Pancreatic Duct Stenting to Prevent Postoperative Pancreatic Fistula (POPF) After Distal Pancreatectomy
Pancreatic Duct Stenting to Prevent Postoperative Pancreatic Fistula (POPF) After Distal Pancreatectomy
To determine whether pre-operative pancreatic stenting for distal pancreatectomy will impact
 the incidence of a post-operative pancreatic fistula, as defined by postoperative. If
 pre-operative pancreatic stenting appears to reduce the formation of Postoperative Pancreatic
 Fistula (POPF) in this pilot study, this will form the basis of a larger randomized trial in
 the future. The hypothesis is that pre-operative pancreatic duct stenting can significantly
 decrease the rate of development of a post-operative pancreatic fistula after distal
 pancreatectomy.
Prophylactic pancreatic duct stenting is to be offered to all patients deemed a candidate for
 a distal pancreatectomy. This is a nonrandomized cohort study with a retrospective and
 prospective control group (Jan 2008 - Dec 2017 or sample size obtained) and a prospective
 endoscopic intervention group (September 2015 - Dec 2017 or until sample size obtained). We
 will then compare the rate of development of a postoperative pancreatic fistula between those
 patients who have preoperative stenting and those who do not. POPF will be defined as the
 amylase level of drain contents equaling three times or more the serum amylase on
 postoperative day 3, as defined by the International Study Group for Pancreatic Fistula
 (ISGPF) or an ICD-9 diagnosis of 577.8. The patient will have a pre-operative visit for stent
 placement and a post-operative visit for stent removal if still in place 4-6 weeks after
 distal pancreatectomy.
Inclusion Criteria:

 1. Adult patients age 18 years of age and older

 2. Patients undergoing distal pancreatectomy for primary pancreatic disorder or isolated
 metastases to the pancreas.

 Exclusion Criteria:

 1. Pediatric patients younger than age 18

 2. Pregnant patients

 3. Patients undergoing distal pancreatectomies performed en bloc for non- pancreatic
 pathologies (gastric cancer, renal cell cancer, etc).