Postoperative Pneumonia is Associated with Long-Term Oncologic Outcomes of Definitive Chemoradiotherapy Followed by Salvage Esophagectomy for Esophageal Cancer
This study aimed to indicate the association between postoperative pneumonia and long-term outcomes of definitive chemoradiotherapy followed by salvage esophagectomy. Furthermore, we determined a prediction model for overall survival (OS) and disease-free survival (DFS) using a survival classification and regression tree (CART).MethodsNinety-three patients who underwent CRT followed by esophagectomy for thoracic esophageal cancer were identified for this study. Forty-nine patients and 44 patients were included in the salvage and neoadjuvant groups, respectively. We investigated the association between postoperative pneumon...
Source: Journal of Gastrointestinal Surgery - July 6, 2018 Category: Surgery Source Type: research

Risk Factors for Post-ERCP Pancreatitis in High-Risk Patients Receiving Post-procedure Rectal Indomethacin
ConclusionsA substantial number of high-risk patients had PEP even receiving post-ERCP rectal indomethacin. The independent risk factors included suspected SOD, hilar stricture, more cannulation attempts, inadvertent PD cannulation, and PD contrast injections.Trial RegistrationNCT02709421 (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 6, 2018 Category: Surgery Source Type: research

Preoperative Biliary Drainage Is Associated with Increased Complications After Liver Resection for Proximal Cholangiocarcinoma
AbstractBackgroundPreoperative biliary drainage (PBD) prior to liver resection for hilar and intrahepatic cholangiocarcinoma (CCA) is common. While PBD for those with distal obstructions has been studied extensively and is associated with increased infectious complications, the impact of PBD among patients undergoing hepatectomy for non-disseminated proximal CCA has yet to be clearly elucidated.MethodsPatients undergoing liver resection between 2014 and 2016 for non-disseminated hilar and intrahepatic CCA were analyzed using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database...
Source: Journal of Gastrointestinal Surgery - July 6, 2018 Category: Surgery Source Type: research

Late Pancreatic Anastomosis Stricture Following Pancreaticoduodenectomy: a Systematic Review
ConclusionPJA stricture following PD is a late, unusual, and potentially serious complication. When there is currently no clear consensus, PJA stricture leading to abdominal pain or acute pancreatitis should be considered treatment. With increasing survival after PD, further studies should focus on late complications.Core TipStricture of pancraticojejunostomy is a late and potentially serious complication after pancreaticoduodenectomy. Incidence reaches 1.4 –11.4% and no risk factor is identified. Symptoms are inconsistent but postprandial abdominal pain, recurrent acute pancreatitis, and impaired pancreatic function...
Source: Journal of Gastrointestinal Surgery - July 6, 2018 Category: Surgery Source Type: research

Practical Contribution of Virtual Hepatectomy for Colorectal Liver Metastases: a Propensity-Matched Analysis of Clinical Outcome
This study sought to assess how three-dimensional analysis using a VH contributed to preoperative planning and postoperative outcome in patients undergoing liver surgery for the treatment of colorectal liver metastases (CRLM).MethodsFrom 2007 to 2017, a total of 473 CRLM patients who received curative hepatectomy were retrospectively assessed. A 1:1 matched propensity analysis was performed between patients who did not receive a VH (without 3D group:n = 188) and received a VH (3D(+) group:n = 285).ResultThe rate of VH increased over the study period (P 
Source: Journal of Gastrointestinal Surgery - July 6, 2018 Category: Surgery Source Type: research

Effects of Calcitonin Gene-Related Peptide on Colonic Motility and Defecation in Conscious Dogs
ConclusionsIntravenous CGRP induces colonic motility and defecation through acetylcholine release in conscious dogs. The continuity of the enteric nerves plays an important role in CGRP-induced colonic contractions and defecation, while the extrinsic nerves suppress CGRP-induced colonic motility. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 6, 2018 Category: Surgery Source Type: research

