Table 1 Eligibility criteria of the WRAP study

Inclusion criteria

(1) Scheduled laparoscopic or robotic distal pancreatectomy

(2) Planned pancreatic transection using a bioabsorbable reinforcement-attached stapler

(3) Eastern Cooperative Oncology Group (ECOG) Performance status: 0–1

(4) Age: 18 years or older

(5) Sufficient organ function, defined as:

 (a) Leukocyte count ≥ 2500 mm³, ≤ 14000 mm³

 (b) Hemoglobin ≥ 9.0 g/dl

 (c) Platelet count ≥ 100,000 mm³

 (d) Total bilirubin ≤ 2.0 mg/dl

 (e) Creatinine ≤ 2.0 mg/dl

(6) Capability to comprehend and willingness to provide written informed consent

Exclusion criteria

 (1) Scheduled open distal pancreatectomy

 (2) Pancreatic transection without the use of a stapler

 (3) History of upper abdominal surgery except for cholecystectomy

 (4) Requirement for emergency surgery

 (5) Necessity for arterial reconstruction, such as the superior mesenteric artery, common hepatic artery, or celiac artery

 (6) Severe ischaemic heart disease

 (7) Significant liver dysfunction due to cirrhosis or active hepatitis

 (8) Severe respiratory disorder requiring oxygen therapy

 (9) Chronic renal failure requiring dialysis

 (10) Requirement for resection of organs other than the left adrenal gland or gallbladder during distal pancreatectomy

 (11) Current immunosuppressive treatment

 (12) History of severe hypersensitivity to polyglycolic acid felt or fibrin glue

 (13) History of other severe drug allergies

 (14) Iodine-based contrast media allergy

 (15) Active secondary malignancy that may influence adverse events

 (16) Planned use of octreotide

 (17) Severe psychological or neurological disorders