Efficacy of the omental roll-up technique in pancreaticojejunostomy to prevent postoperative pancreatic fistula after pancreaticoduodenectomy.

IF 1.1 Q4 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepato-biliary-pancreatic surgery Pub Date : 2024-08-31 Epub Date: 2024-06-05 DOI:10.14701/ahbps.24-016

Sisira Jayaratnam, Cherring Tandup, Yashwant Raj Sakaray, Kailash ChKurdia, Ashish Gupta, Lileswar Kaman

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引用次数: 0

Abstract

Backgrounds/aims: Pancreaticoduodenectomy (PD) is being performed more frequently. A pancreaticojejunostomy (PJ) leak is the major determinant of patient outcomes. An omental flap around PJ might improve postoperative outcomes.

Methods: A prospective randomized controlled trial was planned at PGIMER, Chandigarh. Fifty-eight patients meeting the criteria were included in the study. Group A underwent PD with omental roll-up and group B underwent standard PD.

Results: The mean age of patients in group A was 57.1 ± 14.3 years and 51.2 ± 10.7 in group B. Jaundice (p = 0.667), abdominal pain (p = 0.69), and co-morbidities were equal among the groups. The body mass index of patients in group B was higher at 24.3 ± 5.4 kg/m² (p = 0.03). The common bile duct diameter (12.6 ± 5.3 mm vs. 17.2 ± 10.3 mm, p = 0.13) and the pancreatic duct diameter (4.06 ± 2.01 mm vs. 4.60 ± 2.43 mm, p = 0.91) were comparable. The intraoperative blood loss (mL) was significantly higher in group B (233.33 ± 9.57 vs. 343.33 ± 177.14, p = 0.04). Drain fluid amylase levels on postoperative day (POD) 1 (p = 0.97) and POD3 (p = 0.92) were comparable. The rate of postoperative pancreatic fistula (POPF) grade A (p ≥ 0.99) and grade B (p = 0.54) were comparable. The mean postoperative length of stay among was similar (p = 0.89).

Conclusions: An omental wrap can be performed without increase in complexity of the procedure. However, its utility in preventing POPFs and morbidity remains unclear.

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在胰十二指肠切除术后采用网膜卷起技术预防术后胰瘘的效果。

背景/目的：胰十二指肠切除术（PD）越来越频繁。胰空肠吻合术（PJ）渗漏是患者预后的主要决定因素。在胰空肠周围制作网膜瓣可能会改善术后效果：方法：计划在昌迪加尔的 PGIMER 进行一项前瞻性随机对照试验。符合标准的 58 名患者被纳入研究。结果：A组患者的平均年龄为18岁，B组患者的平均年龄为18岁：A组患者的平均年龄为（57.1±14.3）岁，B组患者的平均年龄为（51.2±10.7）岁。两组患者的黄疸（P = 0.667）、腹痛（P = 0.69）和并发症相同。B 组患者的体重指数较高，为 24.3 ± 5.4 kg/m2（p = 0.03）。总胆管直径（12.6 ± 5.3 mm vs. 17.2 ± 10.3 mm，p = 0.13）和胰管直径（4.06 ± 2.01 mm vs. 4.60 ± 2.43 mm，p = 0.91）相当。B 组的术中失血量（毫升）明显更高（233.33 ± 9.57 vs. 343.33 ± 177.14，p = 0.04）。术后第 1 天（POD）（P = 0.97）和第 3 天（P = 0.92）的引流液淀粉酶水平相当。术后胰瘘（POPF）A级（p ≥ 0.99）和B级（p = 0.54）的发生率相当。术后平均住院时间相似（p = 0.89）：结论：网膜包裹术可以在不增加手术复杂性的情况下进行。结论：网膜包裹术可以在不增加手术复杂度的情况下进行，但其在预防 POPF 和发病率方面的作用仍不明确。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of hepato-biliary-pancreatic surgery

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0.80

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0.00%

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