Division of Minimally-Invasive Surgical Oncology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Piazza dell'Ospedale Maggiore, 3, 20162, Milan, Italy.
Surg Today. 2022 Jul;52(7):1115-1119. doi: 10.1007/s00595-022-02488-6. Epub 2022 Mar 17.
Clinically relevant postoperative pancreatic fistula (CR-POPF) is the most feared complication after pancreaticoduodenectomy (PD), as it can lead to extremely poor outcomes. We herein report the preliminary results of an anastomotic technique based on the use of a novel internal biodegradable stent (IBS) to mitigate POPF sequelae. Between October 2020 and May 2021, all patients undergoing PD with high-risk pancreatic anastomosis received a pancreato-jejunal (PJ) anastomosis with an Archimedes IBS placement. Fifteen patients comprised our study cohort. In 11 cases, a 2-mm Archimedes stent was used, and in the remaining four patients, a 2.6-mm stent was used. Overall postoperative complications occurred in eight patients, with four cases being severe. Two patients developed CR-POPF, with one of them dying. In our small preliminary series, PJ anastomosis with an Archimedes™ IBS showed encouraging results in terms of CR-POPF incidence. Further studies are needed to confirm these findings.
临床相关的术后胰瘘（CR-POPF）是胰十二指肠切除术（PD）后最令人恐惧的并发症，因为它可能导致极其不良的后果。我们在此报告一种基于使用新型内部可生物降解支架（IBS）来减轻 POPF 后遗症的吻合技术的初步结果。在 2020 年 10 月至 2021 年 5 月期间，所有接受高危胰肠吻合术的 PD 患者均接受了带有 Archimedes IBS 放置的胰肠吻合术。我们的研究队列包括 15 名患者。在 11 例中使用了 2mm 的 Archimedes 支架，在其余 4 例中使用了 2.6mm 的支架。8 名患者出现了总体术后并发症，其中 4 例为严重并发症。2 名患者发生了 CR-POPF，其中 1 名死亡。在我们的小系列初步研究中，使用 Archimedes™ IBS 的胰肠吻合术在 CR-POPF 发生率方面显示出令人鼓舞的结果。需要进一步的研究来证实这些发现。
