Clinical Prognosticators of Metastatic Potential in Patients with Small Pancreatic Neuroendocrine Tumors
ConclusionWhile the low metastatic potential of ≤2cm NF-PanNET implies watchful waiting to be an appropriate strategy for most patients, the increased risk of metastatic disease in younger patients with high grade (III–IV) body/tail tumors suggests individualized risk stratification to be optimal. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - March 3, 2021 Category: Surgery Source Type: research

Liver Resection for Patients with Intermediate Stage Hepatocellular Carcinoma: Beyond Rigid Staging Systems Towards a More Personalized Therapeutic Approach
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - March 3, 2021 Category: Surgery Source Type: research

Resection and Reconstruction of a Replaced Common Hepatic Artery and Portal Vein During Pancreaticoduodenectomy
AbstractThe efficacy of FOLFIRINOX chemotherapy gave renewed interest for surgery in case of locally advanced pancreatic ductal adenocarcinoma. Consistent series of pancreatectomy with arterial and venous resection have been reported recently and that described acceptable short and long-term outcomes in selected patients operated by high volume institutions by dedicated surgical team. In a didactical video we showed our approach for resecting a locally advanced pancreatic ductal adenocarcinoma involving both the splenomesentericoportal venous confluence and a replaced common hepatic artery arising from the superior mesente...
Source: Journal of Gastrointestinal Surgery - March 2, 2021 Category: Surgery Source Type: research

Robotic Proximal Gastrectomy with Double-Tract Reconstruction for Gastroesophageal Junction Cancer
AbstractThe current standard surgical procedure for proximal gastric and gastroesophageal junction (P/GEJ) cancers with limited esophageal involvement is total gastrectomy (TG). TG is associated with impaired appetite and weight loss due to decreased levels of ghrelin (a “hunger hormone” secreted by the stomach) and with anemia due to intrinsic factor loss and vitamin B12 malabsorption. Theoretically, proximal gastrectomy (PG) with an anti-reflux technique such as double-tract reconstruction (DTR) can improve quality of life (QoL) by preserving gastric function.1 A recent Japanese prospective GEJ adenocarcinoma...
Source: Journal of Gastrointestinal Surgery - March 2, 2021 Category: Surgery Source Type: research

Mortality and Survival Among Octogenarians with Localized Pancreatic Head Cancer: a National Cancer Database Analysis
AbstractBackgroundPancreatic ductal adenocarcinoma (PDAC) has historically poor outcomes. Difficult decisions must be made by patients and providers, especially in the elderly for whom treatment morbidities may not be tolerable. Herein, we report treatment-dependent outcomes of octogenarians with localized PDAC.MethodsThe National Cancer Database identified patients ≥60 years with localized PDAC of the pancreatic head (2011–2016). Patients were grouped by age (60–79 and ≥80 years) and categorized by treatment regimen: no treatment, chemotherapy, pancreaticoduodenectomy, pancreaticoduodenectomy with periop...
Source: Journal of Gastrointestinal Surgery - February 25, 2021 Category: Surgery Source Type: research

The Utility of Preoperative Tumor Markers in Peritoneal Carcinomatosis from Primary Appendiceal Adenocarcinoma: an Analysis from the US HIPEC Collaborative
This study aims to determine the value of preoperative tumor markers as predictors of progression-free survival (PFS) and overall survival (OS) for patients with peritoneal carcinomatosis from a primary mucinous adenocarcinoma of the appendix (MACA).MethodsWe queried the United States HIPEC Collaborative, a database of patients with peritoneal carcinomatosis treated with CRS/HIPEC at twelve institutions between 2000 and 2017, identifying 409 patients with MACA. Multivariate analysis was used to identify independent predictors of disease progression. Subgroup analysis was conducted to evaluate the impact of tumor grade on t...
Source: Journal of Gastrointestinal Surgery - February 25, 2021 Category: Surgery Source Type: research

