Application of omental interposition to reduce pancreatic fistula and related complications in pancreaticoduodenectomy: A propensity score-matched study

Figure 1 Omental interposition was placed in front of the adjacent vessels and behind the anastomosis where the pancreas stump was fixed to the jejunum. 1: Liver; 2: Portal vein; 3: Hepatic artery; 4: Common bile duct; 5: Hepaticojejunostomy; 6: Gastrojejunostomy; 7: Celiac artery; 8: Pancreaticojejunostomy site; 9: Gastrojejunostomy. site; 10: Omental interposition; 11: Transverse colon.

Figure 2 Application of the omental interposition in pancreaticoduodenectomy. A: The pedicled omental interposition was placed in front of the adjacent vessels (hepatic artery, portal vein, and gastroduodenal artery stump) and behind the pancreaticojejunostomy site; B: The right boundary of the omental interposition was the right margin of the inferior vena cava; C: The upper boundary of the omental interposition was the hepatogastric ligament; the omental interposition was fixed to the hepatic portal and hepatogastric ligament with several sutures to prevent postoperative mobilization; D: Postoperative computed tomography images. The omental interposition elevated the hepaticojejunostomy site and filled the potential cavity.

Figure 3  Causes of death in the two groups.

Figure 4 Differences between the two groups. A: Drain fluid amylase obtained on the first postoperative day (DFA1) before propensity score-matching (PSM); B: DFA1 after PSM.