Surgical Laparoscopy, Endoscopy & Percutaneous Techniques最新文献

{"title":"Minimally Invasive Left Colonic Interposition For Corrosive Esophageal Stricture: Technique and Outcomes.","authors":"Tran Phung Dung Tien, Nguyen Vo Vinh Loc, Lam Viet Trung, Nguyen Lam Vuong","doi":"10.1097/SLE.0000000000001404","DOIUrl":"10.1097/SLE.0000000000001404","url":null,"abstract":"<p><strong>Background: </strong>Corrosive ingestion frequently leads to upper aerodigestive tract strictures, with the optimal surgical approach debated. This study investigates the safety and effectiveness of colonic interposition for this condition.</p><p><strong>Methods: </strong>We retrospectively reviewed 21 patients with corrosive-induced esophageal stricture who underwent left colonic interposition between 2017 and 2024. Procedures involved cervical dissection, colonic mobilization, retrosternal tunnel creation, and reconstruction. Four patients underwent fully open surgical procedures, and 17 patients underwent laparoscopic colon mobilization and retrosternal tunnel creation. Outcomes included surgical complications and short-term and long-term feeding function.</p><p><strong>Results: </strong>The mean age was 37 years, with a male predominance (14/21 patients). All had esophageal stricture secondary to chemical burn for >1 year, and 14 were malnourished. Stricture locations were cervical (5 patients), upper third (8 patients), middle third (8 patients), and lower third (3 patients). Laparoscopic surgery had longer mean operative times than open surgery (361 vs. 294 min). One patient developed gastric outlet obstruction due to an undiagnosed pyloric stenosis. All patients resumed oral feeding by postoperative day 2, and feeding jejunostomy were removed at 1 month. During a median 30-month follow-up, all maintained normal oral intake and survived.</p><p><strong>Conclusions: </strong>Left colonic graft interposition for esophageal reconstruction in caustic strictures is safe and effective. However, the technique is complex, particularly laparoscopically. Adequate graft length, vascularity, and isoperistaltic anastomosis are crucial for success.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969775","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":"Antireflux Surgery: State of the Art From Diagnosis to Treatment.","authors":"Elisa Reitano, Andrea Spota, Pietro Riva, Maria Vannucci, Nicola De' Angelis, Didier Mutter, Bernard Dallemagne, Silvana Perretta","doi":"10.1097/SLE.0000000000001403","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001403","url":null,"abstract":"<p><strong>Background: </strong>Gastroesophageal reflux (GERD) disease is a common condition. It is caused by different underlying causes, ranging from lower oesophageal sphincter (LOS) dysfunction to an impaired gastric emptying and esophageal motility disorders. Although initially representing a benign condition, persistent GERD can result in precancerous lesions. Over time, various surgical and endoscopic solutions have been proposed, particularly for patients in whom medical therapy is either ineffective or poorly tolerated. Both endoscopic and surgical techniques aim to enhance the function of the anti-reflux barrier.</p><p><strong>Methods: </strong>We provided an extensive narrative review of the diagnosis and treatment of GERD treatment, exploring both endoscopic and surgical solutions.</p><p><strong>Results: </strong>Endoscopic procedures generally involve techniques such as gastric plication, delivery of radiofrequency energy at the gastroesophageal junction (EGJ), and the injection bulking agents into the EGJ.</p><p><strong>Conclusions: </strong>The efficacy of endoscopic treatments is not yet supported by robust scientific evidence. To date surgical fundoplication remains the gold standard for the treatment of GERD.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969751","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":"The Comparison Between Endoscopic Ligation and Sclerotherapy on the Treatment Effect and Anorectal Function in Patients With Internal Hemorrhoids.","authors":"Di Zhang, Rui Huang, Tao Ma, Mei Yang, Lei Lei, Zhenmao Li, Yinghui Zhang","doi":"10.1097/SLE.0000000000001381","DOIUrl":"10.1097/SLE.0000000000001381","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the treatment effect of endoscopic ligation and cap-assisted endoscopic sclerotherapy (CAES) for patients with internal hemorrhoids, symptom relief, complication rate and psychological condition, and the anorectal function were observed.</p><p><strong>Methods: </strong>Thirty-two patients who underwent minimally invasive endoscopic treatment for internal hemorrhoids were recruited, with a 3-month follow-up. Patients were divided into 2 groups, with Group A undergoing endoscopic ligation (n=14) and Group B receiving CAES (n=18). The Clinical efficacy and anorectal function between the 2 groups before and after treatment were compared, and the psychological changes in patients before and after treatment were evaluated by various scales.