Journal of Investigative Surgery最新文献

{"title":"Comparison of a TrachoSpray Device and Manual Lidocaine Spray on Hemodynamic Stability and Postoperative Sore Throat in Patients Undergoing Double-Lumen Tube Intubation: A Randomized Controlled Trial.","authors":"Murat Tümer, Fatih Doğu Geyik, Mesut Buz, Kübra Taşkın, Muhammet Selman Söğüt, Banu Çevik, Recep Demirhan","doi":"10.1080/08941939.2025.2586017","DOIUrl":"10.1080/08941939.2025.2586017","url":null,"abstract":"<p><strong>Background: </strong>Postoperative sore throat (POST) is an distressing complication following endotracheal intubation, particularly with double-lumen tube (DLT) intubation. Study evaluated the effects of two local anesthetic techniques on hemodynamic responses and POST in DLT-intubated patients.</p><p><strong>Methods: </strong>A randomized controlled study was conducted with 60 patients scheduled for elective thoracic surgery. Participants were randomized into three groups: TrachoSpray group (2 mL of 10% lidocaine), Manual spray group (10% lidocaine) and, Control group (0.9% saline). Hemodynamic parameters, including systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP), were monitored preoperatively, intraoperatively, and postoperatively. POST was assessed using a visual analog scale at 2, 6, 12, and 24 h post-extubation.</p><p><strong>Results: </strong>Both lidocaine groups demonstrated significant reductions in SBP, DBP, and MAP at key time points compared to control group. Post-extubation, MAP was significantly higher in TrachoSpray group than lidocaine group (<i>p</i> = 0.04). No statistically significant differences in POST scores were observed between groups.</p><p><strong>Conclusions: </strong>TrachoSpray device and manual lidocaine spray improved hemodynamic stability in DLT-intubated patients; however, neither method resulted in a significant reduction in POST scores. Further research is needed to confirm these hemodynamic benefits and to explore potential effects on long-term outcomes.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2586017"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Postoperative Nutritional Management Under a Validated Diabetes-Specific Enhanced Recovery After Surgery Protocol in Patients With Lumbar Spinal Stenosis and Type 2 Diabetes Mellitus.","authors":"Yanxuan Chen, Baiqiu Ke, Li Zhou, Ganqing Li, Kaitao Xu, Honglian Qin","doi":"10.1080/08941939.2026.2717479","DOIUrl":"https://doi.org/10.1080/08941939.2026.2717479","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate early postoperative nutritional management with a diabetes-specific enhanced recovery after surgery (DS-ERAS) pathway in patients with lumbar spinal stenosis (LSS) and type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>This retrospective cohort study compared a DS-ERAS nutritional pathway with conventional perioperative care in LSS patients with T2DM. Outcomes included postoperative recovery, nutritional status, glycemic control, inflammation, complications, and hospital stay. Effect size metrics (relative risk reduction [RRR], absolute risk difference [ARD], number needed to treat [NNT]), subgroup analyses, and multivariable linear regression were performed.</p><p><strong>Results: </strong>The DS-ERAS group demonstrated faster gastrointestinal recovery, improved nutritional status and glycemic control, reduced inflammatory and shorter hospital stay (p < 0.001). The complication rate was lower (10.0% vs. 23.3%; <i>p</i> = 0.016), with a relative risk reduction of 57.1% and absolute risk difference of 13.3%. Subgroup analyses demonstrated consistent benefits across age, sex, body mass index (BMI), diabetes duration, and surgical segments (all <i>P</i> for interaction > 0.05). Multivariable regression show that DS-ERAS was associated with a mean reduction in hospital stay of 1.57 days.</p><p><strong>Conclusion: </strong>Early postoperative nutritional management within the DS-ERAS pathway was associated with improved perioperative recovery in LSS patients with T2DM, with favorable nutritional , metabolic, inflammatory, and clinical outcomes.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2717479"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter Regarding the \"Wrist-Ankle Acupuncture on Postoperative Nausea and Vomiting Prophylaxis in High-Risk Female Patients: A Pragmatic, Randomized, Single-Blind, Sham-Controlled Trial\".","authors":"Yi Ming Liu, Xiaojing Wang, XinYi Hu, Yi Liang","doi":"10.1080/08941939.2026.2696120","DOIUrl":"10.1080/08941939.2026.2696120","url":null,"abstract":"","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2696120"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Adjuvant Chemotherapy on Survival of the Patients with pT1N + M0 Gastric Cancer: A Retrospective Cohort Study.","authors":"Peng Song, Wencong Tian, Jia Zhao, Yanhong Liu, Chuntao Wang, Lei Cao","doi":"10.1080/08941939.2025.2594559","DOIUrl":"https://doi.org/10.1080/08941939.2025.2594559","url":null,"abstract":"<p><strong>Background: </strong>The advantages of postoperative adjuvant chemotherapy (ACT) for gastric cancer patients with pT1N + M0 staging have been a subject of debate. This study aims to assess whether ACT can enhance the overall survival (OS) of postoperative pT1N + M0 gastric cancer patients when compared to surgery alone.