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Reversible endoscopic bypass shows promise for duodenal leaks

A novel procedure, reversible endoscopic gastroduodenal bypass (REGB), demonstrated 100% technical success in six patients with persistent post-surgical duodenal leaks. Patients experienced significant reductions in drain output and resumed oral intake within three days. Following a mean of 52.6 days, five patients successfully underwent REGB reversal, achieving complete healing of ulcers and absence of leaks. This study indicates that REGB is a promising, minimally invasive option for managing complex duodenal leaks, pending further validation.

Journal Article by Kadkhodayan K, Chandan S (…) Irani S et 11 al. in Endoscopy

The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

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Lactated Ringer’s solution reduces severe pancreatitis risk

A meta-analysis of 1,500 acute pancreatitis patients demonstrated that lactated Ringer’s solution significantly lowers the risk of developing moderate-to-severe pancreatitis compared to normal saline (odds ratio 0.48). Additionally, patients receiving lactated Ringer’s experienced shorter hospital stays, reduced ICU admissions (relative risk 0.42), and fewer local complications (relative risk 0.58). Although there were no significant differences in mortality or organ failure rates, the results suggest lactated Ringer’s offers superior clinical outcomes in fluid resuscitation for acute pancreatitis.

Comparative Study by Zhao T, Kang Z (…) Zhu S et 6 al. in Int J Surg

Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc.

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New Guidelines for Managing High-Risk Acute Cholecystitis Patients

An international consensus established practical guidelines for managing high-surgical-risk patients with acute cholecystitis. Early laparoscopic cholecystectomy is advised as first-line treatment for moderate cases failing conservative management. For high-risk patients with severe cholecystitis, percutaneous cholecystostomy is recommended to alleviate symptoms swiftly, followed by reassessment for surgery. The consensus offers a structured approach to optimize treatment options and improve patient outcomes, addressing gaps in existing management protocols.

Journal Article by Pesce A, Ramírez-Giraldo C (…) Cirocchi R et 29 al. in Int J Surg

Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc.

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Recommended needle size and site for tension pneumothorax decompression

A meta-analysis of 51 studies reveals a 32.84% failure rate for needle decompression in tension pneumothorax. Researchers suggest a 7 cm needle for right-sided decompression at either the 5th intercostal space along the midaxillary line or the 2nd intercostal space midclavicular line. For left-sided cases, they recommend the 2nd midclavicular line to mitigate the risk of cardiac injury. These findings highlight variability and potential biases in existing practices, emphasizing the need for individualized clinical decisions.

Review by Ahmad SJS, Degiannis JR (…) Exadaktylos AK et 50 al. in World J Emerg Surg

© 2025. The Author(s).

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A cost-effective liver retraction technique improves laparoscopic surgery.

Researchers introduced a novel liver retraction approach for laparoscopic right adrenalectomy using basic local tools, enhancing feasibility in resource-limited settings. This technique, featuring a unique port configuration and ergonomic support, was designed to prevent liver injury while ensuring optimal surgical exposure. Its simplicity and cost-effectiveness demonstrate potential for broad adoption in developing countries, addressing challenges associated with procuring specialized instruments, ultimately improving surgical outcomes and operational efficiency in complex procedures.

Journal Article by Bari S, Gaurav K, Anand A and Sonkar AA in J Minim Access Surg

Copyright © 2025 Journal of Minimal Access Surgery.

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Liver resection offers survival benefits over interventional treatments

A multicenter study with 5,774 hepatocellular carcinoma (HCC) patients with hypohepatia revealed that liver resection (LR) provides significant survival advantages compared to ablation and transarterial chemoembolization (TACE). The findings showed that LR led to lower risks of death and disease progression across various subgroups, making it a superior option for selected intermediate to advanced patients. In particular, LR demonstrated better overall survival and disease-free survival rates, highlighting its efficacy over alternative treatment methods.

Journal Article by Zhao S, Zhu Y (…) Liu L et 16 al. in Surg Endosc

© 2025. The Author(s).

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Non-pharmacological interventions significantly reduce surgical site infections.

A systematic review of 11 studies revealed that non-pharmacological interventions in Sub-Saharan Africa significantly decrease surgical site infections (SSI) by 15% to 95%. These interventions included improving adherence to protocols, policy changes, and implementing multimodal strategies. The effectiveness of these approaches varied based on patient characteristics, surgical urgency, and healthcare settings. Notably, multimodal interventions emerged as the most comprehensive and effective method in reducing SSI rates across various surgical populations.

Review by Berhe F, Belachew T and Hassen K in BMC Surg

© 2025. The Author(s).

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Preoperative factors influence risk of permanent stoma after surgery

A study involving 639 rectal cancer patients identified key preoperative risk factors for permanent stoma post-sphincter-preserving surgery. Notably, 11.9% of patients developed a permanent stoma within two years. Factors such as male sex, tumor height, and the presence of synchronous liver or lung metastases were linked to a higher likelihood of stoma permanence. Furthermore, patients with anastomotic leakage had reduced rates of stoma closure, emphasizing the need for tailored preoperative discussions.

Journal Article by Planellas P, Fernandes N (…) Marinello F et 7 al. in Cir Esp (Engl Ed)

Copyright © 2025. Published by Elsevier España, S.L.U.

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Identifying key signs of small bowel strangulation improves diagnosis

Findings indicate that mesenteric edema and abnormal bowel wall thickening serve as sensitive and specific indicators for both non-necrotic and necrotic small bowel strangulation (SBS). In a study involving 141 SBS patients, these indicators were significantly less frequent in cases of simple bowel obstruction. Notably, bowel hypo-enhancement was present in only half of the non-necrotic SBS cases, suggesting that detecting intestinal congestion is crucial for accurate diagnosis, especially when hypo-enhancement is absent.

Journal Article by Yamada T, Aoki Y (…) Yoshida H et 7 al. in Ann Gastroenterol Surg

© 2024 The Author(s). Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterological Surgery.

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Updated risk model enhances prediction for pancreatic surgery outcomes

An updated risk prediction model for pancreaticoduodenectomy was developed using data from 35,365 patients in Japan. The study identified 28 factors for surgical mortality and severe complications, and 14 for postoperative pancreatic fistula. The model demonstrated a favorable predictive capability with area under the curve scores of 0.759 for mortality and 0.712 for complications in the development cohort. This advancement will aid clinicians in anticipating surgical risks and managing patient outcomes effectively.

Journal Article by Mizuma M, Endo H (…) Shirabe K et 6 al. in Ann Gastroenterol Surg

© 2024 The Author(s). Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterological Surgery.

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