Published online May 27, 2022. doi: 10.4240/wjgs.v14.i5.482
Peer-review started: December 16, 2021
First decision: March 13, 2022
Revised: March 16, 2022
Accepted: April 24, 2022
Article in press: April 24, 2022
Published online: May 27, 2022
The life-threatening complications following pancreatoduodenectomy (PD), intra-abdominal 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.
To investigate the safety and feasibility of omental interposition to reduce the POPF rate and related complications in pancreaticoduodenectomy.
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 score-matched (PSM) analyses were performed to compare the severe complication rates and mortality between the two groups.
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 inter
The application of omental interposition is an effective and safe approach to reduce the CR-POPF rate and related complications after PD.
Core Tip: Postoperative pancreatic fistula (POPF) is a life-threatening complication after pancreaticoduodenectomy. Multiple methods have been described in the literature to prevent POPF; however, few trials have demonstrated that a certain method can achieve good clinical outcomes. In this study, we proved that the application of omental interposition can reduce the incidence of clinically relevant POPF, which is associated with a trend towards accelerated recovery.