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Walled of necrosis, disconnected pancreatic duct and metal stents: the debate continues!
  1. Surinder Singh Rana1,
  2. Rajesh Gupta2
  1. 1 Gastroenterology, PGIMER, Chandigarh, India
  2. 2 Surgical Gastroenterology, PGIMER, Chandigarh, India
  1. Correspondence to Dr Surinder Singh Rana, Gastroenterology, PGIMER, Chandigarh 160012, India; drsurinderrana{at}

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We read with interest the study by Basha et al on the impact of disconnected pancreatic duct syndrome (DPDS) on recurrence of pancreatic fluid collections (PFC) after removal of metal stents.1 We congratulate authors for conducting large sample retrospective study that has attempted to answer the clinical dilemma of whether or not to exchange metal stent with permanent indwelling plastic stents. Even after resolution of PFC, uncorrected physiological abnormality of disconnected pancreas being unable to drain pancreatic juice into gastrointestinal lumen persists.2 Therefore, these patients can have multitude of clinical problems including recurrent PFC, refractory external pancreatic fistulae and chronic abdominal pain/recurrent pancreatitis.2 These clinical problems can be obviated by maintaining iatrogenic internal fistula by leaving transmural plastic stent in situ permanently.3 4

Even patients with PFC and DPDS treated with large calibre metal …

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  • Contributors SSR: Drafting of manuscript. RG: Drafting of manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; internally peer reviewed.