Trial reportSurgical endoscopy2022
A randomized controlled trial of stapled versus ultrasonic transection in distal pancreatectomy.
Trial report in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 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
21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Preventing pancreatic fistula following pancreatectomy: meta-analysis of randomized clinical trials.BJS open · 2026Pooled it
- Quality assurance of surgical interventions for pancreatic cancer: systematic review of multicentre randomized clinical trials.BJS open · 2025Pooled it
- Reinforced stapling does not reduce postoperative pancreatic fistula in distal pancreatectomy: a systematic review and meta-analysis.Updates in surgery · 2023Pooled it
- Current practice in pancreatic stump management during minimally invasive distal pancreatectomy: results of a national survey from the IGOMIPS registry.Updates in surgery · 2026Article
- Evidence-Based Strategies for Mitigating Pancreatic Fistula After Distal Pancreatectomy: A Systematic Review of Randomized Clinical Trials.Journal of clinical medicine · 2026Review
- Minimally invasive Distal Pancreatectomy eRgonOMic analysis - the DP-ROM trial: An explorative, prospective, observational, cohort study trial.Surgical endoscopy · 2025Observational
- Impact of the stapler method on postoperative pancreatic fistula in robot-assisted pancreaticoduodenectomy: a retrospective study.Surgical endoscopy · 2025Observational
- Developing and validating a nomogram to forecast clinically relevant postoperative pancreatic fistula following distal pancreatectomy.Gland surgery · 2025Article
- Surgical and Oncological Outcomes of Minimally Invasive Left Pancreatectomy for Pancreatic Cancer: Robotic vs. Laparoscopic Approach.Current oncology (Toronto, Ont.) · 2025Article
- Cost-effectiveness of robotic vs laparoscopic distal pancreatectomy. Results from the national prospective trial ROBOCOSTES.Surgical endoscopy · 2024Observational
- Nationwide cost-effectiveness and quality of life analysis of minimally invasive distal pancreatectomy.Surgical endoscopy · 2024Article
- Nationwide validation of the distal fistula risk score (D-FRS).Langenbeck's archives of surgery · 2023Article
- Economic evaluation of robotic and laparoscopic paraesophageal hernia repair.Surgical endoscopy · 2023Article
- Distal pancreatectomy with or without radical approach, vascular resections and splenectomy: Easier does not always mean easy.World journal of gastrointestinal surgery · 2023Review
- New method of remnant closure during distal pancreatectomy.Langenbeck's archives of surgery · 2023Article
- Division of the neck of the pancreas in minimally invasive surgery without a preemptive retropancreatic tunnel.Updates in surgery · 2023Article
- Risk factor analysis and prediction of postoperative clinically relevant pancreatic fistula after distal pancreatectomy.BMC surgery · 2023Article
- Article
- Article
- Modified Frailty Index to Assess Risk in Elderly Patients Undergoing Distal Pancreatectomy: A Retrospective Single-Center Study.World journal of surgery · 2022Article
Corrections and comments
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Authors and funding
18 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe pancreatic transection method during distal pancreatectomy is thought to influence postoperative fistula rates. Yet, the optimal technique for minimizing fistula occurrence is still unclear. The present randomized controlled trial compared stapled versus ultrasonic transection in elective distal pancreatectomy.
methodsPatients undergoing distal pancreatectomy from July 2018 to July 2020 at two high-volume institutions were considered for inclusion. Exclusion criteria were contiguous organ resection and a parenchymal thickness > 17 mm on intraoperative ultrasound. Eligible patients were randomized in a 1:1 ratio to stapled transection (Endo GIA Reinforced Reload with Tri-Staple Technology®) or ultrasonic transection (Harmonic Focus® + or Harmonic Ace® + shears). The primary endpoint was postoperative pancreatic fistula. Secondary endpoints included overall complications, abdominal collections, and length of hospital stay.
resultsOverall, 72 patients were randomized in the stapled transection arm and 73 patients in the ultrasonic transection arm. Postoperative pancreatic fistula occurred in 23 patients (16%), with a comparable incidence between groups (12% in stapled transection versus 19% in ultrasonic dissection arm, p = 0.191). Overall complications did not differ substantially (35% in stapled transection versus 44% in ultrasonic transection arm, p = 0.170). There was an increased incidence of abdominal collections in the ultrasonic dissection group (32% versus 14%, p = 0.009), yet the need for percutaneous drain did not differ between randomization arms (p = 0.169). The median length of stay was 8 days in both groups (p = 0.880). Intraoperative blood transfusion was the only factor independently associated with postoperative pancreatic fistula on logistic regression analysis (OR 4.8, 95% CI 1.2-20.0, p = 0.032).
conclusionThe present randomized controlled trial of stapled versus ultrasonic transection in elective distal pancreatectomy demonstrated no significant difference in postoperative pancreatic fistula rates and no substantial clinical impact on other secondary endpoints.
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