High rates of fragmented practice in hepatopancreatic surgery were associated with increased odds of postoperative complications, extended length of stay, 90-day mortality, and lower likelihood of achieving a textbook outcome. This negative impact persisted regardless of surgeon volume and was more pronounced among female surgeons. Treatment by surgeons with higher fragmented practice also led to […]
Category: General Surgery
Predicting Postoperative Outcomes in Perforated Peptic Ulcers: Charlson’s Index Versus PULP Score
Comparing Charlson’s Weighted Index of Comorbidity (WIC) and other predictive scores in patients with perforated peptic ulcers revealed WIC’s valuable predictability for mortality. Both WIC and the Peptic Ulcer Perforation (PULP) score effectively predicted high comprehensive complication index (CCI) in these patients. Factors such as age, sex, comorbidities, and ASA score >2 were associated with […]
Limited Utility of Routine Upper Gastrointestinal Series Post-bariatric Surgery
Routine upper gastrointestinal series post-bariatric surgery showed limited value in detecting leaks. Out of 135 patients, 23% underwent imaging, with gastric bypass patients having higher rates of complications. The sensitivity and specificity for leak detection in gastric bypass patients were high, but the positive predictive value was low. Sleeve gastrectomy patients and males were less […]
Weight Loss Outcomes of Banded One-Anastomosis Gastric Bypass
The study compared the weight loss outcomes and safety profiles of Banded One-Anastomosis Gastric Bypass (BOAGB) with other bariatric procedures. Despite a longer surgery duration, BOAGB showed favorable weight loss outcomes and weight maintenance at 1 year post-surgery, with no significant differences in complications compared to other procedures. All bariatric procedures led to significant excess […]
Risk Factors for Perforation in Gastric Endoscopic Submucosal Dissection
Study identified risk factors for intraoperative and delayed perforations in gastric endoscopic submucosal dissection for early gastric cancer. Intraoperative perforation occurred in 2.2% of patients, necessitating emergency surgery in 0.04% of cases, while delayed perforation occurred in 0.4% of patients, with emergency surgery required in 0.12% of cases. Factors like location in upper or middle […]
Expert Tips for Successful Direct Percutaneous Endoscopic Jejunostomy (DPEJ) Tube Placement
Direct percutaneous endoscopic jejunostomy (DPEJ) offers stable enteral access, especially for patients intolerant to gastric feeding. This article identifies risk factors for complications and provides top tips for successful DPEJ placement. Despite being less commonly taught, DPEJ demonstrates advantages over other feeding tube methods, including greater stability, reduced risk of clogging, and improved nutrient delivery. […]
Long-term outcomes of laparoscopic surgery for very low rectal cancers: high anus preservation and moderate functional outcomes
Patients undergoing laparoscopic surgery for stage I ultra-low rectal cancers near the anal verge showed a 3-year local recurrence rate of 6.3%. Anus-preserving surgery was successful in 93% of cases, leading to high rates of functional preservation, with moderate improvements in anal function and acceptable incontinence scores. Urinary function recovered rapidly post-surgery, but sexual function […]
Comparison of Short- and Long-Term Outcomes After Resection for Advanced Pancreatic Cancer
Patients with locally advanced pancreatic cancer (LAPC) who underwent resection following induction therapy showed comparable postoperative pancreas-specific complications, mortality, disease-free interval, and overall survival rates as those with (borderline) resectable pancreatic cancer ((B)RPC). Laparoscopic patients had a higher rate of delayed gastric emptying post-surgery compared to (B)RPC patients, but overall outcomes were similar between the […]
NICE Guidelines Emphasize Barrett’s Oesophagus Surveillance
NICE guidance emphasizes the importance of monitoring Barrett’s oesophagus due to its link to oesophageal adenocarcinoma. Risk factors include acid reflux symptoms, obesity, male gender, smoking, and family history. Surveillance allows for early detection and intervention, leading to excellent prognoses for dysplasia and stage I cancer. Endoscopic techniques are crucial for accurate staging and eradication […]
Successful Robotic Ultrasound-Guided Central Pancreatectomy for Intraductal Papillary Mucinous Neoplasm
A parenchymal-sparing central pancreatectomy was performed with robotic assistance and intraoperative endoscopic evaluation of the main pancreatic duct. The procedure had a relatively short operative time of 290 minutes and minimal blood loss. Despite a postoperative complication requiring angioembolization and drainage, the patient was discharged on day 22 with good long-term outcomes, demonstrating the effectiveness […]