Langenbeck's Archives of Surgery最新文献

{"title":"A simplified stent-bridging pancreaticogastrostomy during pancreaticoduodenectomy: How I do it.","authors":"Yan Sun, Zheng Wang, Kaixuan Li, Longchang Chen, Junpeng Wang, Liuxin Duan, Quanda Liu","doi":"10.1007/s00423-025-03738-0","DOIUrl":"https://doi.org/10.1007/s00423-025-03738-0","url":null,"abstract":"<p><strong>Background: </strong>Pancreaticoduodenectomy (PD) remains the standard approach for benign or malignant disease in the pancreatic head and periampullary regions. Despite attempts of diverse pancreatic anastomosis, no reliable pancreatic anastomosis has been recommended.</p><p><strong>Methods: </strong>Between July 2023 to December 2023, a novel method of pancreaticogastrostomy (PG) using a stent bridging the remnant pancreas and the stomach were applied to drain the pancreatic juice into the gastric cavity in 12 consecutive open and laparoscopic cases. The surgical details and postoperative outcomes were analyzed to evaluate this method.</p><p><strong>Results: </strong>The mean operation time was 318 ± 51.60 min. The mean time for the stent-bridging PG was 25.90 ± 4.86 min. No incidence of grades B or C postoperative pancreatic fistula (POPF) or anastomotic failure was occurred during the median follow-up period of 10.20 ± 1.55 months.</p><p><strong>Conclusion: </strong>The stent-bridging PG had the advantages of safety, simplicity and promising efficacy by complete diversion of pancreatic juice and minimal manipulation of the pancreatic remnant under open or laparoscopic PD, proving its value as an alternative technique for mitigating the risk of POPF. By understanding the standardized procedures, surgeons can achieve consistent and reproducible results in complex pancreatic anastomosis. However, further evaluation with clinical trials is required to validate its real benefits.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"163"},"PeriodicalIF":2.1,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086459","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":"Association of health literacy and general self-efficacy with emergency department visits for unclear abdominal pain after bariatric surgery.","authors":"Jenny Angerås-Kraftling, Maria Jaensson, Karuna Dahlberg, Erik Stenberg","doi":"10.1007/s00423-025-03736-2","DOIUrl":"https://doi.org/10.1007/s00423-025-03736-2","url":null,"abstract":"<p><strong>Introduction: </strong>Emergency department visits are common following bariatric surgery and may be partially preventable. Health literacy and general self-efficacy are factors that may influence health-seeking behaviors in these patients. This study aimed to assess whether health literacy and general self-efficacy are associated with an increased frequency of emergency department visits after bariatric surgery.</p><p><strong>Methods: </strong>Patients who underwent bariatric surgery at a single hospital from 2018 to 2020 were evaluated for their health literacy and general self-efficacy levels before surgery. Data on emergency department visits within the patient's residential region were evaluated over a three-year period, with repeated emergency department visits for abdominal pain as the primary outcome.</p><p><strong>Results: </strong>During the follow-up period, 69 of 231 patients (29.9%) had at least one emergency department visit for abdominal pain, and 20 patients (8.7%) had three or more visits. Inadequate functional health literacy (OR 5.56, 95% CI 1.80-17.19, p = 0.003) and inadequate communicative and critical health literacy (OR 10.48, 95% CI 3.13-35.08, p < 0.001) were both significantly associated with an increased risk of repeated emergency department visits over the three-year period. No significant association was found between low general self-efficacy and the frequency of emergency department visits.</p><p><strong>Conclusions: </strong>Inadequate health literacy is associated with an increased risk of repeated emergency department visits for abdominal pain following bariatric surgery.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"162"},"PeriodicalIF":2.1,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086460","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":"Oncologic effect of preoperative endoscopic sphincterotomy in patients undergoing pancreaticoduodenectomy for ampulla of vater cancer.","authors":"Su Min Jeon, Yoo Jin Choi, Hye-Sung Jo, Sae Byeol Choi, Wan-Bae Kim, Hyung-Joon Han, Tae Jin Song, Dong-Sik Kim, Young-Dong Yu","doi":"10.1007/s00423-025-03730-8","DOIUrl":"10.1007/s00423-025-03730-8","url":null,"abstract":"<p><strong>Purpose: </strong>Ampulla of Vater (AoV) cancer often presents with bile flow obstruction requiring bile drainage. Endoscopic sphincterotomy (EST) for AoV cancer may result in inflammation and spread of the tumor due to the abundant lymphatic channels and microvascular structures around the AoV, which may impact the postoperative and oncologic outcomes. This study aimed to evaluate the postoperative and oncological effects of EST on AoV cancer.