Falciform and round ligament reinforcement of distal pancreatectomy stump

(Panel A) The falciform and/or round ligament of the liver are detached from the anterior abdominal wall while keeping vascular supply from the liver.
(Panel B) The vascularized falciform/round ligament pedicle is passed into the lesser sac through a defect created in the lesser omentum (ie, gastrohepatic ligament).
(Panel C) The vascularized pedicle is sutured to the distal pancreatectomy stump as a reinforcement to prevent postoperative pancreatic leak/fistula formation.
Vascularized pedicles, such as the falciform ligament and the round ligament of the liver (ie, ligamentum teres, which contains the remnant of fetal umbilical vein), have been used as reinforcements to cover the cut surface of the distal pancreatectomy stump. Success varied between studies; refer to topic for details.