title: Omental flaps reduces complications after pancreaticoduodenectomy.
abstract: BACKGROUND
  Major complications after pancreaticoduodenectomy are usually caused by a leaking pancreaticojejunal anastomosis. Omental flaps around various anastomoses were used to prevent the formation of fistula.
  
  
  METHODS
  We reviewed 147 patients who had undergone pancreaticoduodenectomy between March 2006 and March 2012. The patients were divided into 2 groups according to the application of omental flaps around various anastomoses: group A (101 patients) who underwent omental wrapping procedure; group B (46 patients) who did not undergo the omental wrapping procedure. Perioperative data of the two groups were reviewed to assess the effectiveness of omental flap procedure in the prevention of pancreatic fistula and other complications.
  
  
  RESULTS
  No differences were observed in the clinical characteristics between the 2 groups. The incidences of pancreatic fistula (4.0% vs 17.4%), post-pancreatectomy hemorrhage (0 vs 6.5%), biliary fistula (1.0% vs 13.0%), and delayed gastric emptying (4.0% vs 17.4%) were significantly less frequent in group A. The overall morbidity (18.8% vs 47.8%) and hospital stay (8.3 vs 9.6 days) were also significantly lower in group A than in group B.
  
  
  CONCLUSIONS
  Omental flaps around various anastomoses after pancreaticoduodenectomy can reduce the incidences of pancreatic fistula, biliary fistula, post-pancreatectomy hemorrhage and delayed gastric emptying. This procedure is simple and effective to reduce the overall morbidity after pancreaticoduodenectomy.
authors.affiliation: Department of Surgical Gastroenterology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India. omarjshah@yahoo.com.
authors.forename: Omar J
authors.initials: OJ
authors.lastname: Shah
authors.forename: Sadaf A
authors.initials: SA
authors.lastname: Bangri
authors.forename: Manmohan
authors.initials: M
authors.lastname: Singh
authors.forename: Reyaz A
authors.initials: RA
authors.lastname: Lattoo
authors.forename: Mohammad Y
authors.initials: MY
authors.lastname: Bhat
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000209:etiology / Q000517:prevention & control; D001658:Biliary Fistula / Q000209:etiology / Q000517:prevention & control; D005260:Female; D018589:Gastroparesis / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010185:Pancreatic Fistula / Q000209:etiology / Q000517:prevention & control; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D013524:Surgical Flaps; D013997:Time Factors; D016896:Treatment Outcome