Standardization of a novel serosal patching technique with Glubran^®2 in robot-assisted distal pancreatectomy:...

Clinically relevant postoperative pancreatic fistula (CR-POPF) is a primary cause of morbidity after distal pancreatectomy (DP). Current stump reinforcement techniques yield inconsistent results. We previously reported promising initial results with a novel Glubran^®2 serosal patching (GSP) technique. This study aims to report outcomes from an expanded series using a standardized GSP methodology. This is a single-center retrospective analysis of 10 consecutive patients who underwent robot-assisted distal pancreatectomy (DP) with standardized GSP for pancreatic stump closure. The primary outcome was the incidence of CR-POPF (Grades B/C) within 90 days, defined according to the International Study Group on Pancreatic Surgery (ISGPS) criteria. Secondary outcomes included overall morbidity and mortality. Ten patients (mean age 71.6 ± 5.4 years; 60% male) were included. The mean operative time was 4.8 ± 1.1 h, and all procedures achieved R0 resection. The mean length of stay was 5.1 ± 2.2 days. The incidence of CR-POPF was 0%. One patient (10%) developed a biochemical leak (formerly Grade A) that resolved without intervention. No major complications (Clavien-Dindo Grade ≥ IIIa) or 90-day mortality occurred. The standardized application of the GSP technique for pancreatic stump closure after robot-assisted DP appears to be a safe and reproducible method. In this small, consecutive series, the technique was associated with a complete absence of clinically relevant pancreatic fistulae; however, these preliminary outcomes must be interpreted with caution. This novel technique shows promise, and its efficacy warrants further investigation in larger, prospective trials.