</p><p><strong>Results: </strong>There was no significant difference in the treatment effect of postoperative bleeding, prolapse, constipation, and complications between the 2 groups. However, Group A has certain advantages in the treatment of prolapse and constipation before and after treatment, and Group B has certain advantages in bleeding. The comprehensive multiscale psychological evaluation showed no significant difference between the 2 groups before and after treatment, but the psychological condition of patients in both groups was significantly improved after treatment. Besides, patients in Group A were better in the improvement of constipation scale, and patients in Group B had a greater improvement in the pain scale. As for anorectal function, there was no significant difference before and after treatment, except for the squeeze duration before treatment. In the comparison pretreatment and post-treatment, patients in Group A had significant differences in resting (average), first defecation and squeeze (average), while patients in Group B had significant differences in resting (average) and first defecation.</p><p><strong>Conclusions: </strong>Two endoscopic therapies were effective in treating internal hemorrhoids, with no significant difference in terms of treatment effect, symptom relief, complication rate, psychological condition, and anorectal function when compared between 2 groups. However, when compared within each group, the different methods had their own advantages in the evaluation of treatment effect and anorectal function.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of Microbiological Contamination of Endoscopes After Endoscopic Debridement of Pancreatic Encapsulated Necrosis With Multidrug Resistant Bacterial Infection.","authors":"Meng-Jiao Zhou, Xi Huang, Jiu-Hong Ma","doi":"10.1097/SLE.0000000000001383","DOIUrl":"10.1097/SLE.0000000000001383","url":null,"abstract":"<p><strong>Background: </strong>To investigate the microbiological contamination of endoscopes after endoscopic debridement of pancreatic encapsulated necrosis with multidrug-resistant bacterial infection by 2 different reprocessing methods of peroxyacetic acid and ethylene oxide.</p><p><strong>Methods: </strong>Endoscopes with auxiliary water function after endoscopic debridement of pancreatic encapsulated necrosis and multidrug-resistant bacterial infection in a tertiary care hospital in Jiangxi Province were selected and divided into 2 groups by random number table method: group A was sterilized by peracetic acid immersion and group B was sterilized by ethylene oxide low temperature. The 3 channels of the endoscopes, namely, the working channel, the air/water channel, and the auxiliary water channel, were collected by the filter membrane method and sent to the laboratory for microbiological culture within 2 hours. The qualification rate, colony count, and isolation of bacteria were compared between the 2 groups of endoscopes.</p><p><strong>Results: </strong>In this study, 78 endoscopes were collected, 39 each from group A and group B, with a total of 312 samples. The overall pass rate of group A and group B was 61.54% and 100%, respectively. The pass rate of group A working channel was 82.05%, the pass rate of air/water channel was 89.74%, the pass rate of auxiliary water channel was 74.36%, and the pass rate of all 3 channels in group B was 100%. The pass rate of group A working channel is 82.05%. The ranges of total bacterial colonies in the channel, air/water channel, and auxiliary water channel were 0 to 6 CFU/channel, 0 to 112 CFU/channel, and 0 to 23 CFU/channel, respectively. A total of 36 strains of bacteria were isolated, mainly multidrug resistant Pseudomonas aeruginosa , methicillin-resistant Staphylococcus aureus , and multidrug resistant Klebsiella pneumoniae . After transferring 15 failed endoscopes in group A to low-temperature sterilization with ethylene oxide, the microbiological surveillance pass rate reached 100%.</p><p><strong>Conclusion: </strong>For endoscopes with pancreatic encapsulated necrosis and multidrug resistant bacterial infection endoscopic debridement, the ethylene oxide cryo-sterilization method is safer and more effective. Routine microbiological surveillance of endoscopes cannot be limited to the surveillance of working channels only, and endoscopes with auxiliary water function need to monitor auxiliary water channels to reduce the risk.