Interval laparoscopic cholecystectomy for cholecystitis with gallstones poses challenges due to factors like impacted stones, post-choledocholithiasis, and older age. A study of 269 patients found that these factors were independent risk factors for conversion to bailout procedures. While bile duct injuries were rare (0.4%), caution is advised for patients with these risk factors during interval […]
Category: General Surgery
Impact of Hospital Readmissions on Healthcare Costs following Robotic Hepatectomy for Neoplastic Disease
Readmission post-robotic hepatectomy correlates with hypertension, higher Child-Pugh scores, and R1 margins. Neoadjuvant chemotherapy is associated with lower readmission rates due to less diffuse liver disease. While not affecting five-year survival, readmissions elevate hospital costs significantly. The study found 44 out of 244 patients were readmitted within 90 days, with risk factors including hypertension, Child-Pugh […]
High Mortality and Predictors of Death in Ileosigmoid Knotting: Insights from a Low-Resource Setting
Ileosigmoid knotting, a severe form of bowel obstruction, carries high mortality in low-resource settings. A retrospective cohort study at Jimma University Medical Center revealed a 27.5% death rate among 40 patients, with shock at presentation and comorbidities significantly impacting survival. Age and intra/postoperative pulse rates were also predictors of death. The study underscores the urgent […]
High Endoscopic Cuffitis Rates Post-Ileal Pouch-Anal Anastomosis: Association with Extensive Disease and Biologic Exposure
Endoscopic cuffitis occurred in approximately 60% of patients who underwent restorative proctocolectomy with stapled ileal pouch–anal anastomosis, and was significantly associated with extensive disease and exposure to multiple biologics before colectomy. Older age, extensive disease, exposure to biologics before colectomy, and exposure to at least 2 or more biologics before colectomy were all significantly associated […]
Tailoring Treatment for Hepatic Adenoma: Subtypes and Molecular Factors
Researchers reviewed advances in diagnosis and management of hepatic adenomas (HA), classified into at least eight subtypes. MRI is the best imaging method for diagnosis and can differentiate among subtypes. HA larger than 5cm have higher risks of bleeding and malignancy and should be resected. A high risk of malignant transformation was found in β-catenin […]
Enhanced Overall Survival and Tumor Reduction in EUS-RFA for Unresectable Pancreatic Adenocarcinoma
Researchers assessed EUS-RFA in 26 patients with unresectable pancreatic ductal adenocarcinoma, showing technical success in all cases and no major adverse events. Six months post-EUS-RFA, 42.3% of patients had improved overall survival and significant performance status enhancement. Tumor reduction and post-treatment necrotic areas were observed, while metastatic disease negatively impacted survival. EUS-RFA proved safe and […]
Successful laparoscopic and robotic s7 segmentectomy using ICG-enhanced compression for hepatocellular carcinoma
ICG-enhanced compression anatomical segment 7 segmentectomy in laparoscopic and robotic approach was successfully performed in two cases of Child-Pugh class A hepatocellular carcinoma. The technique enabled identification and resection of posterosuperior lesions with minimal liver stiffness and no postoperative complications, achieving R0-resection margins and quick patient discharge, showcasing feasibility and reliability for future adoption. Journal […]
Development of a 10-Point Score to Predict Post-Recurrence Survival in Intrahepatic Cholangiocarcinoma
Researchers developed a 10-point score to predict post-recurrence survival (PRS) in patients with intrahepatic cholangiocarcinoma (iCC) following resection. This score successfully stratified patients based on their PRS likelihood, with lower scores associated with higher survival rates. The score included factors like tumor grade, resection margin, and specific tumor markers, providing valuable guidance for treatment decisions […]
Preoperative chemotherapy improves overall survival in liver-limited metastasis from gastric cancer
Preoperative chemotherapy significantly increased overall survival in patients with liver-limited metastasis from gastric cancer who underwent hepatectomy, compared to upfront surgery. Patients who exhibited a partial response to preoperative chemotherapy had better outcomes than those with stable or progressive disease. The preoperative chemotherapy group also had a higher chance of undergoing surgical resection for recurrent […]
Malnutrition and Decreased Phase Angle Predict Postoperative Complications in Oncologic Abdominal Surgery
Preoperative malnutrition and decreased phase angle (< -0.5) on postoperative day 1 were independent predictors of postoperative morbidity in patients undergoing major oncologic upper-GI surgery. Patients with malnutrition had a higher complication rate, and a decline in phase angle was associated with a 13% increase in complication risk. Further investigation is needed to determine if […]