Blog

Expert Tips for Successful Direct Percutaneous Endoscopic Jejunostomy (DPEJ) Tube Placement

Direct percutaneous endoscopic jejunostomy (DPEJ) offers stable enteral access, especially for patients intolerant to gastric feeding. This article identifies risk factors for complications and provides top tips for successful DPEJ placement. Despite being less commonly taught, DPEJ demonstrates advantages over other feeding tube methods, including greater stability, reduced risk of clogging, and improved nutrient delivery. Practical pre-procedure and procedural tips enhance safety and efficacy, promoting better patient outcomes.

Editorial by Ramai D, Morris JD and Fang J in Dig Dis Sci

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

read the whole article in Dig Dis Sci

open it in PubMed

Long-term outcomes of laparoscopic surgery for very low rectal cancers: high anus preservation and moderate functional outcomes

Patients undergoing laparoscopic surgery for stage I ultra-low rectal cancers near the anal verge showed a 3-year local recurrence rate of 6.3%. Anus-preserving surgery was successful in 93% of cases, leading to high rates of functional preservation, with moderate improvements in anal function and acceptable incontinence scores. Urinary function recovered rapidly post-surgery, but sexual function showed poor recovery.

Journal Article by Ito M, Tsukada Y (…) Watanabe M et 24 al. in Ann Surg

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

read the whole article in Ann Surg

open it in PubMed

Comparison of Short- and Long-Term Outcomes After Resection for Advanced Pancreatic Cancer

Patients with locally advanced pancreatic cancer (LAPC) who underwent resection following induction therapy showed comparable postoperative pancreas-specific complications, mortality, disease-free interval, and overall survival rates as those with (borderline) resectable pancreatic cancer ((B)RPC). Laparoscopic patients had a higher rate of delayed gastric emptying post-surgery compared to (B)RPC patients, but overall outcomes were similar between the two groups.

Journal Article by Brada LJH, Schouten TJ (…) Molenaar IQ et 13 al. in Ann Surg

Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

read the whole article in Ann Surg

open it in PubMed

NICE Guidelines Emphasize Barrett’s Oesophagus Surveillance

NICE guidance emphasizes the importance of monitoring Barrett’s oesophagus due to its link to oesophageal adenocarcinoma. Risk factors include acid reflux symptoms, obesity, male gender, smoking, and family history. Surveillance allows for early detection and intervention, leading to excellent prognoses for dysplasia and stage I cancer. Endoscopic techniques are crucial for accurate staging and eradication of Barrett’s oesophagus. Future research should focus on improving dysplasia detection and evidence-based treatment pathways.

Journal Article by di Pietro M, Trudgill NJ (…) Primrose JN et 13 al. in Gut

© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.

read the whole article in Gut

open it in PubMed

Successful Robotic Ultrasound-Guided Central Pancreatectomy for Intraductal Papillary Mucinous Neoplasm

A parenchymal-sparing central pancreatectomy was performed with robotic assistance and intraoperative endoscopic evaluation of the main pancreatic duct. The procedure had a relatively short operative time of 290 minutes and minimal blood loss. Despite a postoperative complication requiring angioembolization and drainage, the patient was discharged on day 22 with good long-term outcomes, demonstrating the effectiveness of combining robotic surgery with ultrasound guidance for challenging pancreatic resections.

Journal Article by Giuliani G, Guerra F (…) Coratti A et 3 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

read the whole article in Ann Surg Oncol

open it in PubMed

Antibiotic Use Prior to Ileal Pouch-Anal Anastomosis Increases Pouchitis Risk

Researchers found that antibiotic exposure in the 12 months before Ileal Pouch-Anal Anastomosis (IPAA) surgery for ulcerative colitis increased the risk of developing pouchitis in the first 2 years post-surgery. Compared to those without antibiotic prescriptions, patients with 1-2 courses had a 30% increased risk, while those with 3 or more courses had a 77% increased risk. Non-steroidal anti-inflammatory drugs and appendectomy were not associated with pouchitis risk.

Journal Article by Barnes EL, Karachalia Sandri A, Herfarth HH and Jess T in Clin Gastroenterol Hepatol

Copyright © 2024. Published by Elsevier Inc.

read the whole article in Clin Gastroenterol Hepatol

open it in PubMed

Management of Right-Sided Diverticulitis: North African Experience

Researchers conducted a retrospective study on 40 patients with right-sided diverticulitis in a North African surgical center. They found that conservative management was successful in 14 cases, while 26 patients underwent operative procedures with no postoperative events and a short hospital stay. Follow-up showed no recurrences, indicating that right-sided diverticulitis has a lower complication rate compared to left-sided diverticulitis, with conservative treatment yielding favorable outcomes.

Journal Article by Jedidi L, Mabrouk A (…) Ben Moussa M et 5 al. in World J Surg

© 2024 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).

read the whole article in World J Surg

open it in PubMed

Appendectomy is associated with a milder clinical course in Crohn’s disease

In a nationwide cohort study, Crohn’s disease patients who had previously undergone appendectomy had a lower rate of CD-related hospital admissions and were less likely to initiate treatment with biologics or undergo colorectal resections compared to those without appendectomy. Rates of small bowel resections were comparable between the two groups. Appendectomy performed after CD diagnosis did not impact the clinical course. This suggests that an appendectomy prior to CD diagnosis may lead to a milder clinical course in CD.

Journal Article by Mark-Christensen A, Kristiansen EB, Laurberg S and Erichsen R in Inflamm Bowel Dis

© The Author(s) 2024. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
© The Author(s) 2024. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

read the whole article in Inflamm Bowel Dis

open it in PubMed

Preoperative Ureteral Stent Placement and Intraoperative Ureteral Injury

Preoperative ureteral stent placement during colorectal surgery did not lead to earlier detection of ureteral injury. Of 6481 patients, 15% had stents placed, with 0.4% experiencing a ureteral injury. Hematuria and UTI risk increased with stent use, but intraoperative identification of injury was not associated with stent placement. Iatrogenic ureteral injury was rare, contrasting with the relatively frequent use of preoperative stents.

Journal Article by Heimberger M, Stocchi L (…) Colibaseanu D et 5 al. in J Gastrointest Surg

Copyright © 2024. Published by Elsevier Inc.

read the whole article in J Gastrointest Surg

open it in PubMed

Survival Outcomes Suggest Consideration of Additional Lymph Node Dissection for Incidentally Diagnosed Intrahepatic Cholangiocarcinoma Patients

Survival outcomes of incidental intrahepatic cholangiocarcinoma patients who did not undergo lymph node dissection were similar to those who underwent dissection in T1 stage, but poorer in T2 and T3+4 stages. Patients incidentally diagnosed with T2 or above T stage may benefit from additional lymph node dissection based on the study’s retrospective analysis of 284 patients who had undergone radical surgery for intrahepatic cholangiocarcinoma.

Journal Article by Kim SH, Han DH (…) Kim KS et 2 al. in J Gastrointest Surg

Copyright © 2024. Published by Elsevier Inc.

read the whole article in J Gastrointest Surg

open it in PubMed