• In a study of 2,183 patients, postoperative pancreatic fistula (POPF) occurred in 32.9% of hand-sewn closures versus 21.0% for stapler closures.
• The reoperation rate was higher and hospital stays longer for hand-sewn patients.

Surgeons should consider stapler closure to reduce POPF risk and improve patient outcomes.

• Findings were consistent across various pancreatic characteristics, reinforcing the need to evaluate closure techniques critically.