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Ultrasound-Guided Lithotripsy: A Game Changer for Common Bile Duct Stones

Researchers compared treatments for common bile duct (CBD) stones, and ultrasound-guided percutaneous transhepatic cholangioscopic lithotripsy (PTCSL) stood out. PTCSL outperformed laparoscopic exploration, with better perioperative outcomes and fewer complications. It also beat endoscopic treatment with fewer instances of pancreatitis, reflux esophagitis, and papillary stenosis. Additionally, the study identified gallstones and family history as independent risk factors for CBD stone recurrence. This research suggests PTCSL as a safe and efficient first-line treatment for CBD stones and provides crucial insights for high-risk patient follow-up.

Journal Article by Gao Z, Ye D (…) Lu W et 5 al. in World J Surg

© 2023. The Author(s) under exclusive licence to Société Internationale de Chirurgie.

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No Negative Impact: Aberrant Right Hepatic Artery in Pancreaticoduodenectomy

A systematic review and meta-analysis explored whether the presence of an aberrant right hepatic artery (A-RHA) influences outcomes after pancreaticoduodenectomy (PD). Results indicate that A-RHA doesn’t significantly affect critical endpoints, such as tumor margin (R1) rate, overall survival, morbidity, mortality, and biliary fistula rate. Additionally, non-critical outcomes like postoperative pancreatic fistula, delayed gastric emptying, post-pancreatectomy hemorrhage, length of stay, and operative time remained similar between groups. This study suggests that the presence of A-RHA doesn’t negatively impact the short-term or long-term clinical outcomes of PD.

Review by Ricci C, Alberici L (…) Casadei R et 5 al. in World J Surg

© 2023. The Author(s).

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Revolutionizing Gastric Cancer Care: Multimodal Prehabilitation for Frail Elderly Patients

Gastric cancer in elderly folks is a global health concern, as it often leads to post-op complications and poor outcomes due to frailty. This innovative study presents a plan: a multimodal prehabilitation combined with enhanced recovery after surgery (ERAS). They’re putting 368 patients through the paces, focusing on nutrition, fitness, and mental health before gastrectomy. Family members are the guides. The main goal? Cutting post-op complications. If it works, it’s a game-changer for improving both short-term and long-term results in elderly gastric cancer patients.

Journal Article by Sun Y, Tian Y (…) Zhou Y et 19 al. in BMJ Open

© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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Game-Changing Prognostic Models Unveiled for Gastrointestinal Melanoma

In a data-driven investigation involving 991 primary gastrointestinal melanoma patients, researchers constructed reliable prognostic models for predicting overall survival (OS) and cancer-specific survival (CSS). These models incorporated key factors like age, disease stage, lymph node density, and surgery. Rigorous testing confirmed their effectiveness, making them valuable tools for assessing the prognosis of primary gastrointestinal melanoma patients. This study empowers clinicians with enhanced predictive capabilities for these specific cases, potentially improving patient care and decision-making.

Journal Article by Zeng J, Zhu L (…) Yang Y et 2 al. in BMJ Open

© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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MRI Scoring Sheds Light on Post-Op Anorectal Function in Rectal Cancer

In a two-center study, researchers established a postoperative MRI-based scoring system for fibrosis in locally advanced rectal cancer patients who received neoadjuvant chemoradiotherapy (NCRT). They found a positive correlation between anastomotic and perirectal fibrosis scores (AFS and PFS) and anorectal function, measured using the Wexner score. Age, tumor height, AFS, and PFS were identified as independent predictors of anorectal function. This innovative scoring system demonstrated its effectiveness in predicting anorectal function, offering a valuable tool for clinicians managing post-NCRT rectal cancer patients.

Journal Article by Yuan Y, Yu Y (…) Shen F et 9 al. in Ann Med

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Consensus-Based Prioritization of Simulation Procedures for General Surgery Trainee Assessment

This study aimed to create a ranked list of surgical procedures for high-stakes simulation assessments in general surgery training. Using a Delphi consensus approach, a diverse group of 30 surgical trainers and a steering committee evaluated procedures based on perceived importance, risk, frequency, and feasibility. The study produced prioritized lists for two key training stages: the end of ‘phase 2’ and the end of training. A total of 21 and 16 procedures, respectively, were identified as suitable for assessment. These lists serve as a foundation for future high-stakes assessments in surgical training.

Journal Article by Toale C, Morris M (…) Kavanagh DO et 4 al. in Ann Surg

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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Elective Hernia Repair Boosts Life Expectancy for Asymptomatic Paraesophageal Hernia Patients

This study reevaluated the best approach for asymptomatic paraesophageal hernia (PEH) patients: elective laparoscopic hernia repair (ELHR) or watchful waiting (WW). The conventional wisdom, based on older analyses, favored WW. However, updated research shows that ELHR leads to increased life expectancy, especially for women aged 40-90. Sensitivity and probabilistic analyses supported this shift, indicating that all PEH patients, regardless of symptoms, should consider elective repair for optimized life expectancy. This update challenges previous recommendations and could prevent avoidable hospitalizations and enhance survival.

Journal Article by DeMeester SR, Bernard L (…) Roth JS et 2 al. in Ann Surg

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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Comparing Strategies for Anastomotic Leak After Rectal Cancer Surgery

A worldwide study investigated the treatment of anastomotic leaks following rectal cancer surgery, categorizing strategies into salvage surgery, passive or active drainage, and no initial faecal diversion. Among 2470 patients, the study found that primary salvage surgery and omitting faecal diversion represented the most severe and least severe cases, respectively. In patients with diverted leaks, stoma-free survival didn’t significantly differ between passive and active drainage. However, active drainage resulted in more secondary surgeries, longer hospital stays, and increased ICU admissions.

Journal Article by Greijdanus NG, Wienholts K (…) de Wilt JHW et 18 al. in Br J Surg

© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd.

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Exploring the Connection Between Social Media and Violent Crime

Researchers conducted a cross-sectional study utilizing data from the Prince George’s County police department to investigate the link between social media engagement, crime, and violence. In a society where over 70% of Americans use various social media platforms, it’s essential to comprehend how online interactions may contribute to real-world conflict and violence. This study aims to quantify this association, offering insights into the potential for using social media as a tool for intervention and violence prevention amid increasing violence rates across the United States.

Journal Article by Garcia Whitlock AE, Gill BP (…) Kaufman EJ et 4 al. in JAMA Surg

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Implementing Trauma Resilience and Recovery Program for Mental Health After Injuries

Trauma centers can effectively promote mental health recovery by introducing the Trauma Resilience and Recovery Program (TRRP). This scalable model offers early mental health intervention after traumatic injuries. The study successfully implemented TRRP in three level I-II trauma centers. Engaging stakeholders, including patients, providers, and hospital administrators, in the early stages of implementation enhanced its acceptability and sustainability. This work showcases the feasibility of integrating cost-effective and sustainable mental health interventions into trauma programs, emphasizing the importance of active monitoring, evaluation, and adaptation.

Journal Article by Davidson TM, Espeleta HC (…) Ruggiero KJ et 10 al. in J Am Coll Surg

Copyright © 2023 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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