“…The study defined patients as high-risk based on the ISGPS definition ( 7 ). However, this relies on subjective assessment of pancreatic texture, which is an important limitation, and it may have been more appropriate to use an objective risk score (e.g., alternative Fistula Risk Score or Birmingham Risk Score) ( 8 , 9 ). The operating surgeon’s experience is likely to be a major factor in determining the incidence and severity of POPF, although the evidence to support this hypothesis is relatively limited.…”