Blog

Prior Gastrointestinal Infections Dramatically Increase Risk of Post-ERCP Infections

Patients with prior gastrointestinal infections face a significantly elevated risk of post-endoscopic retrograde cholangiopancreatography (ERCP) biliary tract infections (PEBTI). In a cohort study of 1,507 individuals, the incidence was 5.4% among those with prior infections versus 4.2% without. After adjusting for confounders, the hazard ratio rose sharply to 2.71, underscoring the need for enhanced prophylactic measures tailored to this vulnerable group. Robust findings emphasize the importance of addressing preoperative gastrointestinal colonization.

Journal Article by Chen Y, Liu J (…) Li P et 8 al. in J Gastroenterol Hepatol

© 2025 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

read the whole article in J Gastroenterol Hepatol

open it in PubMed

Comorbidities and Age Elevate Non-Operative Management Failure in Adhesive Bowel Obstruction

In a substantial analysis of over 1.6 million adhesive small bowel obstruction cases, failure rates for non-operative management soared with increasing age and chronic health issues. Patients over 65 and those with multiple comorbidities faced notably higher risks, with failure rates climbing from 21% in the absence of comorbidities to 26.5% in affected individuals. Surgical intervention was also more common in older patients, underscoring the need for targeted management strategies for this vulnerable population.

Journal Article by Malkiely G, Paran M, Elgabsi M and Kessel B in J Clin Med

read the whole article in J Clin Med

open it in PubMed

Circulating Tumor DNA Testing Aligns with Tissue Analysis in Pancreatic Cancers

A study of 790 patients with advanced pancreatic ductal adenocarcinoma (PDAC) and cholangiocarcinoma (CC) reveals strong mutation concordance (MCR) between circulating tumor DNA (ctDNA) and tissue next-generation sequencing (NGS). In PDAC, 65.4% showed shared alterations, while CC had 66.7%. Additionally, ctDNA could signal resistant clones: increased TP53 variant frequencies correlated with a greater likelihood of disease progression (OR 7.28). This positions ctDNA as a critical tool for diagnosis and monitoring.

Journal Article by Mahadevia H, Majeed U (…) Babiker H et 21 al. in JAMA Netw Open

read the whole article in JAMA Netw Open

open it in PubMed

New Nomograms Predict Surgical Risks in High-Risk GI Cancer Patients

A novel predictive model offers cancer-specific risk stratification for patients undergoing high-risk upper gastrointestinal surgeries. Analyzing 2,823 patients at Memorial Sloan Kettering, the study identifies key risk factors like age and comorbidities that elevate postoperative complications and length of stay. Notably, neoadjuvant chemotherapy and pre-incision antibiotics were linked to reduced hospital stays. The developed nomograms, with a c-index of 0.66 for complications, empower clinicians with essential tools for patient risk assessment and treatment planning.

Journal Article by Abate M, Lin ST (…) Strong VE et 12 al. in Ann Surg

Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.

read the whole article in Ann Surg

open it in PubMed

Robotic Surgery Outperforms Laparoscopy in Rectal Cancer Resection

A meta-analysis of 7 studies involving over 7,000 patients reveals robotic abdominoperineal resection significantly reduces conversion rates to open surgery (4.8% vs. 12.9%) and minimizes intraoperative blood loss and postoperative complications. Furthermore, there’s a lower incidence of circumferential margin involvement with robotic techniques. While laparoscopic methods offered shorter surgical times, robotic approaches demonstrate superior short-term outcomes crucial for patient care in rectal cancer surgeries.

Journal Article by Colombari RC, Pimenta NDS (…) Tejedor P et 2 al. in BMC Surg

Copyright © 2025 Elsevier Inc. All rights reserved.

read the whole article in BMC Surg

open it in PubMed

Nonoperative management of small bowel obstruction leads to higher readmission and mortality risks

A retrospective analysis of 122,778 patients revealed that nonoperative management (NOM) of small bowel obstruction (SBO) significantly increases the likelihood of readmission and mortality. Readmission occurred in 29.8% of cases, with NOM patients exhibiting a 32% higher risk of readmission compared to those who underwent operative management (OM). Notably, NOM patients had a 50% greater chance of mortality during readmission, with each subsequent readmission raising mortality odds by 4%. Cost and complication rates were higher with OM.

Journal Article by Jose AM, Kirsch J (…) Zangbar B et 7 al. in Surg Endosc

© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

read the whole article in Surg Endosc

open it in PubMed

New guidelines endorse routine use of intraoperative cholangiography in gallbladder surgery

Surgeons now have clear guidance favoring routine intraoperative cholangiography (IOC) during laparoscopic cholecystectomy for benign biliary disease. Conditional recommendations highlight IOC’s superiority over fluorescence imaging and confirm its use in both adult and pediatric patients. Additionally, laparoscopic ultrasound remains a viable option. The guidelines stem from a systematic review and input from practicing surgeons, aiming to enhance patient safety and surgical outcomes while identifying future research needs to bolster the evidence.

Journal Article by Kumar SK, Shehata DG (…) Miraflor E et 16 al. in Surg Endosc

© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

read the whole article in Surg Endosc

open it in PubMed

Five New Diagnostic Tools Revolutionize Gastroesophageal Reflux Disease Assessment

Gastroesophageal reflux disease (GERD) diagnosis is set for a revolution with five new scoring tools: the AFS classification, Milan score, Phoenix score, cough reflux score, and Lyon score. These innovations enhance objectivity and reproducibility in assessing GERD, addressing the limitations of existing methods often clouded by symptom overlap. By enabling precise patient stratification and guiding tailored therapies, they aim to improve management and treatment outcomes for patients suffering from this prevalent condition.

Review by Siboni S, Sozzi M (…) Asti E et 2 al. in Rev Gastroenterol Mex (Engl Ed)

Copyright © 2025 Asociación Mexicana de Gastroenterología. Published by Masson Doyma México S.A. All rights reserved.

read the whole article in Rev Gastroenterol Mex (Engl Ed)

open it in PubMed

Indocyanine Green Fluorescence Speeds Up Bile Duct Procedures in Complex Cases

In patients with prior abdominal surgeries, indocyanine green (ICG) fluorescence cholangiography significantly enhances laparoscopic bile duct exploration. A study involving 122 matched patients revealed that the ICG group experienced an 88.5% incidence of positive fluorescence, reducing the time to identify the common bile duct and overall surgical duration. Additionally, the ICG cohort had less intraoperative blood loss and faster recovery, with fewer complications post-surgery compared to conventional methods.

Journal Article by Zhen W, Lei W and Xuzhen W in Am Surg

read the whole article in Am Surg

open it in PubMed

Indocyanine Green Imaging Cuts Colorectal Surgery Leak Rates Significantly

Indocyanine green fluorescence imaging markedly reduces anastomotic leakage risk in colorectal surgery, as evidenced by a meta-analysis of eight randomized trials encompassing over 4,000 patients. The risk ratio of leakage dropped to 0.66, indicating a significant improvement in surgical outcomes. While it may slightly extend recovery and procedure durations, the clear benefits in decreasing leaks and wound infections make a compelling case for its use in surgical practice.

Review by Afridi A, Zulfiqar A (…) Kamil KA et 13 al. in Int J Colorectal Dis

© 2025. The Author(s).

read the whole article in Int J Colorectal Dis

open it in PubMed