</p><p><strong>Methods: </strong>A total of 329 postoperative patients with pT1N + M0 gastric cancer were identified from the Surveillance, Epidemiology, and End Results (SEER) database (2004-2015). Patients were stratified into surgery-alone and surgery-plus-chemotherapy groups. Multivariate Cox regression identified prognostic factors, followed by subgroup analyses stratified by clinical characteristics.</p><p><strong>Results: </strong>This study included 329 patients, of whom 80 received postoperative ACT and 249 underwent surgery alone. Multivariate analysis revealed that race, tumor primary site, differentiation grade, clinical stage, N stage, and ACT were independent prognostic factors for OS. Subgroup analysis demonstrated that the survival benefit of ACT was more pronounced in Asian/Pacific Islander (API) patients (hazard ratio [HR], 0.320; 95% confidence interval [CI], 0.140-0.732; P for interaction = 0.028) and in those with N1 stage (HR, 0.447; 95% CI, 0.272-0.737; P for interaction = 0.022).</p><p><strong>Conclusion: </strong>ACT was associated with a survival benefit versus surgery-alone in pT1N + M0 gastric cancer, especially among API patients or those with N1 stage.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2594559"},"PeriodicalIF":3.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145762904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic Ultrasound-Guided Biopsy: A Safe and Effective Approach for Diagnosing Idiopathic Retroperitoneal Fibrosis.","authors":"Yu-Peng Li, Qian Zhuo, Xiong Chen, Zhi-De Li, Yuan Meng, Zhi-Gang Ma","doi":"10.1080/08941939.2026.2616150","DOIUrl":"10.1080/08941939.2026.2616150","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic retroperitoneal fibrosis (IRPF) is a rare fibroinflammatory condition that is challenging to distinguish from retroperitoneal malignancies based solely on imaging. We evaluated laparoscopic ultrasound-guided biopsy for diagnosing IRPF.</p><p><strong>Methods: </strong>We retrospectively analyzed 12 patients with suspected retroperitoneal fibrosis who underwent laparoscopic ultrasound-guided biopsy. The surgical technique involved systematic laparoscopic exploration, intraoperative ultrasound to delineate the mass and its relation to great vessels, and targeted biopsy.</p><p><strong>Results: </strong>Preoperative imaging suggested retroperitoneal masses in all 12 patients but failed to provide a definitive diagnosis in any case. Laparoscopic biopsy was successfully performed in all patients without conversion to laparotomy. Pathological examination confirmed IRPF in 11 patients and retroperitoneal adenocarcinoma in one. The procedure was safe, with minimal blood loss (20.4 ± 14.8 mL) and a short operative time (68.3 ± 19.0 min). All IRPF patients were treated with a combination of prednisone, tamoxifen, and mycophenolate mofetil, leading to significant lesion regression on follow-up imaging (median 37.9 months).</p><p><strong>Conclusions: </strong>Laparoscopic ultrasound-guided biopsy is a safe and highly effective diagnostic procedure for IRPF. It provides definitive pathological diagnosis to guide appropriate therapy and should be considered when percutaneous biopsy is not feasible.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2616150"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors and Stratification Analysis of Cesarean Scar Pregnancy in Women with Cesarean Scar Diverticulum.","authors":"Yuanhong Zhu, Jianhong Ding, Manyun Liu, Chenhao Zhu","doi":"10.1080/08941939.2026.2643947","DOIUrl":"10.1080/08941939.2026.2643947","url":null,"abstract":"<p><strong>Objective: </strong>To identify risk factors for cesarean scar pregnancy (CSP) in women with cesarean scar diverticulum (CSD) and develop a prediction model with risk stratification.</p><p><strong>Methods: </strong>This retrospective study included 398 women with CSD and subsequent intrauterine pregnancy (82 CSP; 316 non-CSP). Clinical and sonographic variables were compared. Independent predictors from multivariable logistic regression were used to construct a nomogram. Model performance was assessed using ROC, calibration, decision curve analysis, and bootstrap validation. Risk groups were defined by tertiles of predicted probability.