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Smaller Gastrojejunostomy Diameters Linked to Enhanced Weight Loss in Laparoscopic Gastric Bypass

Researchers reviewed the impact of gastrojejunostomy (GJ) anastomosis diameter on weight loss outcomes after laparoscopic Roux-en-Y gastric bypass (RYGB). In the systematic review, including six studies with varying GJ diameters and follow-up durations of 1-5 years, smaller GJ diameters generally led to greater short-to-medium-term weight loss. However, complications like stenosis increased with smaller diameters beyond a certain threshold. The studies had moderate-to-low bias risk, emphasizing the need for precise GJ diameter measurement. This review suggests a negative association between smaller GJ diameters and post-RYGB weight loss.

Review by Al-Fagih OS, Zuberi S (…) Iqbal FM et 9 al. in Obes Surg

© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Prognostic Value of Preoperative CALLY Index in Gastric Cancer Patients

The preoperative CALLY index is a valuable prognostic marker for gastric cancer patients, correlating with clinicopathological factors, overall and disease-free survival, and postoperative complications. A low preoperative CALLY index was significantly associated with advanced disease stages and independently predicted poorer outcomes. This index shows promise for guiding perioperative and oncological management in this patient population.

Journal Article by Okugawa Y, Ohi M (…) Toiyama Y et 12 al. in J Gastrointest Surg

Copyright © 2024 Society for Surgery of the Alimentary Tract. Published by Elsevier Inc. All rights reserved.

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Feasibility and Safety of Highly Complex Liver Resections

Highly complex liver resections (HCLR) can be performed with an acceptable complication profile, similar to major non-HCLR procedures. However, HCLR is associated with increased rates of biliary complications, readmissions, and reoperations. No postoperative 90-day mortality was observed in the HCLR group. Tertiary hepato-pancreato-biliary centers should be considered for cases of questionable resectability.

Journal Article by Pery R, Pencovich N, Eshkenazy R and Nachmany I in J Surg Oncol

© 2023 Wiley Periodicals LLC.

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Management of Infected Collections in Acute Pancreatitis: To Drain or Not Drain?

Recent literature advocates for delaying catheter drainage in acute pancreatitis, but critically ill patients with severe disease and infected peri-pancreatic collections may still benefit from drainage procedures. A retrospective review of 72 patients showed high rates of ICU admission, respiratory and renal failure, and in-hospital mortality. Until more research is done, drainage should continue to be a key aspect of managing infected collections in acute pancreatitis.

Journal Article by Zhang AL, How R (…) Harfouche MN et 2 al. in Am Surg

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Laparoscopic Liver Resection VS Radiofrequency Ablation for Small Hepatocellular Carcinoma

Patients with small hepatocellular carcinoma showed similar overall and recurrence-free survival rates whether treated with laparoscopic liver resection or radiofrequency ablation. This randomized clinical trial suggests that percutaneous radiofrequency ablation may offer comparable therapeutic effects to laparoscopic liver resection for this patient population.

Journal Article by Song J, Cao L (…) Zheng S et 4 al. in Br J Surg

© The Author(s) 2024. 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.
© The Author(s) 2024. 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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Low Morbidity and High Survival with Surgical Microwave Ablation for Colorectal Liver Metastasis

Researchers conducted a retrospective review of 394 microwave ablation (MWA) procedures on 328 patients with colorectal liver metastasis. The study found a low morbidity rate, with Clavien-Dindo grade III or IV complications occurring in 3.6% of patients, all of whom had concomitant procedures. Incomplete ablation and local recurrence rates were 1.5% and 6.3% per tumor, respectively. The one-year survival rate was 91%, with a mean overall survival of 57.6 months. These findings suggest that MWA is a safe and effective treatment option for colorectal liver metastasis.

Journal Article by Wells AB, Butano VW (…) Iannitti DA et 4 al. in J Am Coll Surg

Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Regional Metastasis Worsens Survival in Nonfunctional Pancreatic Neuroendocrine Tumors

Lymph node metastasis (LNM) in nonfunctional pancreatic neuroendocrine tumors (NF-PNET) has a negative impact on disease-free survival (DFS) and overall survival (OS). In a systematic review of 52 studies involving 24,608 PNET cases, reported LNM rates for NF-PNET ranged from 7% to 64%, with higher rates in tumors >2 cm. Additionally, 66% of the studies reported LNM negatively affected DFS, while 60% found a negative impact on OS. These findings suggest that lymphadenectomy should be considered, especially for NF-PNET >2 cm.

Journal Article by Clarke CN, Ward E (…) Evans DB et 3 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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CA19-9 and DUPAN-2 Combination Identifies Early-Stage Pancreatic Adenocarcinoma

Patients with pancreatic ductal adenocarcinoma (PDAC) and normal levels of CA19-9 and DUPAN-2 are more likely to have resectable and early-stage cancer. In a study of 521 patients, those with normal CA19-9 and DUPAN-2 had a significantly higher proportion of resectable PDAC (71.5%) and a 5-year survival rate of 66.0%, much better than other groups with elevated markers. These findings suggest that patients with both markers at normal levels might have less aggressive PDAC.

Journal Article by Sumiyoshi T, Uemura K (…) Takahashi S et 9 al. in Ann Surg Oncol

© 2024. The Author(s).

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Minimally Invasive Surgery Conversion Provides Survival Benefit in Colon Cancer

Conversion from minimally invasive surgery to open surgery in colon cancer patients resulted in higher overall survival compared to upfront laparotomy. This survival advantage was particularly notable in patients over 65 years old, those with significant comorbidities, and individuals with left-sided tumors. Minimally invasive surgery should be favored in the absence of contraindications for patients with colon cancer.

Journal Article by Horesh N, Emile SH (…) Wexner SD et 3 al. in BMC Surg

Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.

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Primary Anastomosis with Diverting Loop Ileostomy in Acute Complicated Diverticulitis

A study of 16,921 cases of nonelective sigmoidectomy for acute complicated diverticulitis revealed a rising trend in the use of primary anastomosis with diverting loop ileostomy, from 5.3% in 2012 to 8.4% in 2020. Compared to Hartmann’s procedure, primary anastomosis with diverting loop ileostomy was associated with lower rates of major adverse events (24.6% vs 29.3%), and reduced risks of respiratory and infectious complications. However, it showed longer operative times and increased odds of 30-day readmission. These findings suggest a shift in surgical approach towards primary anastomosis in the management of acute complicated diverticulitis.

Journal Article by Cho NY, Le NK (…) Benharash P et 5 al. in BMC Surg

Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.

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