The effect of vitamin E supplementation of cow diets containing rapeseed and linseed on the prevention of milk fat oxidation.

Two experiments involving lactating Holstein cows were carried out to quantify the effect of a 550-g supplement of lipids from extruded rapeseed and linseed on milk fatty acid profiles and the susceptibility of milk fat to oxidation. The effect of a daily oral supplement containing 9616 IU of vitamin E (all-rac-alpha-tocopheryl acetate) on milk alpha-tocopherol and protection against oxidation was also evaluated. The intake of oilseeds decreased protein and fat contents in milk, and the proportion of all C18 fatty acids increased. The trans isomers were 2.7 and 10.76% of the milk fatty acids, respectively, for cows fed the control diet and the diet containing extruded rapeseed and linseed. The ratio of oleic to palmitic acid was doubled, and the resistance to oxidation was reduced by 30 to 40% in both experiments. The dietary vitamin E supplement increased the alpha-tocopherol concentration in milk by about 45% and was sufficient to prevent milk fat depression and oxidation. The diet containing oilseeds and supplemented with an adequate amount of vitamin E allowed cows to yield milk that could be used to manufacture butter with high oleic acid content, good spreadability, and resistance to oxidation

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. Methods: This single center retrospective study included 812 open PD (2012-2021) and compared 146 procedures with AC using a ROF (AC-ROF) to 666 PD without AC (no AC). The Fistula Risk Score (FRS; Callery et al., J Am Coll Surg 2013) was calculated. CR-POPF and CR-PPH were recorded according to the ISGPS classification. Results: There were more patients with a high FRS (7-10) in the AC-ROF group: 18 (12%) vs. 48 (7%) with no AC (p<0.01). CR-POPF ocurred in 28 (19%) in the AC-ROF group versus 165 (25%), respectively (p=0.001). CR-PPH was less frequent in the AC-ROF group 5 (3%) versus 66 (10%) with no AC, respectively (p=0.01). There was no reoperations for PPH or POPF in the AC-ROF versus 25 (4%) with no AC (p=0.02). In the 65 patients (8% of the overall population) with FRS=7-10, the CR-PPH rate was 1/20 (5%) in the AC-ROF group vs. 7/45 (16%) in the no AC groupé (p=0.23). Conclusions: AC with ROF can reduce rates of CR-PPH following PD especially in patients at high risk for POPF. This simple and cost-free technique should be further evaluated to confirm these results