Combining On-Table Embolization with Immediate Resection to Safely Excise Giant Hepatic Hemangiomas
We present and demonstrate a technique in the video that utilizes a hybrid operating room with on-table angiogram capabilities to perform hemangioma inflow embolization and immediate hepatic resection under the same anesthesia in a single procedure. Combining on-table embolization with immediate resection avoids many of the pitfalls of preoperative embolization, while enhancing the safety of the resection by decreasing the size of the tumor, enabling compressibility, and facilitating exposure of the vascular inflow and outflow. It is an efficient use of hospital resources and eliminates an intervening hospital admission. W...
Source: Journal of Gastrointestinal Surgery - February 25, 2021 Category: Surgery Source Type: research

Sarcopenic obesity is a postoperative prognostic factor for stage II and III colorectal cancer
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - February 25, 2021 Category: Surgery Source Type: research

Healthcare Disparities in the Management of Acute Cholecystitis: Impact of Race, Gender, and Socioeconomic Factors on Cholecystectomy vs Percutaneous Cholecystostomy
AbstractBackgroundWhile percutaneous cholecystostomy (PC) is a recommended treatment strategy in lieu of cholecystectomy (CCY) for acute cholecystitis among patients who may not be considered good surgical candidates, reports on disparities in treatment utilization remain limited. The aim of this study was to investigate the role of demographic, clinical, and socioeconomic factors in treatment of acute cholecystitis.MethodsPatients with a diagnosis of acute cholecystitis who underwent CCY versus PC were reviewed from the U.S. Nationwide Inpatient Sample (NIS) database between 2008-2014. Measured variables including age, ra...
Source: Journal of Gastrointestinal Surgery - February 24, 2021 Category: Surgery Source Type: research

How to Predict Postoperative Complications After Early Laparoscopic Cholecystectomy for Acute Cholecystitis: the Chole-Risk Score
AbstractBackgroundEarly laparoscopic cholecystectomy (ELC) is the gold standard treatment for patients with acute calculous cholecystitis (ACC); however, it is still related to significant postoperative complications. The aim of this study is to identify factors associated with an increased risk of postoperative complications and develop a preoperative score able to predict them.MethodsMulticentric retrospective analysis of 1868 patients with ACC submitted to ELC. Included patients were divided into two groups according to the presentation of increased postoperative complications defined as postoperative complications ≥...
Source: Journal of Gastrointestinal Surgery - February 24, 2021 Category: Surgery Source Type: research

T1 Rectal Adenocarcinoma: a Different Way to Measure Tumoral Invasion Based on the Healthy Residual Submucosa with Its Prognosis and Therapeutic Implications
We present a different way to measure tumoral invasion derived from the measurement of the healthy residual submucosa with its prognosis and therapeutic implicationsMethodsObservational study of tumor submucosal invasion in patients undergoing transanal endoscopic microsurgery was conducted. Parameters evaluated are submucosal invasion, measuring the healthy residual submucosa at the point of maximum invasion; macroscopic morphology of the tumor; presence of muscularis mucosa, muscularis propria, and measurement of submucosa in the tumor area and the healthy area. The classification proposed is compared with the ones previ...
Source: Journal of Gastrointestinal Surgery - February 24, 2021 Category: Surgery Source Type: research

Economic Burden of Endoscopic Vacuum Therapy Compared to Alternative Therapy Methods in Patients with Anastomotic Leakage After Esophagectomy
ConclusionManagement of AL represents an effortful approach that results in high overall costs. The expenses directly related to EVT and stent therapy were however comparatively low with more than 75% of costs being attributable to the ICU stay. Reduction of ICU care should be a central part of cost reduction strategies. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - February 24, 2021 Category: Surgery Source Type: research

Helicobacter pylori and Gallstone Disease: Incidence and Outcomes in a Los Angeles County Population
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - February 23, 2021 Category: Surgery Source Type: research

Impact of the COVID-19 Pandemic on Surgical Colorectal Cancer Care in the Netherlands: a Multicenter Retrospective Cohort Study
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - February 23, 2021 Category: Surgery Source Type: research

Outcomes of Infection and Risk of Mortality in Liver Transplant Patients with Simultaneous Splenectomy
ConclusionAlthough simultaneous splenectomy does not increase the incidence of infection, simultaneous splenectomy definitely carries risks of infection-related mortality in liver transplantation. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - February 18, 2021 Category: Surgery Source Type: research

