Surgical Laparoscopy, Endoscopy & Percutaneous Techniques最新文献

{"title":"Predictors and Outcomes Following Percutaneous Gallstone Lithotripsy, Lithectomy, and Dual Cholecystoduodenal Stenting.","authors":"Christopher Neely, Ali Husnain, Ezra Teitelbaum, Alexander Nagle, Shahaan Shafi, Hasan Alam, Michael Shapiro, Nabil Issa, Allison Reiland, Shashwat Gupta, Kristine Stiff, Bartley Thornburg, Riad Salem, Abdul A Aadam, Ahsun Riaz","doi":"10.1097/SLE.0000000000001493","DOIUrl":"10.1097/SLE.0000000000001493","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the outcomes of percutaneous gallstone lithotripsy/lithectomy with dual cholecystoduodenal stenting (CDS) in acute calculous cholecystitis (ACC) patients ineligible for surgery.</p><p><strong>Materials and methods: </strong>Thirty patients with ACC who underwent percutaneous cholecystostomy (PC) followed by lithectomy (with or without lithotripsy/dual CDS) under fluoroscopy and endoscopy guidance from March 2022 to December 2023 were included in this retrospective study. Demographics, reasons for surgical ineligibility, and procedural data were collected. Gallstone characteristics on preprocedural imaging were recorded, including the number of stones, the size of the largest stone, and the calcification status.</p><p><strong>Results: </strong>Eighteen (60%) patients were female [median age 66 (30 to 94)]. Cardiopulmonary comorbidities were the most common reason for surgical ineligibility [15 (50%)]. The median duration between PC and the index lithectomy procedure was 100 days (28 to 280). Lithotripsy/lithectomy was performed in 22 patients (73%), with lithectomy alone in 8 (27%). CDS was performed concurrently in 24 patients (80%). Technical success, defined as a >50% decrease in gallstone burden and dual CDS, was achieved in 23 patients (77%). PC tubes were removed in 25 (83%) patients: immediately postprocedure in 19 (63%) and on follow-up in 6 (20%). Larger gallstone size correlated with longer procedure times (R=0.45; P=0.026). Uncomplicated acute pancreatitis occurred in 4 (13%) patients. Clinical success, defined as the absence of cholecystitis recurrence, was 100%, with a median follow-up of 364 days (range, 301 to 573).</p><p><strong>Conclusions: </strong>Percutaneous lithectomy with/without lithotripsy and dual CDS is a safe and effective procedure for managing ACC in poor surgical candidates to enable them to live drain-free.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":"36 5","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115140","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":"Robotic Versus Laparoscopic Hiatal Hernia Repair: A Statewide Analysis Using Severity-Graded Complication Outcomes.","authors":"Jorge Urbina, Carlos Galvani, Salvatore Docimo, Christopher DuCoin, Rana Pullatt, Nicholas Spurbeck, Benjamin Clapp","doi":"10.1097/SLE.0000000000001511","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001511","url":null,"abstract":"<p><strong>Background: </strong>Robotic-assisted hiatal hernia repair has increased substantially, but comparative outcomes relative to laparoscopy remain incompletely defined.</p><p><strong>Methods: </strong>We performed a retrospective cohort study using the 2024 Texas Inpatient Public Use Data File. Adult patients undergoing minimally invasive hiatal hernia repair were identified using ICD-10-PCS codes and stratified by surgical approach and mesh use. The primary outcome was major complication (Clavien-Dindo ≥III proxy). Multivariable logistic regression adjusted for demographics, comorbidity burden, admission acuity, and clinical presentation.</p><p><strong>Results: </strong>Among 3511 patients (1739 laparoscopic and 1772 robotic), major complications differed across groups, with the highest rates in robotic cases without mesh (14.4% vs. 9.3%, P=0.002). The robotic approach was associated with increased odds of major complications (aOR=1.28, 95% CI: 1.04-1.59, P=0.021), persisting in elective cases (aOR=1.38, P=0.013). No differences were observed in Clavien-Dindo ≥IV complications or mortality.</p><p><strong>Conclusions: </strong>Robotic repair was associated with increased intervention-level complications, with no differences in severe complications or mortality.