Efficacy of the omental roll-up technique in pancreaticojejunostomy to prevent postoperative pancreatic fistula after pancreaticoduodenectomy.
| Autor: | Jayaratnam S; Department of General Surgery, PGIMER, Chandigarh, India., Tandup C; Department of General Surgery, PGIMER, Chandigarh, India., Sakaray YR; Department of General Surgery, PGIMER, Chandigarh, India., ChKurdia K; Department of General Surgery, PGIMER, Chandigarh, India., Gupta A; Department of General Surgery, AIMS, Mohali, India., Kaman L; Department of General Surgery, PGIMER, Chandigarh, India. |
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| Jazyk: | angličtina |
| Zdroj: | Annals of hepato-biliary-pancreatic surgery [Ann Hepatobiliary Pancreat Surg] 2024 Aug 31; Vol. 28 (3), pp. 358-363. Date of Electronic Publication: 2024 Jun 05. |
| DOI: | 10.14701/ahbps.24-016 |
| Abstrakt: | Backgrounds/aims: Pancreaticoduodenectomy (PD) is being performed more frequently. A pancreaticojejunostomy (PJ) leak is the major determinant of patient outcomes. An omental flap around PJ might improve postoperative outcomes. Methods: A prospective randomized controlled trial was planned at PGIMER, Chandigarh. Fifty-eight patients meeting the criteria were included in the study. Group A underwent PD with omental roll-up and group B underwent standard PD. Results: The mean age of patients in group A was 57.1 ± 14.3 years and 51.2 ± 10.7 in group B. Jaundice ( p = 0.667), abdominal pain ( p = 0.69), and co-morbidities were equal among the groups. The body mass index of patients in group B was higher at 24.3 ± 5.4 kg/m 2 ( p = 0.03). The common bile duct diameter (12.6 ± 5.3 mm vs. 17.2 ± 10.3 mm, p = 0.13) and the pancreatic duct diameter (4.06 ± 2.01 mm vs. 4.60 ± 2.43 mm, p = 0.91) were comparable. The intraoperative blood loss (mL) was significantly higher in group B (233.33 ± 9.57 vs. 343.33 ± 177.14, p = 0.04). Drain fluid amylase levels on postoperative day (POD) 1 ( p = 0.97) and POD3 ( p = 0.92) were comparable. The rate of postoperative pancreatic fistula (POPF) grade A ( p ≥ 0.99) and grade B ( p = 0.54) were comparable. The mean postoperative length of stay among was similar ( p = 0.89). Conclusions: An omental wrap can be performed without increase in complexity of the procedure. However, its utility in preventing POPFs and morbidity remains unclear. |
| Databáze: | MEDLINE |
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