Closure of the Pancreatic Remnant after Distal Pnacreatectomy A prospective randomized controlled trial

INTERVENTION: placement of a collagen patch on the sutured or stapled pancreatic remnant, with a sutured/stapled closed pancreatic remnant as control. CONDITION: Chronic pancreatitis, Pancreatitis ; ; PRIMARY OUTCOME: development of pancreatic fistula SECONDARY OUTCOME: mortality ; ; morbidity ; ; costs INCLUSION CRITERIA: ‐ Age above 18 years ‐ Expected survival time more than 12 months ‐ WHO Karnofsky performance status >50% / ASA I‐II ‐ Patients with chronic pancreatitis, cystic pancreatic lesions, malignant pancreatic lesions and neuroendocrine tumors located in the body or tail of the pancreas. ‐ patients who are planned to undergo distal pancreatectomy as part of an extensive resection for other malignancies (i.e. sarcoma, GIST, gastric carcinoma). ‐ written informed consent