Pancreaticojejunal Anastomotic Stent-Related Complications after Pancreaticoduodenectomy. Review of the Literature

The placement of a stent in the Wirsung across the anastomosis is widely accepted to perform pancreaticojejunostomy during pancreaticoduodenectomy. Beyond being related to pancreaticojejunal anastomosis failure, stent placement can lead to other complications. Stent migration, stenosis of the pancreatic duct, obstruction, stent occlusion, intestinal obstruction, or fracture of the stent are reported as late complications after pancreaticoduodenectomy. Internal stents are supposed to pass spontaneously into and out of the bowel at a variable postoperative interval. However stent persistence in the gastrointestinal tract can be associated with subsequent complications. Their management is reported to be endoscopical when possible but also surgical when bowel perforation occurs. Despite the rarity of these complications, surgeons should be aware of their potential role in unclear post-operative abdominal pain when deciding whether to place a stent when performing a pancreaticojejunostomy.