ArticleThe Lancet regional health. Europe2023
Minimally invasive versus open distal pancreatectomy for resectable pancreatic cancer (DIPLOMA): an international randomised non-inferiority trial.
Article in The Lancet regional health. Europe, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06167421 (Comparison of Kimura Versus Warshaw Technique for Laparoscopic Spleen-Preserving Distal Pancreatectomy), which is not on this map. Cited by 68 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Comparison of Kimura Versus Warshaw Technique for Laparoscopic Spleen-Preserving Distal Pancreatectomy: A Multicenter Randomized Controlled Clinical Trial
Who cites it
68 citing papers in PubMed, 3 syntheses or guidelines pooled it, 112 citations in OpenAlex.
- Quality assurance of surgical interventions for pancreatic cancer: systematic review of multicentre randomized clinical trials.BJS open · 2025Pooled it
- Laparoscopic radical antegrade modular pancreatosplenectomy vesus laparoscopic distal pancreatosplenectomy for left-sided pancreatic cancer: a systematic review and meta-analysis.Frontiers in oncology · 2025Pooled it
- Comparison of the perioperative outcomes of robotic vs. open distal pancreatectomy: a meta-analysis of propensity-score-matched studies.Frontiers in surgery · 2025Pooled it
- Minimally Invasive vs Open Left Pancreatectomy for Resectable Pancreatic Cancer: Long-Term Results of the Randomized DIPLOMA Trial.JAMA surgery · 2025Trial
- Surgical site infection after open versus minimally invasive left pancreatectomy: a retrospective cohort study.Surgical endoscopy · 2026Article
- Article
- Article
- Short-term outcomes of robotic-assisted versus open Frey procedure in chronic pancreatitis: a single-center retrospective cohort study.Journal of robotic surgery · 2026Article
- Pancreatic ductal adenocarcinoma and pancreatic surgery in the 21st century: triumphs, turning points, and unresolved challenges.Updates in surgery · 2026Review
- Postoperative hyperamylasemia-an early warning signal after distal pancreatectomy.Hepatobiliary surgery and nutrition · 2026Article
- Challenges and catalysators in building a robotic HPB program: the experience of a tertiary cancer center.Updates in surgery · 2026Article
- Competency, Proficiency, and Mastery: Learning Curves for Robotic Distal Pancreatectomy at 16 International Expert Centers.Annals of surgery · 2026Article
- Robotic Distal Splenopancreatectomy and Left Nephrectomy: Double Docking for En Bloc Resection of Pancreatic Cancer.Annals of surgical oncology · 2026Article
- Article
- Review
- A comparison of laparoscopic and robotic distal pancreatectomy with spleen and Splenic vessels preservation: an intention-based evaluation in a single-center retrospective study.Surgery today · 2026Article
- Anatomy-based individualised trocar placement in robotic pancreatic surgery: challenging the universal approach.Journal of robotic surgery · 2026Article
- Current practice in pancreatic stump management during minimally invasive distal pancreatectomy: results of a national survey from the IGOMIPS registry.Updates in surgery · 2026Article
- A risk-based framework to support conversion decision-making during minimally invasive left pancreatectomy: results from a multicentre registry.Updates in surgery · 2026Article
- Article
8 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
38 authors at 20 institutions in 7 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The oncological safety of minimally invasive surgery has been questioned for several abdominal cancers. Concerns also exist regarding the use of minimally invasive distal pancreatectomy (MIDP) in patients with resectable pancreatic cancer as randomised trials are lacking. Methods: In this international randomised non-inferiority trial, we recruited adults with resectable pancreatic cancer from 35 centres in 12 countries. Patients were randomly assigned to either MIDP (laparoscopic or robotic) or open distal pancreatectomy (ODP). Both patients and pathologists were blinded to the assigned approach. Primary endpoint was radical resection (R0, ≥1 mm free margin) in patients who had ultimately undergone resection. Analyses for the primary endpoint were by modified intention-to-treat, excluding patients with missing data on primary endpoint. The pre-defined non-inferiority margin of -7% was compared with the lower limit of the two-sided 90% confidence interval (CI) of absolute difference in the primary endpoint. This trial is registered with the ISRCTN registry (ISRCTN44897265). Findings: Between May 8, 2018 and May 7, 2021, 258 patients were randomly assigned to MIDP (131 patients) or ODP (127 patients). Modified intention-to-treat analysis included 114 patients in the MIDP group and 110 patients in the ODP group. An R0 resection occurred in 83 (73%) patients in the MIDP group and in 76 (69%) patients in the ODP group (difference 3.7%, 90% CI -6.2 to 13.6%; p Interpretation: This trial provides evidence on the non-inferiority of MIDP compared to ODP regarding radical resection rates in patients with resectable pancreatic cancer. The present findings support the applicability of minimally invasive surgery in patients with resectable left-sided pancreatic cancer. Funding: Medtronic Covidien AG, Johnson & Johnson Medical Limited, Dutch Gastroenterology Society.
Indexed as
Identifiers
What OpenQuestion holds
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.