Omental Free Shaped Flap Reinforcement on Anastomosis and Dissected Area (OFFROAD) Following Gastrectomy

The frequency of anastomotic leakage after gastrectomy is reported to be 0.9~8%. To reduce deleterious outcomes of anastomotic leakage, we devised the “Omental Free-shaped Flap Reinforcement On Anastomosis and Dissected area” procedure not only to prevent fatal complications following anastomotic leakage but also to promote vascularity of anastomoses and other expected oncological benefits. This video illustrates the surgical procedure following a totally laparoscopic distal gastrectomy. After completion of the anastomosis, the remaining omentum was mobilized upward and divided into two sections. We placed the left section of the omental flap under the anastomosis between the stomach and pancreas. Finally, we grasped and curved the tip of the section to cover the anastomosis from behind, and we placed the right section of the omental flap above the anastomosis. These two sections were approximated with clips to the anterior wall of the stomach. The patient was discharged without complications.

Trend of Pediatric Cholecystectomy: Clinical Characteristics and Indications for Cholecystectomy / 소아외과

PURPOSE: Number of pediatric cholecystectomy has been recently showing a gradually increasing trend. The purpose of this study was to investigate the clinical features of patients who underwent pediatric cholecystectomy, and the latest trend in cholecystectomy. METHODS: In the present study, we conducted a retrospective chart review on 47 patients who had undergone cholecystectomy at a single center. The entire patient population was divided into two groups, according to the time of cholecystectomy (early group, January 1999 to December 2006; late group, January 2007 to August 2014). RESULTS: The comparison between the early and late groups showed that the number of cholecystectomy increased from 13 to 34 cases representing a 2.6-fold increase. The mean patient age also increased from 5.94±4.08 years to 10.51±5.57 years (p=0.01). Meanwhile, laparoscopic surgery also increased from 15.4% to 79.4%, respectively (p<0.001). However, sex, mean body mass index, comorbidities, indications of cholecystectomy, and previous total parenteral nutrition were not statistically significant. CONCLUSION: The results of this study showed that pediatric cholecystectomy cases are increasing, particularly in the 10 to 19 years age group and laparoscopic cholecystectomies are also being performed at an increasing rate. When the patients were compared according to the time of cholecystectomy, there were no differences in other risk factors or indications for cholecystectomy.