</p><p><strong>Results: </strong>Compared with controls, the CSP group had larger niche length and depth, thinner residual myometrium, shorter cesarean interval, and lower early log(hCG) and progesterone (all <i>p</i> < 0.05). Independent predictors were cesarean interval (OR = 0.812), niche length (OR = 1.235), niche depth (OR = 2.129), residual myometrium thickness (OR = 0.326), log(hCG) (OR = 0.445), and progesterone (OR = 0.830). The model showed excellent discrimination (AUC = 0.970, 95% CI: 0.954-0.983). CSP incidences were 0.0%, 0.8%, and 60.9% in the low-, medium-, and high-risk groups, respectively.</p><p><strong>Conclusions: </strong>Morphological defect severity, short interpregnancy interval, and low early-pregnancy hormone levels were associated with CSP risk in women with CSD. The model may support early risk stratification and clinical management.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2643947"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147520971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic Omega-type fundoplication (ΩTF) is a Safe and Effective Method for GERD - Data on Radiologic and Clinical Follow-Up.","authors":"Lisa Gensthaler, Max Stauffer, Milena Bologheanu, Dagmar Kollmann, Joy Feka, Gerd Jomrich, Erwin Rieder, Marcel Philipp, Franz M Riegler, Reza Asari, Sebastian F Schoppmann","doi":"10.1080/08941939.2026.2664321","DOIUrl":"10.1080/08941939.2026.2664321","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic Ω-type fundoplication (ΩTF) is a novel technique for gastroesophageal reflux disease (GERD), combining hiatoplasty with His-angle reconstruction by a 150° two-layered left-sided fundoplication. This retrospective analysis evaluated safety and efficacy of ΩTF during one-year follow-up.</p><p><strong>Methods: </strong>198 consecutive patients undergoing ΩTF at the Medical University Vienna were included. Safety, symptoms, hernia recurrence, and quality of life were evaluated. GERD-HRQL scores and contrast swallow X-rays were performed during follow-up.</p><p><strong>Results: </strong>Early hernia recurrence occurred in 4 patients, 2 requiring revisional surgery. Normal food intake by day 2 was achieved in 98.6 %, median hospital stay was 1day (IQR: 1-2). At mean follow-up of 1.1 (0.7-1.5) years, PPI use decreased from 88.0% to 5.1%. Reflux, bloating and dysphagia decreased to 4.6%, 8.8% and 4.0% (<i>p</i> < 0.001), while new onset dysphagia occurred in 2.6%. GERD-HRQLs improved from 25 ± 9.6 to 4 ± 7.5 (Δ-17, <i>p</i> < 0.001). Suboptimal clinical response was reported by 4.5% (<i>n</i> = 9), whereas radiologic recurrence occurred in 6 cases (3.0%). Revisional surgery was required in 7 cases (3.5%). Overall, 82.4% reported improved postoperative satisfaction and QoL (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>ΩTF appears safe and effective, providing substantial symptom relief, improved QoL, and low short-term hernia recurrence. Prospective studies are required to confirm these results.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2664321"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147930478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in ERAS to Reduce the Incidence of Chronic Post-Surgical Pain and Persistent Postoperative Opioid Use: A Narrative Review.","authors":"Zhiyou Peng, Pavan Tankha, Zhiying Feng, Jijun Xu","doi":"10.1080/08941939.2026.2664932","DOIUrl":"10.1080/08941939.2026.2664932","url":null,"abstract":"<p><strong>Background: </strong>Chronic postsurgical pain (CPSP) remains a clinically significant complication following major surgery, contributing to long-term functional impairment, reduced quality of life, and persistent opioid use. Enhanced Recovery After Surgery (ERAS) pathways have transformed perioperative care by integrating multimodal, opioid-sparing strategies to improve acute recovery; however, their effectiveness in preventing CPSP is less clearly defined.</p><p><strong>Methods: </strong>We conducted a narrative review of randomized controlled trials, meta-analyses, cohort studies, and clinical guidelines evaluating perioperative interventions relevant to CPSP prevention, including systemic pharmacologic agents, regional and neuraxial techniques, preemptive analgesia, and early mobilization strategies. Evidence was appraised with respect to acute analgesic efficacy, impact on CPSP incidence, safety, and feasibility within ERAS pathways.</p><p><strong>Results: </strong>Most single-modality interventions demonstrated consistent benefit for acute pain control and opioid reduction, but limited or inconsistent effects on CPSP prevention when used in isolation. Gabapentinoids and neuraxial techniques showed little support for long-term benefit and raised concerns regarding adverse effects and recovery delays. In contrast, multimodal strategies incorporating peripheral and interfascial regional techniques, intravenous lidocaine, duloxetine in select populations, wound infiltration, and early mobilization showed more promising associations with reduced persistent pain, particularly when tailored to patient risk and surgical context. Early mobilization and effective acute pain control emerged as critical, interdependent elements influencing pain chronification.