Pancreatic Fistula Clinical Trial
Official title:
Prospective Randomized Controlled Trial of Omental Roll-up Technique on Pancreato-jejunostomy Anastomosis for Reducing Perioperative Complication in Patients Undergoing Pancreatoduodenectomy
Despite the fact that pancreatoduodenectomy is the standard treatment of malignant tumor at
periampullary area, the morbidity and mortality rate with intra-abdominal collection, post
pancreatectomy hemorrhage, and delayed gastric emptying, is still high at approximately
50-60%. The causes of these complications usually come from post-operative pancreatic
fistula. Nowadays, several methods have been reported to reduce the incidence of pancreatic
fistula after undergoing pancreatoduodenectomy, such as pancreatic stenting, the use of
intravenous somatostatin, the use of sealant material and wrapping anastomosis by soft
tissue.
Wrapping pancreato-jejunal anastomosis with omentum is not a complicate procedure and
requires no extra treatment expenses of the patient. It has been reported this technique has
been applied in the non-randomized controlled trials and their data have significantly shown
that the technique could reduce pancreatic fistula rate. Therefore, the researchers want to
conduct an RCT study to compare complication rates between omental roll-up pancreato-jejunal
anastomosis and non-omental roll-up groups.
This is a RCT study designed to compare the use of omental roll-up technique with non-omental roll-up technique at pancreato-jejunal anastomosis in patients undergoing pancreatoduodenectomy. The purpose of this study is to prove the hypothesis that omental roll-up technique can reduce the complication rate or pancratic fistula after pancreatoduodenectomy. This study was approved by the committee on human rights to conduct the research involving human subjects, faculty of medicine Ramathibodi hospital, Mahidol university. The patients are operated by experienced surgeons of Hepato-pancreato-biliary unit, department of surgery, Ramathibodi hospital and randomized into two groups by using the closed envelope method after completing pancreato-jejunal anastomosis. Then, patients are followed-up and the data are collected for 30 days after the surgery. ;
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