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. 2022 Oct;46(10):2440-2443.
doi: 10.1007/s00268-022-06641-7. Epub 2022 Jul 2.

Retromesenteric Omental Flap for Complete Arterial Coverage During Pancreaticoduodenectomy: Surgical Technique

Lancelot Marique  1 , Tatiana Codjia  2 , Alain Sauvanet  2
Affiliations

Retromesenteric Omental Flap for Complete Arterial Coverage During Pancreaticoduodenectomy: Surgical Technique

Lancelot Marique et al. World J Surg. 2022 Oct.

Abstract

Postoperative pancreatic fistula is a frequent complication of pancreaticoduodenectomy that can trigger arterial lesions resulting in post-pancreatectomy hemorrhage (PPH) in up to 10-15% of cases. We describe an original omental flap technique including mobilization of the greater omentum through the retromesenteric window allowing coverage of all exposed peripancreatic arteries before reconstruction. This technique, used in 146 patients, did not carry any specific morbidities except for one case of partial flap necrosis treated conservatively and was associated with a significant reduction in grade B/C PPH.

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References

    1. Bassi C, Marchegiani G, Dervenis C, Sarr M, Abu Hilal M, Adham M, Allen P, Andersson R, Asbun HJ, Besselink MG, Conlon K, Del Chiaro M, Falconi M, Fernandez-Cruz L, Fernandez-Del Castillo C, Fingerhut A, Friess H, Gouma DJ, Hackert T, Izbicki J, Lillemoe KD, Neoptolemos JP, Olah A, Schulick R, Shrikhande SV, Takada T, Takaori K, Traverso W, Vollmer CR, Wolfgang CL, Yeo CJ, Salvia R, Buchler M; International Study Group on Pancreatic Surgery (ISGPS) (2017) The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 years after. Surgery 161(3):584–591. https://doi.org/10.1016/j.surg.2016.11.014 .
    1. Callery MP, Pratt WB, Kent TS, Chaikof EL, Vollmer CM Jr (2013) A prospectively validated clinical risk score accurately predicts pancreatic fistula after pancreatoduodenectomy. J Am Coll Surg 216(1):1–14. https://doi.org/10.1016/j.jamcollsurg.2012.09.002 - DOI - PubMed
    1. Wente MN, Veit JA, Bassi C, Dervenis C, Fingerhut A, Gouma DJ, Izbicki JR, Neoptolemos JP, Padbury RT, Sarr MG, Yeo CJ, Büchler MW (2007) Postpancreatectomy hemorrhage (PPH): an International Study Group of Pancreatic Surgery (ISGPS) definition. Surgery 142(1):20–25. https://doi.org/10.1016/j.surg.2007.02.001 - DOI - PubMed
    1. Andrianello S, Marchegiani G, Malleo G, Masini G, Balduzzi A, Paiella S, Esposito A, Landoni L, Casetti L, Tuveri M, Salvia R, Bassi C (2020) Pancreaticojejunostomy with externalized stent vs pancreaticogastrostomy with externalized stent for patients with high-risk pancreatic anastomosis: a single-center, phase 3 randomized clinical trial. JAMA Surg 155(4):313–321. https://doi.org/10.1001/jamasurg.2019.6035 - DOI - PubMed
    1. Andreasi V, Partelli S, Crippa S, Balzano G, Tamburrino D, Muffatti F, Belfiori G, Cirocchi R, Falconi M (2020) A systematic review and meta-analysis on the role of omental or falciform ligament wrapping during pancreaticoduodenectomy. HPB (Oxford) 22(9):1227–1239. https://doi.org/10.1016/j.hpb.2020.05.003 - DOI

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