A Prospective, Randomized, Phase III Study to Evaluate the Efficacy and Safety of Fibrin Sealant Grifols as an Adjunct to Hemostasis as Compared to Cellulose Sheets in Hepatic Surgery Resections
AbstractBackgroundLocal hemostatic agents have a role in limiting bleeding complications associated with liver resection.MethodsIn this randomized, phase III study, we compared the efficacy and safety of Fibrin Sealant Grifols (FS Grifols) with oxidized cellulose sheets (Surgicel ®) as adjuncts to hemostasis during hepatic resections. The primary efficacy endpoint was the proportion of patients achieving hemostasis at target bleeding sites (TBS) within 4 min (T4) of treatment application. Secondary efficacy variables were time to hemostasis (TTH) at a later time point if re-bleeding occurs and cumulative proportio...
Source: Journal of Gastrointestinal Surgery - July 2, 2018 Category: Surgery Source Type: research

Effect of Inclusion of Oral Antibiotics with Mechanical Bowel Preparation on the Risk of Clostridium Difficile Infection After Colectomy
ConclusionThe use of OA as bowel preparation may reduce, rather than increase, the risk of 30-day CDI after colectomy. This effect may partly be due to the other recovery advantages associated with oral antibiotics. These data further support current data recommending the use of oral antibiotics for bowel preparation before colectomy. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 2, 2018 Category: Surgery Source Type: research

Obstructed Paraduodenal Hernia
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 29, 2018 Category: Surgery Source Type: research

Anterior Approach to Major Resection for Colorectal Liver Metastasis
AbstractPurposeThe aim of this study was to examine the merits of the anterior approach, if any, in colorectal liver metastasis (CRLM) resection.MethodsData of patients who underwent partial hepatectomy for CRLM were reviewed. Patients treated by the anterior approach were compared with patients treated by the conventional approach.ResultsNinety-eight patients had right hepatectomy, extended right hepatectomy, or right trisectionectomy. Among them, 71 patients underwent the conventional approach (CA group) and 27 underwent the anterior approach (AA group). The two groups were comparable in demographic, pathological, and pe...
Source: Journal of Gastrointestinal Surgery - June 29, 2018 Category: Surgery Source Type: research

Giant Primary Retroperitoneal Dedifferentiated Liposarcoma
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 29, 2018 Category: Surgery Source Type: research

Disseminated Peritoneal Leiomyomatosis
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 29, 2018 Category: Surgery Source Type: research

Further Classification for Node-Positive Gastric Neuroendocrine Neoplasms
The objective of this study was to evaluate the prognostic significance of the number of involved locoregional nodes among resected GNEN.MethodsThe National Cancer Database (2004 –2014) was queried for GNEN patients who had undergone partial/total gastrectomy with known nodal status. Nearest-neighborhood grouping was used to identify survival clusters by number of metastatic nodes and to use these groupings to construct a new N classification (pN). External validation was performed using the SEER database. Kaplan-Meier analysis and Cox regression models were used to assess the prognostic strength of the pN classifica...
Source: Journal of Gastrointestinal Surgery - June 27, 2018 Category: Surgery Source Type: research

The Cost of Complications Following Major Resection of Malignant Neoplasia
ConclusionsQuantifying and comparing the impact of complications on an indication-specific level in more complex patients offers an important step toward allowing providers/payers to meaningfully prioritize the design of novel and adaptation of existing value-maximization approaches. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 26, 2018 Category: Surgery Source Type: research

Should Surgical Treatment Be Provided to Patients with Colorectal Cancer Who Are Aged 90  Years or Older?
This study aimed to investigate the clinical outcomes of patients with primary colorectal cancer aged ≥ 90 years.MethodsWe retrospectively reviewed the medical records of 100 patients (aged ≥ 90 years) with primary colorectal adenocarcinoma. Their demographic and clinical characteristics and surgical outcomes were assessed.ResultsThe patients who underwent tumor resections (n = 71) showed longer overall and cancer-specific survival than those who underwent non-operative treatments (n = 29) (median overall survival time: 23.92 months vs. 2.99 months,P 
Source: Journal of Gastrointestinal Surgery - June 25, 2018 Category: Surgery Source Type: research

Sarcopenic Obesity Is Associated with Severe Postoperative Complications in Gastric Cancer Patients Undergoing Gastrectomy: a Prospective Study
ConclusionsSarcopenic obesity, together with age, open surgery, and combined resection are independent predictors of SPCs. Obesity will significantly increase the risk of SPCs in sarcopenic patient with gastric cancer, but it will not bring higher risk to normal patients. Our nomogram is a simple and practical instrument to identify patients at high risk of surgical complications. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 25, 2018 Category: Surgery Source Type: research