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144544876","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":"Transcystic Duct Gallbladder-preserving Cholecystolithotomy by ERCP: Efficacy in Managing Cholecystolithiasis With or Without Common Bile Duct Stones.","authors":"Jing-Feng Du, Gong-Li Yang, Zhong-Ming Dai, Xun-Chao Cai, Hai-Yan Zhong, Lu Liu, Yun Qian, Long Xu","doi":"10.1097/SLE.0000000000001379","DOIUrl":"10.1097/SLE.0000000000001379","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to assess the efficacy of transcystic duct gallbladder-preserving cholecystolithotomy by endoscopic retrograde cholangiopancreatography (TDGPCE) in patients diagnosed with cholecystolithiasis, both in the presence and absence of common bile duct stones (CBDS).</p><p><strong>Methods: </strong>A total of 54 patients with cholecystolithiasis, including those with and without CBDS, who underwent TDGPCE between March 2021 and May 2024 at the Endoscopy Center of Shenzhen University General Hospital were enrolled in this study. Clinical data and follow-up results were documented for all patients.</p><p><strong>Results: </strong>Gallbladder stones were successfully removed in 45 patients (83.3%) by TDGPCE. Comparisons of the success rate of stone removal, operative time, and full-covering metal stent (FCMS) placement time revealed no significant differences between patients with cholecystolithiasis, regardless of CBDS presence ( P >0.05). Post-ERCP pancreatitis (n=3, 6.7%) and hyperamylasemia (n=21, 46.7%) were resolved with subsequent interventions. Notably, the 3 patients who developed post-ERCP pancreatitis did not receive pancreatic duct stent insertion due to the presence of an accessory pancreatic duct. Concomitant CBDS did not correlate with an increased risk of post-ERCP pancreatitis or hyperamylasemia in patients undergoing TDGPCE ( P >0.05). During the follow-up period, among the patients (n=45) who underwent this procedure, one reported residual gallbladder stones, and 2 experienced recurrence of gallbladder stones.</p><p><strong>Conclusion: </strong>TDGPCE is a safe and effective approach for the removal of gallbladder stones in patients with cholecystolithiasis, offering the advantage of preserving gallbladder function without the need for incisions to the abdominal wall or gastrointestinal tract.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200013","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":"Complication of Internal Herniation-related Bowel Obstruction Post-Single Anastomosis Sleeve Ileal (SASI) Bypass and Management: Series Case Sharing (Video Report).","authors":"Yi-Jie Wang, Hsin-Mei Pan, Kong-Han Ser, Kuo-Feng Hsu","doi":"10.1097/SLE.0000000000001376","DOIUrl":"10.1097/SLE.0000000000001376","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a global health concern associated with multiple comorbidities, and bariatric surgery remains one of the most effective interventions for sustained weight loss and metabolic improvement. The Single Anastomosis Sleeve Ileal (SASI) bypass is a novel procedure that offers a simplified surgical approach while maintaining efficacy. However, despite its advantages, SASI bypass carries a risk of postoperative complications, including internal herniation-related bowel obstruction-a rare but potentially life-threatening condition requiring prompt recognition and intervention.</p><p><strong>Method: </strong>We report 3 cases of internal herniation following SASI bypass, 2 performed robotically and 1 laparoscopically. Despite uneventful surgical procedures, all 3 patients developed postoperative internal herniation, with symptom onset ranging from 1 week to 16 months after surgery. A comparative summary of their clinical presentations and outcomes is provided in the accompanying table. Due to timely diagnosis and prompt surgical intervention, all patients had favorable outcomes. In addition, we compiled and edited a surgical video from the third case to illustrate the operative management of this complication.</p><p><strong>Results: </strong>Computed tomography (CT) emerged as the gold standard for diagnosis, although immediate surgical exploration was necessary in cases of peritonitis or hemodynamic instability. Notably, 1 patient (Case 2) experienced rapid weight loss, a factor previously implicated as a potential risk for internal herniation. Petersen's defect was the most common herniation site in SASI bypass, resembling the pattern seen in One Anastomosis Gastric Bypass (OAGB) but differing from Roux-en-Y Gastric Bypass (RYGB), where multiple mesenteric defects increase the risk. While a longer biliopancreatic limb may predispose SASI and OAGB patients to herniation, consensus on routine defect closure remains lacking.</p><p><strong>Conclusion: </strong>Internal herniation is a rare but serious complication of SASI bypass, with delayed diagnosis potentially leading to bowel ischemia or perforation. CT is essential for early detection, while timely surgical intervention is critical in symptomatic cases. The necessity of routine Petersen's defect closure remains debated, highlighting the need for further studies to determine the true incidence and optimal prevention strategies.