Ratnayake CBB, et al. - Given the high incidence of postoperative pancreatic fistula (POPF) after distal pancreatectomy despite the availability of different pancreatic stump closure techniques used to reduce the incidence, researchers performed a network meta-analysis comparing the most commonly used pancreatic stump closure techniques after distal pancreatectomy and examining the technique connected with the lowest POPF rate. The network meta-analysis included 16 RCTs comprising 1,984 patients and eight different pancreatic stump closure techniques. The technique that was identified as the best was patch coverage of the pancreatic stump (round ligament or seromuscular patch) after stapler or suture closure; it led to the lowest rates of clinically relevant POPF, lowest volume of intraoperative blood loss, fewer intra-abdominal abscesses, and lower rates of overall complications and 30-day mortality. They observed round ligament patch closure to perform better than seromuscular patch closure in preventing clinically relevant POPF with a significantly larger cohort for comparative analysis. For most reported postoperative outcomes, consistently poor performance of pancreaticoenteric anastomotic closure was reported.