Talukder, TuhinIslam, Kazi MazharulElahi, Mohammad MahbubAwal, Mohammad AbdulAzam, ANM NureRayhan, Golam MahmudHakim, H A Nazmul2024-12-072024-12-072024-09Talukder Tuhin, Islam Kazi Mazharul, Elahi Mohammad Mahbub, Awal Mohammad Abdul, Azam ANM Nure, Rayhan Golam Mahmud, Hakim H A Nazmul. Early Complications of Internal Versus External Pancreatic Duct stent in Patients with Pancreaticoduodenectomy. Annals of International Medical and Dental Research. 2024 Sep; 10(5): 54-632395-28222395-2814https://imsear.searo.who.int/handle/123456789/241040Background: Pancreaticoduodenectomy (PD) is a complex surgical procedure with significant postoperative complications, including pancreatic fistula, delayed gastric emptying, and intra-abdominal infections. This study aims to compare the early postoperative complications of internal versus external pancreatic duct stents in patients undergoing PD. Material & Methods: This prospective observational study was conducted at Dhaka Medical College Hospital from January 1, 2023, to December 27, 2023. A total of 40 patients scheduled for PD were divided into two groups: 20 managed with internal stents and 20 with external stents. Data on demographic characteristics, per-operative factors, and postoperative complications were collected and analyzed. Results: The study population had a mean age of 56.78 years, with males constituting 65%. The most common histopathological diagnosis was periampullary carcinoma (50%). In the internal stenting group, 10% had a soft pancreas, 65% had a firm pancreas, and 25% had a hard pancreas. In the external stenting group, 40% had a soft pancreas, 50% had a firm pancreas, and 10% had a hard pancreas. Wound infections occurred in 10% of the internal stenting group and 15% of the external stenting group. Intra-abdominal collections were found in 5% of the internal stenting group and 10% of the external stenting group. GI bleeding was absent in the internal stenting group but occurred in 5% of the external stenting group. Intra-abdominal bleeding was absent in the internal stenting group but present in 10% of the external stenting group. Delayed gastric emptying was noted in 5% of participants in both groups. Grade A pancreatic fistula was observed in 10% of the internal stenting group and 15% of the external stenting group. Grade B and C pancreatic fistulas were only present in the external stenting group, at rates of 10% and 5%, respectively. Conclusions: Internal pancreatic duct stents are associated with lower incidences of wound infections, intra-abdominal collections, and severe pancreatic fistulas compared to external stents. These findings suggest that internal stents may offer better postoperative outcomes, although stent selection should be individualized based on patient-specific factors. Further research is warranted to confirm these results and guide clinical practice.PancreaticoduodenectomyPancreatic Duct StentsInternal StentsExternal StentsPostoperative ComplicationsPancreatic FistulaDelayed Gastric EmptyingIntra-Abdominal Collections.Journal ArticleIndiaJunior Consultant, Department of Surgery, Dhaka Medical College Hospital, Dhaka, Bangladesh, Email: tuhin_dmc58@yahoo.com, Orcid ID: 0009-0004-0887-1887Junior Consultant, Department of Surgery, Dhaka Medical College Hospital, Dhaka, Bangladesh, Email: mazhar.dmc61@gmail.com, Orcid ID:0009-0009-2648-5994Senior Consultant, Department of Surgery, Dhaka Medical College Hospital, Dhaka, Bangladesh, Email: melahi_53@yahoo.com, Orcid ID: 0009-0002-4498-5422Senior Consultant, Department of Surgery, Dhaka Medical College Hospital, Dhaka, Bangladesh, Email: a.awal98@yahoo.com, Orcid ID: 0009-0003-0919-7081Junior Consultant, Department of Surgery, Sheikh Hasina National Institute of Burn and Plastic Surgery, Dhaka, Bangladesh, Email: nashanafiz@gmail.com, Orcid ID:0000-0002-3590-2405Junior Consultant, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, Email: rayhan.dmc.k63@gmail.com, Orcid ID: 0009-0008-7185-0797Associate Professor, Department of Surgery, Dhaka Medical College Hospital, Dhaka, Bangladesh, Email: nazmulhakim75@gmail.com, Orcid ID:0000-0002-3590-3248