Andrianello S, Marchegiani G, Malleo G, et al. - Researchers investigated if pancreaticojejunostomy or pancreaticogastrostomy, both with externalized transanastomotic stent, is the best reconstruction method for patients at high risk for pancreatic fistula after pancreaticoduodenectomy. At the Department of General and Pancreatic Surgery, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy, from July 12, 2017, through March 15, 2019, they conducted a randomized clinical trial of 72 patients at high risk for pancreatic fistula that combined the use of an externalized stent and prophylactic octreotide omission. Outcomes revealed no significant difference in the rate of pancreatic fistula between cases who underwent a pancreaticojejunostomy (38.9%) vs those who underwent a pancreaticogastrostomy (50.0%). Less severe morbidity and a reduced clinical burden in cases of pancreatic fistula were observed in correlation with pancreaticojejunostomy. Based on these findings, they recommend considering pancreaticojejunostomy with the use of an externalized stent and prophylactic octreotide omission as the most appropriate technical strategy for patients at high risk for pancreatic fistula,.