Journal of Gastrointestinal Surgery最新文献

{"title":"Letter to Editor regarding: Preoperative endoscopy in revisional bariatric surgery: who should hold the scope?","authors":"Jia Chen, Xu Zhang, Lei Zhu","doi":"10.1016/j.gassur.2026.102639","DOIUrl":"https://doi.org/10.1016/j.gassur.2026.102639","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102639"},"PeriodicalIF":2.8,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166972","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":"Invited commentary on: Venous Thromboembolism after Surgery for Chronic Pancreatitis: Is Extended Postoperative Chemoprophylaxis Warranted?","authors":"J Christopher Polanco-Santana, Tara S Kent","doi":"10.1016/j.gassur.2026.102635","DOIUrl":"https://doi.org/10.1016/j.gassur.2026.102635","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102635"},"PeriodicalIF":2.8,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169409","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":"Escalation of Care: Association of Weekend and Nighttime Postoperative ICU Admission with Poor Outcomes After Gastrointestinal Cancer Surgery.","authors":"Qaidar Alizai, Lorenza Arena, Selamawit Woldesenbet, Timothy M Pawlik","doi":"10.1016/j.gassur.2026.102632","DOIUrl":"https://doi.org/10.1016/j.gassur.2026.102632","url":null,"abstract":"<p><strong>Background: </strong>Postoperative intensive care unit (ICU) admission represents an important escalation of care after surgery. We evaluated the association between ICU admission timing and outcomes after gastrointestinal (GI) cancer surgery.</p><p><strong>Methods: </strong>Adults undergoing GI cancer surgery with postoperative ICU care were identified in Epic Cosmos from 2016 to 2025 and classified as weekday, weekend-day, weeknight, or weekend-night admission. Outcomes included complications during the index hospitalization and within 30 days, 30-day mortality, readmission, discharge home, and prolonged length of stay (LOS ≥75th percentile of the cohort). Multivariable logistic regression evaluated associations between ICU timing and outcomes.</p><p><strong>Results: </strong>Among 77,054 patients, 36.4% were classified as weekday, 15.4% weekend-day, 25.0% weeknight, and 23.2% weekend-night. Weekend-night classification was associated with the highest adjusted odds of 30-day mortality (aOR 1.52, 95% CI 1.42-1.63), any 30-day complication (aOR 1.76, 95% CI 1.69-1.84), and prolonged LOS (aOR 2.32, 95% CI 2.21-2.44), as well as lower odds of discharge home (aOR 0.70, 95% CI 0.67-0.73). Weeknight classification was also associated with higher odds of mortality (aOR 1.28, 95% CI 1.20-1.37), complications (aOR 1.42, 95% CI 1.36-1.48), and prolonged LOS (aOR 1.55, 95% CI 1.47-1.64).</p><p><strong>Conclusions: </strong>Nighttime ICU classification, particularly weekend-night classification, identified patients at elevated postoperative risk after GI cancer surgery and may help inform surveillance and escalation strategies during off-hours.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102632"},"PeriodicalIF":2.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147691","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":"Gastritis cystica profunda presenting as a subpedunculated polypoid lesion.","authors":"Chen-Xi Zhang, Li-Rong Liu, Wei Liu","doi":"10.1016/j.gassur.2026.102629","DOIUrl":"https://doi.org/10.1016/j.gassur.2026.102629","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102629"},"PeriodicalIF":2.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147844","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":"Triphasic Differentiation in a Bile Duct Neoplasm.","authors":"Yubo Chi, Huan Liu, Jialin Qi","doi":"10.1016/j.gassur.2026.102626","DOIUrl":"https://doi.org/10.1016/j.gassur.2026.102626","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102626"},"PeriodicalIF":2.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148009","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":"Characteristics of metagenome and metabolomics of biliary flora in biliary acute pancreatitis for severity prediction.","authors":"YingFeng Zhang, RongHua Lu","doi":"10.1016/j.gassur.2026.102625","DOIUrl":"https://doi.org/10.1016/j.gassur.2026.102625","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the characteristics of the metagenome and metabolomics of biliary flora in patients with acute biliary pancreatitis and its predictive value for the severity of the disease.</p><p><strong>Methods: </strong>This study included 80 ABP patients (Jan 2022 - Dec 2024) and 30 healthy controls. ABP patients were divided into mild (n = 50) and moderate-severe (n = 30) groups using the revised Atlanta criteria. Chao1 index, Shannon index, relative abundances of Klebsiella, Enterococcus, and Escherichia coli, serum amylase, and C-reactive protein (CRP) were compared. ROC analysis assessed predictive value of Shannon index, Klebsiella abundance, and CRP for severity. Correlations between these parameters and severity were examined.