title: Double omental flap reduced perianastomotic collections and relaparotomy rates after pancreaticoduodenectomy with pancreaticogastrostomy.
abstract: BACKGROUND
  In an attempt to reduce the perioperative morbidity after pancreaticoduodenectomy, the results of double omental flap (DOF) after pancreaticoduodenectomy (PD) with pancreaticogastrostomy (PG) were compared to a standard technique.
  
  
  METHODS
  From January 2009 to December 2009, 61 patients underwent PD with PG for pancreatic adenocarcinoma in our department. Perioperative data were prospectively recorded, and postoperative outcome of patients who underwent or not a DOF (group DOF+ = 33 and group DOF- = 28, respectively) was analyzed.
  
  
  RESULTS
  The overall postoperative mortality was 1.6 % (n = 1). The overall postoperative morbidity rate was 27.8 % (n = 17). PF occurred in eight (13.1 %) patients and was grade A in six (9.8 %) patients. Clinically relevant PF (grade B and C) occurred in two (3.2 %) patients. The univariate analysis showed that in the DOF+ groups there was a significant reduction of perianastomotic collections (P = 0.034) and a significant reduction of the relaparotomy rate (P = 0.05).
  
  
  CONCLUSIONS
  The DOF contributed to reduce the rate of perianastomotic collections as well as the rate of relaparotomy.
  
  
  CONCLUSIONS
  A DOF should be considered a further step toward a reduction of surgical-related complications after PD with PG.
authors.affiliation: Centre de Chirurgie Viscérale et de Transplantation, Hôpitaux Universitaire de Strasbourg, CHU Hautepierre, Avenue Molière, 67098, Strasbourg Cedex, France.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Rosso
authors.forename: Patricia
authors.initials: P
authors.lastname: Lopez
authors.forename: Marie Noel
authors.initials: MN
authors.lastname: Roedlisch
authors.forename: Masato
authors.initials: M
authors.lastname: Narita
authors.forename: Elie
authors.initials: E
authors.lastname: Oussoultzoglou
authors.forename: Philippe
authors.initials: P
authors.lastname: Bachellier
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000517:prevention & control; D005260:Female; D005774:Gastrostomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000601:surgery*; D010179:Pancreas / Q000601:surgery*; D010185:Pancreatic Fistula / Q000517:prevention & control; D010190:Pancreatic Neoplasms / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000379:methods*; D010996:Pleural Effusion / Q000517:prevention & control; D011183:Postoperative Complications / Q000517:prevention & control*; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013524:Surgical Flaps