SynthesisPloS one2018
Pancreatic stump closure techniques and pancreatic fistula formation after distal pancreatectomy: Meta-analysis and single-center experience.
Synthesis in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 4 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 4 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- Stapler versus scalpel resection followed by handsewn closure of the pancreatic remnant for distal pancreatectomy.The Cochrane database of systematic reviews · 2025Pooled it
- Suture versus stapler in distal pancreatectomy and its impact on postoperative pancreatic fistula.Scientific reports · 2025Pooled it
- Pooled it
- Continuous irrigation after pancreatectomy: a systematic review.Langenbeck's archives of surgery · 2023Pooled it
- Preventing clinically relevant pancreatic fistula with combination of linear stapling plus continuous suture of the stump in laparoscopic distal pancreatectomy.BMC surgery · 2020Trial
- Global research trends and frontier evolution in robot-assisted distal pancreatectomy: a bibliometric and visualization analysis.Journal of robotic surgery · 2026Review
- Quadruple reinforcement technique for pancreatic stump during robotic distal pancreatectomy.Surgical endoscopy · 2026Article
- A Multicenter, Single-Blind, Randomized Trial Comparing Stapler Closure With Clip-on-Staple Method Versus Stapler Closure Alone During Distal Pancreatectomy (CLIP-DP Trial).Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026Article
- Clinical feasibility analysis of reducing the incidence of pancreatic fistula after laparoscopic distal pancreatectomy by using a pancreatic duct stent to occlude the residual main pancreatic duct.Surgical endoscopy · 2026Article
- Correlation between inflammation, vascularization, adipocyte percentage and exocrine cell percentage at the resection margin and the postoperative pancreatic fistula rate after distal pancreatectomy.Langenbeck's archives of surgery · 2026Article
- Meta-analysis and trial sequential analysis of pancreatic stump closure using a hand-sewn or stapler technique in distal pancreatectomy.Annals of hepato-biliary-pancreatic surgery · 2024Review
- Comparative Analysis of Complications Following Distal Resections for Neuroendocrine Tumors and Adenocarcinoma: Unveiling the Differences.Medical science monitor : international medical journal of experimental and clinical research · 2024Article
- Refractory postoperative pancreatic fistula following laparoscopic distal pancreatectomy for pancreatic cancer caused by incomplete pancreas divisum: a case report.Clinical journal of gastroenterology · 2024Article
- Interaction analysis of subgroup effects in randomized trials: the essential methodological points.Scientific reports · 2024Article
- Efficacy of pancreaticojejunostomy of the pancreatic stump during distal or central pancreatectomy.Langenbeck's archives of surgery · 2024Article
- Pancreatectomy and Pancreatic Surgery.Life (Basel, Switzerland) · 2023Article
- Risk Factor Identification for Delayed Gastric Emptying after Distal Pancreatectomy-An Evaluation of 1688 Patients Based on the German StuDoQ|Pancreas Registry.Journal of clinical medicine · 2022Article
- Central Pancreatectomy: Significance of Vascularity on Anastomotic Integrity and a Note on Reconstructive Technique.Cureus · 2021Article
- The Oncologic Impact of Pancreatic Fistula After Distal Pancreatectomy for Pancreatic Ductal Adenocarcinoma of the Body and the Tail: A Multicenter Retrospective Cohort Analysis.Annals of surgical oncology · 2021Article
- Impact of pasireotide on postoperative pancreatic fistulas following distal resections.Langenbeck's archives of surgery · 2021Article
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPancreatic fistula/PF is the most frequent and feared complication after distal pancreatectomy/DP. However, the safest technique of pancreatic stump closure remains an ongoing debate. Here, we aimed to compare the safety of different pancreatic stump closure techniques for preventing PF during DP.
methodsWe performed a PRISMA-based meta-analysis of all relevant studies that compared at least two techniques of stump closure during DP with regard to PF rates/PFR. We further performed a retrospective analysis of our institutional PFR in correlation with stump closure techniques.
results8301 studies were initially identified. From these, ten randomized controlled trials/RCTs, eleven prospective and 59 retrospective studies were eligible. Stapler closure (26%vs.31%, OR:0.73, p = 0.02), combination of stapler and suture (30%vs.33%, OR:0.70, p = 0.05), or stump anastomosis (14%vs.28%, OR:0.51, p = 0.02) were associated with lower PFR than suture closure alone. Spleen preservation/splenectomy, or laparoscopic/open DP, TachoSil®, fibrin-like glue-application, or bioabsorbable-stapler-reinforcements (Seamguard®) did not influence PFR after DP. In contrast, autologous patches (falciform ligament/seromuscular patches) resulted in lower PFR than no patch application (21.9%vs.25,8%, OR:0.60, p = 0.006). In our institution, the major three techniques of stump closure resulted in comparable PFR (suture:27%, stapler:29%, or combination:24%). However, selective suturing/clipping of the main pancreatic duct during pancreatic stump closure prevented severe PF (p = 0.02).
conclusionAfter DP, stapler closure, pancreatic anastomosis, or falciform/seromuscular patches lead to lower PFR than suture closure alone. However, the differences are rather small, and further RCTs are needed to test these effects. Selective closure of the main pancreatic duct during stump closure may prevent severe PF.
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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.