Independent Predictors of Increased Operative Time and Hospital Length of Stay Are Consistent Across Different Surgical Approaches to Pancreatoduodenectomy
AbstractBackgroundWhile minimally invasive approaches are increasingly being utilized for pancreatoduodenectomy (PD), factors associated with prolonged operative time (OpTime) and hospital length of stay (LOS) remain poorly defined, and it is unclear whether these factors are consistent across surgical approaches.MethodsThe ACS-NSQIP targeted pancreatectomy database from 2014 to 2016 was used to identify all patients who underwent open (OPD), laparoscopic (LPD), or robotic (RPD) pancreatoduodenectomy. Multivariable linear regression analyses were used to evaluate predictors of OpTime and LOS, as well as quantify the change...
Source: Journal of Gastrointestinal Surgery - June 25, 2018 Category: Surgery Source Type: research

Use of Epidural Analgesia in Sigmoidectomy: Is There Any Advantage in the Era of Minimally Invasive Surgery?
ConclusionsEpidural analgesia did not offer benefits on postoperative analgesia or outcomes after elective laparoscopic sigmoidectomy, causing longer length of stay, later mobilisation and higher complication rate. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 25, 2018 Category: Surgery Source Type: research

Acquired Adult Aerodigestive Fistula: Classification and Management
ConclusionBy classifying ADFs, we have demonstrated that anatomical location correlates with the size, history of malignancy, previous radiotherapy and aetiology of ADF, which can affect management. The proposed classification system will aid in formulating multi-modality individualised treatment plans. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 25, 2018 Category: Surgery Source Type: research

Laparoscopic Heller Myotomy and Hiatal Hernia Repair After Failed Peroral Endoscopic Myotomy
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 25, 2018 Category: Surgery Source Type: research

The Efficacy of Antimicrobial-Coated Sutures for Preventing Incisional Surgical Site Infections in Digestive Surgery: a Systematic Review and Meta-analysis
ConclusionAntimicrobial-coated sutures are significantly more efficacious for preventing SSIs during digestive and colorectal surgery, even when restricted to clean-contaminated wounds. However, the hospital stay length was not affected. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 20, 2018 Category: Surgery Source Type: research

Anatomy of the Right Anterior Sector of the Liver and Its Clinical Implications in Surgery
ConclusionBetter knowledge of RAS anatomy could allow for parenchymal preservation by using subsegmentectomy of the RAS, selective or as a part of a major hepatectomy. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 18, 2018 Category: Surgery Source Type: research

Synergistic Effects of Perioperative Complications on 30-Day Mortality Following Hepatopancreatic Surgery
The objective of the current study was to define the interaction effect of postoperative complications among patients undergoing HP surgery on 30-day mortality.MethodsUsing the ACS-NSQIP Procedure Targeted Participant Use Data File, patients who underwent HP surgery between 2014 and 2016 were identified. Hazard ratios (HRs) for 30-day mortality were estimated using Cox proportional hazard models. Two-way interaction effects assessing combinations of complications relative to 30-day mortality were calculated using the relative excess risk due to interaction (RERI) in separate adjusted Cox models.ResultsAmong 26,824 patients...
Source: Journal of Gastrointestinal Surgery - June 18, 2018 Category: Surgery Source Type: research

Comparison of Models for Predicting Quality of Life After Surgical Resection of Hepatocellular Carcinoma: a Prospective Study
AbstractBackgroundThe essential issue of internal validity has not been adequately addressed in prediction models such as artificial neural network (ANN), support vector machine (SVM), Gaussian process regression (GPR), and multiple linear regression (MLR) models.MethodsThis prospective study compared the accuracy of these four models in predicting quality of life (QOL) after hepatic resection received by 332 patients with hepatocellular carcinoma (HCC) during 2012 –2015. An estimation subset was used to train the models, and a validation subset was used to evaluate their performance. Sensitivity score approach was a...
Source: Journal of Gastrointestinal Surgery - June 18, 2018 Category: Surgery Source Type: research

Anatomical Boundary Between the Caudate Lobe of the Liver and Adjacent Segments Based on Three-Dimensional Analysis for Precise Resections
ConclusionsThe paracaval portion of the liver protruded on the liver surface underneath the right diaphragm in one third of our participants. The paracaval vein can be a landmark for the boundary between the caudate lobe and the segment 7 or 8 in half of the cases. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 18, 2018 Category: Surgery Source Type: research

