Journal of Gastrointestinal Surgery最新文献

{"title":"POST-OPERATIVE ANALGESIA WITH INSTILLATION OF INTRAPERITONEAL ROPIVACAINE IN PATIENTS UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMIES.","authors":"Antônio Benincá Albuquerque, Carolina Carlesso de Freitas, Isabela Corrêa Bitencourt, Isadora Alves Pereira Chiuchetta, Plínio Carlos Baú, Alexandre Vontobel Padoin","doi":"10.1016/j.gassur.2025.102034","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.102034","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102034"},"PeriodicalIF":2.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumour Biology Characteristics Score Based on AFP and PIVKA-II Predicts Recurrence and Survival After Curative Resection for Hepatocellular Carcinoma: A Multicentre Cohort Study.","authors":"Ming-Da Wang, Bai-Dong Wang, Yong-Kang Diao, Chao Li, Lan-Qing Yao, Han Liu, Yong-Yi Zeng, Zhong Chen, Han Wu, Xin-Fei Xu, Li-Hui Gu, Jia-Hao Xu, Dong-Xu Yin, Yu-Chen Li, Fu-Jie Chen, Alfred Wei Chieh Kow, Timothy M Pawlik, Feng Shen, Tian Yang","doi":"10.1016/j.gassur.2025.102038","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.102038","url":null,"abstract":"<p><strong>Background: </strong>Current hepatocellular carcinoma (HCC) staging systems lack comprehensive assessment of tumour biological characteristics. This study aimed to develop and validate a tumour biology characteristics score (TBCS) based on alpha-fetoprotein (AFP) and protein induced by vitamin K absence or antagonist-II (PIVKA-II) to predict long-term oncologic outcomes after HCC resection.</p><p><strong>Methods: </strong>In this multicentre retrospective cohort study, patients who underwent curative resection for HCC between June 2018 and December 2022 were included. TBCS (range 2-6 points) was calculated by combining preoperative AFP (<20, 20~199, ≥200ng/mL) and PIVKA-II (<40, 40~399, ≥400 mAU/mL) levels. Patients were stratified into low (2 points), medium (3~4 points), and high (5~6 points) TBCS groups. The primary outcomes were recurrence-free survival (RFS) and overall survival (OS).</p><p><strong>Results: </strong>A total of 695 patients were analysed; the low, medium, and high TBCS groups comprised 132 (19.0%), 233 (33.5%), and 330 (47.5%) patients, respectively. 5-year RFS was 30.4%, 14.7%, and 9.7%, while 5-year OS was 42.1%, 35.5%, and 23.5% for low, medium, and high TBCS groups, respectively (both P<0.001). Multivariate analysis identified TBCS as an independent predictor of both RFS (medium TBCS: HR 1.583, 95% CI 1.219-2.057, P=0.001; high TBCS: HR 1.895, 95% CI 1.473-2.438, P<0.001) and OS (high TBCS: HR 1.781, 95% CI 1.353-2.343, P<0.001).</p><p><strong>Conclusions: </strong>The novel TBCS combining AFP and PIVKA-II effectively stratified HCC patients into distinct prognostic groups after curative-intent resection, independently predicting both RFS and OS. This score may help identify high-risk patients for more intense postoperative recurrence surveillance, as well as receipt of adjuvant therapies.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102038"},"PeriodicalIF":2.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bypass is associated with lower treatment failure than stricturoplasty in duodenal Crohn's disease: a systematic review with pairwise and network meta-analyses.","authors":"Justin Dourado, Anjelli Wignakumar, Sameh Hany Emile, Peter Rogers, Brett P Weiss, Sualeh Muslim Khan, Pauline Aeschbacher, Steven D Wexner","doi":"10.1016/j.gassur.2025.102041","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.102041","url":null,"abstract":"<p><strong>Background: </strong>Crohn's disease (CD) of the duodenum is uncommon, with the goal of treatment often being avoidance of surgery. However, as many as one-third of these patients will eventually require surgery for their disease. This study aimed to compare outcomes and safety of surgical treatments for duodenal CD.</p><p><strong>Methods: </strong>In this meta-analysis, a search was conducted for studies that reported outcomes of surgical treatment of duodenal CD. The primary outcome was treatment failure. Secondary outcomes were postoperative complications and reoperation rate.</p><p><strong>Results: </strong>10 studies published between 1970 and 2023, including 325 patients with predominately stricturing duodenal CD, were included. Bypass was the surgical treatment for 155 (68.6%) patients followed by stricturoplasty (21.7%) and resection (8.4%). Pairwise meta-analyses revealed that the only significant finding was a lower rate of treatment failure in favor of bypass when compared to stricturoplasty (OR: 0.41, 95% CI: 0.18; 0.95, p = 0.038) with similar odds of complications and reoperation among the 3 operations. In the network meta-analysis, bypass ranked the best with lowest failure, complication, and reoperation rates. Stricturoplasty was followed by a significantly higher rate of failure compared to bypass (OR: 2.51, 95% CI: 1.10; 5.27, p = 0.028,).</p><p><strong>Conclusion: </strong>Among the three procedures, surgical bypass ranked best with lowest failure, complications, and reoperation rates. While bypass was associated with lower failure than stricturoplasty, both procedures were associated with similar complication and reoperation rates. The authors propose surgical bypass as a safe and effective option for the treatment of stricturing duodenal CD.