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Risk of Postoperative Pancreatic Fistula Tied to Vein Anatomy

Left gastric vein anatomy impacts the risk of pancreatic fistula after laparoscopic gastrectomy.

  • Among 566 patients, 2.5% developed postoperative pancreatic fistula (POP).
  • Type C vein anatomy (dorsal to the splenic artery) had a 17.9% POP rate, compared to just 1.7% for other types (p < 0.001).

Consider robotic gastrectomy to reduce POP risk, especially in patients with type C anatomy.

  • No POP events occurred after robotic gastrectomy in this study.

Journal Article by Matsumoto Y, Terashima M (…) Bando E 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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Pocket-Creation Method Non-Inferior in Gastric ESD

The pocket-creation method for gastric tumors matches conventional techniques in safety and effectiveness, with fewer subsequent surgeries.

  • Adverse event rates: 14.3% for pocket-creation vs. 12.9% for conventional.
  • Significantly lower need for further surgery in pocket-creation group (2.9% vs. 12.9%, p=0.028).

Consider using the pocket-creation method to reduce follow-up interventions while achieving comparable resection rates.

  • Procedure times are similar: 56.8 min for pocket-creation vs. 59.7 min for conventional.

Journal Article by Lim DH, Sung IK (…) Lee HL et 3 al. in Gastrointest Endosc

Copyright © 2026. Published by Elsevier Inc.

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Enhanced Recovery Program Cuts Colorectal Surgery Stay

Quebec’s new enhanced recovery program significantly reduces hospital stays for colorectal surgery patients while maintaining safety.

  • Median length of stay dropped from 4 to 3 days post-implementation (p<0.001).
  • Complication rates remained stable, with a 5.5% reduction linked to greater adherence to protocols.

Surgeons should prioritize ERAS adherence to optimize patient outcomes and streamline recovery processes.

  • Nearly half of hospitals improved adherence, indicating a need for ongoing quality improvement strategies.

Journal Article by Puterman-Salzman L, Samson E (…) Lee L et 5 al. in J Am Coll Surg

Copyright © 2026 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Ventral Hernia Repair: Onlay Mesh Reduces Risks

Onlay mesh placement significantly lowers the risk of reoperation for recurrence and bowel obstruction after ventral hernia repair.

  • Retromuscular mesh placement and IPOM both showed higher reoperation risks: HR 1.63 and HR 1.38, respectively, compared to onlay.
  • The risk of bowel obstruction was also elevated, with HRs of 2.01 for retromuscular and 3.47 for IPOM.

Surgeons should consider onlay or preperitoneal approaches to minimize complications in primary ventral hernia repairs.

Journal Article by Á Lakjuni Guttesen E, Reistrup H (…) Baker JJ et 3 al. in JAMA Surg

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Inguinal Hernia Repair: Stakeholders Disagree on Success Metrics

Different stakeholders prioritize diverse outcomes after inguinal hernia repair in older adults, impacting surgical practice.

  • Veterans ranked postoperative urinary retention, physical function restoration within two months, and minimizing cognitive dysfunction as key success factors.
  • Surgeons also emphasized returning to normal function in two months but added avoiding inguinodynia.

Understanding these discrepancies can enhance patient-centered care and improve surgical outcomes.

  • Anesthesiologists focused on preventing intraoperative pain and avoiding cognitive dysfunction, while hospital leaders considered readmission critical.

Journal Article by Thornton M, Cher BAY (…) Balentine CJ et 15 al. in BMC Surg

Copyright © 2026. Published by Elsevier Inc.

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Innovative Technique Reduces Tension in Hiatal Hernia Repair

A modified technique using lateral relaxing incisions may improve outcomes in complex hiatal hernia repairs.

  • Recurrence rates in redo patients were 12% and 18% in giant hernia cases.
  • 84% of patients reported symptom improvement, including heartburn.

This approach aims to enable tension-free repairs, particularly for those with high tension risks.

  • Follow-up will assess long-term efficacy and recurrence rates further.

Journal Article by Karunaratne R, Bergmann C (…) Prager MRE et 5 al. in BMC Surg

Copyright © 2026 Elsevier Inc. All rights reserved.

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Comparing ERCP Techniques in Billroth II Gastrectomy

Forward-viewing endoscopy with a cap shows similar efficacy to side-viewing duodenoscopy for ERCP in Billroth II patients.

  • No significant differences in biliary cannulation or clinical success rates between the two techniques.
  • Adverse event rates were comparable; however, post-ERCP pancreatitis rates were higher with the forward-viewing approach (14.5% vs 6.7%).

Surgeons should interpret these findings cautiously due to limited sample sizes and consider patient selection when choosing techniques.

  • Larger studies are needed for clearer insights into the safety and efficacy of these approaches.

Review by de Carvalho Bertaccini Guriam G, Pornchai A, Dutra LP and de Araujo E Sousa AM in Gastrointest Endosc

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

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Improved Peritoneal Disease Detection in Advanced Gastric Cancer

Staging laparoscopy reveals peritoneal disease in over half of advanced gastric cancer patients, enhancing surgical decision-making.

  • Peritoneal disease was found in 54.9% of patients undergoing staging laparoscopy, with positivity rates of 61.7% in type 4 lesions.
  • The sensitivity and specificity of staging laparoscopy were 94.6% and 100%, respectively, demonstrating high diagnostic accuracy.

The four-factor predictive score aids in patient selection, increasing the potential to tailor surgical interventions based on individual risk.

  • Risk factors include elevated CA19-9 and CA125 levels and specific tumor histologies, with disease incidence ranging from 32.4% to 100% based on score.

Journal Article by Kudou K, Irino T (…) Nunobe S et 2 al. in Br J Surg

© The Author(s) 2026. Published by Oxford University Press on behalf of BJS Foundation Ltd. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.

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Plastic and Metal Stents Show No Survival Difference in Pancreatic Cancer

Stent choice for preoperative biliary drainage in pancreatic cancer does not affect long-term survival.

  • Among 6,429 patients, overall and recurrence-free survival were similar for plastic (PS) and metal stents (MS) after pancreaticoduodenectomy, even in those receiving neoadjuvant therapy.
  • No significant difference in postoperative complications between PS and MS.

Choose stents based on drainage duration and treatment approach, not survival expectations.

  • Secondary analysis showed no survival differences between endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic biliary drainage (PTBD).

Journal Article by Nagai K, Hirakawa S (…) Masamune A et 15 al. in Gastrointest Endosc

Copyright © 2026. Published by Elsevier Inc.

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Prehabilitation Shows Promise in Abdominal Cancer Surgery

Multimodal prehabilitation may enhance baseline immune function in patients before abdominal cancer surgery, but its effect on postoperative immune outcomes appears limited.

  • In a study of 130 patients (102 prehabilitation, 28 control), prehabilitation reduced pro-inflammatory cytokines and increased IL-10 levels.
  • No significant immune function differences were noted on postoperative day 1 between groups.

This suggests prehabilitation might optimize pre-surgical readiness, but benefits for postoperative immune response may not be substantial.

Journal Article by Jacobs LMC, Drager LD (…) Warlé MC et 6 al. in Br J Surg

© The Author(s) 2026. Published by Oxford University Press on behalf of BJS Foundation Ltd.

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