Pancreatoduodenectomy with or without prophylactic falciform ligament wrap around the hepatic artery for prevention of postpancreatectomy haemorrhage: randomized clinical trial (PANDA trial).

A total of 445 procedures were included. In the intention to treat analysis, there was no significant reduction in haemorrhage (2.9 versus 7.1 per cent, odds ratio 0.39, 95 per cent confidence interval 0.15 to 1.02, P=0.071). In the per protocol analysis the effect was more positive: odds ratio 0.26, 0.09 to 0.8, P=0.017.

Comment: The authors reasonably conclude falciform wrap should be considered during pancreaticoduodenectomy.