Double Omental Flap Reduced Perianastomotic Collections and Relaparotomy Rates after Pancreaticoduodenectomy with Pancreaticogastrostomy

Abstract

A DOF should be considered a further step toward a reduction of surgical-related complications after PD with PG.

Wrapping in pancreatic surgery: a systematic review

“…Two focused on the surgical technique; two more were written by the same surgical teams, of which we selected the one that included more patients. Finally, we selected 12 articles, which form the basis of our research. Five articles compared groups with and without the use of omentum or FL as wrapping, and the other seven described series of patients in whom some kind of wrapping was performed .…”

“…Finally, we selected 12 articles, which form the basis of our research. Five articles compared groups with and without the use of omentum or FL as wrapping, and the other seven described series of patients in whom some kind of wrapping was performed . Seven studies were retrospective and five were prospective …”

“…Pancreatic fistula (PF) and post‐operative bleeding are the most serious complications after pancreatic surgery . Multiple technical modifications have been used in attempts to reduce the incidence of these complications.…”

“…First described by Moriura in 1994, wrapping in pancreatic surgery involves the use of the omentum or FL to wrap the local retroperitoneal vessels, the pancreatojejunal (PJ) anastomosis or the pancreatic section of distal pancreatectomy (DP). Although popular in Asia, the technique is not in frequent use in Europe or the US . It has two purposes: firstly, to reduce the rate of post‐operative haemorrhage and pseudoaneurysms, avoiding the slipping of vascular ligatures due to the action of pancreatic juice, and, secondly, to decrease the rate of PF around the PJ anastomosis or in the DP section, thereby preventing the associated complications …”

Pancreatoduodenectomy - Preventing Complications

“…A retrospective study by Tani et al revealed higher incidence of POPF in omental wrapping group compared to nonwrapping (42.8 % versus 37.3 %) [85]. However, some studies have shown a benefit in reducing the rate of perianastomotic collections [86,87], but their role in reducing the incidence of POPF is questionable and need further studies.…”