{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T20:38:21Z","timestamp":1791578301434,"version":"4.3.4"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:00:00Z","timestamp":1773792000000},"content-version":"vor","delay-in-days":17,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Mortality and morbidity following pancreaticoduodenectomy (PD) have significantly decreased due to multimodal treatment approach and refinement in surgical techniques. Despite lacking proven benefits, surgeons continue using pancreaticojejunostomy (PJ) transanastomotic stent to mitigate post-operative pancreatic fistula (POPF). We share a morbid case of jejunal perforation caused by PJ stent. A 69\u00a0years male presented with features of gastric outlet obstruction secondary to carcinoma second part of duodenum. After proper optimization, he underwent pylorus resecting PD with child\u2019s reconstruction and placement of a transanastomotic PJ stent. Initial postoperative course was well. Later he developed signs of biliary peritonitis. Computed tomography of abdomen revealed perforation of jejunal segment between PJ and hepaticojejunostomy. Despite urgent re-exploration and repair of perforation, the patient ultimately succumbed to sepsis, multi-organ failure, and died. The case highlights the need for thoughtful consideration while attempting to place PJ stents, given the associated risks and the ambiguous impact on mitigating POPF.<\/jats:p>","DOI":"10.1093\/jscr\/rjag171","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T14:32:09Z","timestamp":1773844329000},"source":"Crossref","is-referenced-by-count":1,"title":["Jejunal perforation caused by transanastomotic pancreaticojejunostomy internal stent following pancreaticoduodenectomy: a case report"],"prefix":"10.1093","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9981-1201","authenticated-orcid":false,"given":"Bed Prakash","family":"Sah","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Surgery, BP Koirala Institute of Health Sciences , Dharan ,","place":["Nepal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunal Bikram","family":"Deo","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, BP Koirala Institute of Health Sciences , Dharan ,","place":["Nepal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barurendra Raj","family":"Yogi","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, BP Koirala Institute of Health Sciences , Dharan ,","place":["Nepal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulav","family":"Budhathoki","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, BP Koirala Institute of Health Sciences , Dharan ,","place":["Nepal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanju","family":"Ghimire","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, BP Koirala Institute of Health Sciences , Dharan ,","place":["Nepal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shailesh","family":"Adhikary","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, BP Koirala Institute of Health Sciences , Dharan ,","place":["Nepal"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"2026031810320130300_ref1","doi-asserted-by":"publisher","first-page":"1995","DOI":"10.1007\/s11605-015-2906-0","article-title":"Migration of internal pancreaticojejunostomy stents into the bile ducts in patients undergoing pancreatoduodenectomy","volume":"19","author":"Park","year":"2015","journal-title":"J Gastrointest Surg"},{"key":"2026031810320130300_ref2","doi-asserted-by":"crossref","first-page":"97","DOI":"10.4161\/jig.23740","article-title":"Successful management of recurrent biliary colic caused by pancreatic stent migration after Whipple procedure","volume":"2","author":"Bawany","year":"2012","journal-title":"J Interv 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report","volume":"99","author":"Bao","year":"2020","journal-title":"Med (United States)"},{"key":"2026031810320130300_ref6","doi-asserted-by":"publisher","first-page":"512","DOI":"10.3348\/jksr.2022.0102","article-title":"Migrated Pancreaticojejunal stent forming a stent\u2013stone complex in the jejunum with resultant small bowel obstruction: a case report","volume":"84","author":"Kim","year":"2023","journal-title":"J Korean Soc Radiol"},{"key":"2026031810320130300_ref7","doi-asserted-by":"publisher","first-page":"e77992","DOI":"10.7759\/cureus.77992","article-title":"Jejunal perforation due to internal pancreatic stents following pancreaticoduodenectomy: a case series and technical modification","volume":"17","author":"Tamura","year":"2025","journal-title":"Cureus"},{"key":"2026031810320130300_ref9","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1002\/bjs.8654","article-title":"Randomized clinical trial of external stent drainage of the pancreatic duct to reduce postoperative pancreatic fistula after pancreaticojejunostomy","volume":"99","author":"Motoi","year":"2012","journal-title":"Br J Surg"},{"key":"2026031810320130300_ref10","doi-asserted-by":"publisher","first-page":"CD008914","DOI":"10.1002\/14651858.CD008914.pub3","article-title":"Stents for the prevention of pancreatic fistula following pancreaticoduodenectomy","volume":"2016","author":"Dong","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"2026031810320130300_ref11","doi-asserted-by":"publisher","first-page":"1046","DOI":"10.1016\/j.hpb.2020.10.025","article-title":"Pros and pitfalls of externalized trans-anastomotic stent as a mitigation strategy of POPF: a prospective risk-stratified observational series","volume":"23","author":"Andrianello","year":"2021","journal-title":"Hpb."}],"container-title":["Journal of Surgical Case 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