To the Editor Yamada et al1 report the results of Combined Resection vs Separated Resection After Mobilization of the Splenic Vein During Distal Pancreatectomy (COSMOS-DP), a multicenter randomized clinical trial in which they compare the outcomes of performing section of the splenic vein separately (n = 146) or together with transection of the pancreatic parenchyma (n = 133) in distal pancreatectomy. Although the authors conclude that there are no differences in postoperative complications and that combined section of the splenic vein and the pancreas is safe, some of their data cast some doubt on their findings.
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Cienfuegos JA, Valenti V, Rotellar F. Learning From Technical Details With Effect on Postoperative Pancreatic Fistula. JAMA Surg. 2021;156(12):1183. doi:10.1001/jamasurg.2021.3750
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