</p><p><strong>Results: </strong>Significant differences were observed among the three groups in Chao1 and Shannon indices, relative abundances of the three bacterial genera, and serum amylase and CRP levels (all P < 0.05). ROC analysis showed that Shannon index, Klebsiella relative abundance, and CRP level predicted disease severity with AUCs of 0.804, 0.804, and 0.850, respectively (P < 0.05). Shannon index was negatively correlated with ABP severity, while Klebsiella abundance and CRP level were positively correlated with severity (P < 0.05).</p><p><strong>Conclusion: </strong>In this cohort, biliary microbiome characteristics and serum inflammatory markers were associated with the severity of biliary acute pancreatitis. The Shannon index, Klebsiella relative abundance, and CRP showed exploratory discriminatory performance. These findings provide a basis for further prospective validation; they do not establish a causal driving factor, a clinically validated early-warning system, or an individualized treatment strategy.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102625"},"PeriodicalIF":2.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148285","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":"Pouchitis Incidence Following IPAA: Multicenter comparison of Open and Minimally Invasive Surgical Approaches.","authors":"Kevin Hoffman, Riyad Abdalla, Eric Chiou","doi":"10.1016/j.gassur.2026.102624","DOIUrl":"https://doi.org/10.1016/j.gassur.2026.102624","url":null,"abstract":"<p><strong>Background: </strong>Pouchitis is the most common long-term complication following ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC) and is a leading cause of chronic morbidity and pouch failure. We sought to examine whether the surgical approach, open versus minimally invasive (MIS), may influence the incidence of pouchitis post-IPAA surgery in patients with UC.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the Epic COSMOS electronic health record database (2016-2025) to identify UC patients who underwent IPAA. The cohort was stratified by open vs MIS. Demographics were compared and the incidence of post-operative pouchitis was analyzed using Poisson regression, chi-square tests with 95% confidence intervals, and Mantel-Haenszel tests; significance was set at p < 0.05.</p><p><strong>Results: </strong>A total of 2,821 patients who underwent IPAA treatment for UC were identified, including 1,001 patients who had an open surgical approach versus 1,820 MIS patients. Absolute pouchitis incidence was 44.8% after open surgery versus 36.8% following MIS. Employing MIS was associated with a decrease in relative risk of developing pouchitis compared to open when adjusting for age, sex, and race using Poisson regression (0.795, 95% CI 0.703-0.899, p = 0.0003).</p><p><strong>Conclusions: </strong>Minimally invasive IPAA shows a significant reduced risk of developing pouchitis as compared to an open surgical approach. Our findings are consistent with prior literature and warrant prospective trials comparing surgical approach and later development of pouchitis complications.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102624"},"PeriodicalIF":2.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136976","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":"Diagnostic Accuracy of Imaging Modalities for Gallbladder Polyps: A 30-Year Multi-Institutional Study.","authors":"Alfredo Verastegui, Zhuo Li, Zhihui Judy Fang, Thiyagarajan Sibi Krishna, Mary Tice, Erica Loomis, Chee-Chee H Stucky, John A Stauffer, Stephanie Heller, Katherine Poruk","doi":"10.1016/j.gassur.2026.102623","DOIUrl":"https://doi.org/10.1016/j.gassur.2026.102623","url":null,"abstract":"<p><strong>Background: </strong>METHODS: RESULTS: CONCLUSION.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102623"},"PeriodicalIF":2.8,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110991","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":"Preoperative optimization for ventral hernia repair: augmented evidence review","authors":"Fathi Moustafa,&nbsp;Aldo Fafaj,&nbsp;Clayton Petro,&nbsp;Marisa H. Blackman,&nbsp;Kaela E. Blake","doi":"10.1016/j.gassur.2026.102535","DOIUrl":"10.1016/j.gassur.2026.102535","url":null,"abstract":"<div><h3>Background</h3><div>Preoperative optimization is widely recommended for patients undergoing ventral hernia repair. However, the clinical impact of individual risk factors remains uncertain. This study aimed to evaluate the association of obesity, diabetes mellitus, and smoking with postoperative outcomes and to compare these findings with surgeon practices and existing literature.</div></div><div><h3>Methods</h3><div>The augmented evidence review (AER) was performed using 3 evidence streams to answer the unified question: “What are the key components of preoperative patient optimization for ventral hernia repair?” Empiric evidence was gathered using a retrospective analysis of the Abdominal Core Health Quality Collaborative database. Social media evidence was gathered by surveying practicing surgeons via the International Hernia Collaboration social media group. Artificial intelligence (AI) evidence was obtained from the OpenEvidence platform, which performed a data-driven literature review. Each evidence stream was analyzed independently before integrating it in the AER.