This randomized controlled trial investigates the safety and efficacy of injecting N-butyl-2- cyanoacrylate (Histoacryl®) into the pancreatic parenchyma during pancreaticoduodenectomy (PD) to enhance the security of the pancreaticojejunostomy (PJ) anastomosis and reduce postoperative pancreatic fistula (POPF) rates.
Patients undergoing pancreaticoduodenectomy for malignant lesions meeting the curative treatment intent in accordance with clinical guidelines.
Soft pancreatic texture.
Small main pancreatic duct diameter (<3 mm).
Informed consent obtained.
Known hypersensitivity to cyanoacrylate or Lipiodol®.
Extremely hard, fibrotic pancreas.
Significant pancreatitis involving the pancreatic remnant.
Active infection at the surgical site.