title: Fixation of the greater omentum for prevention of delayed gastric emptying after left hepatectomy with lymphadenectomy for cholangiocarcinoma.
abstract: OBJECTIVE
  Delayed gastric emptying (DGE) sometimes occurs after left hepatectomy with lymphadenectomy. We performed fixation of the greater omentum to the peritoneum to prevent DGE and other complications in patients undergoing left hepatectomy with lymphadenectomy for cholangiocarcinoma.
  
  
  METHODS
  Patients undergoing left hepatectomy with lymphadenectomy for cholangiocarcinoma were divided into a fixation group (n = 9) and a nonfixation group (n = 10). In the fixation group, the greater omentum was sutured to the peritoneum 3 cm from the greater curvature of the stomach to prevent contact between the stomach and the cut surface of the liver.
  
  
  RESULTS
  Mean age, sex, disease, and hepatectomy procedures were similar in the two groups. DGE developed in six patients in the nonfixation group (60.0%) versus no patients in the fixation group (P = 0.011). The total number of complications was higher in the nonfixation group (16 complications) than in the fixation group (3 complications; P = 0.003). Overall morbidity was higher in the nonfixation group (60.0%) than in the fixation group (22.2%). Postoperative hospitalization was longer in the nonfixation group (67.4 days) than in the fixation group (20.2 days; P = 0.0041).
  
  
  CONCLUSIONS
  Fixation of the greater omentum to the peritoneum decreases the occurrence of DGE and other complications after left hepatectomy with lymphadenectomy for cholangiocarcinoma.
authors.affiliation: Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yoshida
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Mamada
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Taniai
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Mizuguchi
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Shimizu
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kakinuma
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Ishikawa
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Kanda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Shigeki
authors.initials: S
authors.lastname: Yokomuro
authors.forename: Koho
authors.initials: K
authors.lastname: Akimaru
authors.forename: Takashi
authors.initials: T
authors.lastname: Tajiri
mesh_terms: D000368:Aged; D001650:Bile Duct Neoplasms / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000601:surgery*; D018281:Cholangiocarcinoma / Q000601:surgery*; D005260:Female; D005746:Gastric Emptying; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D007902:Length of Stay; D008197:Lymph Node Excision / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome