INTRODUCTION: In an attempt to reduce the perioperative morbidity after pancreaticoduodenectomy, the results of double omental flap (DOF) after pancreaticoduodenectomy (PD) with pancreaticogastrostomy (PG) were compared to a standard technique. METHODS: From January 2009 to December 2009, 61 patients underwent PD with PG for pancreatic adenocarcinoma in our department. Perioperative data were prospectively recorded, and postoperative outcome of patients who underwent or not a DOF (group DOF+ = 33 and group DOF- = 28, respectively) was analyzed. RESULTS: The overall postoperative mortality was 1.6 % (n = 1). The overall postoperative morbidity rate was 27.8 % (n = 17). PF occurred in eight (13.1 %) patients and was grade A in six (9.8 %) patients. Clinically relevant PF (grade B and C) occurred in two (3.2 %) patients. The univariate analysis showed that in the DOF+ groups there was a significant reduction of perianastomotic collections (P = 0.034) and a significant reduction of the relaparotomy rate (P = 0.05). DISCUSSION: The DOF contributed to reduce the rate of perianastomotic collections as well as the rate of relaparotomy. CONCLUSIONS: A DOF should be considered a further step toward a reduction of surgical-related complications after PD with PG.
INTRODUCTION: In an attempt to reduce the perioperative morbidity after pancreaticoduodenectomy, the results of double omental flap (DOF) after pancreaticoduodenectomy (PD) with pancreaticogastrostomy (PG) were compared to a standard technique. METHODS: From January 2009 to December 2009, 61 patients underwent PD with PG for pancreatic adenocarcinoma in our department. Perioperative data were prospectively recorded, and postoperative outcome of patients who underwent or not a DOF (group DOF+ = 33 and group DOF- = 28, respectively) was analyzed. RESULTS: The overall postoperative mortality was 1.6 % (n = 1). The overall postoperative morbidity rate was 27.8 % (n = 17). PF occurred in eight (13.1 %) patients and was grade A in six (9.8 %) patients. Clinically relevant PF (grade B and C) occurred in two (3.2 %) patients. The univariate analysis showed that in the DOF+ groups there was a significant reduction of perianastomotic collections (P = 0.034) and a significant reduction of the relaparotomy rate (P = 0.05). DISCUSSION: The DOF contributed to reduce the rate of perianastomotic collections as well as the rate of relaparotomy. CONCLUSIONS: A DOF should be considered a further step toward a reduction of surgical-related complications after PD with PG.
Authors: Marco Niedergethmann; Niloufar Dusch; Rizky Widyaningsih; Christel Weiss; Peter Kienle; Stefan Post Journal: World J Surg Date: 2010-07 Impact factor: 3.352
Authors: Philippe Bachellier; Elie Oussoultzoglou; Edoardo Rosso; Radu Scurtu; Ioan Lucescu; Akihiko Oshita; Daniel Jaeck Journal: Arch Surg Date: 2008-10