Preventive effect of omental flap in pancreaticoduodenectomy against postoperative complications: a meta-analysis.

Abstract

Background/aims: To systematically determine the effect of omental flap in pancreaticoduodenectomy against postoperative complication through metaanalysis of published studies.

Methodology: Thorough literature search in Ovid-MEDLINE and EMBASE databases was conducted to identify studies whether the use of Omental Flap to prevent postoperative complications. Review of 14 article candidates, identified 4 eligible articles with a total of 2971 patients for meta-analysis. Dichotomous data regarding distinction between omental roll-up and nonmental roll-up were pooled using random effects model to obtain the diagnostic odds ratios and their 95% confidence intervals (CIs).

Results: 1129 patients in omental roll-up group, 1842 patients in nonomental group. Omental roll-up during pancreaticoduodenectomy could not prevent postoperative pancreatic fistula (OR=0.81, 95%CI 0.40-1.63, P=0.56). it also could not prevent postoperative intra-abdominal bleeding (OR=0.67, 95%CI 0.28-1.59, P=0.37). We use the sensitivity analysis which found The pancreatic fistula was lower in the nonomental roll-up group than in the omental roll-up group (OR=1.24, 95%CI 1.03-1.50, P=0.02).

Conclusions: The use of omental roll-up could not decrease the risk of pancreatic fistula after pancreaticoduodenectomy. Further randomized controlled trials are needed to identify the effect of omental roll-up technique for pancreaticoduodenectomy.