</p><p><strong>Conclusions: </strong>Current evidence does not support reliance on any single perioperative intervention to prevent CPSP. Instead, prevention appears to require a comprehensive, mechanism-based, and patient-centered ERAS approach integrating preoperative risk stratification, multimodal pharmacotherapy, targeted regional techniques, and early functional recovery.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2664932"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147948678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-Guided Dorsal Penile Nerve Block Reduces Perioperative Opioid Requirements in Pediatric Circumcision: A Systematic Review and Meta-Analysis.","authors":"Amani N Alansari, Marwa Messaoud, Mohamed Sayed Zaazouee, Naser El-Mefleh, Surendra M Chinnappa, Nabil A Shallik","doi":"10.1080/08941939.2026.2679313","DOIUrl":"10.1080/08941939.2026.2679313","url":null,"abstract":"<p><strong>Aim: </strong>This meta-analysis compares ultrasound-guided and landmark-based dorsal penile nerve block (DPNB) in pediatric circumcision.</p><p><strong>Methods: </strong>We systematically searched PubMed, Scopus, Web of Science, Embase, and Cochrane CENTRAL from inception to December 2025. Eligible studies included randomized controlled trials (RCTs) and observational cohorts comparing ultrasound-guided with landmark-based DPNB in pediatric patients (≤18 years) undergoing circumcision. Primary outcomes were intraoperative and postoperative opioid rescue requirements. Secondary outcomes included pain scores at incision, surgical duration, discharge time, and postoperative nausea/vomiting. Meta-analyses were performed using RStudio version 4.4.3.</p><p><strong>Results: </strong>Nine studies involving 949 children met inclusion criteria (five RCTs, four retrospective cohorts). Ultrasound-guided DPNB significantly reduced intraoperative opioid rescue (risk ratio 0.39, 0.18-0.88; <i>p</i> = 0.028) and postoperative opioid requirements (risk ratio 0.26, 0.07-0.94; <i>p</i> = 0.0442) compared with landmark-based techniques. No significant differences emerged in pain scores at incision, discharge time, or postoperative nausea/vomiting. Ultrasound-guided blocks required modestly longer procedural time (mean difference 1.48 min, 0.03-2.94; <i>p</i> = 0.048).</p><p><strong>Conclusions: </strong>Ultrasound-guided DPNB substantially may reduce perioperative opioid requirements in pediatric circumcision compared with landmark-based approaches, despite slightly longer procedural times. When resources and expertise permit, ultrasound guidance should be considered the technique of choice for optimizing opioid-sparing anesthesia in this population.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2679313"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Common Bile Duct Opening Versus Ligation on Postoperative Outcomes in Patients Undergoing Pancreaticoduodenectomy.","authors":"Hong-Yu Xu, Wei-Zhen Tang, Tai-Hang Liu, Fei Han, Qin-Yu Cai, Hao-Wen Chen, Yi-Fan Zhao, Wang Qi Rui Liu, He-Zhe Hua, Jun Ding, Peng Guo, Zhi-Yong Xiang","doi":"10.1080/08941939.2026.2715825","DOIUrl":"10.1080/08941939.2026.2715825","url":null,"abstract":"<p><strong>Background: </strong>Complications after pancreaticoduodenectomy are common and may be life-threatening. Management of the common bile duct stump may affect biliary pressure, drainage, and postoperative outcomes. This study seeks to compare open versus ligated bile duct stump management during pancreaticoduodenectomy.</p><p><strong>Methods: </strong>This retrospective cohort included 125 patients who underwent pancreaticoduodenectomy between 2019 and 2025. Surgical outcomes and postoperative recovery were compared between the open-stump and ligation groups. Multivariable logistic regression identified associations between stump management and postoperative complications; biochemical indicators were also assessed.</p><p><strong>Results: </strong>After adjustment, the opening group had significantly lower risks of pancreatic fistula (aOR = 0.18, 95%CI: 0.05 - 0.68, <i>P</i> = 0.011) and intra-abdominal and gastrointestinal bleeding (aOR = 0.09, 95%CI: 0.01 - 0.77, <i>P</i> = 0.028) versus the ligation group. The opening group also demonstrated a shorter surgical duration (315 minutes vs. 420 minutes, <i>P</i> < 0.001), reduced postoperative hospitalization (24 days vs. 30 days, <i>P</i> = 0.002), and lower costs (109,375 RMB vs. 137,518 RMB, <i>P</i> < 0.001). No significant changes were seen in liver function or coagulation markers.</p><p><strong>Conclusion: </strong>Keeping the common bile duct open markedly enhances perioperative management during pancreaticoduodenectomy, thus serving as a significant reference for refining surgical protocols.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2715825"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}