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Managing Median Arcuate Ligament in Pancreaticoduodenectomy

Median arcuate ligament (MAL) can significantly affect outcomes in pancreaticoduodenectomy (PD) patients.

  • MAL stenosis occurred in 1.3% (115/8676), with hemodynamically significant cases in 0.7% (59 patients).
  • Preoperative stenting was performed in 14%, while 83% underwent intraoperative division; 14% of divisions required vascular reconstruction due to failure.

MAL management doesn’t worsen overall outcomes but demands early detection and tailored surgical approaches.

  • Overall morbidity was 25%, with 4.3% mortality, including deaths from hepatic ischemia linked to MAL.

Journal Article by Fernandez-de-Sevilla E, Collard MK (…) Gelli M et 17 al. in Ann Surg Oncol

© 2026. The Author(s).

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Psychosocial Interventions Enhance Outcomes in GI Cancer Surgery

Psychosocial support during gastrointestinal cancer surgery can significantly improve patient outcomes.

  • 56.3% of studies showed improved quality of life after interventions.
  • 75% reported reduced anxiety levels, while 66.7% noted decreased depression.

Incorporating these interventions may enhance overall surgical recovery and patient satisfaction.

  • Varied modalities include education, behavioral training, and emotional support, emphasizing the need for tailored approaches.

Review by Monton O, Kopecky K (…) Johnston FM et 4 al. in Ann Surg Oncol

© 2026. The Author(s).

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Increased Mortality in Robotic Pancreatic Surgery

Surgeons need to be aware that robotic pancreaticoduodenectomy (RPD) initially carries higher mortality risks compared to open procedures.

  • 30-day mortality for RPD is 2.7%, compared to 2.0% for open pancreaticoduodenectomy (adjusted relative risk 1.43, p = 0.029).
  • Mortality risk significantly decreases with surgeon experience: 0.92% for those with 19-71 RPD cases (Q5) versus 3.9% for less experienced surgeons (Q1).

Structured training programs are crucial for safely adopting robotic techniques to improve patient outcomes.

Journal Article by Donnelly CB, Sacks GD (…) Massie AB et 4 al. in Ann Surg Oncol

© 2026. Society of Surgical Oncology.

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Qualitative research enhances surgical insights and practices.

  • There’s a growing need for surgeons to engage with qualitative studies to understand patient experiences better.
  • This article offers clear guidelines on crafting qualitative articles for surgical journals, focusing on effective communication and methodological rigor.

Surgeons can leverage these insights to improve patient care and address complex health issues more comprehensively.

  • By increasing the representation of qualitative studies, we can enrich the surgical literature and inform practice with nuanced patient perspectives.

Journal Article by Bradley SE, Szczygiel L and Suwanabol PA in BMC Surg

Copyright © 2026 The Authors. Published by Elsevier Inc. All rights reserved.

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Bowel Prep’s Role in Elective Colectomy Outcomes

Combining mechanical bowel preparation with oral antibiotics significantly reduces complications after elective colectomy for colon cancer.

  • Surgical site infection dropped from 8.7% without prep to 5.0% with combined prep.
  • All bowel prep regimens lowered the risk of postoperative complications versus no prep, with combined prep showing the best relative risk reduction (infection: 0.60, leak: 0.66, any complication: 0.70).

The effectiveness of oral antibiotics in bowel prep holds across varying body mass indexes.

  • Mechanical prep alone was not superior for right-sided resections.

Journal Article by Wu GL, Horesh N (…) Nasseri Y et 4 al. in Dis Colon Rectum

Copyright © The ASCRS 2026.

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Gender Disparity in General Surgery Leadership Persists

Women remain underrepresented in general surgery residency leadership, limiting equity in surgical practice.

  • In 363 programs, only 33.4% of leaders are women, with men dominating all leadership roles except assistant professors.
  • Men have more years of practice and higher scholarly output, though this difference disappears when accounting for career length.

Improving promotion paths and leadership selection could help balance gender representation.

  • Disparity is most pronounced at the department chair level, suggesting systemic barriers in academic advancement.

Journal Article by Fok A and Dauer E in Am J Surg

Copyright © 2026 Elsevier Inc. All rights reserved.

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Perioperative CA19-9 Tracking Improves Prognosis in Pancreatic Cancer

Tracking CA19-9 levels after pancreatic cancer resection can better guide surgical prognostication and patient outcomes.

  • Patients with normalized CA19-9 levels post-surgery had a median time-to-treatment failure of 693 days, while those with persistent elevation faced just 138 days.
  • Neoadjuvant therapy patients presented with much higher pre-treatment CA19-9 (273 u/ml) compared to surgery-first patients (19 u/ml).

Evaluating CA19-9 trajectories is crucial for identifying high-risk patients after surgery, moving beyond single value assessments.

Journal Article by Elemosho A, Chatzipanagiotou OP (…) Pawlik TM et 4 al. in J Gastrointest Surg

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

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Surgeons Need to Embrace Palliative Care Engagement

Surgeons are missing crucial opportunities to integrate palliative care for seriously ill older patients undergoing elective surgeries.

  • Palliative care practices were infrequently utilized, despite their importance.
  • Clinicians from various surgical fields acknowledged alignment with palliative care, but many felt it conflicted with their role.

Surgeons often prioritized technical issues over patients’ psychosocial concerns, indicating the need for improved communication.

  • Reframing the surgical identity could bridge gaps between surgical and palliative care objectives.

Journal Article by Morton CR, Reich AJ (…) Cooper Z et 7 al. in Ann Surg

Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved.

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International Consensus on Presacral Tumor Management

This consensus sets new guidelines for diagnosing and managing presacral tumors, enhancing surgical practices and patient outcomes.

  • High-resolution MRI with structured reporting is crucial for risk stratification.
  • Image-guided biopsies are necessary for high-risk lesions needing histological confirmation.

Tailor surgical approaches to tumor biology, with complete resection as the goal.

  • Non-operative surveillance is advocated for low-risk, asymptomatic cystic lesions.

Consensus Statement by Perry WRG, Brown KGM (…) Dozois EJ et 18 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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Trauma Transport Gaps: Rural and Socioeconomic Disparities

Timely transport of critically injured patients to trauma centers is critical, yet significant geographic and socioeconomic factors hinder access.

  • 54% of critically injured patients were transported to trauma centers; rates varied regionally, with the Northeast at 44% and the Midwest at 67% (p < .001).
  • Rural areas showed lower transport rates compared to urban areas, particularly in the Northeast (35% vs 46%) but were similar in the Midwest (65% vs 68%).

Surgeons must consider these disparities when evaluating patient outcomes and tailoring trauma response strategies.

  • Patients from lower deprivation areas had a higher transport rate (56%) compared to those from wealthier areas (47%) (p < .001).

Journal Article by Sampson A, Helderop E (…) Berry C et 10 al. in BMC Surg

Copyright © 2026 The Authors. Published by Elsevier Inc. All rights reserved.

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