Preoperative endoscopic injection of botulinum toxin (BTX) into the sphincter of Oddi (SO) was safe and feasible in patients undergoing distal pancreatectomy (DP).
BTX injection did not reduce the rate of clinically relevant postoperative pancreatic fistula (POPF) grades B/C or 30-day mortality compared to control.
The PREBOTPilot randomized controlled trial was prematurely terminated due to futility after interim analysis.
Findings do not support routine use of SO BTX injection for POPF prevention following DP.