Colorectal Cancer Surgery Outcomes in the Non-elective Setting: a Target for Improvement
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - February 17, 2021 Category: Surgery Source Type: research

Perioperative Blood Management of Preoperative Anemia Determines Long-Term Outcome in Patients with Pancreatic Surgery
AbstractBackground/PurposeAnemia affects the postoperative course of patients undergoing a major surgical procedure. However, it remains unclear whether anemia has a different impact on the long-term outcome of patients with malignant or benign pancreatic disease.MethodsA retrospective analysis of patients undergoing pancreatic surgery for pancreatic malignancies or chronic pancreatitis was conducted between January 2012 and June 2018 at the University Hospital Dresden, Germany. The occurrence of preoperative anemia and the administration of pre-, intra-, and postoperative blood transfusions were correlated with postoperat...
Source: Journal of Gastrointestinal Surgery - February 11, 2021 Category: Surgery Source Type: research

Prognostic Value of Combination of Inflammatory and Tumor Markers in Resectable Gastric Cancer
AbstractBackgroundInflammatory response and tumor marker levels have been shown to correlate with the prognosis in several human tumors. However, only a few studies on these markers have been performed in gastric cancer (GC) patients; the clinical significance of the combined markers is unclear. We aimed to evaluate the role of the combination of preoperative neutrophil-to-lymphocyte ratio (NLR) and carbohydrate antigen 19-9 (CA19-9) for predicting the prognosis of patients with GC.MethodsThis retrospective study included 458 patients who underwent gastrectomy with curative intent between January 2013 and July 2014 in the ...
Source: Journal of Gastrointestinal Surgery - February 11, 2021 Category: Surgery Source Type: research

Robotic Total Pancreatectomy: A Novel Pancreatic Head-First Approach (with Video)
ConclusionsRTP is a technically challenging procedure; however, the pancreatic head-first approach of RTP has several advantages. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - February 11, 2021 Category: Surgery Source Type: research

A Large Hypervascular Mesenteric Mass
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - February 10, 2021 Category: Surgery Source Type: research

A Nomogram in Predicting Risks of Intrahepatic Cholangiocarcinoma After Partial Hepatectomy for Hepatolithiasis
ConclusionsA nomogram for predicting ICC after PH for hepatolithiasis was constructed based on risk factors of developing ICC. Patients with a nomogram point of ≥48 were predicted to have a high risk of ICC. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - February 9, 2021 Category: Surgery Source Type: research

Reduced Laparoscopic Intra-abdominal Pressure During Laparoscopic Cholecystectomy and Its Effect on Post-operative Pain: a Double-Blinded Randomised Control Trial
AbstractBackgroundLaparoscopic surgery is regarded as the gold standard for the surgical management of cholelithiasis. To improve post-operative pain, low-pressure laparoscopic cholecystectomies (LPLC) have been trialed. A recent systematic review found that LPLC reduced pain; however, many of the randomised control trials were at a high risk of bias and the overall quality of evidence was low.MethodsOne hundred patients undergoing elective laparoscopic cholecystectomy were randomised to a LPLC (8 mmHg) or a standard pressure laparoscopic cholecystectomy (12 mmHg) (SPLC) with surgeons and anaesthetists blinded to the press...
Source: Journal of Gastrointestinal Surgery - February 9, 2021 Category: Surgery Source Type: research

Detection of Tumor Multifocality in Resectable Intrahepatic Cholangiocarcinoma: Defining the Optimal Pre-operative Imaging Modality
ConclusionCT is inadequate for pre-operative diagnosis of MTF in resectable ICC, even when performed within 30 days of hepatectomy. We recommend liver-protocol MRI as the standard pre-operative imaging modality in non-metastatic ICC. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - February 9, 2021 Category: Surgery Source Type: research

Factors that Minimize Curative Resection for Gallbladder Adenocarcinoma: an Analysis of Clinical Decision-Making and Survival
ConclusionsPatients undergoing definitive resection have a significantly improved survival, including as part of a re-operative strategy. Universal referral to a surgical specialist is a modifiable factor resulting in increased definitive resection rates. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - February 9, 2021 Category: Surgery Source Type: research

