Omental wrapping combined with external pancreatic drainage is associated with a lower incidence of clinically relevant postoperative pancreatic fistula after pancreaticoduodenectomy: a retrospective study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Postoperative pancreatic fistula (POPF) remains the most challenging complication following pancreaticoduodenectomy (PD), with clinically relevant POPF (CR-POPF) significantly impacting patient outcomes and healthcare resources. Although external pancreatic drainage and omental wrapping have each been explored for fistula prevention, their combined effect has not been well characterized. This study aimed to evaluate whether the combination of omental wrapping of the pancreaticojejunostomy with external pancreatic drainage reduces the incidence of CR-POPF after PD. Methods: We retrospectively analyzed 130 patients who underwent PD between January 2023 and June 2024. Patients were divided into three groups: control (n=55), external drainage alone (n=45), and external drainage with omental wrapping (n=30). Perioperative data and postoperative complications were compared across groups. Univariable and firth penalized logistic regression analyses were performed to identify independent factors associated with CR-POPF. Results: 52.7%, P=0.009). The external drainage-alone group showed no significant difference from controls in any complication. Multivariable analysis confirmed that external drainage with omental wrapping was an independent protective factor against CR-POPF [adjusted odds ratio (OR) =0.244, 95% confidence interval (CI): 0.061-0.980, P=0.047]. Conclusions: Combining omental wrapping with external pancreatic drainage was associated with a lower incidence of CR-POPF after PD, whereas external drainage alone was not. This simple technique may have clinical implications and requires validation in prospective randomized trials.
Source: Gland Surgery
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7222592581