The use of omental fl ap in the prevention of infl ammation after pancreaticoduodenectomy

Objective. To determine the effect of covering pancreato–jejunal anastomosis with an omental flap on the intensity of the inflammatory response after pancreatoduodenectomy. Materials and methods. A prospective study was conducted involving 60 patients who underwent pancreatoduodenectomy. In the main group, a pancreaticoduodenal anastomosis was covered with omentum, while in the control group, the standard technique was used. Levels of C–reactive protein, interleukin–6, procalcitonin, and leukocytes were determined before surgery and on the 1st, 3rd, and 7th days after the procedure. For statistical data processing, the Mann–Whitney U test, Friedman's test, regression analysis, Cohen's coefficient, and sensitivity analysis were used. Results. Patients in the main group showed statistically significant (p< 0.001) lower levels of inflammatory markers at all stages of the study, with a particularly pronounced difference on day 7 (Cohen's d coefficient for C–reactive protein –1.15, interleukin–6 –1.43, leukocytes –1.94). Regression analysis confirmed the independent anti–inflammatory effect of salinized coverage of the pancreato–jejunal anastomosis. Conclusions. The use of omentum covering of the anastomosis statistically significantly reduces the severity of the inflammatory response after pancreatoduodenectomy and can be recommended as an effective component of the prevention of postoperative complications.