ArticleMedicine2016
Optimal stapler cartridge selection according to the thickness of the pancreas in distal pancreatectomy.
Article in Medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03880773 (Tri Stapler vs. Ultrasonic Scalpel in Distal Pancreatectomy), which is not on this map. Cited by 17 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Tri Stapler vs. Ultrasonic Scalpel in Distal Pancreatectomy
Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- Impact of Pancreatic Stump Wrapping with Mesh on Post-Operative Pancreatic Fistula in Patients Undergoing Distal/Left Pancreatectomy for Malignant or Benign Diseases: A Systematic Review and Meta-Analysis.Medicina (Kaunas, Lithuania) · 2025Pooled it
- Reinforced stapling does not reduce postoperative pancreatic fistula in distal pancreatectomy: a systematic review and meta-analysis.Updates in surgery · 2023Pooled it
- Thick pancreas, dense duct branching, and limited fibrosis as risk factors for pancreatic fistula after distal pancreatectomy.BMC gastroenterology · 2026Article
- Use of a reinforced triple-row stapler with a powered stapling system reduces the occurrence of postoperative pancreatic fistula after distal pancreatectomy.Surgery today · 2026Article
- Interaction analysis of subgroup effects in randomized trials: the essential methodological points.Scientific reports · 2024Article
- Spleen-preserving distal pancreatectomy from multi-port to reduced-port surgery approach.World journal of gastrointestinal surgery · 2023Article
- Risk factor analysis and prediction of postoperative clinically relevant pancreatic fistula after distal pancreatectomy.BMC surgery · 2023Article
- Efficacy of the slow firing method using a reinforced triple-row stapler for preventing postoperative pancreatic fistula during laparoscopic distal pancreatectomy.Surgery today · 2022Article
- Clinical Impact of Stump Closure Reinforced With Hemopatch on the Prevention of Clinically Relevant Pancreatic Fistula After Distal Pancreatectomy: A Multicenter Randomized Trial.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2021Article
- Splenectomy and distal pancreatectomy in advanced ovarian cancer.Gland surgery · 2021Review
- Risk Factors for Clinically Relevant Postoperative Pancreatic Fistula (CR-POPF) after Distal Pancreatectomy: A Single Center Retrospective Study.Canadian journal of gastroenterology & hepatology · 2021Article
- Stapler sizes optimized for pancreatic thickness can reduce pancreatic fistula incidence after distal pancreatectomy.Surgery today · 2020Article
- Prevention and treatment of pancreatic fistula after pancreatic body and tail resection: current status and future directions.Frontiers of medicine · 2020Review
- Is there any different risk factor for clinical relevant pancreatic fistula according to the stump closure method following left-sided pancreatectomy?Annals of hepato-biliary-pancreatic surgery · 2019Article
- Pancreatic fistula following laparoscopic distal pancreatectomy is probably unrelated to the stapler size but to the drainage modality and significantly decreased with a small suction drain.Langenbeck's archives of surgery · 2019Article
- Pancreatic stump closure using only stapler is associated with high postoperative fistula rate after minimal invasive surgery.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2018Article
- Pancreatic Fistula after Distal Pancreatectomy with Stapler.JSLS : Journal of the Society of Laparoendoscopic SurgeonsArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Stapling is a popular method for stump closure in distal pancreatectomy (DP). However, research on which cartridges are suitable for different pancreatic thickness is lacking. To identify the optimal stapler cartridge choice in DP according to pancreatic thickness.From November 2011 to April 2015, data were prospectively collected from 217 consecutive patients who underwent DP with 3-layer endoscopic staple closure in Seoul National University Hospital, Korea. Postoperative pancreatic fistula (POPF) was graded according to International Study Group on Pancreatic Fistula definitions. Staplers were grouped based on closed length (CL) (Group I: CL ≤ 1.5 mm, II: 1.5 mm < CL < 2 mm, III: CL ≥ 2 mm). Compression ratio (CR) was defined as pancreas thickness/CL. Distribution of pancreatic thickness was used to find the cut-off point of thickness which predicts POPF according to stapler groups.POPF developed in 130 (59.9%) patients (Grade A; n = 86 [66.1%], B; n = 44 [33.8%]). The numbers in each stapler group were 46, 101, and 70, respectively. Mean thickness was higher in POPF cases (15.2 mm vs 13.5 mm, P = 0.002). High body mass index (P = 0.003), thick pancreas (P = 0.011), and high CR (P = 0.024) were independent risk factors for POPF in multivariate analysis. Pancreatic thickness was grouped into <12 mm, 12 to 17 mm, and >17 mm. With pancreatic thickness <12 mm, the POPF rate was lowest with Group II (I: 50%, II: 27.6%, III: 69.2%, P = 0.035).The optimal stapler cartridges with pancreatic thickness <12 mm were those in Group II (Gold, CL: 1.8 mm). There was no suitable cartridge for thicker pancreases. Further studies are necessary to reduce POPF in thick pancreases.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.