Retromesenteric Omental Flap as Arterial Coverage in Pancreaticoduodenectomy: A Novel Technique to Prevent Post-pancreatectomy Hemorrhage

Background: Post-pancreatectomy hemorrhage (PPH) occurs in 10-15% of patients following pancreaticoduodenectomy (PD), mainly in association with clinically relevant postoperative pancreatic fistula (CR-POPF). Prevention of PPH by arterial coverage (AC) with a round ligament plasty or an omental flap is controversial. This study evaluated clinically relevant PPH (CR-PPH) rate following AC with an original retromesenteric omental flap (ROF) in patients undergoing PD.