Feasibility of Laparoscopic Distal Gastrectomy for Stage I Gastric Cancer in Patients Outside of Clinical Trials
ConclusionLADG was as safe as ODG in patients who did not meet the eligibility criteria of JCOG 0912. LADG could be a standard treatment option for patients with stage I gastric cancer, regardless of their general condition. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 18, 2018 Category: Surgery Source Type: research

Robotic Excision of Retrorectal Mass
We present a case of successful robotic removal of a large retrorectal cyst.MethodsVideo presentation of a robotic excision of a retrorectal mass.ResultsWe present a case of robotic removal of a large retrorectal mass extending up to the S3 vertebra.DiscussionRobotic approach is a very useful tool for successful removal of large pelvic masses that cannot be removed by traditional posterior or trans perineal approach. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 15, 2018 Category: Surgery Source Type: research

R1 Resection for Colorectal Liver Metastases: a Survey Questioning Surgeons about Its Incidence, Clinical Impact, and Management
ConclusionsA negative margin is still standard for CLM, but R1 resection is no longer just a technical error. R1 resection should be part of the modern multidisciplinary, aggressive approach to CLM. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 8, 2018 Category: Surgery Source Type: research

Perioperative Net Fluid Balance Predicts Pancreatic Fistula After Pancreaticoduodenectomy
ConclusionHigh net 72-h fluid balance is an independent predictor of POPF after PD. Given ongoing efforts to minimize PD morbidity, net fluid balance may represent a clinical predictor and, possibly, a modifiable target for prevention of POPF. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 4, 2018 Category: Surgery Source Type: research

Outcomes of Surgical and Endoscopic Resection of Duodenal Neuroendocrine Tumours (NETs): a Systematic Review of the Literature
ConclusionsRadical surgical resection in the form of PD was associated with higher post-operative morbidity among patients with dNETs yet provided better margin clearance. Patients with dNETs need systematic evaluation with a view to obtain most of the information about the prognostic factors in order to tailor the treatment options. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 4, 2018 Category: Surgery Source Type: research

Gastric Calcifying Fibrous Tumor Manifesting as a Subepithelial Tumor
AbstractA gastric subepithelial tumor is a common finding during upper gastric endoscopy. The differential diagnosis of such lesions is broad, and sometimes a rare disease can be diagnosed. A calcifying fibrous tumor (CFT) is a rare, benign mesenchymal tumor that usually affects children and young adults. To our knowledge, a CFT of the tubular gastrointestinal tract is very rare with fewer than 30 cases of gastric CFTs reported in the literature. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - May 23, 2018 Category: Surgery Source Type: research

ALPPS for Hepatocellular Carcinoma Is Associated with Decreased Liver Remnant Growth
DiscussionIn our study, HCC patients demonstrated significantly less FLR growth after ALPPS-Stage 1 compared to non-HCC patients. Hepatic fibrosis was also found to negatively impact FLR growth. When considering suitability for ALPPS, patients with HCC may benefit from additional pre-operative assessment of fibrosis. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - May 23, 2018 Category: Surgery Source Type: research

IgG4-Related Disease of the Appendix
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - May 23, 2018 Category: Surgery Source Type: research

Peri-Operative Blood Transfusion Does Not Influence Overall and Disease-Free Survival After Radical Gastrectomy for Stage II/III Gastric Cancer: a Propensity Score Matching Analysis
ConclusionsThe present study revealed that BTF did not influence OS and DFS after radical gastrectomy for stage II/III GC. Worse oncological outcomes were caused by clinical circumstances requiring blood transfusions, including longer operation time and advanced tumor stage, not due to BTF itself. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - May 18, 2018 Category: Surgery Source Type: research

A Nomogram to Predict Anastomotic Leakage in Open Rectal Surgery —Hope or Hype?
ConclusionsThe proposed nomogram and the adopted risk score failed to reliably predict the occurrence of anastomotic leakage after rectal resection. Risk scores as prognostic models for the prediction of anastomotic leakage, independently of the study population, still need to be identified. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - May 18, 2018 Category: Surgery Source Type: research

