To investigate the application value of preoperative endoscopic biliary and pancreatic stenting in local resection of pancreatic head and neck tumors.

A retrospective descriptive study was conducted. Clinical data of 26 patients who underwent local resection of pancreatic head and neck tumors from January 2019 to December 2022 were collected, including 10 males and 16 females, with a median age of 54 years (range, 17~72 years). All patients received preoperative endoscopic stent placement. Observation indicators: (1) perioperative conditions; (2) postoperative conditions. Measurement data were expressed as absolute numbers.

(1) Perioperative conditions: All patients underwent endoscopic retrograde cholangiopancreatography (ERCP) for stent placement before surgery, among whom 20 received stent placement on the day of surgery. A pancreatic duct stent was placed in all patients, and a biliary stent was additionally placed in 21 patients. Two patients with multiple lesions in the pancreatic head and tail underwent distal pancreatectomy plus local resection of the pancreatic head, while the others with single lesions underwent local resection of pancreatic tumors only. Eleven patients underwent Roux-en-Y pancreaticojejunostomy during local tumor resection. (2) Postoperative conditions: No surgery-related death occurred in the 26 patients, with a mean hospital stay of 20.8 days. Grade B pancreatic fistula occurred in 13 patients, biochemical fistula in 7, and no grade C fistula was observed. Delayed gastric emptying occurred in 3 patients (grade C in 2, grade A in 1). Postoperative hemorrhage occurred in 4 patients (grade A in 1, grade B in 3). Biliary fistula occurred in 1 patient. Five patients had intra-abdominal encapsulated effusion.

Preoperative endoscopic biliary and pancreatic stenting is safe and feasible in local resection of pancreatic tumors. It extends the indications of local resection, helps protect the biliary and pancreatic ducts, reduces surgical difficulty, improves surgical success rate, accelerates postoperative recovery, and reduces the incidence of postoperative pancreatic fistula and biliary fistula.