Innovative Techniques for the Decrease of the Complications Following the Whipple/Traverso Procedure

Xenaki S*, Athanasakis E and Chrysos E

Department of General Surgery, University Hospital of Heraklion, Greece

^*Correspondance to: Sofia Xenaki 

 PDF  Full Text DOI: 10.25107/2474-1647.3104

Abstract

Objectives: Pancreaticoduedenectomy (PDE) or Whipple Procedure (WP) or Traverso Procedure (TP) remains the procedure of choice that obtains better survival in pancreatic-head cancer. Many studies have been published describing the complications of these procedures as well as several methods of preventing them. Although very few of them have been proved as highly creditable. Few studies have been published describing the benefits of wrapping the omentum around the anastomosis in order to prevent hemorrhage and/or fistula formation. In our prospective consecutive case series study we compare the frequency of pancreatic fistula formation between patients undergone omental roll-up of the Pancreatojejunostomy (PJ) and Choledochojejunostomy (ChJ) and the ones who have not. Methods: Thirty (n=30) patients underwent PDE in our department within seven years. The patients were divided into two groups. The first group (n=7) underwent PDE without using the omental flap technique and the second group (n=23), underwent PDE using the omental roll-up technique. The perioperative as well as the postoperative outcome were compared. A prospective consecutive case series was conducted. The pancreatic fistula where detected by measuring the amylase levels from the abdominal drain fluid on the 1st and 3rd postoperative day. Results: Four patients from Group A developed pancreatic fistula in comparison with three patients from Group B who underwent PDE with the roll up technique. Moreover, one patient from each group appeared with postoperative bleeding and passed away. Conclusion: Wrapping of the omentum is in favor of benefit the reduction of pancreatic fistula and anastomotic leakage after pancreaticoduodenectomy. Since, more randomized controlled studies shall be published.

Keywords

Omental flap; Roll up; Pancreatic cancer; Fistula; Whipple procedure; Traverso Procedure

Cite the article

Xenaki S, Athanasakis E, Chrysos E. Innovative Techniques for the Decrease of the Complications Following the Whipple/Traverso Procedure. Clin Surg. 2021; 6: 3104..