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Liver Pucker Sign as a Predictor of Difficult Laparoscopic Cholecystectomy

The liver pucker sign, a depression in the region of the gallbladder caused by chronic contractive inflammation, indicates a challenging laparoscopic cholecystectomy. A case series reports three instances where the pucker sign was discovered during surgery, suggesting it can be used to anticipate complications. This sign typically arises in cases of chronic cholecystitis with delayed cholecystectomy, potentially guiding surgeons to modify their approach to minimize the risk of biliary or vascular injury.

Journal Article by Laudari U, Acharya S and Malla BR in Ann Med Surg (Lond)

Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.

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Guidelines for Maximising Tissue Value in Intrahepatic Cholangiocarcinoma Management

Pathologists developed recommendations based on international consensus to enhance the clinical value of tissue samples in intrahepatic cholangiocarcinoma management. The guidance includes consensus statements on specimen handling, reporting content, and the need for molecular information to guide personalised therapies. These recommendations aim to standardize reporting practices and optimize tissue utilization for improved patient care.

Journal Article by Kendall T, Overi D (…) Carpino G et 6 al. in JHEP Rep

© 2024 The Authors.

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Transarterial Chemoembolization with Targeted Therapy and Immunotherapy Improves Outcomes in Unresectable Hepatocellular Carcinoma

Transarterial chemoembolization (TACE) combined with targeted therapy and immunotherapy (TACE-T-I) shows greater efficacy and safety compared to TACE with targeted therapy alone (TACE-T) in treating unresectable hepatocellular carcinoma (HCC). A meta-analysis of 14 studies with 2144 patients revealed that the TACE-T-I group had higher overall survival (OS) and progression-free survival (PFS), as well as a higher objective response rate and disease control rate, with a similar risk of treatment-related adverse events compared to TACE-T. The findings suggest that adding immunotherapy to TACE-T offers significant clinical benefits for unresectable HCC patients.

Meta-Analysis by Feng J, Zhao Y, Zhai L and Zhou J in Medicine (Baltimore)

Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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Validation of Indonesian Hemorrhoidal Disease Symptom Score and Short Health Scale

The Indonesian adaptations of the Hemorrhoidal Disease Symptom Score (HDSS) and the Short Health Scale Hemorrhoidal Disease (SHSHD) have been validated and confirmed as reliable tools for assessing health-related quality of life in Indonesian patients with hemorrhoidal disease. The study included 91 patients (55 males, 36 females). The correlations in the subscale interpretations and the full scale scored above 0.25, indicating validity. All reliability scores were r-value ≥0.8 (p < 0.05), confirming the reliability of the HDSS and SHSHD in this context.

Journal Article by Amsriza FR, Fakhriani R and Pangki AA in Turk J Surg

Copyright © 2023, Turkish Surgical Society.

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Safe Postoperative Outcomes Following Early Cholecystectomy for Acute Calculus Cholecystitis

Early cholecystectomy for acute calculus cholecystitis shows safe postoperative outcomes, regardless of symptom onset timing. Operative time was longest for patients with delayed surgery, but bile leaks and conversion rates were similar across groups. Hospital stay was slightly longer for those operated on within 72 hours of symptoms. Surgeons can confidently perform early cholecystectomy for this condition beyond the recommended 72-hour window.

Journal Article by Woong Choi JD, John Fong M (…) James Curran R et 4 al. in Turk J Surg

Copyright © 2023, Turkish Surgical Society.

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Reducing Invasive Evaluations in Patients with Incidental Common Bile Duct Dilation

Endoscopic ultrasound (EUS) for incidental common bile duct (CBD) dilation revealed that only 8.3% of cases had significant findings. Researchers identified predictors including age ≥70, non-biliary-type abdominal pain, CBD diameter ≥15 mm, and prior ERCP. A novel clinical prediction model was created, scoring age, pain type, prior ERCP, and CBD dilation. A score <1 predicted <2% chance of significant findings, potentially reducing low-yield EUS in nearly a third of cases.

Journal Article by Raza Z, Altayar O (…) Das KK et 12 al. in Gastrointest Endosc

Copyright © 2024 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

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Predictors of 1-year Mortality After Gastrectomy for Gastric Cancer

A scoring system based on seven significant independent prognostic factors, including age, comorbidity, gastrectomy type, complications, cancer stage, and resection status, was developed and validated to predict 1-year mortality in patients with gastric cancer undergoing gastrectomy. This system demonstrated high sensitivity and specificity, aiding in selecting appropriate care planning strategies for these patients.

Research Support, Non-U.S. Gov’t by Sekimoto A, Miyake H (…) Yuasa N et 2 al. in World J Surg

© 2023 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).

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Scoring Systems for Predicting Outcomes of Acute Lower Gastrointestinal Bleeding

The oakland and Glasgow-Blatchford scores demonstrated excellent performance in predicting severe LGIB, need for blood transfusion, and mortality, outperforming the AIMS65 score. Hemostatic interventions and rebleeding prediction by all scores were suboptimal. These results suggest Glasgow-Blatchford score as an alternative for risk stratification in patients with acute lower GI bleeding.

Research Support, Non-U.S. Gov’t by Prasitvarakul K, Attanath N and Chang A in World J Surg

© 2023 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).

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Transferability of Laparoscopic Surgical Skills to Robot-Assisted Surgery

Transfer of technical surgical skills from laparoscopic to robot-assisted surgery is feasible and efficient, facilitating combined training and credentialing. However, no evidence supports skill transfer from open to robot-assisted surgery. Recommendations for future studies aim to enhance comparability and significance in assessing skill transfer across surgical modalities.

Meta-Analysis by Schmidt MW, Fan C (…) Kowalewski KF et 8 al. in World J Surg

© 2023 The Authors. World Journal of Surgery published by John Wiley & Sons Ltd on behalf of International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).

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Effectiveness of Esophageal Pull-Down Technique in Achalasia

Esophageal pull-down technique significantly improves outcomes in end-stage achalasia compared to classical laparoscopic Heller-Dor myotomy. Treatment failure rates were significantly lower in the pull-down technique group, confirming its efficacy in challenging cases. This technique shows promise in enhancing treatment success for difficult-to-treat achalasia patients with a sigmoid-shaped esophagus.

Journal Article by Nezi G, Forattini F (…) Salvador R et 9 al. in J Gastrointest Surg

Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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