</p><p><strong>Methods: </strong>Medical records of 131 patients with AoV cancer who underwent pancreaticoduodeenectomy between 2011 and 2020 were reviewed. We compared the perioperative outcomes, overall survival, and disease recurrence in the patients.</p><p><strong>Results: </strong>Approximately 71 patients underwent EST for preoperative biliary drainage, whereas 60 did not receive any procedure or underwent percutaneous transhepatic biliary drainage. No significant differences were observed in the 5-year overall survival rate (EST 69.9% vs. no EST 75.1%, P = 0.804) or the 5-year cumulative recurrence rate (EST 49.1% vs. no EST 56.8%, P = 0.855). However, in subgroup analysis using the T stage, EST was associated with reduced 5-year overall survival in the T3 and T4 stages (EST 34.8% vs. no EST 78.0%: P = 0.038).</p><p><strong>Conclusion and discussion: </strong>Preoperative endoscopic intervention for AoV cancer did not affect oncologic outcomes. However, in the advanced stage, direct manipulation of cancer may result in lower overall survival, requiring careful consideration for preoperative biliary drainage.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"161"},"PeriodicalIF":2.1,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078882","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":"Temporary abdominal closure in trauma surgery: a comparative cohort study between open abdomen techniques with negative pressure therapy.","authors":"Yuri Thomé Machado Petrillo, Gabrieli Flesch da Silva, Vitor Steffens Bracht, Neiva Baldissera, Mariana Kumaira Fonseca, Leandro Totti Cavazzola","doi":"10.1007/s00423-025-03725-5","DOIUrl":"10.1007/s00423-025-03725-5","url":null,"abstract":"<p><strong>Background: </strong>The use of negative pressure therapy (NPT) to maintain an open abdomen (OA) is a well-established practice in trauma surgery. The aim of this study was to compare two techniques for temporary closure of the OA using negative pressure therapy NPT with regard to the outcome of definitive closure of the abdominal wall, the incidence of complications and mortality.</p><p><strong>Methodology: </strong>Controlled retrospective cohort study with trauma patients submitted to NPT as a method of maintaining OA. The groups were divided into \"Group B\", referring to the use of NPT by Barker dressing, and \"Group V\", referring to the use of NPT by RENASYS™ AB abdominal dressing.</p><p><strong>Results: </strong>A total of 76 patients were analyzed (Group B, n = 48; Group V, n = 28), with mean age of 34 years, and 92% male. The groups were equivalent in their trauma severity scores. The overall rate of abdominal cavity closure was 38%, higher in Group V than in Group B (46%, n = 13 vs. 33%, n = 16, p = 0.374). The peritoneostomy outcome was significantly higher in group B (48%, n = 23 vs. 21%, n = 6, p = 0.028). Moderate negative correlation was observed between the duration of OA therapy and the rate of definitive closure of the abdominal cavity (ρ -0.637; p < 0.0001). Damage control surgery (DCS) and shorter duration of OA were identified as predictors of closure.</p><p><strong>Conclusion: </strong>OA with NPT by industrial abdominal dressing decreases the rate of peritoniostomy as abdominal wall outcome compared to Barker dressing.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"159"},"PeriodicalIF":2.1,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078889","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":"Safety and feasibility of open abdomen with negative pressure therapy in major liver trauma: a retrospective bicenter study.","authors":"Andrea Coppola, Arianna Mottola, Marcello Della Corte, Mariafelicia Valeriani, Giovanni Aprea, Patrizio Festa, Giuseppe Palomba","doi":"10.1007/s00423-025-03729-1","DOIUrl":"10.1007/s00423-025-03729-1","url":null,"abstract":"<p><strong>Background: </strong>Abdominal trauma is the third leading cause of death in the young population, and liver trauma is among the most common. For major liver injury, perihepatic packing (PHP) is a life-saving procedure that allows rapid control of the hemorrhage. The use of the open abdomen (OA) represents a strategy for the management of major abdominal trauma. However, the effects of combined use with Negative Pressure Therapy (NPT) in patients with liver trauma are not yet clear. The aim of our study was to evaluate the safety and feasibility of OA with NPT.