Improved Outcomes in 394 Pancreatic Cancer Resections: the Impact of Enhanced Recovery Pathway
The objectives were to assess compliance with Enhanced Recovery After Surgery (ERAS) elements and to assess outcomes in pancreatic surgery.MethodsProspective study conducted from February 2014 to December 2016, following elective pancreatic cancer surgery. Team was educated prior to implementation of ERAS. Patients were followed up until 30  days postoperatively or discharge. Data was recorded regarding the compliance with the protocol, functional GI recovery, mobilisation, and postoperative morbidity and mortality.ResultsA total of 394 patients underwent surgery. Compliance with ER elements implemented was 84% (23 &n...
Source: Journal of Gastrointestinal Surgery - May 18, 2018 Category: Surgery Source Type: research

Revision of Surgical Margin under Frozen Section to Achieve R0 Status on Survival in Patients with Pancreatic Cancer
ConclusionsThe present study did not support the concept of achieving an R0 resection by intraoperative re-resection would benefit the patient ’s survival. R1 margin at the time of surgery is more like a marker of aggressive tumor biology. Future well-designed randomized controlled trials are needed to confirm the conclusion. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - May 18, 2018 Category: Surgery Source Type: research

Combined Preoperative ALBI and FIB-4 Is Associated with Recurrence of Hepatocellular Carcinoma After Curative Hepatectomy
This study aimed to develop a nomogram incorporating the combined albumin-bilirubin (ALBI) and fibrosis-4 (FIB-4) scores and the peritumoral inflammation score (PIS) to predict postoperative recurrence-free survival (RFS) of hepatocellular carcinoma (HCC).MethodsThe prognostic roles of preoperative ALBI and FIB-4 scores for HCC recurrence were investigated, and a nomogram was developed. The predictive ability of the nomogram was compared with the American Joint Commission on Cancer (AJCC) and Barcelona Clinic Liver Cancer (BCLC) staging systems for HCC. Necroinflammatory activity in the peritumoral liver tissues was evalua...
Source: Journal of Gastrointestinal Surgery - May 18, 2018 Category: Surgery Source Type: research

Distal Bowel Re-feeding in Patients with Proximal Jejunostomy
ConclusionsPatients with proximal jejunostomies can be managed with distal re-feeding. It is a cost-effective and effective substitute for PN, is associated with few problems, and has a fairly good long-term outcome. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - May 18, 2018 Category: Surgery Source Type: research

Readmission After Abdominal Surgery for Crohn ’s Disease: Identification of High-Risk Patients
The objective of this study is to identify predictive factors and high-risk patients for readmission after abdominal CD surgery.MethodsAll patients who underwent abdominal surgery for CD in one tertiary referral center between January 2004 and December 2016 were included. Patients who required readmission and those without were compared. Perineal procedures, elective readmissions, and abdominal procedures for non-Crohn ’s indications were not included.ResultsNine hundred eight abdominal procedures were performed in 712 patients. Readmission rates were 8, 8.5, 8.6, 8.8, and 8.9% at 30, 60, and 90  days and 12 and...
Source: Journal of Gastrointestinal Surgery - May 16, 2018 Category: Surgery Source Type: research

Gastro-Gastric Fistula after Sleeve Gastrectomy
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - May 16, 2018 Category: Surgery Source Type: research

Toward a More Sensitive Endpoint for Assessing Postoperative Complications in Patients with Inflammatory Bowel Disease: a Comparison Between Comprehensive Complication Index (CCI) and Clavien-Dindo Classification (CDC)
AbstractBackgroundThe comprehensive complication index (CCI) is a novel approach to evaluate complications. However, application of the CCI in inflammatory bowel disease (IBD) population is scarce and the difference between the CCI and the Clavien-Dindo classification (CDC) remains unknown. The aim of this study was to compare the CCI to the conventional CDC by applying the CCI among the IBD patients.MethodsThe data of 426 IBD patients who underwent surgery between September 1, 2015 and August 31, 2017 were collected. Univariate and multivariate analyses were conducted to identify risk factors for postoperative complicatio...
Source: Journal of Gastrointestinal Surgery - May 15, 2018 Category: Surgery Source Type: research

