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Retromesenteric Omental Flap for Complete Arterial Coverage During Pancreaticoduodenectomy: Surgical Technique

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Abstract

Postoperative pancreatic fistula is a frequent complication of pancreaticoduodenectomy that can trigger arterial lesions resulting in post-pancreatectomy hemorrhage (PPH) in up to 10–15% of cases. We describe an original omental flap technique including mobilization of the greater omentum through the retromesenteric window allowing coverage of all exposed peripancreatic arteries before reconstruction. This technique, used in 146 patients, did not carry any specific morbidities except for one case of partial flap necrosis treated conservatively and was associated with a significant reduction in grade B/C PPH.

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Abbreviations

POPF:

Postoperative pancreatic fistula

CR-POPF:

Clinically relevant POPF

PD:

Pancreaticoduodenectomy

FRS:

Fistula risk score

PPH:

Post-pancreatectomy hemorrhage

CR-PPH:

Clinically relevant PPH

ROF:

Retromesenteric omental flap

References

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Authors and Affiliations

  1. Department of HPB Surgery and Liver Transplantation, Hôpital Beaujon, APHP and University of Paris Cité, Clichy, France

    Lancelot Marique, Tatiana Codjia & Alain Sauvanet

Authors
  1. Lancelot Marique
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  2. Tatiana Codjia
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  3. Alain Sauvanet
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Correspondence to Lancelot Marique.

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Marique, L., Codjia, T. & Sauvanet, A. Retromesenteric Omental Flap for Complete Arterial Coverage During Pancreaticoduodenectomy: Surgical Technique. World J Surg 46, 2440–2443 (2022). https://doi.org/10.1007/s00268-022-06641-7

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  • DOI: https://doi.org/10.1007/s00268-022-06641-7

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