Evaluation of pancreatic stump binding and ligation in reducing postoperative pancreatic fistula after distal pancreatectomy: a retrospective cohort study

This study evaluates the efficacy of pancreatic stump binding and ligation (PSBL) in reducing postoperative pancreatic fistula (POPF) after distal pancreatectomy (DP). A retrospective cohort analysis included 217 patients undergoing DP between 2015 and 2022. Patients were classified into two groups: those receiving PSBL (B-Group, n = 96) and those without (NB-Group, n = 121). The primary outcome was incidence of clinically relevant POPF (Grade B/C). The B-Group demonstrated lower POPF rates (11.5% vs. 28.9%, P = 0.003) compared to the NB-Group, with grade B fistulas particularly reduced ( P = 0.002). Multivariate analysis identified independent risk factors for POPF: BMI ≥ 28 kg/m 2 (OR = 14.105, P < 0.001), Preoperative Hypoalbuminemia (OR = 7.031, P < 0.001), Manual Method of Stump Closure (OR = 2.558, P = 0.020), and non-PSBL Technique (OR = 4.463, P < 0.001). In this retrospective cohort, PSBL is a promising, feasible technique associated with reduced clinically relevant POPF incidence after DP. Given the retrospective design, these findings are hypothesis-generating and warrant prospective, multicenter validation.