ArticleSurgical endoscopy2026
Robotic crush and clip technique for pancreatic transection in robotic distal pancreatectomy.
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStapler transection during robotic distal pancreatectomy (RDP) has limitations, including device cost, difficulty in thick pancreas, and challenges in pathological assessment of the margin. We developed the crush and clip (CC) technique, in which the parenchyma is crushed using Maryland forceps and the main pancreatic duct is clipped without stump reinforcement. This study aimed to describe the CC technique and assess its non-inferiority to stapler transection regarding postoperative pancreatic fistula (POPF).
methodsWe retrospectively analyzed 127 RDP cases at a high-volume center (CC: 23; stapler: 104) between 2010 and 2025. Procedures used included da Vinci Xi, da Vinci SP, or hinotori™ systems. The primary endpoint includes clinically relevant POPF (ISGPS grade B/C). Body mass index, stump thickness, and robotic platform were used to estimate the propensity score, and overlap weighting was applied. Non-inferiority was prespecified as a risk difference (CC - stapler) of less than + 5% with a 90% bootstrap confidence interval (CI).
resultsPOPF occurred in 13% of CC and 26% of stapler cases (p = 0.280). The weighted analysis revealed incidences of 16.0% and 32.0%, respectively. The weighted risk difference was - 16.0% (90% CI, - 34.0% to + 4.3%), thereby meeting the non-inferiority margin. POPF was significantly lower with CC (6% vs. 47%, p = 0.013) when the pancreatic stump thickness was ≥ 14 mm. Major complications (Clavien-Dindo ≥ III) occurred in 14% of stapler cases but in none of the CC cases (p = 0.071).
conclusionsThe CC technique was feasible and safe and statistically non-inferior to stapler transection for POPF, while providing technical advantages.
Indexed as
Identifiers
41350788What 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.