In this retrospective multicenter analysis the authors presented a series of 280 patients in whom distal pancreatectomy for primary RPS was performed. The study identified three major findings. First, it showed that the rate of major complications and clinically relevant postoperative pancreatic fistula (POPF) after distal pancreatectomy for primary RPS compares favorably with studies evaluating distal pancreatectomy for primary pancreatic disease and that these postoperative complications do not have an impact on overall survival. Second, it showed that factors to mitigate POPF were not successful and that further research is needed to develop better techniques to avoid this complication. Third, it showed that the pancreas is commonly invaded by RPS.

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