</p><p><strong>Materials and methods: </strong>This retrospective bicenter study enrolled all patients affected by liver trauma who underwent operative management from January 2019 to September 2023 at the Emergency Surgical Units of the \"A. Cardarelli\" Hospital in Naples and the \"San Giovanni di Dio e Ruggi d'Aragona\" in Salerno. The two groups were compared in terms of intra- and postoperative outcomes.</p><p><strong>Results: </strong>Out of a total of 213 patients with liver trauma, 43 patients were divided into two groups: group A (24 patients treated with PHP and OA) and group B (19 patients with PHP, OA and NPT). There were no significant differences in terms of demographic data, preoperative characteristics, length of stay, mortality, or intraoperative or postoperative complications. Hb increase at the time of depacking was higher in group B (p = 0.039).</p><p><strong>Conclusions: </strong>Open Abdomen with Negative Pressure Therapy appears safe and feasible. Furthermore, it does not affect mortality or hospital stay but it seems to be associated with higher hemoglobin (Hb) levels during the depacking phase.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"160"},"PeriodicalIF":2.1,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078886","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":"Effectiveness of recurrent laryngeal nerve monitoring on nerve paralysis during open McKeown esophagectomy: a prospective, cohort study.","authors":"Shuwen Fu, Ying Guo, Xiaofan Lu, Xiong Song, Weiyi Qin, Liquan Zheng, Xiaofeng Huang, Manxiu Xie, Yali Lu, Renchun Lai","doi":"10.1007/s00423-025-03732-6","DOIUrl":"10.1007/s00423-025-03732-6","url":null,"abstract":"<p><strong>Background: </strong>Recurrent laryngeal nerve paralysis (RLNP) is a critical postoperative complication in esophagectomy. Intraoperative nerve monitoring (IONM) is a technique that can be used in high-risk surgeries to prevent, identify, and mitigate nerve damage. In this prospective study, we evaluated the feasibility and effectiveness of IONM in open McKeown esophagectomy for esophageal cancer.</p><p><strong>Methods: </strong>From December 2020 to September 2023, 88 patients diagnosed with esophageal cancer were enrolled to receive IONM for open McKeown esophagectomy at Cancer Center, Sun Yat-sen University. The primary outcome was the incidence of RLNP after extubation. The secondary outcomes were postoperative complications, number of dissected lymph nodes, length of hospital stay, ICU duration and number of deaths.</p><p><strong>Results: </strong>A total of 83 patients were included in the final analysis. The incidence of RLNP after extubation was 30.1%. The occurrence of postoperative pulmonary complications was 20.5%. The median hospital stays were 13 days. The incidence of anastomotic leakage was 13.3%. No in-hospital deaths were reported. Postoperative RLNP prolonged the length of hospital stay (P = 0.042).</p><p><strong>Conclusion: </strong>Our findings indicated that IONM could potentially be associated with a possible reduction in RLNP incidence following open McKeown esophagectomy for esophageal cancer. However, future research including well-designed randomized controlled trials may be beneficial to clarify these preliminary results.</p><p><strong>Trial registration number: </strong>ChiCTR2000029687 https://www.chictr.org.cn/showproj.html?proj=49103.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"158"},"PeriodicalIF":2.1,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031106","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":"Preoperative proton pump inhibitor therapy and anastomotic leak after esophagectomy-a new perspective.","authors":"Lukas Pollmann, Jonas Linnemann, Nicola S Pollmann, Claudius Jürgens, Maximilian Schmeding","doi":"10.1007/s00423-025-03727-3","DOIUrl":"10.1007/s00423-025-03727-3","url":null,"abstract":"<p><strong>Purpose: </strong>Proton pump inhibitors (PPIs) are indispensable in the treatment of gastro-esophageal reflux disease and peptic ulcers or for the prevention of stress ulcers after major abdominal surgery. However, long-term PPI therapy leads to several side effects such as delayed gastric emptying and distinct changes in mucosal histology. Therefore, this retrospective study aims to evaluate the impact of preoperative PPI therapy on the anastomotic leak rate after esophagectomy.