Abstract: Objective The aim of this study was to investigate the clinical application value of the integrated wrapping and reinforcing technique of liver round and falciform ligament in pancreaticoduodenectomy(PD). Methods The clinical data of 759 patients who underwent PD or pylorus-preserving pancreaticoduodenectomy(PPPD)from January 2016 to December 2021 were retrospectively analyzed.According to whether the integrated wrapping and reinforcing technique of the liver round and falciform ligament was used or not,the patients were divided into the wrapping and reinforcing group(372 cases)and the non-wrapping or reinforcing group(387 cases).The basic characteristics,intraoperative data,postoperative data,and late post-pancreatectomy hemorrhage(PPH)data were compared between the two groups. Results The incidences of clinically relevant postoperative pancreatic fistula(CR-POPF),grade C pancreatic fistula,grade B/C and grade C PPH,late PPH,extraluminal PPH,intra-abdominal infection and percutaneous catheter drainage,90-day re-operation,and PPH-related 90-day re-operation were significantly lower in the wrapping and reinforcing group than those in the non-wrapping or reinforcing group(P＜0.05).And the postoperative hospital stay was also significantly shortened in the wrapping and reinforcing group(P＜0.05).The incidences of late extraluminal PPH,grade B/C and grade C late extraluminal PPH,invasive treatment and re-operation were significantly lower in the wrapping and reinforcing group than those in the non-wrapping or reinforcing group(P＜0.05). Conclusion The integrated wrapping and reinforcing technique of the liver round and falciform ligament can reduce the incidence of CR-POPF and late PPH after PD,especially the incidence of grade C pancreatic fistula,grade B/C and grade C late extraluminal PPH.At the same time,it can reduce the rate of intra-abdominal infection,percutaneous catheter drainage and re-operation,and shorten the postoperative hospital stay.

Key words: Liver round ligament, Falciform ligament, Wrapping, Reinforcement, Pancreaticoduodenectomy