Preventive effect of omental flap in pancreaticoduodenectomy against postoperative pseudoaneurysm formation

Hiroaki Matsuda, Hiroshi Sadamori, Yuzo Umeda, Susumu Shinoura, Ryuichi Yoshida, Daisuke Satoh, Masashi Utsumi, Takahito Yagi, Toshiyoshi Fujiwara

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)

Abstract

Background/Aims: An omental flap covering the splanchnic vessels might reduce postoperative intraabdominal hemorrhage after pancreaticoduodenectomy. However, the efficiency of such a procedure remains to be verified. The purpose of this study was to determine the effect of omental flap placement in pancreaticoduodenectomy on the incidence of postoperative pseudoaneurysms. Methodology: Of 229 consecutive patients who underwent pancreaticoduodenectomy, the most recent 157 patients received the omental flap, while the initial 72 patients had no omental flap placement. Various preoperative factors were considered in the evaluation (age, gender, body mass index, primary disease and concurrent disease), as well as operative factors (operation time, blood loss, operative procedures, pancreatic texture, size of pancreatic duct and surgeon's experience). Results: Eighty-one patients (35.4%) developed pancreatic fistula. Nine patients (3.9%) developed postoperative pseudoaneurysm. Among the patients with pancreatic fistula, those without omental flap developed pseudoaneurysms more frequently (21.7%) than those with omental flap placement (5.2%). Multivariate analysis identified pancreatic fistula, no use of omental flap and hypertension, in that order, as predisposing factors for a pseudoaneurysm. The omental flap significantly prevented pseudoaneurysms (p=0.021; OR=0.151; 95% CI, 0.030-0.751). Conclusions: Omental flap placement over splanchnic vessels could be a feasible and efficient surgical procedure to prevent postoperative pseudoaneurysms following pancreaticoduodenectomy.

Original languageEnglish
Pages (from-to)578-583
Number of pages6
JournalHepato-gastroenterology
Volume59
Issue number114
DOIs
Publication statusPublished - Mar 2012

Keywords

  • Intra-abdominal hemorrhage
  • Omental flap placement
  • Pancreatic fistula
  • Pancreaticoduodenectomy
  • Pseudoaneurysm

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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