Comparison of preoperative biliary metallic and plastic stents in terms of intraoperative effects in malignant pancreatic head tumors.

In practice, the aim of this study is to compare intraoperative effects of preoperative metallic and plastic stents that were inserted via endoscopic retrograde cholangiopancreatography, pancreatic cancer surgery.

Between December 2016 -January 2018, 130 patients who were preoperatively inserted metallic or plastic stent and operated consecutively were prospectively included in this study. All patients underwent to Whipple's operation. Stents were extracted and sent for microbiological evaluation intraoperatively. Surgical difficulty was evaluated by an independent surgeon according to visual analogy scale from 1 to 10. Age, gender, stent cultures, postoperative infection rates, operation time, estimated blood loss, hospitalization time were compared between two groups.

Metallic stent was used for 29 patients and plastic stent was used for 101 patients. In metallic stent group 13 of 29 patients were stent positive culture, whereas in plastic stent group 80 of 101 patients were stent positive culture. When culture positivity was statistically compared, there was significant difference. However, there was no statistically significant difference about operational difficulty scores between two groups.

Preoperative fully covered metallic stent is an effective way to decrease high bilirubin levels without increase in operational difficulty with the advantage of low positive stent culture and surgical site infection rates.