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 Years after, Surgery, 161, 584, 10.1016/j.surg.2016.11.014 Wente, 2007, Postpancreatectomy hemorrhage (PPH)-An international study group of pancreatic surgery (ISGPS) definition, Surgery, 142, 20, 10.1016/j.surg.2007.02.001 Wente, 2007, Delayed gastric emptying (DGE) after pancreatic surgery: a suggested definition by the international study group of pancreatic surgery (ISGPS), Surgery, 761, 10.1016/j.surg.2007.05.005 Besselink, 2017, Definition and classification of chyle leak after pancreatic operation: a consensus statement by the international study group on pancreatic surgery, Surgery, 161, 365, 10.1016/j.surg.2016.06.058 Connor, 2016, Defining post-operative pancreatitis as a new pancreatic specific complication following pancreatic resection, HPB, 18, 642, 10.1016/j.hpb.2016.05.006 Singer, 2016, The third international consensus definitions for sepsis and septic shock (Sepsis-3), JAMA, 315, 801, 10.1001/jama.2016.0287 Dindo, 2004, Classification of surgical complications. A new proposal with evaluation in a cohort of 6336 patients and results of a survey, Ann Surg, 240, 205, 10.1097/01.sla.0000133083.54934.ae Vollmer, 2015, Establishing a quantitative benchmark for morbidity in pancreatoduodenectomy using ACS-NSQIP, the accordion severity grading system, and the postoperative morbidity index, Ann Surg, 261, 527, 10.1097/SLA.0000000000000843 Porembka, 2010, Quantitative weighting of postoperative complications based on the accordion severity grading system: demonstration of potential impact using the American college of surgeons national surgical quality improvement program, J Am Coll Surg, 210, 286, 10.1016/j.jamcollsurg.2009.12.004 Strasberg, 2011, Postoperative morbidity index: a quantitative measure of severity of postoperative complications, J Am Coll Surg, 213, 616, 10.1016/j.jamcollsurg.2011.07.019 Dong, 2016, Stents for the prevention of pancreatic fistula following pancreaticoduodenectomy, Cochrane Database Syst Rev, 10.1002/14651858.CD008914.pub3 Kamoda, 2008, Usefulness of performing a pancreaticojejunostomy with an internal stent after a pancreatoduodenectomy, Surg Today, 38, 524, 10.1007/s00595-007-3662-x Motoi, 2012, Randomized clinical trial of external stent drainage of the pancreatic duct to reduce postoperative pancreatic fistula after pancreaticojejunostomy, Br J Surg, 99, 524, 10.1002/bjs.8654 Poon, 2007, External drainage of pancreatic duct with a stent to reduce leakage rate of pancreaticojejunostomy after pancreaticoduodenectomy: a prospective randomized trial, Ann Surg, 246, 425, 10.1097/SLA.0b013e3181492c28 Tani, 2010, A prospective randomized controlled trial of internal versus external drainage with pancreaticojejunostomy for pancreaticoduodenectomy, Am J Surg, 199, 759, 10.1016/j.amjsurg.2009.04.017 Wang, 2014, A prospective randomized controlled trial of pancreatic duct stent internal versus external drainage with pancreaticojejunostomy for the early curative effect after pancreaticoduodenectomy, Zhonghua Wai Ke Za Zhi, 52, 333 Winter, 2006, Does pancreatic duct stenting decrease the rate of pancreatic fistula following pancreaticoduodenectomy? Results of a prospective randomized trial, J Gastrointest Surg, 10, 1280, 10.1016/j.gassur.2006.07.020 Yokoyama, 2014, Is the enteral replacement of externally drained pancreatic juice valuable after pancreatoduodenectomy?, Surg Today, 44, 252, 10.1007/s00595-013-0522-8 Trudeau, 2020, The fistula risk score catalog: toward precision medicine for pancreatic fistula after pancreatoduodenectomy, Ann Surg, 10.1097/SLA.0000000000004068 Andrianello, 2020, Pancreaticojejunostomy with externalized stent vs pancreaticogastrostomy with externalized stent for patients with high-risk pancreatic anastomosis: a single-center, Phase 3, randomized clinical trial, JAMA Surg, 155, 313, 10.1001/jamasurg.2019.6035 Mungroop, 2019, Alternative fistula risk score for pancreatoduodenectomy (a-FRS), Ann Surg, 269, 937, 10.1097/SLA.0000000000002620 Giuliani, 2019, Preoperative fecal elastase-1 (FE-1) adds value in predicting post-operative pancreatic fistula: not all soft pancreas share the same risk – a prospective analysis on 105 patients, HPB, 22, 415, 10.1016/j.hpb.2019.07.012