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Omental Roll up Technique in Pancreaticojejunostomy (In Whipple/Traverso Procedure) Decreases the Formation of Pancreatic Fistula - A Prospective Consecutive Case Series

Objectives Pancreaticoduedenectomy or Whipple procedure remains the procedure of choice that obtains long survival in pancreatic-head cancer. Few studies have been published describing the benefits of wrapping the omentum around the anastomosis. In our prospective consecutive case series study we compare the frequency of pancreatic fistula formation between patients who underwent omental roll up of the pancreatojejunostomy and the ones who have not. Methods Twenty-two patients underwent pancreatoduodenectomy in our department within six years. The patients were divided into two groups. The first group (n=7) underwent PDE without using the omental flap technique and the second group (n=15), underwent PDE using the omental roll-up technique. The perioperative as well as the postoperative outcome were compared. A prospective consecutive case series was conducted. The pancreatic fistula were detected by measuring the amylase levels from the abdominal drain fluid on the 2nd and 4th postoperative day. Results Four patients from Group A developed pancreatic fistula in comparison with two patients from Group B who underwent PDE with the roll up technique. Moreover, one patient from each group presented with postoperative bleeding. Conclusions Wrapping of the omentum is in favor of benefit the reduction of pancreatic fistula after pancreaticoduodenectomes. However, more randomized controlled studies are needed.


Xenaki Sofia, Andreou Alexandros, Athanasakis Elias, Daskalaki Anna, Chalkiadakis George, Chrysos Emmanuel

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