Yamamoto and colleagues are to be congratulated on the third and, thus far, the largest single-institution series examining the addition of a buttress to reinforce a stapled distal pancreatic transection. I, along with my colleagues, have also presented a case series on this subject,1 and, like my own, the article by Yamamoto et al has a number of significant shortcomings that prevent a definitive conclusion regarding the effectiveness of buttressing.
Hawkins WG. To Mesh or Not to Mesh, That Is the QuestionComment on “Use of Seamguard to Prevent Pancreatic Leak Following Distal Pancreatectomy”. Arch Surg. 2009;144(10):899. doi:10.1001/archsurg.2009.34