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102041"},"PeriodicalIF":2.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diuretic long-term medication is an independent predictor of posthepatectomy liver failure.","authors":"Alexander Betzler, Johanna Betzler, Andreas Bogner, Elene Walther, Mohammad Rahbari, Christoph Reissfelder, Carina Riediger, Jürgen Weitz, Nuh N Rahbari, Emrullah Birgin","doi":"10.1016/j.gassur.2025.102035","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.102035","url":null,"abstract":"<p><strong>Background: </strong>Posthepatectomy liver failure (PHLF) is the most fatal complication following liver resection, particularly, in patients with comorbidities. This study aimed to assess the impact of long-term medication on PHLF incidence after open liver resections.</p><p><strong>Methods: </strong>A retrospective analysis of 682 patients who underwent elective open hepatectomies between 2008 and 2015 at two academic centers was performed. Preoperative, intraoperative, and postoperative data were collected, including long-term medication. Risk factors for the development of PHLF and other postoperative complications were evaluated using univariate and multivariable logistic regression analyses.</p><p><strong>Results: </strong>PHLF occurred in 11.9% (n=81) of patients, with a higher incidence in those taking diuretics as long-term medication (17.7% vs. 5.3%, P < 0.001). Diuretic use was identified as a strong independent risk factor for PHLF (OR 3.8, 95%CI 2.1 - 7.0, P < 0.001), alongside liver cirrhosis (OR 3.8, 95%CI 1.9 - 7.6, P < 0.001), primary liver malignancies (OR 3.8, 95%CI 1.6 - 9.3, P < 0.001), major hepatectomies (OR 3.1, 95%CI 1.7 - 5.7, P < 0.001) and long operating time (OR 4.2, 95% CI 2.4 - 7.2, P < 0.001). Patients with long-term diuretic intake were older, had higher BMIs, and more comorbidities, including liver cirrhosis.</p><p><strong>Conclusion: </strong>Long-term diuretic use is associated with a significantly increased risk of PHLF after open hepatectomy.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102035"},"PeriodicalIF":2.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the preoperative transpapillary unilateral biliary drainage methods for the future remnant liver in patients with hilar cholangiocarcinoma with liver resection: A retrospective cross-sectional study.","authors":"Mitsuru Okuno, Keisuke Iwata, Takuji Iwashita, Tsuyoshi Mukai, Kota Shimojo, Yosuke Ohashi, Yuhei Iwasa, Akihiko Senju, Shota Iwata, Ryuichi Tezuka, Hironao Ichikawa, Naoki Mita, Shinya Uemura, Kensaku Yoshida, Akinori Maruta, Eiichi Tomita, Ichiro Yasuda, Masahito Shimizu","doi":"10.1016/j.gassur.2025.102039","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.102039","url":null,"abstract":"<p><strong>Background and aims: </strong>Transpapillary preoperative biliary drainage (PBD) only for the future remnant liver (FRL) in hilar cholangiocarcinoma (HCCA) can be performed minimally invasively, with the expectation of swelling of the FRL. However, verification of the appropriate transpapillary unilateral PBD method for FRL is limited since the cases of liver resection are insufficient.</p><p><strong>Methods: </strong>A total of 63 patients with resectable HCCA were evaluated. Twelve unilateral across-the-papilla plastic stent placement cases (PS group), 14 unilateral intraductal plastic stent placement cases (IS group), and 11 unilateral endoscopic nasobiliary drainage cases (ENBD group) met the inclusion criteria. Each group was compared regarding the hospital stay duration for the endoscopic procedure, recurrent biliary obstruction (RBO), time to RBO (TRBO), overall survival (OS), and surgical outcomes.</p><p><strong>Results: </strong>No significant differences were observed in the patient characteristics between the groups. Hospital stay for the endoscopic procedure was significantly longer in the ENBD group (50[33-163]days) than in the PS group (14[2-36]days; P<0.01) or IS group (21[6-118]days; P<0.01). There were no significant differences in the RBO, TRBO, OS, surgical time, amount of intraoperative blood loss, or post-surgical adverse events (AEs) between the groups. In the multivariate analysis, there were no significantly related factors for RBO, TRBO, OS, and post-surgical AEs.</p><p><strong>Conclusions: </strong>The PS, IS, and ENBD groups showed similar clinical outcomes in liver resection cases for HCCA, excluding the hospital stay duration for the endoscopic procedure. Considering the hospital stay duration, unilateral PS and IS placement can be considered acceptable for transpapillary PBD.</p><p><strong>Clinical trial registration: </strong>UMIN000052598.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102039"},"PeriodicalIF":2.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Outcomes of Parenchyma-Sparing Repeat Pancreatectomy versus Completion Pancreatectomy: Impact on Endocrine Function and Diabetes Management.","authors":"Ryoji Furuya, Yoshinori Takeda, Atsushi Takahashi, Ryota Ito, Hirofumi Ichida, Ryuji Yoshioka, Yoshihiro Mise, Yosuke Inoue, Yu Takahashi, Akio Saiura","doi":"10.1016/j.gassur.2025.102040","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.102040","url":null,"abstract":"<p><strong>Background: </strong>Although completion pancreatectomy (CP) is the standard approach for repeat pancreatectomy of secondary pancreatic tumors, the incidence of postoperative endocrine insufficiency is high. Parenchyma-sparing repeat pancreatectomy (PSRP) could preserve this function; however, its feasibility and long-term outcomes have not been evaluated. This study compared short-term outcomes and long-term endocrine pancreatic function between PSRP and CP.