Author: STITCHES Newsletter

Recommendations for Enhancing Surgical Education

A Blue Ribbon Committee II has identified key challenges in surgical education and proposed recommendations to improve medical student training. The subcommittee conducted a comprehensive literature review to inform its strategies, which address recruitment, surgical engagement, and the transition from undergraduate to graduate medical education. Major shifts in medical education and surgical practice over the […]

Guidelines for Metabolic and Bariatric Surgeons

A consensus was achieved among 89 international metabolic and bariatric surgeons on 29 of 30 statements regarding the prerequisites for practicing metabolic and bariatric surgery (MBS). Key criteria include holding a general surgery degree, completing a dedicated fellowship, and proficiency in managing postoperative complications. The learning curve for various MBS procedures was defined, ranging from […]

No-drainage policy enhances patient outcomes after distal pancreatectomy

A systematic review covering 3,610 patients undergoing distal pancreatectomy reveals that a no-drainage approach significantly reduces complications. The odds of postoperative pancreatic fistula decreased to 0.38, while major morbidity, readmissions, and reinterventions also showed considerable reduction (odds ratios of 0.64, 0.69, and 0.70, respectively). Additionally, patients experienced a shorter hospital stay by an average of […]

Bile microRNAs can effectively distinguish between disease types.

A cohort study identified specific bile microRNAs (miRNAs) that differentiate malignant from benign pancreaticobiliary diseases. Among 111 patients, 14 differentially-expressed miRNAs were identified, with bile miR-340 and miR-182 significantly validated. The study achieved an area under the curve (AUC) of 0.79, demonstrating sensitivity of 65% and specificity of 82% in predicting malignancy. These findings underscore […]

Biodegradable prosthesis shows promise for bile duct replacement

Development of a biodegradable prosthesis utilizing electrospun poly(d,l-lactide-co-glycolide)-polycaprolactone-gelatin nanofibers successfully demonstrated mechanical strength, biocompatibility, and biodegradability in a pig model. This innovative scaffold maintained bile duct permeability and facilitated cell adhesion and growth without adversely affecting liver function over two years. Notably, immunohistochemical evaluations confirmed the presence of biliary epithelium, showcasing the scaffold’s potential for […]

A grading system improves patient selection for minimally-invasive pancreatoduodenectomy

The ISGPS developed a complexity and experience grading system for minimally-invasive pancreatoduodenectomy (MIPD), aimed at enhancing patient selection. This system categorizes patient risk factors and surgeon experience, enabling optimal decision-making for safe MIPD implementation. It assesses anatomical and conditional risks alongside surgeon experience and center volume. By employing this evidence-based approach, the grading system facilitates […]

Alvimopan reduces postoperative ileus and hospital stay duration.

A systematic review and meta-analysis analyzing 94,833 patients revealed that alvimopan significantly lowers the risk of postoperative ileus (odds ratio: 0.57) and shortens hospital stays in individuals undergoing bowel resection. These findings strongly support the routine incorporation of alvimopan into enhanced recovery after surgery programs for open bowel resections. Further investigation is required to explore […]

Novel predictive model improves risk assessment for hemorrhage

A new lasso-logistic regression model was developed and validated, identifying nine independent risk factors for postpancreatectomy hemorrhage among 9,631 patients across two cohorts. The model demonstrated strong predictive accuracy, achieving an area under the receiver operating characteristic curve of 0.87 during external validation, significantly outperforming previous prediction models (p

Early surgery after 3 months of neoadjuvant therapy best for pancreatic cancer.

In a study of 282 patients with borderline resectable pancreatic cancer, those undergoing neoadjuvant treatment (NAT) followed by surgery exhibited the best overall survival (OS) of 35 months compared to 23 months for upfront surgery and 16 months for chemotherapy only. Patients receiving at least 3 months of NAT showed significantly improved OS, while those […]