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.