Stapling is a popular method for stump closure in distal pancreatectomy (DP). However, research on which cartridges are suitable for different pancreatic thickness is lacking. To identify the optimal stapler cartridge choice in DP according to pancreatic thickness. From November 2011 to April 2015, data were prospectively collected from 217 consecutive patients who underwent DP with 3-layer endoscopic staple closure in Seoul National University Hospital, Korea. Postoperative pancreatic fistula (POPF) was graded according to International Study Group on Pancreatic Fistula definitions. Staplers were grouped based on closed length (CL) (Group I: CL ≤ 1.5?mm, II: 1.5 mm POPF developed in 130 (59.9%) patients (Grade A; n?=?86 [66.1%], B; n?=?44 [33.8%]). The numbers in each stapler group were 46, 101, and 70, respectively. Mean thickness was higher in POPF cases (15.2?mm vs 13.5?mm, P?=?0.002). High body mass index (P?=?0.003), thick pancreas (P?=?0.011), and high CR (P?=?0.024) were independent risk factors for POPF in multivariate analysis. Pancreatic thickness was grouped into 17?mm. With pancreatic thickness P?=?0.035). The optimal stapler cartridges with pancreatic thickness
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机译：吻合术是远端胰切除术（DP）中残端闭合的一种流行方法。然而，缺乏关于哪种药筒适合于不同的胰腺厚度的研究。为了根据胰腺厚度确定DP中最佳的订书机钉盒选择。从2011年11月至2015年4月，前瞻性收集了韩国首尔国立大学医院连续217例接受3层内窥镜吻合钉闭塞治疗的患者的数据。术后胰瘘（POPF）根据国际胰瘘定义研究小组进行分级。根据闭合长度（CL）将订书机分组（I组：CL≤1.5？mm，II：1.5 mm POPF在130（59.9％）名患者中发生（A级; n == 86 [66.1％]，B; n α＝α44[33.8％]），每个订书机组分别为46、101和70，在POPF病例中平均厚度更高（15.2？mm对13.5？mm，P？= 0.002）。体重指数（P <= 0.003），胰腺厚（P = 0.011）和高CR（P = 0.024）是多因素分析中POPF的独立危险因素，胰腺厚度分为17？mm。胰腺厚度P≥0.035）。胰腺厚度最佳的订书机盒
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