title: DISCOVER trial- Distal resection of the pancreas with or without coverage of the pancreatic remnant: study protocol of a randomised controlled trial.
abstract: BACKGROUND
  Distal pancreatectomy for benign and malignant tumours is the second most common surgical procedure on the pancreas. Postoperative pancreatic fistulas (POPF) represent the most significant clinical complication, causing prolongation of hospital stay and the need for additional diagnostic and therapeutic procedures. Although various techniques for preventing POPF have been evaluated, to date, there is no available technique that ensures closure of the pancreatic remnant.
  
  
  METHODS
  DISCOVER will aim to investigate differences in the postoperative course after a distal pancreatectomy comparing the standard surgical technique with an alternative technique that provides additional coverage of the pancreatic remnant by the falciform ligament. The primary endpoint of this trial will be the rate of POPF. As secondary endpoints, incidence of postoperative morbidity and mortality, length of hospital stay, and quality of life will be assessed.DISCOVER is a single-centre, randomised, controlled surgical trial. For statistical analysis, a binary logistic regression model will be used. With a level of significance of 5% and a power of 80%, a sample size of 75 patients per group has been identified as necessary.
  
  
  CONCLUSIONS
  The findings of this trial will help to evaluate the usefulness of the coverage procedure at reducing the rate of POPF. The results could influence the standard procedure for remnant closure after distal pancreatectomy.
  
  
  BACKGROUND
  Clinical trials register (DRKS-ID: DRKS00000546).
authors: Matthias
authors: M
authors: Hassenpflug
authors: Thomas
authors: T
authors: Bruckner
authors: Philip
authors: P
authors: Knebel
authors: Markus K
authors: MK
authors: Diener
authors: Markus W
authors: MW
authors: Büchler
authors: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany. jens.werner@med.uni-heidelberg.de.
authors: Jens
authors: J
authors: Werner
mesh_terms: D015982:Bias; D002985:Clinical Protocols; D003625:Data Collection; D006801:Humans; D016015:Logistic Models; D010180:Pancreatectomy / Q000009:adverse effects / Q000379:methods*; D010185:Pancreatic Fistula / Q000517:prevention & control; D011183:Postoperative Complications / Q000517:prevention & control; D018401:Sample Size