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Article Abstract
Purpose: Stapled closure is the standard technique for pancreatic resection via distal pancreatectomy (DP). The Signia™ Stapling System allows for adaptive stapling based on real-time tissue resistance. This study aims to investigate whether DP using the Signia™ system could reduce the incidence of clinically relevant post-operative pancreatic fistula (CR-POPF).
Methods: We retrospectively analyzed 53 patients who underwent DP between 2020 and 2025. 26 patients underwent DP using the Signia™ Stapling System (powered stapler group), and 27 patients using a manual stapler (manual stapler group). The primary outcome was the CR-POPF rate.
Results: In the powered stapler group, 38.5% of patients developed biochemical leakage, but no cases of CR-POPF were observed. In contrast, the manual stapler group had a CR-POPF rate of 18.5% (p = 0.021). A receiver operating characteristic curve was generated to determine the pancreatic thickness threshold predictive of CR-POPF. The calculated cut-off value was 16 mm. In the powered group, there were no cases of CR-POPF even if the pancreatic thickness at the resection line was ≥ 16 mm.
Conclusions: The use of a powered stapler may therefore help reduce the risk of POPF associated with variability in the thickness and hardness of the pancreas during DP.
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| http://dx.doi.org/10.1007/s00595-025-03123-w | DOI Listing |
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