Category: General Surgery

Global Discrepancies in Metabolic and Bariatric Surgery Guidelines and Coverage

Analysis of worldwide IFSO survey on metabolic and bariatric surgery (MBS) indicates that 74.6% of national societies have MBS guidelines, with 34% adopting the latest ASMBS/IFSO 2022 guidelines. However, 22% still follow outdated NIH 1991 recommendations. Financial coverage for MBS is present in 65% of countries, highlighting the need for standardization of indications and increased […]

Identification of Difficulty Scores for Robotic Hepatectomy Using Tampa Difficulty Score System

Researchers developed and validated a novel Difficulty Score System for robotic hepatectomy based on 274 patients. Factors such as neoadjuvant chemotherapy, tumor characteristics, extent of resection, and additional procedures were associated with operative time and blood loss, resulting in difficulty scores ranging from 1 to 49. The patients were grouped into different levels of difficulty, […]

Successful Surgical Management of Sigmoid Gallstone Ileus Resulting in Patient Discharge

Researchers report a successful case of a 90-year-old woman with a 6 cm gallstone causing sigmoid colon obstruction. Despite deferring colonoscopy due to gallstone size, urgent laparotomy for gallstone removal resulted in uneventful post-operative recovery and discharge on the 6th day. The study highlights the importance of multidisciplinary discussions between endoscopists and surgeons for optimal […]

Novel Prognostic Role of Tumor Microbiome in Intrahepatic Cholangiocarcinoma

Characterization of the tumor microbiome in intrahepatic cholangiocarcinoma revealed a higher diversity than in adjacent nontumoral liver tissues, with increased abundance of specific bacterial groups. Higher tumor microbial diversity was linked to lymph node metastasis and predicted shorter overall and recurrence-free survival. A risk score formulated from 11 selected bacteria could independently predict overall survival, […]

Reduced Gas Embolism with Low Pneumoperitoneum Pressure in Laparoscopic Liver Resection

Low pneumoperitoneum pressure reduces the incidence and duration of severe gas embolism during laparoscopic liver resection, leading to steadier hemodynamics, vital signs, and overall improved patient outcomes. Group L, with low pressure, showed significantly fewer cases of severe gas embolism, shorter duration of embolism episodes, and less physiological stress compared to Group S with standard […]

Non-Therapeutic Laparotomy in Locally Advanced Pancreatic Cancer has Limited Impact on Survival

Non-therapeutic laparotomy occurred in 28.2% of patients with locally advanced pancreatic cancer after induction (m)folfirinox, with no significant difference in overall survival or palliative therapy compared to those who did not undergo surgery. The 5-year overall survival rates were 11.4% for group a (laparotomy), 8.7% for group b (no surgery), and 24.7% for group c […]

Comparable Efficacy of Lumen Apposing Metal Stents vs. Balloon Dilation for Benign Colorectal Anastomotic Strictures

Lumen apposing metal stents (LAMS) appear to be as effective as endoscopic balloon dilation (EBD) for treating benign colorectal anastomotic strictures (BCAS), with a potential for requiring fewer procedures and being safer. Twenty-nine patients were involved, showing no significant differences in outcomes between LAMS and EBD, but a trend towards fewer procedures and adverse events […]

Understanding Functional Disorders in Ileal-Anal Pouch

Functional disorders in the ileal-anal pouch present a spectrum of symptoms, some expected and others related to surgical complications. Studies have attempted to define and measure normal pouch function, but few have addressed pouch physiology. The confusion surrounding pouch function highlights the need for a better understanding of expected changes in defecation physiology post-surgery. Identifying […]

Impact of Endoscopic Surgical Skill Qualification on Conversion to Laparotomy in Rectal Cancer Patients

Participation of ESQS-certified physicians was associated with lower risk of both indicated and technical conversion to laparotomy for rectal cancer patients undergoing laparoscopic surgery. Other factors influencing conversion included tumor diameter, combined resection of adjacent organs, and institution type. Referral to specialized centers, especially for high-risk patients, may improve outcomes. Journal Article by Goto K, […]

The Lethal Triad: Acute Cholecystitis, Obesity, and Steatohepatitis Increase Bile Duct Injury Risk

The study analyzed 387,501 laparoscopic cholecystectomy cases from the NSQIP registry and found that the presence of the lethal triad (acute cholecystitis, obesity, and steatohepatitis) significantly increased the risk of bile duct injury (BDI) by over 15-fold. Those with the triad had a BDI incidence rate of 1.49% compared to 0.09% in those without. This […]