Prognostic Significance of Post-Operative Morbidity Severity Score After Potentially Curative D2 Gastrectomy for Carcinoma
AbstractBackgroundSurvival and relapse after gastric cancer surgery are largely attributed to tumor biology and surgical radicality; yet, other prognostic factors have been reported, including respiratory sepsis and anastomotic leakage, but not global morbidity severity score (MSS). The hypothesis tested was that MSS would be associated with both disease-free (DFS) and overall survival (OS).MethodsConsecutive 373 patients undergoing potentially curative surgery for gastric adenocarcinoma between 2004 and 2016 in a UK cancer network were studied. Complications were defined prospectively as any deviation from a pre-determine...
Source: Journal of Gastrointestinal Surgery - May 15, 2018 Category: Surgery Source Type: research

The Impact of MDCT and Endoscopic Transpapillary Mapping Biopsy to Predict Longitudinal Spread of Extrahepatic Cholangiocarcinoma
ConclusionsMDCT demonstrated highest accuracy of diagnosing longitudinal extension at possible surgical ductal margins in patients with extrahepatic cholangiocarcinoma. The depth of tumor invasion could be predicted by ductal wall thickness and contrast enhancement of MDCT. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - May 15, 2018 Category: Surgery Source Type: research

Complete Appendiceal Intussusception Associated with Endometriosis
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - May 15, 2018 Category: Surgery Source Type: research

Natural History of Gas Configurations and Encapsulation in Necrotic Collections During Necrotizing Pancreatitis
ConclusionsGas configurations occur in every phase of the disease and develop in half of the patients with infected necrotizing pancreatitis. Opposed to traditional views, clinically relevant walled-off necrosis occurs frequently within the first 3  weeks. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - May 11, 2018 Category: Surgery Source Type: research

Distal Pancreatectomy Combined with Multivisceral Resection Is Associated with Postoperative Complication Rates and Survival Comparable to Those After Standard Procedures
AbstractBackgroundFor pancreatic tumors located in the body or tail of the pancreas, distal pancreatectomy (DP) remains the surgical procedure of choice to achieve radical tumor removal. Purpose of this study was to evaluate outcome and overall survival of patients who underwent DP combined with multivisceral resection (MVR).MethodsRetrospective single-center case-matched analysis. Between January 1994 and June 2014, 494 consecutive patients were entered into a prospective database, and 126 patients undergoing DP + MVR (cases) were matched with 126 patients undergoing DP (controls) for gender, age, and underlying final dia...
Source: Journal of Gastrointestinal Surgery - May 10, 2018 Category: Surgery Source Type: research

The Impact of Discharge Timing on Readmission Following Hepatopancreatobiliary Surgery: a Nationwide Readmission Database Analysis
The objective of the current study was to define the impact of discharge timing on readmission, mortality, and charges following hepatopancreatobiliary (HPB) surgery.MethodsThe Nationwide Readmissions Database (NRD) was used to identify patients undergoing HPB procedures between 2010 and 2014. Length of stay (LOS) was categorized as early discharge (4 –5 days), routine discharge (6–9 days), and late discharge (10–14 days). Univariable and multivariable analyses were utilized to identify factors associated with 90-day readmission.ResultsA total of 28,114 patients underwent HPB procedures. Ov...
Source: Journal of Gastrointestinal Surgery - May 7, 2018 Category: Surgery Source Type: research

A Propensity Score-Matched Comparison of Robotic Versus Laparoscopic Gastrectomy for Gastric Cancer: Oncological, Cost, and Surgical Stress Analysis
AbstractBackgroundRobotic-assisted gastrectomy (RAG) has been rapidly adopted for gastric cancer (GC) treatment. However, whether RAG provides any significant outcome/cost advantages over laparoscopy-assisted gastrectomy (LAG) for the experienced laparoscopist remains unclear.MethodsA retrospective review of a prospectively collected database identified 768 consecutive patients who underwent either RAG (n = 103) or LAG (n = 667) for GC between July 2016 and June 2017 at a large center. A 1:3 matched propensity score analysis was performed. The short-term outcomes and hospital costs between the t...
Source: Journal of Gastrointestinal Surgery - May 7, 2018 Category: Surgery Source Type: research

Immunohistochemical Predictors for Intestinal and Pancreatobiliary Types of Adenocarcinoma of The Ampulla of Vater
ConclusionsCDX2 and CK7 were the immunohistochemical markers that best discriminated the intestinal from the pancreatobiliary type. Lymph node involvement had a high impact on survival and proved to be more frequent in the pancreatobiliary type. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - May 7, 2018 Category: Surgery Source Type: research