Conclusion
Our data support the assumption that DP can now be performed without significant mortality (i.e., 1.6% in our analysis). However, the morbidity after DP is still high due to the occurrence of POPF. By selective stitched ligation of the pancreatic duct and fish-mouth closure of the pancreatic remnant, a low POPF rate comparable to the results in the literature could be achieved. Chronic inflammation of the pancreatic remnant should be considered a risk factor for POPF during the intraoperative decision process for stump closure, and maybe an anastomosis of the remnant to the small intestine, e.g. using a jejunal limb, should be considered in these cases.