Complementary Roles of Cadaveric and Living Donor Liver Transplantation in Acute Liver Failure
AbstractBackgroundLiving donor liver transplantation may complement cadaveric transplantation in acute liver failure (ALF) patients.MethodsBetween 2008 and 2017, 89 patients were treated for ALF; 15 patients (17%) recovered with intensive care treatment; 31 (35%) died without transplant. The records of the remaining 43 patients (median (range) age: 14 (1 –62)) who underwent transplantation were evaluated.ResultsThe etiologic factors were toxic agents (10; mushrooms: 8; herbs: 2), hepatitis viruses (7; A: 1; B: 6), Wilson ’s disease (7), autoimmune hepatitis (4), and Budd-Chiari syndrome (2); 13 cases were idiop...
Source: Journal of Gastrointestinal Surgery - February 9, 2021 Category: Surgery Source Type: research

Internal Herniation of the Small Bowel Through a Mesosalpinx Defect: GI Image
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - February 9, 2021 Category: Surgery Source Type: research

Robotic Pancreaticoduodenectomy for a Technically Challenging Pancreatic Head Cancer
ConclusionIn high-volume centers, the robotic approach can be safely used in selected cases of technically challenging BR pancreatic head cancers. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - February 9, 2021 Category: Surgery Source Type: research

Better Safe than Sorry: Prevention of Esophagojejunostomy Leak by Intraoperative Methylene Blue Test in Advanced Gastric Cancer
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - February 9, 2021 Category: Surgery Source Type: research

Clinical and Cost Profile of Controlled Grade B Postoperative Pancreatic Fistula: Rationale for Their Consideration as Low Risk
AbstractBackgroundDespite standardization, the 2016 ISGPF criteria are limited by their wider applicability and oversimplification of grade B POPF. This work applied the 2016 ISGPF grading criteria within a US academic cancer center to verify clinical and fiscal distinctions and sought to improve grading criteria for grade B POPF.MethodsThe 2008 –2018 cost and NSQIP data from pancreaticoduodenectomy to postoperative day 90 were merged. All POPFs were coded by 2016 ISGPF criteria. The Clavien-Dindo Classification (CD) defined complication severity. On sub-analyses, grade B POPFs were divided into those with adequate d...
Source: Journal of Gastrointestinal Surgery - February 8, 2021 Category: Surgery Source Type: research

Intestinal Metaplasia in the Esophageal Remnant Is Rare After Ivor Lewis Esophagectomy
ConclusionsOur findings suggest that despite several factors predisposing to mucosal damage following esophagectomy, occurrence of new intestinal metaplasia after trimodality therapy in our patient population appears to be rare, even among patient with a previous history of this pathologic finding, which may have significant implications for surveillance and cost-savings after resection. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - February 8, 2021 Category: Surgery Source Type: research

Extent of Surgical Resection in Inflammatory Bowel Disease Associated Colorectal Cancer: a Population-Based Study
AbstractBackgroundThe extent of surgical resection in inflammatory bowel disease (IBD) patients who develop colorectal cancer (CRC) is not prescribed by guidelines. We aim to evaluate, at a population level, the association of extent of surgical resection with survival outcomes.MethodsUsing a validated Ontario registry of Crohn ’s disease (CD) and ulcerative colitis (UC) patients, we identified patients who underwent colorectal cancer resection between 2007 and 2015. Patient, tumor, and treatment factors, including type of surgical resection, were collected. Resections were grouped as segmental, total colectomy, and ...
Source: Journal of Gastrointestinal Surgery - February 8, 2021 Category: Surgery Source Type: research

Portal Annular Pancreas (PAP): an Underestimated Devil in Pancreatic Surgery —Systematic Review of Literature and Case Report
ConclusionIt is of utmost importance for pancreatic surgeons to diligently look for and identify PAP in the preoperative imaging. Additional imaging in the form of MRCP helps to define abnormal pancreatic ductal anatomy. Surgeons need to be cognisant of pancreatic stump management in patients with PAP to reduce associated higher rates of POPF. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - February 8, 2021 Category: Surgery Source Type: research

