Li Y, Liang Y, Deng Y, Cai ZW, Ma MJ, Wang LX, Liu M, Wang HW, Jiang CY. Application of omental interposition to reduce pancreatic fistula and related complications in pancreaticoduodenectomy: A propensity score-matched study. World J Gastrointest Surg 2022; 14(5): 482-493 [PMID: 35734624 DOI: 10.4240/wjgs.v14.i5.482]
Corresponding Author of This Article
Chong-Yi Jiang, MD, Chief Doctor, Department of General Surgery, Huadong Hospital Affiliated to Fudan University, No. 221 West Yan’an Road, Shanghai 200040, China. jiangzhongyi9@sina.com
Research Domain of This Article
Surgery
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. May 27, 2022; 14(5): 482-493 Published online May 27, 2022. doi: 10.4240/wjgs.v14.i5.482
Application of omental interposition to reduce pancreatic fistula and related complications in pancreaticoduodenectomy: A propensity score-matched study
Yang Li, Yun Liang, Yao Deng, Zhi-Wei Cai, Ming-Jian Ma, Long-Xiang Wang, Meng Liu, Hong-Wei Wang, Chong-Yi Jiang
Yang Li, Yun Liang, Yao Deng, Zhi-Wei Cai, Ming-Jian Ma, Long-Xiang Wang, Meng Liu, Hong-Wei Wang, Chong-Yi Jiang, Department of General Surgery, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China
Yun Liang, Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China
Author contributions: Li Y, Liang Y, and Deng Y contributed equally to this manuscript; Jiang CY participated in the conception and design of this study; Deng Y, Cai ZW, Ma MJ, Wang LX, Liu M, and Wang HW participated in the data collection; Li Y participated in the data collection, analysis, and drafting of the article; Liang Y participated in the design of the study and data analyses; All authors have read and approved the final manuscript.
Supported bythe Shanghai Science and Technology Commission of Shanghai Municipality, No. 20Y11908600; the Shanghai Shenkang Hospital Development Center, No. SHDC2020CR5008; and Shanghai Municipal Health Commission, No. 20194Y0195.
Institutional review board statement: The study was reviewed and approved by the Ethics Review Committee of Huadong Hospital (Shanghai).
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: No additional data are available
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chong-Yi Jiang, MD, Chief Doctor, Department of General Surgery, Huadong Hospital Affiliated to Fudan University, No. 221 West Yan’an Road, Shanghai 200040, China. jiangzhongyi9@sina.com
Received: December 16, 2021 Peer-review started: December 16, 2021 First decision: March 13, 2022 Revised: March 16, 2022 Accepted: April 24, 2022 Article in press: April 24, 2022 Published online: May 27, 2022 Processing time: 159 Days and 17.8 Hours
ARTICLE HIGHLIGHTS
Research background
Postoperative pancreatic fistula (POPF) is a life-threatening complication after pancreaticoduodenectomy (PD).
Research motivation
Several methods have attempted to reduce the POPF after PD, few have been considered effective. The safety and short-term clinical benefits of omental interposition remain controversial.
Research objectives
To investigate the safety and feasibility of omental interposition to reduce the POPF rate and related complications in PD.
Research methods
In total, 196 consecutive patients underwent PD performed by the same surgical team, the patients were divided into two groups: an omental interposition group (127, 64.8%) and a non-omental interposition group (69, 35.2%). Propensity score-matched analyses were performed to compare the severe complication rates and mortality between the two groups.
Research results
The clinically relevant POPF (CR-POPF; 10.1% vs 24.6%; P = 0.025) and delayed postpancreatectomy hemorrhage (1.4% vs 11.6%; P = 0.016) rates were significantly lower in the omental interposition group. The omental interposition technique was associated with a shorter time to resume food intake (7 vs 8 d; P = 0.048) and a shorter hospitalization period (16 vs 21 d; P = 0.031).
Research conclusions
The application of the omental interposition is an effective and safe approach to reduce the CR-POPF rate and related complications after PD.
Research perspectives
Prospective studies are needed on the role of omental interposition in reducing CR-POPF.
