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Predictors of Perioperative Complications in Open Biliary Bypass for Malignant Biliary Obstruction

Patients undergoing open biliary bypass for malignant biliary obstruction face significant perioperative risks. A multicenter study identified preoperative cholangitis, longer surgery duration, and elevated serum bilirubin levels as predictors of complications. Hazard ratios revealed 2.49 times higher risk with cholangitis, 2.47 times higher risk with longer surgery, and a 14% increase in risk per 1 mg/dl rise in bilirubin. These findings inform risk stratification and optimization strategies for improved perioperative outcomes.

Journal Article by Bezabih YS and Gebremariam SN in Eur J Surg Oncol

© 2024 Published by Elsevier Ltd.

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Improved Esophageal Cancer Response Assessment with Early Contrast-Enhanced MRI

Early contrast-enhanced MR imaging showed higher accuracy in detecting complete tumor response in esophageal squamous cell carcinoma post-neoadjuvant therapy compared to T2WI+DWI. ECE-MRI had an AUC of 0.85 for diagnosing ypt1-4, significantly better than T2WI+DWI. Performance improved with increasing tumor stage, with higher AUCs in ypt1 and ypt2 tumors. ECE-MRI visual evaluation is promising for accurate diagnosis, aiding in individualized treatment decisions for patients.

Journal Article by Shi YJ, Yan S (…) Sun YS et 5 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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Comparable Efficacy of Lumen-Apposing Metal Stents and Plastic Stents for Walled-Off Necrosis Drainage: PROMETHEUS Study

This multicenter, randomized trial compared lumen-apposing metal stents (LAMS) and double-pigtail plastic stents (DPS) for walled-off necrosis drainage. Results showed similar short and long-term clinical success rates between both groups. LAMS had a shorter procedure duration, similar hospital stay, and safety profile compared to DPS, with a lower incidence of de novo fever. Overall, the clinical superiority of LAMS over DPS was not demonstrated, highlighting the importance of considering factors such as procedure time in treatment decisions for walled-off necrosis.

Journal Article by Gornals JB, Velasquez-Rodriguez JG (…) Vazquez-Sequeiros E et 24 al. in Surg Endosc

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

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Virtual Reality with Head-Mounted Display Improves Decision-Making in Hepatic Surgery Training.

A study compared virtual reality with head-mounted display (VR-HMD), on-screen 3D visualization, and 2D computed tomography for hepatic surgery training. Results showed higher accuracy and faster responses in the VR-HMD and 3D groups compared to the 2D group. Both VR-HMD and 3D were equally effective, indicating VR-HMD’s usefulness in determining liver anatomy and tumor involvement during surgery.

Journal Article by Preukschas AA, Wise PA (…) Kenngott HG et 12 al. in Surg Endosc

© 2024. The Author(s).

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Safe and Effective Robot-Assisted Gastric Resection: 5-Year Clinical Outcome

Robot-assisted endoscopic full-thickness gastric resection with regional lymph node dissection using a 3D near-infrared video system resulted in no metastasis or mortality in patients with early gastric cancer over a 5-year follow-up period. This approach may be a safe and effective method for radical gastrectomy in such patients, highlighting the potential benefits of this technique in the clinical setting.

Journal Article by Lee AY, Kim MC (…) Cho JY et 6 al. in Surg Endosc

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

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Small Bowel Obstruction Recurrence Score (SBORS) Predicts Risk of Recurrence in Patients with History of Intra-abdominal Surgery.

Researchers conducted a study in Taiwan to assess the risk of recurrent small bowel obstruction (SBO) after non-operative management in patients with a history of intra-abdominal surgery. They developed a scoring system, the Small Bowel Obstruction Recurrence Score (SBORS), which successfully predicted 6-month recurrence of SBO after non-surgical management. Patients with scores >2 had higher rates and risks of recurrence, mortality, and operative events. The SBORS model showed good calibration and discrimination, aiding in predicting SBO recurrence in this patient population.

Journal Article by Lin SW, Chen CY (…) Chen JH et 3 al. in Surg Endosc

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

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Comparison of Laparoscopic and Open Pancreatectomy for Solid Pseudopapillary Neoplasms

Outcome and survival were similar between laparoscopic and open pancreatectomy for solid pseudopapillary neoplasms in 102 patients. Laparoscopic approach was associated with lower blood loss, shorter surgery duration, fewer complications, and smaller tumor size for specific procedures. Recurrence rates were low and unrelated to the surgical approach. Laparoscopic pancreatectomy is safe and effective but should be used cautiously for large lesions requiring pancreatoduodenectomy.

Journal Article by Codjia T, Marique L (…) Dokmak S et 9 al. in Surg Endosc

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

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Key ERAS Recommendations Predict Surgical Outcomes in Multi-Institutional US Study

Compliance to the Enhanced Recovery after Surgery (ERAS) protocol significantly impacts surgical outcomes in the United States, with certain recommendations showing more predictive value than others. Early Foley catheter removal, limited nasogastric tube use, oral carbohydrates, and patient education are associated with improved recovery and reduced complications in specific surgeries. Future research should validate these findings and consider surgery-specific predictive models using individual ERAS recommendations.

Journal Article by Cochran AR, Shaw G (…) Vrochides D et 2 al. in World J Surg

© 2024 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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Identification of Predictive Factors for Clinically Relevant Postoperative Pancreatic Fistula

Researchers identified that a combination of inflammatory parameters and drainage fluid culture results on postoperative day 3 can accurately predict the risk of clinically relevant postoperative pancreatic fistula (CR-POPF) after pancreatectomy. Factors such as drainage fluid amylase level ≥722 IU/L, culture positivity, and neutrophil count ≥5473/mm significantly influence the onset of CR-POPF. A predictive model based on these values can help clinicians anticipate CR-POPF following pancreatoduodenectomy or distal pancreatectomy.

Journal Article by Suto H, Matsukawa H (…) Okano K et 9 al. in World J Surg

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

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Last day of hospital stay has minimal impact on total charges for surgical patients

Reducing post-operative length of stay for surgical patients may not have a significant impact on cost savings, as the last day of stay contributes only a small portion to total charges. Costs are primarily concentrated on the day of surgery, emphasizing the need for cost containment efforts during the perioperative period.

Journal Article by Hashmi SA, Raja MHR (…) Pal KMI et 3 al. in World J Surg

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

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