Inclusion criteria |
(1) Scheduled laparoscopic or robotic distal pancreatectomy |
(2) Planned pancreatic transection using a bioabsorbable reinforcement-attached stapler |
(3) Eastern Cooperative Oncology Group (ECOG) Performance status: 0–1 |
(4) Age: 18 years or older |
(5) Sufficient organ function, defined as: |
(a) Leukocyte count ≥ 2500 mm3, ≤ 14000 mm3
|
(b) Hemoglobin ≥ 9.0 g/dl |
(c) Platelet count ≥ 100,000 mm3
|
(d) Total bilirubin ≤ 2.0 mg/dl |
(e) Creatinine ≤ 2.0 mg/dl |
(6) Capability to comprehend and willingness to provide written informed consent |
Exclusion criteria |
(1) Scheduled open distal pancreatectomy |
(2) Pancreatic transection without the use of a stapler |
(3) History of upper abdominal surgery except for cholecystectomy |
(4) Requirement for emergency surgery |
(5) Necessity for arterial reconstruction, such as the superior mesenteric artery, common hepatic artery, or celiac artery |
(6) Severe ischaemic heart disease |
(7) Significant liver dysfunction due to cirrhosis or active hepatitis |
(8) Severe respiratory disorder requiring oxygen therapy |
(9) Chronic renal failure requiring dialysis |
(10) Requirement for resection of organs other than the left adrenal gland or gallbladder during distal pancreatectomy |
(11) Current immunosuppressive treatment |
(12) History of severe hypersensitivity to polyglycolic acid felt or fibrin glue |
(13) History of other severe drug allergies |
(14) Iodine-based contrast media allergy |
(15) Active secondary malignancy that may influence adverse events |
(16) Planned use of octreotide |
(17) Severe psychological or neurological disorders |