Using the greater omental flap to cover the cut surface of the liver for prevention of delayed gastric emptying after left-sided hepatobiliary resection: a prospective randomized controlled trial.
OBJECTIVE
The aim of this randomized controlled trial is to evaluate the effect on delayed gastric emptying (DGE) of using the greater omental flap to cover the cut surface of the liver after left-sided hepatobiliary resection.


METHODS
From June 2007 to December 2008, all eligible patients were randomly assigned to either the greater omental flap group (OF group) or the control group (non-OF group).


RESULTS
A total of 40 patients remained for final analysis. The incidence of DGE after left-sided hepatobiliary resection was 25%. The incidence of DGE showed no statistically significant differences between the OF group (10%) and the non-OF group (40%) (p = 0.065). The assessment of DGE using radiopaque rings revealed that changes over time in the gastric emptying ratio (GER, percentage of rings excreted from stomach) did not differ in a significant manner between the two groups. There were significant differences in changes over time in GER (p = 0.044) between the patients with and without DGE. The patients with DGE also showed higher GER at 5 h (p = 0.042) and at 6 h (p = 0.034) than those without DGE.


CONCLUSIONS
Using the greater omental flap to cover the cut surface of the liver may reduce the incidence of DGE after left-sided hepatobiliary resection. Assessment using radiopaque markers may be useful to evaluate DGE.
Igami
Tsuyoshi
T
Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.
Nishio
Hideki
H
Ebata
Tomoki
T
Yokoyama
Yukihiro
Y
Sugawara
Gen
G
Nagino
Masato
M
D000368:Aged; D001650:Bile Duct Neoplasms / Q000601:surgery; D001653:Bile Ducts, Intrahepatic / Q000601:surgery*; D018281:Cholangiocarcinoma / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005746:Gastric Emptying; D005764:Gastroesophageal Reflux / Q000209:etiology / Q000517:prevention & control*; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D008099:Liver / Q000601:surgery*; D008113:Liver Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000637:transplantation*; D011183:Postoperative Complications; D011446:Prospective Studies; D016896:Treatment Outcome