Menonna F, Napoli N, Kauffmann EF, et al. - As postoperative pancreatic fistula frequently occur after pancreatoduodenectomy, researchers here described a modification of the Blumgart pancreaticojejunostomy and compared it with the Cattel-Warren pancreaticojejunostomy in cohorts of patients matched by propensity scores based on factors predictive of clinically relevant postoperative pancreatic fistula. They identified 415 pancreatoduodenectomies from October 2011 to May 2019; these were performed with either a Cattel-Warren pancreaticojejunostomy (n = 225) or a modification of the Blumgart pancreaticojejunostomy (n = 190). Following exclusion of robotic pancreatoduodenectomies (the Cattel-Warren pancreaticojejunostomy: 82; modification of the Blumgart pancreaticojejunostomy: 66), 267 open pancreatoduodenectomies remained, among which 109 pairs were identified with the matching process. Outcomes suggest non inferiority of the modification of the Blumgart pancreaticojejunostomy to the Cattel-Warren pancreaticojejunostomy in open pancreatoduodenectomy with respect to clinically relevant postoperative pancreatic fistula, grade B postoperative pancreatic fistula, and grade C postoperative pancreatic fistula as well as to all secondary study endpoints. In addition, the technique is feasible in robotic pancreatoduodenectomy.