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047264","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":"Endoscopic Ultrasound-Guided Biliary Drainage for Acute Cholangitis Secondary to Biliary Obstruction: A Systematic Review and Meta-Analysis.","authors":"Yash Shah, Sahib Singh, Dushyant S Dahiya, Ernesto Calderon-Martinez, Sneha A Sebastian, Manesh K Gangwani, Zohaib Ahmed, Saurabh Chandan, Babu Mohan, Rashmi Advani","doi":"10.1097/SLE.0000000000001386","DOIUrl":"10.1097/SLE.0000000000001386","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic retrograde cholangiopancreatography (ERCP) remains the primary treatment for biliary obstruction, yet fails in 5% to 7% of cases, necessitating alternative therapeutic options like endoscopic ultrasound-guided biliary drainage (EUS-BD). With acute cholangitis posing significant morbidity and mortality risks, assessing the safety and efficacy of EUS-BD in these patients is vital. This is the first meta-analysis with a subgroup analysis assessing the outcomes of EUS-BD in patients with acute cholangitis secondary to biliary obstruction.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted following PRISMA guidelines, searching MEDLINE, Embase, Web of Science, Clinicaltrials.gov, and Cochrane databases until December 23, 2023. Studies involving adult patients undergoing EUS-BD for cholangitis were included. Outcomes assessed were pooled technical and clinical success rates, complications, and mortality. Standard meta-analysis methods were employed using the random-effects model, and heterogeneity was assessed using the I2 % statistics.</p><p><strong>Results: </strong>Among the included 5 studies (109 patients), EUS-BD achieved a pooled technical success rate of 95.5% (95% CI: 91.0-98.5) and a clinical success rate of 92.1% (95% CI: 86.4-96.3), with low heterogeneity across studies ( I2 : 0.00% for both outcomes). The pooled complication rate was 12.2% (95% CI: 5.1-21.8, I2 : 37.46%), with predominantly mild and self-limiting complications.</p><p><strong>Conclusion: </strong>EUS-BD demonstrated excellent pooled technical and clinical success rates, particularly when ERCP is not feasible in patients with acute cholangitis secondary to biliary obstruction. Most postprocedure complication rates are also mild and self-limiting making EUS-BD a possible alternative for the management of patients with cholangitis.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476765","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 Reverse Cholangiopancreatography (LRCP): Our Algorithm For Laparoscopic Common Bile Duct Exploration (LCBDE).","authors":"Robin R Cotter, Tawni M Johnston, Casey R Lamb, Eleah D Porter, Jenaya L Goldwag, James C Cooros, D Joshua Mancini, Kari M Rosenkranz, B Fernando Santos","doi":"10.1097/SLE.0000000000001377","DOIUrl":"10.1097/SLE.0000000000001377","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic common bile duct exploration (LCBDE) is safe and efficacious. \"Classic\" LCBDE technique utilizes isolated choledochoscope-guided retrograde basketing; however, it is less effective than transcholedochal exploration. We report on the evolution of our LCBDE technique away from \"classic\" transcystic approach towards prioritizing antegrade clearance using a novel algorithm utilizing a variety of tools, which we term laparoscopic reverse cholangiopancreatography (LRCP).</p><p><strong>Methods: </strong>We report an algorithm-driven LRCP technique for LCBDE that tailors intervention to the patient's anatomy and stone burden (size, location, number) seen on cholangiogram (IOC). For cystic ducts ≥4 mm, we use a choledochoscope-assisted technique versus a fluoroscopy-guided technique if <4 mm. For small stones, we use wire basketing (with the \"classic\" technique) or the \"snow-plow\" maneuver. For medium (≤10 mm) or multiple stones, we utilize sphincteroplasty plus \"snow-plow\" if needed. For large (>10 mm), we use laser or electrohydraulic lithotripsy. Fallback methods are ERCP or transcholedochal exploration.</p><p><strong>Results: </strong>We retrospectively reviewed our 80 LCBDE cases at a single Veterans Affairs hospital: 50 cases in the \"classic\" phase and 30 subsequent cases using LRCP. Transcystic clearance was significantly higher for LRCP at 97% vs. 56% during the \"classic\" phase (χ2=15.14, P <0.001). There was zero utilization of choledochotomy during LRCP.</p><p><strong>Conclusions: </strong>Algorithm-driven LRCP dramatically improved transcystic clearance success and reduced reliance on choledochotomy. Our algorithm serves as a decision aid, allowing surgeons to utilize a variety of available tools for LCBDE.