Related Experiment Video
Updated: Jun 12, 2026
Application of Simplified Stent-bridging Pancreaticogastrostomy in Open Pancreaticoduodenectomy
Published on: March 17, 2026
Do transanastomotic pancreatic ductal stents after pancreatic resections improve outcomes?
Parul J Shukla1, Savio G Barreto, Abe Fingerhut
1Department of Gastrointestinal Surgical Oncology, Tata Memorial Hospital, Mumbai, India. pjshukla@doctors.org.uk
Objectives:
Despite strategies aimed at reducing a postoperative pancreatic fistula (POPF) after pancreatectomies, the overall incidence remains unchanged. One such procedure, until now incompletely explored, is transanastomotic pancreatic (TAP) ductal stenting.
Methods:
We conducted a systematic search using MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials from 1983-2008 to determine if TAP ductal stents provide any benefit and, if so, in which clinical scenarios they can be recommended.
Results:
Stents can be internal or external, intraoperative only, or temporary (several days). One randomized trial on internal stents across pancreaticojejunostomy (PJ) suggested a higher POPF rate in the stented group. One nonrandomized study using an internal stent for pancreaticogastrostomy (PG) revealed a 0% POPF rate. Results from studies where external stents were used across PJ/PG reported a lower incidence of POPF. No statistically significant difference was reported in a POPF incidence when internal stents were compared with externalized stents. Available data suggest improved outcomes of pancreatoenteric anastomosis when TAP ductal stent is inserted in small ducts (< or =3 mm).
Conclusions:
There is insufficient evidence to support or refute improved outcomes after TAP ductal stent insertion in patients with PJ/PG with small ducts (< or =3 mm) or soft pancreata. More evidence of benefit is needed before use of external stents can be recommended.
