Farooqui Waqas, Tschuor Christoph, Storkholm Jan Henrik, Krohn Paul Suno, Hansen Carsten Palnæs, Burgdorf Stefan Kobbelgaard
Department of Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Ann Med Surg (Lond). 2025 Jan 31;87(3):1609-1616. doi: 10.1097/MS9.0000000000002940. eCollection 2025 Mar.
Postoperative pancreatic fistula (POPF) is a serious complication following pancreatoduodenectomy, due to the risk of complications related to the leak. Intraoperative internal and external stenting of the pancreaticojejunostomy, have been used as a prophylactic measure with mixed results and with a risk of complications. Biodegradable stents could be a potential way to avoid complications associated with traditional stents and reduce the risk of pancreatic leaks and fistulas.
A systematic review was conducted to investigate the effectiveness of biodegradable stents in reducing POPF after pancreatoduodenectomy. Studies using biodegradable stents and reporting the incidence of POPF were included. Reviews, case reports, and non-English studies were excluded.
Eight observational studies with a total of 155 patients were included. A meta-analysis was conducted, and the pooled incidence of POPF was around 7% (18 out 155 patients). Apart from one study (comparing biodegradable stent to regular stent), there were no comparator groups. Using ROBINS-I tool to assess the risk of bias, there was overall a moderate risk of bias.
Biodegradable stents may be associated with lower risk of POPF. However, the observational design of the studies, the risk of bias and sample sizes, reduced the significance of the results. Well-designed randomized controlled trials are needed to assess the effectiveness.
术后胰瘘（POPF）是胰十二指肠切除术后的一种严重并发症，因为存在与渗漏相关的并发症风险。胰空肠吻合术的术中内外置支架已被用作一种预防措施，但其效果不一且存在并发症风险。可生物降解支架可能是避免与传统支架相关并发症并降低胰漏和胰瘘风险的一种潜在方法。
进行了一项系统评价，以研究可生物降解支架在降低胰十二指肠切除术后POPF方面的有效性。纳入了使用可生物降解支架并报告POPF发生率的研究。排除综述、病例报告和非英文研究。
纳入了八项观察性研究，共155例患者。进行了荟萃分析，POPF的合并发生率约为7%（155例患者中有18例）。除了一项研究（将可生物降解支架与常规支架进行比较）外，没有对照组。使用ROBINS-I工具评估偏倚风险，总体存在中度偏倚风险。
可生物降解支架可能与较低的POPF风险相关。然而，研究的观察性设计、偏倚风险和样本量降低了结果的显著性。需要设计良好的随机对照试验来评估其有效性。
