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Novel Laparoscopic Technique for Duodenal Perforation Repair

A new laparoscopic approach for treating duodenal perforations could reshape surgical practices.

  • Successfully repaired a descending duodenal perforation using a trans-mesocolic technique in a 69-year-old woman.
  • The surgery utilized the superior mesenteric vein for safe access, leading to an uncomplicated recovery.

This technique may reduce operative trauma compared to traditional methods, highlighting the need for further studies to establish broader indications.

Editorial by Zou H, Hou H (…) Tao Q et 3 al. in Am J Surg

Copyright © 2026 Elsevier Inc. All rights reserved.

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Conservative management of postoperative bowel obstructions works for some patients.

  • 63.4% of patients with adhesive small bowel obstruction (ASBO) had successful conservative treatment.
  • Key factors predicting treatment failure include: vomiting (aOR 0.476), abdominal distension (aOR 0.301), and guarding/rebound tenderness (aOR 0.354).
  • Generalized tenderness was positively associated with success (aOR 1.903).

Surgeons can use these clinical symptoms and imaging findings to identify patients who may need timely surgical intervention, improving overall outcomes.

Journal Article by Fikre E, Ersamo T (…) Gebrehiwot G et 5 al. in Am J Surg

Copyright © 2026 Elsevier Inc. All rights reserved.

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Ventral hernia management shifting based on new trials

Recent RCTs show significant reversals in accepted hernia practices, urging surgeons to reassess interventions.

  • One-third of relevant trials led to medical reversals, highlighting outdated practices.
  • Of 396 guideline comparisons, 37.5% contradicted current recommendations.

Surgeons must stay updated on emerging evidence to ensure optimal patient outcomes.

  • Over half of trials explored areas not covered by existing guidelines.

Review by Quach D, Rosamond BM (…) Liang MK et 2 al. in Am J Surg

Copyright © 2026. Published by Elsevier Inc.

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Frailty Risks Drive Mortality After Pancreatectomy

Frailty significantly raises the risk of death and readmission after pancreatic surgery, primarily through postoperative complications.

  • 22.2% of 71,104 patients were frail, with 30-day mortality linked to frailty (aOR 1.29) and readmission (aOR 1.11).
  • Complications mediated 80.72% of the frailty-mortality association, with unplanned reintubation and major infections among the top culprits.

Focus on preventing complications and enhancing post-operative care for frail patients to improve outcomes.

Journal Article by Bitar ER, Kostov A (…) Tsung A et 7 al. in J Am Coll Surg

Copyright © 2026 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Optimize Postoperative Nutrition for Pancreatoduodenectomy

Early enteral nutrition (EEN) via nasojejunal tube reduces complications after pancreatoduodenectomy compared to oral nutrition (ON).

  • EEN patients had a mean 90-day complication index of 25.5 vs. 35.8 for ON (p = .02).
  • Overall morbidity was slightly higher in ON (51/59) vs. EEN (45/59), but not statistically significant.

Implementing EEN in nutritionally at-risk patients can improve surgical outcomes without increasing specific complication rates.

  • Nasojejunal tube was replaced in 14 EEN patients due to removal.

Journal Article by Joliat GR, Martin D (…) Schäfer M et 10 al. in JAMA Surg

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Funnel-Shaped Mesh Reduces Parastomal Hernias After Colostomy

Using funnel-shaped mesh during rectal adenocarcinoma surgery cuts parastomal hernias significantly.

  • At 3 years, CT-confirmed parastomal hernia occurred in 57% of the mesh group vs. 82% in controls, a 25% reduction.
  • Clinically diagnosed hernias were 10% in the mesh group compared to 39% in the control group, marking a 29% difference.

This supports funnel-shaped mesh as a safe option to lower hernia risk post-colostomy.

  • Median hernia size was significantly larger in controls (185.9 ml) vs. mesh group (86.8 ml).

Journal Article by Mäkäräinen E, Järvinen J (…) Rautio T et 8 al. in JAMA Surg

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Watch and Wait for Rectal Cancer: Surveillance Gaps Identified

Surgeons need to know that only 62% of patients on watch and wait for rectal cancer adhered to optimal surveillance, raising concerns about early regrowth detection.

  • 53 patients studied, median follow-up of 17 months.
  • Younger patients (median age 54) were more likely to follow optimal surveillance (p = .04).

Surveillance failures commonly occurred within the first year, particularly missing the initial endoscopic or imaging exams.

  • Lack of adherence may impact outcomes in patients undergoing nonoperative management.

Journal Article by Egbert LK, Kavirayani V (…) Etzioni DA et 2 al. in BMC Surg

Copyright © 2026 Elsevier Inc. All rights reserved.

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Minimally invasive gastric cancer surgery outperforms open approach

Minimally invasive techniques, especially robotic surgery, yield better results for gastric cancer patients.

  • Textbook outcome achieved in 31.4% of open cases, 56.8% of laparoscopic, and 68.6% of robotic.
  • Hospital stays were shorter for laparoscopic and robotic procedures.

Achieving a textbook outcome is linked to improved 1-year survival rates across all techniques.

  • Robotic gastrectomy showed superior oncological resection with a higher R0 rate.

Journal Article by Garsot Savall E, Clavell A (…) Viciano M et 5 al. in BMC Surg

Copyright © 2026 Elsevier Inc. All rights reserved.

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Gallbladder cancer survival improves with liver resection

Surgeons should consider liver resection for patients with incidental gallbladder cancer (gbc) to enhance survival outcomes.

  • 5-year disease-free survival is 41.5%, overall survival is 45.1% after incidental gbc diagnosis.
  • Patients who underwent liver resection showed significantly improved disease-free survival (51 vs. 15 months) and overall survival (72 vs. 26 months).
  • Completion of adjuvant chemotherapy further boosts survival: disease-free (35 vs. 15 months) and overall (47 vs. 26 months).

Identifying adverse tumor features like nodal metastases is crucial for guiding treatment decisions.

Journal Article by McClements J, Lee WT (…) Gomez D et 51 al. in Br J Surg

© The Author(s) 2026. 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) 2026. 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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Machine learning distinguishes MD-IPMN from chronic pancreatitis

A new model helps surgeons accurately differentiate main-duct intraductal papillary mucinous neoplasms from chronic pancreatitis when imaging results are unclear.

  • Among 123 patients, intraductal nodules were found in 20% of MD-IPMN cases vs 2.4% in chronic pancreatitis (p=0.003).
  • Ductal stones were present in 77.1% of chronic pancreatitis cases compared to just 2.5% in MD-IPMN (p<0.001).

The model shows high accuracy (AUC of 0.946; F1-score of 0.879) and remains reliable even in stone-negative scenarios.

  • A web-based tool is available to aid clinical decision-making and standardize evaluations.

Journal Article by Li J, Prabhakaran SD (…) Akshintala VS et 13 al. in Gastrointest Endosc

Copyright © 2026. Published by Elsevier Inc.

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