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Algorithm-based care versus usual care for the early recognition and management of complications after pancreatic resection in the Netherlands: an open-label, nationwide, stepped-wedge cluster-randomised trial.

Smits FJ, Henry AC, Besselink MG, Busch OR, van Eijck CH, Arntz M et al, for the Dutch Pancreatic Cancer Group.

Lancet 2022; 399: 1867-1875.

This multicentre study included 1748 pancreatic resections. Use of the algorithm reduced the composite risk of complications from 14 to 8 per cent, relative risk 0.48, 95 per cent confidence interval 0.38 to 0.61, P<0.0001.

Comment: There is no substitute for specialist care.

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