ArticleAnnals of surgery open : perspectives of surgical history, education, and clinical approaches2026
A Multicenter, Single-Blind, Randomized Trial Comparing Stapler Closure With Clip-on-Staple Method Versus Stapler Closure Alone During Distal Pancreatectomy (CLIP-DP Trial).
Article in Annals of surgery open : perspectives of surgical history, education, and clinical approaches, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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17 authors.
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Abstract
Objective: To determine whether the clip-on-staple method reduces clinically relevant postoperative pancreatic fistula (CR-POPF) following distal pancreatectomy (DP). Background: CR-POPF remains the most significant source of morbidity after DP, particularly in patients with thick pancreatic parenchyma. Effective, pragmatic strategies to reduce CR-POPF are needed. Methods: The CLIP-DP trial was a multicenter, single-blind, randomized controlled study conducted at 16 Japanese institutions (UMIN000042217). Adults undergoing DP were randomized 1:1 to reinforced stapler closure alone (Arm A) or the clip-on-staple method (Arm B). Allocation employed a central system with minimization method stratified by pancreatic thickness (≤12 mm vs >12 mm), surgical approach, and institution. The primary endpoint was CR-POPF (grade B/C) or death within 30 days. Analyses were prespecified for both the full-analysis set (FAS) and per-protocol set (PPS). Results: Among 190 randomized patients, 177 were included in the FAS (Arm A, n = 85; Arm B, n = 92) and 170 in the PPS (Arm A, n = 82; Arm B, n = 88). In the FAS, CR-POPF or death occurred in 23.5% of Arm A versus 15.2% of Arm B ( Conclusions: The clip-on-staple method reduces CR-POPF after DP compared with stapler closure alone, with the greatest benefit in thick pancreas.
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