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094943","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":"Clinically Related Factors of Liver Failure in Patients With Liver Cirrhosis After Hepatectomy.","authors":"Jun-Ping Gao, Zhan Lu, Jie Zhang, Shang-Dong Qin, Jing-Fei Zhao, Jun-Tao Huang, Wen-Feng Gong, Bang-De Xiang","doi":"10.1097/SLE.0000000000001387","DOIUrl":"10.1097/SLE.0000000000001387","url":null,"abstract":"<p><strong>Introduction: </strong>Many patients with cirrhosis develop posthepatectomy liver failure (PHLF). Factors associated with clinically relevant PHLF (CRPHLF) in cirrhosis with different remnant liver volume (RLV)-to-standard liver volume (SLV) ratios are unclear.</p><p><strong>Aim: </strong>The study aimed to determine whether an RLV/SLV value of <40% is safe for hepatectomy in patients with cirrhosis.</p><p><strong>Material and methods: </strong>Patients with cirrhosis were divided into an RLV/SLV <40% group (28 cases) and an RLV/SLV ≥40% group (39 cases) based on their RLV/SLV ratio. The incidence of CRPHLF and surgical complications in the 2 groups were analysed, and CRPHLF was determined according to the criteria of the International Study Group of Liver Surgery. Factors associated with CRPHLF were identified using multivariate logistic regression for all patients. We further performed the Hosmer-Lemeshow test and calculated the area under the receiver operating characteristic curve (AUC) to assess the overall model fit. All analyses were performed using SPSS 19.0 software.</p><p><strong>Results: </strong>Patients who developed CRPHLF had a higher rate of severe complications (17.1%) than those who did not. Body mass index (BMI), prothrombin time (PT), RLV/SLV value, and blood transfusion were associated with CRPHLF in all patients with cirrhosis ( P <0.05). Clinically relevant PHLF was associated with PT in patients with RLV/SLV ≥40% and with BMI in patients with RLV/SLV <40% ( P <0.05). Model diagnostics suggested satisfactory calibration (Hosmer-Lemeshow P =0.436) and moderate discrimination (AUC=0.78) in the overall cohort. Patients with cirrhosis with an RLV/SLV value of <40% (and ≥30%) had the same complications or CRPHLF as patients with an RLV/SLV value of ≥40% ( P >0.05).</p><p><strong>Conclusion: </strong>We found that a high PT was a risk factor in patients with RLV/SLV ≥40%, while a low BMI was a risk factor in those with RLV/SLV <40%. Increased surgical complications may not be associated with low RLV/SLV ratios, and hepatectomy may be safe in some patients with cirrhosis with RLV/SLV values <40% (and ≥30%).</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326857","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":"The Effects of Machine-Based and Manual Hand Massage on Pain, Anxiety, and Gastrointestinal Function Following Laparoscopic Cholecystectomy.","authors":"Münevver Şengül, Sevim Çelik","doi":"10.1097/SLE.0000000000001375","DOIUrl":"10.1097/SLE.0000000000001375","url":null,"abstract":"<p><strong>Background: </strong>Inadequate management of pain, anxiety, and gastrointestinal function after laparoscopic cholecystectomy can lead to an increase in the incidence of nausea and vomiting, disruption of gastric functions, delayed postoperative recovery, prolonged hospital stay, increased risk of mortality, opioid use, and unwanted side effects. To evaluate the impact of manual and machine-based hand massage following laparoscopic cholecystectomy on pain, anxiety, and gastrointestinal function.</p><p><strong>Methods: </strong>This randomized controlled trial study was conducted with 171 patients. Patients were divided into 2 intervention (manual hand massage and machine-based hand massage) groups (n=57), and a control group (n=57). Data were collected at 0, 4, and 8 hours postoperatively using the survey form, Numerical Rating Scale, State-Trait Anxiety Inventory, and Gastrointestinal Function Monitoring Form.</p><p><strong>Results: </strong>The severity of pain in the manual hand massage group decreased statistically significantly after massage ( P <0.05). Anxiety levels in the intervention groups were lower at all time intervals postoperatively ( P <0.001). The severity of nausea in the massage groups was lower at 8 hours ( P <0.05). The number of bowel sounds at 8 hours in the massage groups showed a greater increase ( P <0.05).</p><p><strong>Conclusion: </strong>Both manual and machine-based hand massage positively affected pain, anxiety, nausea intensity, and bowel sounds following laparoscopic cholecystectomy. Manual hand massage was more effective than machine-based hand massage in reducing pain intensity and increasing bowel sounds.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042960","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}