ArticleCurrent oncology (Toronto, Ont.)2025
Pancreatico-Jejunostomy Fistula After Pancreaticoduodenectomy: Where Do We Stand? Results from an International Survey.
Article in Current oncology (Toronto, Ont.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionPancreatico-duodenectomy (PD) remains one of the most complex abdominal surgeries, and pancreatico-jejunostomy (PJ) fistula is its most critical postoperative complication. In efforts to reduce the incidence of postoperative pancreatic fistula (POPF), several PJ techniques and adjuncts, including stents, have been recommended. This article presents data from an international survey regarding PJ methods, the use of pancreatic stents, and their correlation with POPF rates from surgical centers worldwide.
methodsA nine-item online questionnaire was sent globally through social networks, individual mailing lists, and the ASHBPS mailing list. Data were analyzed through the Student's
resultsA total of 122 units of pancreatic surgery from 26 countries distributed across five continents responded to the survey. Most centers performed less than 50 PDs a year, preferred a duct-to-mucosa PJ, and employed a stent routinely. Mean POPF grade B and C incidences were lower in high-volume (15.24% ± 7.29 and 3.95% ± 2.39) and in PJ stent-using centers (16.25% ± 8.7 and 5.37% ± 7.49).
conclusionsInstitutional case volume and stent usage are more crucial determinants of POPF incidence than the PJ technique itself. Centralization and standardization of PD procedures are related to reductions in major fistula rates.
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