Gastric Bypass Increases Circulating Bile Acids and Activates Hepatic Farnesoid X Receptor (FXR) but Requires Intact Peroxisome Proliferator Activator Receptor Alpha (PPAR α) Signaling to Significantly Reduce Liver Fat Content
AbstractBackgroundWe interrogate effects of gastric bypass (RYGB), compared with a low-calorie diet, on bile acid (BA), liver fat, and FXR, PPAR α, and targets in rats with obesity and non-alcoholic fatty liver disease (NAFLD).MethodsMale Wistar rats received a high-fat diet (obese/NAFLD,n=24) or standard chow (lean,n=8) for 12 weeks. Obese/NAFLD rats had RYGB (n=11), sham operation pair-fed to RYGB (pair-fed sham,n=8), or sham operation (sham,n=5). Lean rats had sham operation (lean sham,n=8). Post-operatively, five RYGB rats received PPAR α antagonist GW6417. Sacrifice occurred at 7 weeks. We measured weight ...
Source: Journal of Gastrointestinal Surgery - February 8, 2021 Category: Surgery Source Type: research

Esophagus Obstruction in a Body-Packer
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - February 8, 2021 Category: Surgery Source Type: research

Laparoscopic Duodenal Diverticulectomy via the Inframesocolic Route
AbstractThe duodenum is traditionally reached and dissected by an anterior approach. Optimal exposure is achieved via complete hepatic flexure mobilization and kocherization of the duodenum and head of the pancreas, which can be technically challenging and time-consuming, especially in the setting of minimally invasive surgery. On the contrary, an inframesocolic approach provides a ready and neat access to the second and third segments of the duodenum with distinct advantages in terms of exposure and operative time. This video presents the details of our laparoscopic technique of approaching the duodenum via the inframesoc...
Source: Journal of Gastrointestinal Surgery - February 8, 2021 Category: Surgery Source Type: research

Incidence of Perforated Appendicitis during the COVID-19 Pandemic: Lessons to Be Considered in the Second Wave
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - February 8, 2021 Category: Surgery Source Type: research

Recent Improvements in Racial Disparity in the Treatment of Hepatocellular Carcinoma: How Times Have Changed
ConclusionRacial disparities for blacks and Hispanics have improved. Although Asians were less likely to undergo transplant, they had better survival after undergoing resection or ablation. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - February 5, 2021 Category: Surgery Source Type: research

Safety and Efficacy of Early ( & lt;4 Weeks of Illness) Endoscopic Transmural Drainage of Post-acute Pancreatic Necrosis Predominantly Located in the Body of the Pancreas
AbstractBackgroundEndoscopic transmural drainage is usually not performed for pancreatic necrotic collection (PNC)
Source: Journal of Gastrointestinal Surgery - February 5, 2021 Category: Surgery Source Type: research

Impact of Metabolic Syndrome on Postoperative Outcomes Among Medicare Beneficiaries Undergoing Hepatectomy
The objective of the current study was to examine the association of MetS with individual perioperative outcomes, as well as the composite “textbook outcome” (TO) following liver resection for both benign and malignant indications.MethodsThe Medicare 100% Standard Analytic Files were reviewed to identify Medicare beneficiaries who underwent hepatectomy between 2013 and 2017. The impact of MetS on complications, length of stay (LOS), 90-day readmission, 90-day mortality, and TO following hepatectomy was investigated.ResultsAmong 13,898 patients who underwent hepatectomy, 2491 (17.9%) had MetS while 11,407 (82.1%...
Source: Journal of Gastrointestinal Surgery - February 5, 2021 Category: Surgery Source Type: research

Stromal Organization as a Predictive Biomarker of Response to Neoadjuvant Therapy in Locally Advanced Rectal Cancer
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - February 5, 2021 Category: Surgery Source Type: research

Anatomical Basis of Routine Caudate Lobe Resections in Hilar Cholangiocarcinoma
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - February 5, 2021 Category: Surgery Source Type: research

Primary Small Cell Neuroendocrine Carcinoma of the Gallbladder with Lymph Node Metastasis
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - February 5, 2021 Category: Surgery Source Type: research

