Published online May 27, 2022. doi: 10.4240/wjgs.v14.i5.482
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
Postoperative pancreatic fistula (POPF) is a life-threatening complication after pancreaticoduodenectomy (PD).
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.
To investigate the safety and feasibility of omental interposition to reduce the POPF rate and related complications in PD.
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.
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).
The application of the omental interposition is an effective and safe approach to reduce the CR-POPF rate and related complications after PD.
Prospective studies are needed on the role of omental interposition in reducing CR-POPF.