</div></div><div><h3>Results</h3><div>Obesity was associated with increased wound complications, but showed no significant association with systemic complications. Diabetes status and glycemic control were not associated with postoperative complications. Smoking was associated with increased surgical site occurrence and pneumonia. Survey results demonstrated that most surgeons consider these risk factors important. However, implementation varied, with individualized approaches favored for obesity and smoking, whereas defined thresholds were used for glycemic control. AI-derived evidence demonstrated similar heterogeneity.</div></div><div><h3>Conclusion</h3><div>The evaluated risk factors demonstrated modest differences in postoperative outcomes, some of which were statistically significant. However, the clinical significance is mainly determined by the surgeon, as reflected by our survey. Most surgeons favored an individualized approach for obesity, followed by smoking, and less so for diabetes mellitus.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 10","pages":"Article 102535"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148604164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in inguinal hernia repair approach: an augmented evidence review","authors":"William T. Head,&nbsp;Sidhant Kalsotra,&nbsp;Divyaam Satija,&nbsp;Savannah Renshaw,&nbsp;Courtney E. Collins,&nbsp;Benjamin K. Poulose","doi":"10.1016/j.gassur.2026.102547","DOIUrl":"10.1016/j.gassur.2026.102547","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Minimally invasive surgery (MIS) has transformed inguinal hernia management; however, its utilization compared with open approaches remains poorly quantified, particularly in the recurrent setting. This study aims to assess trends in the utilization of open and MIS in inguinal hernia repair (IHR) using an innovative review methodology.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This study employs a novel framework, the “Augmented Evidence Review (AER),” to address the following unified research question: \"How has the surgical approach for IHR changed over the last 10 years, and has this affected how we approach the repair of recurrent inguinal hernias specifically?” The AER framework integrates 3 complementary evidence streams: (i) empiric, (ii) social media, and (iii) artificial intelligence. The empiric evidence was drawn from the Abdominal Core Health Quality Collaborative registry and included patients who underwent IHR via open, laparoscopic, or robotic approaches from 2016 to 2023. Social media evidence was collected through the International Hernia Collaboration, a private Facebook (Meta Inc., Menlo Park, CA) group with more than 15,000 professional members. Artificial intelligence evidence was obtained from the platform OpenEvidence (OpenEvidence, Inc., Miami, FL), which was used to synthesize peer-reviewed literature. Each evidence stream was analyzed independently before being evaluated within the AER framework. Findings were then synthesized to identify areas of convergence, divergence, and potential directions for future study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The Abdominal Core Health Quality Collaborative analysis included 2766 patients undergoing initial IHR (1777 open vs 989 MIS) and 294 patients undergoing recurrent IHR (142 open vs 152 MIS). MIS utilization increased by 20.2% and 18.0% in the initial and recurrent settings, respectively, with robot-assisted repair being the primary driver. Laparoscopic utilization declined. Temporal trend analysis confirmed a significant correlation between MIS repair and chronological year (initial IHR |rho| = 0.89; &lt;em&gt;P&lt;/em&gt; =.012; recurrent IHR |rho| = 0.96; &lt;em&gt;P&lt;/em&gt; =.002). The International Hernia Collaboration poll had 474 responses, with 72.4% of respondents reporting a transition toward MIS. The most common transitions were from open to laparoscopic (31.0%) and from laparoscopic to robotic (29.3%), with 41.4% of respondents reporting adoption of robotic repair. OpenEvidence corroborated these findings with numerous published guidelines and studies. Areas of divergence included the degree of preference for the robotic vs laparoscopic platforms and adherence to the “Alternate-Plane Principle” in the recurrent setting, both of which represent priorities for future study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;This is the first evaluation of recent IHR trends using a novel methodology: the AER. All 3 evidence streams converged on a major shift toward MIS, parti","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 10","pages":"Article 102547"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}