title: Wrapping in pancreatic surgery: a systematic review.
abstract: BACKGROUND
  Wrapping in pancreatic surgery involves the use of the omentum or falciform ligament (FL) to wrap the local retroperitoneal vessels, the pancreatojejunal anastomosis or the pancreatic section of distal pancreatectomy. However, there is no clear evidence that wrapping in fact provides benefits. We have performed a systematic review of the literature about this topic.
  
  
  METHODS
  We conducted a literature search in the PubMed/MEDLINE database (1966-2012) for any language using various combinations of the following terms: wrapping, omental, omentum, pancreas, pancreatoduodenectomy and falciform ligament.
  
  
  RESULTS
  We selected 12 articles. Among five series that included a control group, only one obtained a statistically significant reduction in pancreatic fistula (PF) in the wrapping group and other series showed a lower percentage of post-operative haemorrhage in the wrapping group. In the seven series without control groups, a slight decrease in the rate of post-operative bleeding and PF was observed.
  
  
  CONCLUSIONS
  On the basis of the literature available at present, we cannot recommend the use of wrapping with omentum and/or FL in pancreatic surgery. Prospective randomized studies applying a systematic wrapping technique are needed in order to establish whether its use should be generalized.
authors.affiliation: HPB Surgical Service, Department of Surgery, University Hospital of Guadalajara, Guadalajara, Spain.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Ramia
authors.forename: Roberto
authors.initials: R
authors.lastname: de la Plaza
authors.forename: Farah
authors.initials: F
authors.lastname: Adel
authors.forename: Carmen
authors.initials: C
authors.lastname: Ramiro
authors.forename: Vladimir
authors.initials: V
authors.lastname: Arteaga
authors.forename: Jorge
authors.initials: J
authors.lastname: Garcia-Parreño
mesh_terms: D006801:Humans; D008022:Ligaments / Q000601:surgery*; D009852:Omentum / Q000601:surgery*; D010180:Pancreatectomy / Q000379:methods*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*; D016896:Treatment Outcome
keywords: falciform; omental; omentum; pancreas; pancreatoduodenectomy; review; surgery; wrapping.