Median appropriateness scores for surgical techniques for distal pancreatectomy
| Intervention | Scenario | ||
|---|---|---|---|
| Soft gland | Firm gland | Blood loss > 400 mL | |
| Handsewn stump closure | 6 | 6 | 6 |
| Stapled stump closure | 7 (appropriate) | 7 (appropriate) | 7 (appropriate) |
| Reinforced stapled stump closure | 7 (appropriate) | 7 (appropriate) | 7 (appropriate) |
| RFA stump closure | 4 | 4 | 4 |
| Gastrointestinal anastomosis stump closure (PG or PJ) | 3 (inappropriate) | 3 (inappropriate) | 3 (inappropriate) |
| Adjunct: autologous patch | 5 | 5 | 5 |
| Adjunct: sealant, fibrin glue | 4 | 4 | 4 |
| Adjunct: sealant, PGA mesh | 6 | 5 | 5 |
| Drain | 7 (appropriate) | 5 | 5 |
| No drain | 5 | 5 | 5 |
| If drain: suction drainage | 5 | 5 | 5 |
| If drain: gravity drainage | 5 | 5 | 5 |
PG = pancreaticogastrostomy; PGA = polyglycolic acid; PJ = pancreaticojejunostomy; RFA = radiofrequency ablation.