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Guidance for Better Liver Surgery Care

New European consensus offers critical updates on liver resection management.

  • Strong recommendations include prehabilitation and early mobilization.
  • Evidence gaps identified in perioperative thromboprophylaxis and post-hepatectomy liver failure management.

Standardizing practices and expanding multicenter studies are essential to enhance surgical outcomes.

  • Only 32 statements reached consensus from over 200 publications, revealing variability in evidence strength.

Consensus Development Conference by Maier E, Stättner S (…) Maglione M et 43 al. in Br J Surg

© The Author(s) 2025. Published by Oxford University Press on behalf of BJS Foundation Ltd.

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Minimally invasive surgery reduces loss of independence after pancreatoduodenectomy in the elderly.

  • 22 patients (16.7%) over 65 experienced loss of independence after surgery, compared to none under 65.
  • Key risk factors include age ≥80 years, sarcopenia, and open surgical approach.

Identifying these factors can enhance patient selection and surgical decision-making.

  • A loss of independence score was developed, showing a strong correlation with the incidence of loss of independence (p < 0.001).

Journal Article by Nara A, Ueda H (…) Ban D et 6 al. in Surg Endosc

© 2025. The Author(s).

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New Scoring Tool Predicts 30-Day Mortality in Emergency Laparotomy

Surgeons can now leverage a validated scoring system to predict 30-day mortality rates in emergency laparotomy patients, improving decision-making and resource allocation.

  • The model included 12 preoperative factors: ASA grade, cardiovascular disease, serum creatinine, preoperative sepsis, and follow-up surgery.
  • It achieved a cross-validated AUROC of 0.7922, indicating strong predictive capability.

This tool enhances risk stratification and is applicable even in resource-limited settings; external validation will confirm its utility in diverse surgical practices.

Journal Article by Kuchuru R, Sundaramurthi S (…) Muthukumar RS et 4 al. in ANZ J Surg

© 2025 Royal Australasian College of Surgeons.

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New Wound Protector Cuts SSI Risk in Abdominal Surgery

A novel wound protector, Viclean®, helps reduce surgical site infections by preventing contamination during open abdominal procedures.

  • In emergency cesarean sections, Viclean® rapidly diverted amniotic fluid, safeguarding the incision.
  • During elective left hemicolectomy, enteric effluent was effectively managed, keeping wound edges clean and dry.

This innovative device is positively reviewed by surgical teams and is now authorized in over 20 countries, though not yet available worldwide.

Journal Article by Qian J, Xiong Y (…) Xu S et 2 al. in Surg Innov

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New Consensus Guidelines for Peritoneal Mesothelioma Care

A recent consensus on managing peritoneal mesothelioma reaffirms critical treatment strategies.

  • Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is the standard for completely resectable cases.
  • Strong agreement on using cisplatin-doxorubicin for HIPEC in routine care and performing a total parietal peritonectomy for all patients.
  • Neoadjuvant chemotherapy recommended for patients with sarcomatoid or biphasic subtypes and specific disease characteristics.

These guidelines enhance decision-making frameworks for improved patient outcomes in surgical practice.

Journal Article by Chatterjee A, Rajagopal AK (…) Bhatt A et 9 al. in Indian J Surg Oncol

© The Author(s), under exclusive licence to Indian Association of Surgical Oncology 2025. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

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Left-Sided Stoma Cuts Outlet Obstruction in Ulcerative Colitis

Left-sided ileostomy during ileal pouch-anal anastomosis significantly lowers stoma outlet obstruction rates in ulcerative colitis patients.

  • Obstruction incidence dropped to 9.8% with left-sided stomas, compared to 31.1% on the right (p = 0.0004).
  • Left-sided placement is a protective factor (odds ratio 0.24; p = 0.001) and leads to shorter hospital stays (median 22 days vs. 33 days with obstruction, p < 0.001).

Consider revising stoma placement to enhance surgical outcomes and reduce complications.

Journal Article by Kuwahara R, Uchino M (…) Ikeuchi H et 5 al. in Dis Colon Rectum

Copyright © The ASCRS 2025.

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Fluid Management Revolution in Pancreaticoduodenectomy

Fluid management impacts outcomes in pancreaticoduodenectomy for localized cancer.

  • Excessive fluid can lead to complications like postoperative pancreatic fistula and increased inflammatory responses.
  • A shift towards restrictive fluid regimens has shown to reduce overall complications and shorten hospital stays.
  • Goal-directed fluid therapy (GDFT) tailors fluid delivery, improving outcomes but requires careful balance to avoid hypoperfusion.

Future studies must aim for standardized protocols and long-term data to refine practices.

Review by Grim M, Zheng R (…) Nevler A et 3 al. in J Gastrointest Surg

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

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Impact of Lipid Levels on Recurrent CBD Stones Post-ERCP

Higher cholesterol and HbA1c levels increase the risk of recurrent bile duct stones after ERCP.

  • Cholesterol and HbA1c >6.5% are key risk factors for recurrence.
  • Triglycerides and HDL levels are protective against stone formation.

Consider lipid management and medications like statins and aspirin in patient care to potentially lower recurrence rates.

  • Study involved 5,132 patients; outcomes vary across different metabolic subgroups.

Journal Article by Wang SF, Wu CH (…) Cheng K et 6 al. in Dig Dis Sci

© 2025. The Author(s).

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Postoperative Ketamine Infusion Cuts Pain and Opioid Use

Postoperative ketamine infusion within ERAS protocols significantly improves pain management and reduces opioid consumption following elective open abdominal surgeries.

  • Pain scores decreased by 0.53 on the VAS scale within the first 24 hours (p < 0.05).
  • Opioid use dropped by 0.44 morphine equivalents during the same period (p < 0.05).

While ketamine had no significant effects on postoperative nausea and vomiting or other adverse events, it shows promise as an effective pain management tool.

  • Further research is needed to determine optimal dosing and administration strategies for best outcomes.

Systematic Review by Molla YD, Setargew KH and Alemu HT in BMC Surg

© 2025. The Author(s).

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Mobile Endoscopy Expands GI Access in Rural South Africa

A mobile endoscopy outreach program significantly improves access to essential gastrointestinal diagnostic services in resource-limited settings.

  • 515 procedures performed, including 94% esophagogastroduodenoscopies.
  • Common diagnoses: gastritis (76%), hiatal hernia (70%), and esophagitis (69%).

This model reduces patient travel from 102 km to an average of just 13.6 km to receive care.

  • Easily replicable in similar resource-limited areas to enhance healthcare access.

Journal Article by Deal M, Karam J (…) Stark H et 5 al. in BMJ Open Gastroenterol

© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.

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