</p><p><strong>Methods: </strong>A retrospective, single-center analysis was conducted for all patients treated with esophagectomy and gastric conduit reconstruction between January 2016 and November 2024. Preoperative treatment with PPIs, as well as patient comorbidities, histopathological findings and surgical techniques were noted. Subsequently, a group-wise comparison was carried out for the differences in anastomotic leak rate and postoperative complications in patients with and without preoperative PPI therapy. Finally, a multivariate logistic regression analysis was conducted for the occurrence of anastomotic leak.</p><p><strong>Results: </strong>A total of 229 patients were included in the study. The group-wise comparison revealed a significantly higher rate of anastomotic leaks and postoperative complications in patients with preoperative PPI therapy compared to those without. The multivariate logistic regression analysis indicated a 2.5-fold increased risk of anastomotic leaks in patients with preoperative PPI therapy compared to patients without.</p><p><strong>Conclusion: </strong>Preoperative PPI therapy may represent a modifiable risk factor for the development of anastomotic leaks after esophagectomy. Further prospective, interventional studies are necessary to verify the results.</p><p><strong>Trial registration: </strong>The study was retrospectively registered in the German clinical trial database (Application number DRKS00035536, Registration date 03.12.2024).</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"157"},"PeriodicalIF":2.1,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007039","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":"Surgical and oncological outcomes in transverse colon carcinoma: does tumor sublocation make a difference?","authors":"L Schabl, L C Duraes, K Erozkan, A Alipouriani, S R Steele, H Kessler","doi":"10.1007/s00423-025-03665-0","DOIUrl":"https://doi.org/10.1007/s00423-025-03665-0","url":null,"abstract":"<p><strong>Background: </strong>Transverse colon carcinomas are often treated as a single entity in medical literature, despite differences in embryology, anatomy, physiology, genetics, and surgical treatment. We hypothesized that tumor sublocation affects demographics, oncological, surgical and quality of life outcomes.</p><p><strong>Methods: </strong>A retrospective analysis of patients who underwent surgery for transverse colon carcinomas between 2000 and 2018 was conducted. Tumor localization was determined by operative, pathological and imaging reports, and procedures were defined by the extent of vascular resection.</p><p><strong>Results: </strong>The study included 273 patients aged 69 years (SD 12.3), of whom 44% were female. The BMI was 28.8 kg/m² (SD 6.2), and 61% were ASA class 3. Carcinomas were in the proximal (22%), the mid (42%), and the distal transverse colon (36%). Mid-transverse carcinomas exhibited the highest prevalence among female patients (53% vs. 35% proximal vs. 39% distal, p < 0.03). Proximal transverse carcinomas presented with a higher proportion of pathological stage II than mid and distal transverse carcinomas (68.3% vs. proximal vs. 44.3% mid-vs. 49% distal, p = 0.006). On multivariate analysis, anemia was more likely in mid than proximal (p = 0.009) and distal (p = 0.002) transverse colon cancers. Obstruction occurred more often in proximal than mid (p = 0.003), and hematochezia in distal than in mid (p < 0.001) and proximal (p = 0.014) transverse colon carcinomas. The 30-day mortality and morbidity and 5-year overall and disease-free survival rates were similar between the tumor sublocations.</p><p><strong>Conclusion: </strong>Sublocations of the transverse colon carcinomas affect the symptoms of patients. Tumor sublocation does not impact the intraoperative, postoperative, or oncological outcomes and quality of life.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"156"},"PeriodicalIF":2.