Laparoscopic Dissection of Lymph Nodes on the Posterior Surface of the Pancreatic Head for Gastric Cancer Invading the Duodenum
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - February 3, 2021 Category: Surgery Source Type: research

Practice-Changing Milestones in Anti-reflux and Hiatal Hernia Surgery: a Single Surgeon Perspective over 27 years and 1200 Operations
ConclusionsOver the last 27 years, a number of practice-changing advances have been made. These have led to changes in technique and operation selection of anti-reflux and hiatal hernia surgery. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - February 2, 2021 Category: Surgery Source Type: research

Postoperative Dysphagia Following Esophagogastric Fundoplication: Does the Timing to First Dilation Matter?
AbstractBackgroundPostoperative dysphagia after anti-reflux surgery typically resolves in a few weeks. However, even after the initial swelling has resolved at 6 weeks, dysphagia can persist in 30% of patients necessitating esophageal dilation. The purpose of this study was to investigate the effect of esophageal dilation on postoperative dysphagia, the recurrence of reflux symptoms, and the efficacy of pneumatic dilations on postoperative dysphagia.MethodsA prospectively collected database was reviewed for patients who underwent partial/complete fundoplication with/without paraesophageal hernia repair between 2006 and 201...
Source: Journal of Gastrointestinal Surgery - February 2, 2021 Category: Surgery Source Type: research

Standardizing Diagnostic and Surgical Approach to Management of Bile Duct Injuries After Cholecystectomy: Long-Term Outcomes of Patients Treated at a High-Volume HPB Center
ConclusionWith appropriate referral to a specialist, surgical reconstruction of BDIs can have excellent outcomes, even with accompanying arterial injuries. Based on our experience, MR as first imaging modality and supplemental angiography served as the optimal diagnostic strategy. Delayed repair, using Hepp-Couinaud technique, with selective liver resection results in high long-term patency rates. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - February 2, 2021 Category: Surgery Source Type: research

Quantitative Prognostic Prediction Using ADV Score for Hepatocellular Carcinoma Following Living Donor Liver Transplantation
This study included 843 HCC patients who underwent LDLT between January 2006 and December 2015 at Asan Medical Center. These cases were divided into treatment-na ïve (TN,n = 256]) and pretransplant-treated (PT,n = 587 [69.6%]) groups.ResultsThere were weak or nearly no correlations among AFP, DCP, and TV. There existed high correlations between the pretransplant and explant findings regarding tumor number, size, and ADV score. Right lobe grafts were implanted in 760 (90.2%) patients. HCC recurrence and all-cause patient death occurred in 182 (15.9%) and 126 (15.0%) respectively during the follow-up period for 75.6 &pl...
Source: Journal of Gastrointestinal Surgery - February 2, 2021 Category: Surgery Source Type: research

Subtotal Cholecystectomy After Failed Critical View of Safety Is an Effective and Safe Bail Out Strategy
ConclusionsDespite complications of STC, morbidity associated with BDI is much higher due to high long-term reoperation rate, in addition to secondary biliary cirrhosis. STC is a safe alternative that can prevent BDI if properly and timely performed in the context of difficult cholecystectomy. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - February 2, 2021 Category: Surgery Source Type: research

Improved Quality of Care and Efficiency Do Not Always Mean Cost Recovery After Minimally Invasive Ivor Lewis Esophagectomy
AbstractPurposeThe aim of this study is to determine the financial impact of clinical complications and outcomes after minimally invasive Ivor Lewis esophagectomy (MILE) at a safety-net hospital.MethodsThis was a single-center retrospective analysis of consecutive patients undergoing MILE from 2013 to 2018. Postoperative complications were classified by Clavien-Dindo grade and associated total and direct recovered costs were assessed. Direct cost and LOS index were defined as the ratio of observed to expected values (>1 denotes above nationwide expectations). Annual outcomes were based on Medicare fiscal years.ResultsOn...
Source: Journal of Gastrointestinal Surgery - February 2, 2021 Category: Surgery Source Type: research

Celiacomesenteric Trunk: a Rare Variation that Must Be Known Before Pancreatic Surgery
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - February 2, 2021 Category: Surgery Source Type: research