Application of omental interposition to reduce pancreatic fistula and related complications in pancreaticoduodenectomy:A propensity score-matched study  

作　　者：Yang Li Yun Liang Yao Deng Zhi-Wei Cai Ming-Jian Ma Long-Xiang Wang Meng Liu Hong-Wei Wang Chong-Yi Jiang 

机构地区：[1]Department of General Surgery,Huadong Hospital Affiliated to Fudan University,Shanghai 200040,China [2]Department of Pancreatic Surgery,Fudan University Shanghai Cancer Center,Shanghai 200032,China

出　　处：《World Journal of Gastrointestinal Surgery》2022年第5期482-493,共12页世界胃肠外科杂志（英文版）（电子版）

基　　金：Supported by the Shanghai Science and Technology Commission of Shanghai Municipality,No.20Y11908600;the Shanghai Shenkang Hospital Development Center,No.SHDC2020CR5008;Shanghai Municipal Health Commission,No.20194Y0195。

摘　　要：BACKGROUND The life-threatening complications following pancreatoduodenectomy(PD),intraabdominal hemorrhage,and postoperative infection,are associated with leaks from the anastomosis of pancreaticoduodenectomy.Although several methods have attempted to reduce the postoperative pancreatic fistula(POPF)rate after PD,few have been considered effective.The safety and short-term clinical benefits of omental interposition remain controversial.AIM To investigate the safety and feasibility of omental interposition to reduce the POPF rate and related complications in pancreaticoduodenectomy.METHODS In total,196 consecutive patients underwent PD performed by the same surgical team.The patients were divided into two groups:An omental interposition group(127,64.8%)and a non-omental interposition group(69,35.2%).Propensity scorematched(PSM)analyses were performed to compare the severe complication rates and mortality between the two groups.RESULTS Following PSM,the clinically relevant POPF(CR-POPF,10.1%vs 24.6%;P=0.025)and delayed postpancreatectomy hemorrhage(1.4%vs 11.6%;P=0.016)rates were significantly lower in the omental interposition group.The omental interposition technique was associated with a shorter time to resume food intake(7 d vs 8 d;P=0.048)and shorter hospitalization period(16 d vs 21 d;P=0.031).Multivariate analyses showed that a high body mass index,nonapplication of omental interposition,and a main pancreatic duct diameter<3 mm were independent risk factors for CR-POPF.CONCLUSION The application of omental interposition is an effective and safe approach to reduce the CR-POPF rate and related complications after PD.

关 键 词：PANCREATICODUODENECTOMY Pancreatic fistula COMPLICATION Omental interposition 

分 类 号：R657.5[医药卫生—外科学]