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Management Strategies for Acute Cholecystitis in Surgical Non-Candidates

Post author By STITCHES Newsletter
Post date 20/12/2025
Categories In Appendix, Gallbladder and Surgical Emergencies, General Surgery

Surgeons need to adapt to novel treatments for acute cholecystitis (AC) when surgery isn’t an option.

Percutaneous cholecystostomy is recommended for patients unfit for lumen-apposing metal stents, aiming to transition to cholecystectomy.
Endoscopic ultrasound-guided gallbladder drainage is advised for never-surgical candidates if conditions allow monitored anesthesia.

Multidisciplinary protocols are essential, though variability exists in institutional practices. Further research is necessary to validate these emerging techniques.

Review by Baron TH, Jorge I (…) Riaz A et 10 al. in Ann Surg

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Neoadjuvant Therapy Outperforms Upfront Surgery for Pancreatic Cancer

Post author By STITCHES Newsletter
Post date 20/12/2025
Categories In General Surgery, HPB & Spleen

Neoadjuvant chemotherapy with gemcitabine and S-1 significantly improves survival for patients with resectable pancreatic ductal adenocarcinoma compared to upfront surgery.

Median overall survival: 37.0 months (nac-gs) vs. 26.6 months (ups); hazard ratio for mortality: 0.73.
Median relapse-free survival: 14.3 months (nac-gs) vs. 11.3 months (ups); hazard ratio for relapse: 0.77.

Consider neoadjuvant therapy in surgical planning to enhance patient outcomes.

Comparative Study by Unno M, Motoi F (…) Kosuge T et 12 al. in Ann Surg

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Transforming Suturing Skills in Medical Education

Post author By STITCHES Newsletter
Post date 20/12/2025
Categories In General Surgery, Perspectives, Opinions and Curiosities

Teaching aesthetic suturing significantly elevates competency for medical students.

Mean student scores jumped from 14.8 to 29.26 after a 3-4 hour workshop (p < 0.001).
Passing rates soared from 1.4% to 80%, showing marked improvement across all assessment domains.

This approach can enhance surgical outcomes by ensuring better initial wound closure techniques among future providers.

Focusing on techniques like edge eversion and symmetry minimizes long-term disfigurement risks.

Journal Article by Sultan MT, Jiaxiang X (…) GuangShuai L et 2 al. in J Surg Res

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Effective Low-Cost Simulation for Surgical Skills Training

Post author By STITCHES Newsletter
Post date 20/12/2025
Categories In General Surgery, Hernia, Perspectives, Opinions and Curiosities

A novel foam model enhances residents’ confidence in abdominal procedures.

Residents’ overall comfort with ostomy techniques rose by 2 points after training (p < 0.001).
Specific skills improved: siting the stoma (+1 point), creating trephine (+2 points), securing stoma (+1 point).
For abdominal access methods, confidence increased: Veress needle (+2), optical trocar (+1), Hasson (+1.5).

This low-fidelity simulation offers a practical, risk-free training tool for critical surgical skills.

Journal Article by Ziegler O, Greene AC (…) Kulaylat AS et 6 al. in J Surg Res

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Higher-Volume Hospitals Cut Mortality in Colorectal Surgery

Post author By STITCHES Newsletter
Post date 20/12/2025
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract

Higher hospital volume significantly reduces postoperative mortality in colorectal cancer surgery, which is crucial for patient selection and outcomes.

Postoperative mortality risk decreased by 27% for colon resection and 25% for rectal resection at high-volume hospitals.
A threshold of 30 rectal resections per year is suggested for defining high-volume hospitals; no similar threshold was found for colon resections.

Surgeons should consider these findings when referring patients for colorectal cancer surgery to optimize outcomes.

Meta-Analysis by Guo YR, Bai X (…) Zhang CD et 4 al. in Int J Surg

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Novel approach for complex polyp removal in colon.

Post author By STITCHES Newsletter
Post date 19/12/2025
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract, Surgical Endoscopy

Combined endoscopic and robotic-assisted transcolonic polypectomy effectively addresses challenging, benign colonic lesions.

Successfully resected a complex polyp that failed endoscopic techniques.
Procedure had no significant complications, shorter operative time, and faster recovery than partial colectomy.

This method offers a minimally invasive option, reducing the need for more invasive surgery, particularly in high-risk patients.

Journal Article by Nghiem E, Zigouras S (…) Taylor J et 3 al. in Surg Endosc

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Minimally Invasive Surgery Cuts Risks in Colorectal Resection

Post author By STITCHES Newsletter
Post date 19/12/2025
Categories In Appendix, Gallbladder and Surgical Emergencies, General Surgery, Intestine and Lower Gastrointestinal Tract

Minimally invasive surgery significantly reduces adhesive small bowel obstructions after colorectal cancer resections.

Adhesive small bowel obstruction occurs 42% less often with minimally invasive techniques (relative risk 0.58).
The study analyzed data from 23,032 patients across 10 studies, with 36.5% in the minimally invasive group.

Surgeons can consider minimally invasive approaches to improve postoperative outcomes and reduce complications.

The risk of other complications like hernias is also lower, enhancing patient recovery.

Journal Article by Sanha V, Plascevic J (…) Fujiki M et 8 al. in Am Surg

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Effective biliary stenting improves choledocholithiasis outcomes

Post author By STITCHES Newsletter
Post date 19/12/2025
Categories In Appendix, Gallbladder and Surgical Emergencies, General Surgery, HPB & Spleen

Using a self-detachable biliary stent for closure after choledochotomy enhances recovery.

Patients with primary duct closure experienced a shorter hospital stay—reduced by several days—compared to those with t-tube drainage.
Complication rates were significantly lower in the stent group, indicating a safer alternative to traditional methods.

Surgeons may consider this approach to reduce postoperative issues and costs.

No differences in operative time or blood loss suggest comparable surgical efficiency between techniques.

Journal Article by Wang S, Hui P (…) Zhang W et 2 al. in Langenbecks Arch Surg

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Improved Technique Enhances Bile Duct Cannulation Success

Post author By STITCHES Newsletter
Post date 19/12/2025
Categories In General Surgery, HPB & Spleen, Surgical Endoscopy

Modified endoscopic ultrasound-guided rendezvous shows promise for challenging biliary access in benign cases.

Higher technical success rate with modified technique: 95.3% vs. 83.7%, especially effective with CBD diameter ≤ 3 mm (96.9% vs. 61.1%, p=0.002).
Reduced procedure time: median of 6.12 minutes vs. 10 minutes (p<0.001) and lower radiation exposure (median 208.93 vs. 345 mGy, p<0.001).

Consider adopting the modified approach to enhance efficiency and safety in complex biliary cannulations.