Intrapapillary Botulinum Toxin Injection for PREvention of Post-surgical PAncREactic Fistula

Inclusion Criteria: * Patients with scheduled distal pancreatectomy for any indication: open or laparoscopic distal pancreatectomy with or without splenectomy * Age ≥ 18years Exclusion Criteria: * History of myasthenia gravis or Eaton-Lambert syndrome * Inflammatory myositis \<2 years or preexisting motor neuron disease or neuropathies * ASA score \> III * Pregnancy or lactation * Altered anatomy of the duodenum and/or the major papilla (prior surgery, prior endoscopic sphincterotomy) * Scheduled pancreaticoduodenectomy (Whipple procedure) * Scheduled total pancreatectomy * Scheduled central pancreatectomy * Scheduled pancreatic enucleation * Calcified chronic pancreatitis (suspected on preoperative cross-sectional imaging) * Pancreas divisum (suspected on preoperative cross-sectional imaging) * Toxin botulinum contraindications (hypersensitivity to albumin or to saccharose, infection or inflammation at the injection site concerned, generalized muscle weakness) * Preoperative administration of somatostatin analogs: for long-acting somatostatin analogs, a 1-month washout period is necessary; for short-acting somatostatin analogs, a 24-hours washout period is necessary * Any kind of surgical method to reinforce the pancreatic stump: * Use of a bioabsorbable patch * Use of fibrin glue * Use of a ligament patch * Tutorship, trusteeship * Concurrent participation in other experimental trials * Not Affiliation to the French social security * Not Ability to give their consent and not written informed consent * Distal pancreatectomy extended to neighbouring organs (except spleen and gallbladder) or to the vessels (celiac axis, portal vein) Secondary exclusion criteria: patients who did not have the planned surgery in less than 4 weeks after the botulinum toxin injection.