Efficacy of the Omental Roll-up Technique in Pancreaticojejunostomy as a Strategy to Prevent Pancreatic Fistula After Pancreaticoduodenectomy

Choi, Sae Byeol; Lee, Jin Suk; Kim, Wan Bae; Song, Tae Jin; Suh, Soon Yong; Choi, Sang Yong

doi:10.1001/archsurg.2011.865

Cited by 33 publications

(60 citation statements)

References 25 publications

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“…A retrospective study by Tani et al revealed higher incidence of POPF in omental wrapping group compared to nonwrapping (42.8 % versus 37.3 %) [85]. However, some studies have shown a benefit in reducing the rate of perianastomotic collections [86,87], but their role in reducing the incidence of POPF is questionable and need further studies.…”

Section: Role Of Omentum and Falciform Ligamentmentioning

confidence: 99%

Pancreatoduodenectomy - Preventing Complications

Penumadu

Barreto

Goel

et al. 2014

Indian J Surg Oncol

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Increased awareness of periampullary & pancreatic head cancers, and the accompanying improved outcomes following pancreatoduodenectomy (PD), has possibly led to an increase in patients seeking treatment for the same. While there has definitely been a reduction in morbidity rates following PD in the last few decades, this decline has not mirrored the drastic fall in mortality. Amongst the foremost in the factors responsible for this reduction in mortality is the standardization of surgical technique and development of dedicated teams to manage all aspects of this demanding procedure. This review intends to provide the reader with an overview of major complications following this major surgery and measures to prevent them based on the authors' experience.

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Section: Role Of Omentum and Falciform Ligamentmentioning

confidence: 99%

Pancreatoduodenectomy - Preventing Complications

Penumadu

Barreto

Goel

et al. 2014

Indian J Surg Oncol

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“…Pancreatic fistula (PF) and post‐operative bleeding are the most serious complications after pancreatic surgery . Multiple technical modifications have been used in attempts to reduce the incidence of these complications.…”

Section: Introductionmentioning

confidence: 99%

“…Although popular in Asia, the technique is not in frequent use in Europe or the US . It has two purposes: firstly, to reduce the rate of post‐operative haemorrhage and pseudoaneurysms, avoiding the slipping of vascular ligatures due to the action of pancreatic juice, and, secondly, to decrease the rate of PF around the PJ anastomosis or in the DP section, thereby preventing the associated complications …”

Section: Introductionmentioning

confidence: 99%

Wrapping in pancreatic surgery: a systematic review

Ramia

Plaza

Adel

et al. 2013

ANZ Journal of Surgery

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“…Various techniques have been suggested to reduce the chance of pseudoaneurysm formation, including the ‘wrapping’ technique, in which the exposed retroperitoneal vessels are covered with omentum or the falciform ligament. Others have suggested leaving 1 cm at the origin of the GDA stump to minimize the likelihood of lytic pancreatic juices coming into contact with the vessel.…”

Section: Discussionmentioning

confidence: 99%

Systematic review of the incidence, presentation and management of gastroduodenal artery pseudoaneurysm after pancreatic resection

Brodie

Kocher

2019

BJS Open

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BackgroundGastroduodenal artery (GDA) pseudoaneurysm is a serious complication following pancreatic resection, associated with high morbidity and mortality rates. This review aimed to report the incidence of GDA pseudoaneurysm after pancreatic surgery, and describe clinical presentation and management.MethodsMEDLINE and Embase were searched systematically for clinical studies evaluating postoperative GDA pseudoaneurysm. Incidence was calculated by dividing total number of GDA pseudoaneurysms by the total number of pancreatic operations. Additional qualitative data related to GDA pseudoaneurysm presentation and management following pancreatic resection were extracted and reviewed from individual reports.ResultsNine studies were selected for systematic review involving 4227 pancreatic operations with 55 GDA pseudoaneurysms, with a reported incidence of 1·3 (range 0·2–8·3) per cent. Additional data were extracted from 39 individual examples of GDA pseudoaneurysm from 14 studies. The median time for haemorrhage after surgery was at 15 (range 4–210) days. A preceding complication in the postoperative period was documented in four of 21 patients (67 per cent), and sentinel bleeding was observed in 14 of 20 patients (70 per cent). Postoperative complications after pseudoaneurysm management occurred in two‐thirds of the patients (14 of 21). The overall survival rate was 85 per cent (33 of 39).ConclusionGDA pseudoaneurysm is a rare yet serious cause of haemorrhage after pancreatic surgery, with high mortality. The majority of the patients had a preceding complication. Sentinel bleeding was an important clinical indicator.

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Efficacy of the Omental Roll-up Technique in Pancreaticojejunostomy as a Strategy to Prevent Pancreatic Fistula After Pancreaticoduodenectomy

Cited by 33 publications

References 25 publications

Pancreatoduodenectomy - Preventing Complications

Pancreatoduodenectomy - Preventing Complications

Wrapping in pancreatic surgery: a systematic review

Systematic review of the incidence, presentation and management of gastroduodenal artery pseudoaneurysm after pancreatic resection

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