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EUS-Guided Biopsy for Pancreatic Cysts: Key Outcomes and Risks

EUS-guided through-the-needle biopsy (EUS-TTNB) offers valuable diagnostic insights for pancreatic cysts but carries significant risks that surgeons must navigate.

  • Diagnostic adequacy is high at 80.3%, with changes in management seen in 16.3% of cases.
  • Adverse events (AEs) occurred in 20.9% of procedures, predominantly acute pancreatitis (15%).
  • Intraductal papillary mucinous neoplasm (IPMN) significantly raises AE risk (OR 2.24).

Surgeons should use a risk stratification model to enhance patient selection and mitigate complications.

  • Risk categories: low (11.9% AE), moderate (20.6% AE), high (37.0% AE for patients with IPMN).

Journal Article by Lee HS, Song TJ (…) Seo DW et 3 al. in Gastrointest Endosc

Copyright © 2026 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

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Smaller Staplers Safe in Esophagojejunostomy Outcomes

Using smaller circular staplers in esophagojejunostomy does not harm patients’ quality of life post-surgery.

  • No differences were found in quality-of-life scores between patients using small vs. large staplers.
  • Anastomotic lumen diameter had no impact on quality-of-life outcomes.

Surgeons can confidently select smaller staplers when anatomical constraints arise without compromising patient recovery.

  • Findings challenge the notion that larger stapler sizes are essential for better postoperative outcomes.

Journal Article by Yazdi SAM, Chinisaz F (…) Sahebi L et 2 al. in Ann Surg Oncol

© 2026. Society of Surgical Oncology.

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Laparoscopic Surgery Reduces Complications for Strangulated SBO

Laparoscopic surgery may significantly lower postoperative complications in patients with strangulated small bowel obstruction (SSBO).

  • Complications (Clavien-Dindo grade ≥ II) were 7.4% with laparoscopy versus 29.6% for open surgery (p = 0.036).
  • Conversion to open surgery occurred in 25.6% of laparoscopic cases, primarily in those with prior laparotomies or gastrointestinal surgeries.

Surgeons should consider laparoscopic approaches but assess patient history carefully to anticipate the need for conversion.

Journal Article by Kobayashi T, Suda R (…) Kawachi S et 15 al. in World J Surg

© 2026 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).

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Navigating Challenges in Emergency Surgery for Older Adults

Surgeons need to recognize unique diagnostic hurdles when treating older adults in emergency general surgery, as these can lead to worse outcomes.

  • Key challenges identified include atypical presentations, multiple comorbidities, and age-related complications.
  • Emphasis on non-diagnostic factors like functional health, patient preferences, and family involvement must not be overlooked.

Tailoring strategies, like using surgical risk calculators and multidisciplinary teams, could enhance diagnostic accuracy.

  • Practitioners highlighted barriers to implementing these tools, signaling a need for quality improvement in surgical care for this demographic.

Journal Article by Liu JK, Peters XD (…) Ko CY et 3 al. in World J Surg

© 2026 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).

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ESD outperforms TEM for early rectal tumors in cost-effectiveness.

  • ESD showed a significant net monetary benefit of €1,797 for complete resection at one year.
  • The en-bloc excision rate was higher with ESD (99%) compared to TEM (92.5%).

Choosing ESD could enhance surgical outcomes while managing costs effectively.

  • Disease-free survival was better with ESD at 94.3%, versus 84.6% for TEM.

Journal Article by Beyer-Berjot L, Delettrez C (…) Lepilliez V et 33 al. in Gastroenterology

Copyright © 2026 AGA Institute. Published by Elsevier Inc. All rights reserved.

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New Machine Learning Model Enhances Open Surgery Skill Assessment

Surgeons can now assess open surgical skills more accurately with a novel machine learning model.

  • Achieved an 80.1% mean F1 score, surpassing previous assessment methods.
  • Novice classification accuracy reached 90.1%, while proficient levels scored 86.3%.

Consider using this model for objective skill evaluation in training to ensure higher surgical quality and patient safety.

  • The model predicts skill levels in just 10.2 seconds per video, streamlining assessments.

Journal Article by Alipour A, Balian J (…) Benharash P et 4 al. in BMC Surg

Copyright © 2026 The Author(s). Published by Elsevier Inc. All rights reserved.

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Robotic Pancreatoduodenectomy Implementation Shows Promise

A new robotic pancreatoduodenectomy program demonstrates safe implementation with improved outcomes.

  • 79.5% of post-implementation surgeries were robotic with a conversion rate of 19.4%.
  • Median length of stay decreased from 8 days to 5 days (p < .0001), while maintaining similar complication and mortality rates.

Surgeons can consider a liberal patient selection approach without sacrificing patient safety or recovery time.

  • Fewer pancreatic fistulas were noted post-implementation (-12.3%, p = .02).

Journal Article by Fong ZV, Stucky CC (…) Wasif N et 9 al. in BMC Surg

Copyright © 2025 The Author(s). Published by Elsevier Inc. All rights reserved.

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Sustainable Choices Slash Costs in Colorectal Surgery

Shifting to reusable instruments in colorectal surgeries can save money and help the environment.

  • Total savings across 65 laparoscopic resections: £14,239.03.
  • Reusable harmonic devices offered savings of £24.7k-£28.5k and were cost-effective across various scenarios.

Prioritize reusable textiles, which consistently outperformed disposables.

  • Reusable ports showed no cost savings and should be evaluated against current pricing before implementation.

Journal Article by Aseem R, Lodhia S, Rockall T and Jackson D in BMC Surg

Copyright © 2025 Elsevier Inc. All rights reserved.

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Indocyanine Green Reduces Anastomotic Leaks in Colorectal Surgery

Indocyanine green fluorescence significantly lowers anastomotic leak rates in colorectal surgery, crucial for surgical decision-making.

  • Patients who received ICG had a 36% lower rate of anastomotic leaks compared to those with standard white light (OR=0.64; p<0.0001).
  • Surgical strategy changes were more frequent in the ICG group (OR=7.50; p=0.02), indicating adaptability in approach.

Consider implementing ICG, especially for left-sided and rectal resections, to enhance patient outcomes.

  • No differences observed in reoperation rates (OR=0.94; p=0.64).

Review by Maroli A, Paoluzzi Tomada E (…) Spinelli A et 6 al. in Surg Endosc

© 2026. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Radical Surgery Insights for Adenocarcinoma of Esophagogastric Junction

Prioritizing lymphadenectomy and specific surgical approaches improves outcomes in patients with adenocarcinoma of the esophagogastric junction.

  • In a study of 2,044 patients, neoadjuvant therapy lowered lymph node metastasis rates overall.
  • Total gastrectomy resulted in fewer complications (14.8%) compared to proximal gastrectomy (21.0%; p=0.001).

Laparoscopic approaches facilitated faster recovery without increasing complications (16.5% vs 17.3%).

  • High lymph node metastasis was found primarily in abdominal stations, underscoring the need for thorough abdominal lymphadenectomy.

Journal Article by Zheng J, Li Y (…) Li Y et 41 al. in Gut

© Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.

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