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064068","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":"Early readmission after adrenalectomy for pheochromocytoma. A retrospective study.","authors":"Tamer A A M Habeeb, Abd Al-Kareem Elias, Abdelmonem A M Adam, Mohamed A Gadallah, Saad Mohamed Ali Ahmed, Ahmed Khyrallh, Mohammed H Alsayed, Esmail Tharwat Kamel Awad, Emad A Ibrahim, Mohamed Fathy Labib, Sobhy Rezk Ahmed Teama, Mahmoud Hassib Morsi Badawy, Mohamed Ibrahim Abo Alsaad, Abouelatta Kh Ali, Hamdi Elbelkasi, Mahmoud Ali Abou Zaid, Ibtsam AbdElMaksoud Mohamed El Shamy, Boshra Ali Ali El-Houseiny, Mahmoud El Azawy, Ahmed Elhoofy, Ali Hussein Khedr, Abdelrahman Mohamed Hasanin Nawar, Ahmed Salah Arafa, Ahmed Mesbah Abdelaziz, Abdelfatah H Abdelwanis, Mostafa M Khairy, Ahmed M Yehia, Ahmed Kamal El Taher","doi":"10.1007/s00423-025-03719-3","DOIUrl":"https://doi.org/10.1007/s00423-025-03719-3","url":null,"abstract":"<p><strong>Purpose: </strong>Adrenalectomy for pheochromocytoma (PHEO) presents a significant challenge due to the high incidence of early hospital readmission (ER). This study evaluated the incidence and risk factors of ER for PHEO within 30 days of adrenalectomy.</p><p><strong>Methods: </strong>A retrospective analysis of 346 patients > 18 years with unilateral PHEO who underwent adrenalectomy between September 2012 and September 2024. The patients were categorised into ER (n = 49) and no ER (n = 297) groups. Logistic regression analyses were performed to predict risk factors for ER.</p><p><strong>Results: </strong>The most common causes of ER were postoperative maintained hypotension (42.9%), bleeding (6.1%), ileus (24.5%), wound infection (4.1%), hyperkalemia (8.2%), pneumonia (2%), intra-abdominal abscess (2%), acute MI (4.1%), and colonic injury (6.1%). Most postoperative complications were Clavien-Dindo grade II (n = 40, 81.6%). Two perioperative deaths (4%) occurred in the ER group. Logistic regression showed that low body mass index (OR 0.849, 95% CI, 0.748-0.964; p = 0.012), tumor size < 5 cm (OR 0.096, 95% CI, 0.030-0.310; p < 0.001), and low ASA (OR 0.435, 95% CI, 0.249-0.761; p = 0.003) were associated with risk reduction for ER while malignancy (OR 5.302, 95% CI, 1.214-23.164; p = 0.027), open approach(OR 12.247, 95% CI, 5.227-28.694; p < 0.001), and intraoperative complications (OR 19.149, 95% CI, 7.091-51.710; p < 0.001) were associated with risk increase of ER.</p><p><strong>Conclusion: </strong>Postoperatively maintained hypotension and ileus were the most common causes of ER. Low body mass index, tumour size < 5 cm, and low ASA were risk reductions for ER, while malignancy, open approach, and intraoperative complications were the independent risk increase factors.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"154"},"PeriodicalIF":2.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003046","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":"Higher incidence of trocar site hernia with gallbladder extraction via umbilical versus epigastric trocar port: a multicentre retrospective analysis of laparoscopic cholecystectomy.","authors":"Eduard A van Bodegraven, Paulieke C Oosterwijk, Sanne M van Aalten, Boudewijn E Schaafsma, Robert M Smeenk","doi":"10.1007/s00423-025-03721-9","DOIUrl":"https://doi.org/10.1007/s00423-025-03721-9","url":null,"abstract":"<p><strong>Background: </strong>Trocar site hernia (TSH) is a known complication of laparoscopic cholecystectomy (LC). Gallbladder extraction is typically performed through the umbilical or epigastric trocar port. However, data on the incidence of TSH in relation to the extraction site is limited. This study aimed to evaluate the need for surgical repair of TSH following gallbladder extraction through the umbilical versus epigastric trocar port.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted across two Dutch general hospitals. It assessed the occurrence of TSH after LC and examined commonly described risk factors in relation to the TSH location.</p><p><strong>Results: </strong>Among 2 377 patients that underwent LC, the extraction site of the gallbladder was known in 1756 patients. Gallbladder extraction was performed via the umbilical trocar port in 929 (53%) of cases and via the epigastric trocar port in 827 (47%) of cases. TSH repair was required in 36 (2.1%) patients, with a higher incidence in patients with gallbladder extraction through the umbilical trocar port (3.2%) compared to the epigastric trocar port (0.7%), (p < 0.001).</p><p><strong>Conclusion: </strong>The need for operative repair of a TSH after a LC is significantly reduced when the gallbladder is retrieved through the epigastric trocar site port compared to the umbilical trocar site port.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"155"},"PeriodicalIF":2.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064067","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}