A prospective randomized controlled trial of internal versus external drainage with pancreaticojejunostomy for pancreaticoduodenectomy

Abstract 

Background

A stent often is placed across the pancreaticojejunostomy. However, there is no report compared between internal drainage and external drainage.

Methods

We conducted a prospective randomized trial (NCT00628186 registered at http://ClinicalTrials.gov) with 100 patients who underwent pancreaticoduodenectomy and we compared the effects on postoperative course.

Results

The incidence of pancreatic fistula according to the International Study Group on Pancreatic Fistula criteria was not different (external, 20%; vs internal, 26%), and the incidence of the other complications was similar between stent types. The median postoperative hospital stay was 21 days (range, 8–163 d) in the internal drainage group, which was shorter than the median stay of 24 days (range, 21–88 d) in the external drainage group (P = .016).

Conclusions

Both internal drainage and external drainage were safety devices for pancreaticojejunostomy. Internal drainage simplifies postoperative managements and it might shorten postoperative stay for pancreaticoduodenectomy.

Keywords: Randomized controlled trial, Stent, Pancreaticojejunostomy, Pancreaticoduodenectomy, Pancreatic fistula, Complications