</p><p><strong>Methods: </strong>Consecutive patients who underwent a second pancreatectomy between April 2005 and March 2024 at two high-volume centers were included. We compared the short- and long-term outcomes between the PSRP and CP groups. Serum HbA1c levels 6 months after surgery and the occurrence of hypoglycemic episodes were evaluated as indicators of endocrine function.</p><p><strong>Results: </strong>Thirty patients (11 PSRP and 19 CP) were included. The two groups showed no significant differences in the preoperative or intraoperative findings. None of the patients in the PSRP group experienced major morbidity (Clavien-Dindo grade ≥ 3), while four patients (21%) in the CP group experienced major morbidity. HbA1c levels and the requirement for insulin therapy were significantly lower in the PSRP group (6.2% vs. 7.6%, p < 0.001 and 27% vs. 100%, p < 0.001). Hypoglycemic episodes were observed only in the CP group (4 patients).</p><p><strong>Conclusion: </strong>PSRP might have favorable short-term outcomes and better long-term endocrine function than CP.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102040"},"PeriodicalIF":2.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities In Access to Surgical Resection in Patients with Pancreatic Cancer - A Systematic Review.","authors":"Michelle M Holland, Hamza Khan, Krisha Amin, Jaspinder S Sanghera, Ioannis Liapis, Nritya Nair, Joshua Richman, Smita Bhatia, Larry R Hearld, Martin J Heslin, Annabelle L Fonseca","doi":"10.1016/j.gassur.2025.102037","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.102037","url":null,"abstract":"<p><strong>Background: </strong>Surgical resection is a critical component in the treatment of pancreatic cancer, yet multiple disparities in access to surgical resection have been described. This systematic review aims to critically assess and summarize these disparities to improve equity in cancer care.</p><p><strong>Methods: </strong>PubMed, Web of Science, Embase, Medline and Cochrane databases were searched from 2000 to 2023. Primary research articles from the United States specifically evaluating surgical resection for resectable pancreatic adenocarcinoma cancer were included. Bias assessment was conducted using the modified Newcastle-Ottawa scale.</p><p><strong>Results: </strong>19 studies met final inclusion criteria. 16 studies reported disparities in minority groups with Black and Hispanic patients less likely to receive surgery. 15 studies reported older age being predictive for non-receipt of surgery. Eight studies reported lower socioeconomic status and seven studies reported non-private insurance as an independent risk factor for decreased receipt of surgery respectively. Five studies reported patients treated in community hospitals were less likely to receive surgery. Four studies identified being single as an independent risk factor of non-receipt of surgery. One study identified residence in a rural location, and another study reported male sex to be predictive of decreased receipt of surgery.</p><p><strong>Discussion: </strong>A variety of sociodemographic factors influence access to surgical resection for pancreatic cancer. These factors are proxies for multiple underlying barriers along the continuum of care, some of which may be modifiable. Identifying and understanding these barriers will allow us to develop targeted interventions to improve the delivery of oncologic care.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102037"},"PeriodicalIF":2.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor regarding “University hospital status and gastric cancer mortality: a population-based nationwide study in Finland”","authors":"Xue Fang ,&nbsp;Shuang Li ,&nbsp;Chunyan Yang ,&nbsp;Wenxin Yang","doi":"10.1016/j.gassur.2025.102042","DOIUrl":"10.1016/j.gassur.2025.102042","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 5","pages":"Article 102042"},"PeriodicalIF":2.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Switching Biologic Drug Class After Resection for Crohn's Disease is Associated with Increased Risk of Re-intervention.","authors":"Olivia Ziegler, Alicia C Greene, Eric W Schaefer, Michael J Deutsch, Jeffrey S Scow, Matthew D Coates, Audrey S Kulaylat","doi":"10.1016/j.gassur.2025.102033","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.102033","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102033"},"PeriodicalIF":2.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic therapy with fully covered metal stents for management of post- colorectal surgery anastomotic stenoses: a retrospective study.","authors":"Rahul Karna, Cyrus Jahansouz, Paolo Goffredo, Nabeel Azeem, Stuart K Amateau","doi":"10.1016/j.gassur.2025.102032","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.102032","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102032"},"PeriodicalIF":2.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}