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081883","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":"Not Crossing the Line: A Modified Port Placement That Eliminates the Crossover Step in eTEP Inguinal Hernia Repair.","authors":"Monika Gureh, Pankaj Kumar","doi":"10.1097/SLE.0000000000001513","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001513","url":null,"abstract":"","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026060","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":"Intracorporeal Circular-Stapled Roux-en-Y Reconstruction in Totally Laparoscopic Distal Gastrectomy: Laparoscopic Purse-String Suture Clamp and Multifunctional Seal Cap Technique.","authors":"Jianmin Zhang, Qingsong Tao, Linsen Zhou, Yang Yang, Ying Yang, Jing Zhuang, Jianjun Du, Haohai Jiang","doi":"10.1097/SLE.0000000000001510","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001510","url":null,"abstract":"<p><strong>Background: </strong>Totally laparoscopic distal gastrectomy (TLDG) has become one of the standard surgical procedures for early and advanced gastric cancer. The Roux-en-Y reconstruction is the most commonly used method after TLDG to effectively prevent bile reflux esophagitis and residual gastric inflammation. Gastrojejunal Roux-en-Y reconstruction mainly includes 3 types of anastomosis: circular, linear, and manual. Circular-stapled anastomosis is frequently used in open gastrointestinal surgery. However, it faces significant technical challenges. The study aimed to evaluate the feasibility and safety of using a laparoscopic purse-string suture clamp (Lap-PSC) and a multifunctional seal cap (MSC) for gastrojejunal Roux-en-Y circular anastomosis, aiming to establish a new standard method for Roux-en-Y reconstruction in TLDG.</p><p><strong>Methods: </strong>A multicenter retrospective analysis was conducted on 101 gastric cancer patients undergoing TLDG with Lap-PSC and MSC from October 2023 to April 2025, with all patients receiving intracorporeal gastrojejunal Roux-en-Y circular anastomosis. Surgical details and postoperative outcomes were analyzed to evaluate this method.</p><p><strong>Results: </strong>All 101 patients underwent successful TLDG with negative resection margins, defined as completion without intraoperative complications or conversion. The mean operation time was 187.5±36.4 minutes. The mean time for the purse-string suture was 7.2±2.5 minutes, and an average of 5.3 minutes was required for anvil placement. The overall incidence of early postoperative complications was 9.9% in this study. 1 patient (1.0%) experienced postoperative gastroparesis, 3 patients (3.0%) had postoperative pneumonia, 3 patients (3.0%) developed abdominal infection, and 2 patients (2.0%) suffered wound infection. During the median follow-up period of 11.8 months, 2 patients (2.0%) experienced gastrojejunostomy stenosis, and both were treated successfully by endoscopic balloon dilation. No anastomotic leaks or perioperative deaths occurred.</p><p><strong>Conclusion: </strong>The laparoscopic purse-string suture clamp combined with the multifunctional seal cap technique is a safe, feasible, and easily standardized method for circular anastomosis, offering a valuable alternative for gastrojejunal Roux-en-Y reconstruction in TLDG.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026057","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":"Outcomes of Peroral Endoscopic Myotomy (POEM) for Treatment of Achalasia in Elderly Patients: A Single Institution Retrospective Cohort Study.","authors":"Konstantinos P Economopoulos, Deanna L Palenzuela Rothman, Elan Witkowski, Charudutt Paranjape, Kumar Krishnan","doi":"10.1097/SLE.0000000000001512","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001512","url":null,"abstract":"<p><strong>Background: </strong>POEM has been shown to have excellent safety and efficacy in adults. We report our experience with the POEM for the treatment of achalasia in elderly patients (65 y or older).</p><p><strong>Methods: </strong>This is a single-institution retrospective cohort study over a span of 4 years. The primary outcome was clinical success, defined as improvement in dysphagia score to ≤1 without need for a reintervention in the first 6 months. Secondary outcomes included technical success, rate of reintervention, and postprocedural complications.</p><p><strong>Results: </strong>A total of 51 patients (male 52.9%, mean age: 72.9±6.2 y; range 65 to 91 y) underwent POEM for treatment of achalasia. Most patients [n=27 (52.9%)] had achalasia type II, while 13 (25.5%) had achalasia type I and 11 (21.6%) had achalasia type III. Technical success was achieved in 100% of patients (n=51), and clinical success was achieved in 96.1% of patients (n=49). The median dysphagia score improved significantly from 3 (IQR=1 to 3) preprocedure to 0 (IQR=0 to 0) at the most recent follow-up (P<0.001). Median regurgitation scores also improved from 1 (IQR=0 to 2) preprocedure to 0 (IQR=0 to 0) postprocedure at the most recent follow-up (P<0.001). Reintervention due to recurrence of symptoms was required in 2 patients (3.9%) during a mean length of follow-up of 9 months (range: 1 to 37 mo).</p><p><strong>Conclusion: </strong>POEM is a safe, effective, and durable treatment for all types of achalasia in elderly patients.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026050","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":"Has the Robot Made Cholecystectomy Safer? Bile Duct Injury, Minilaparoscopy, and the Enduring Lesson of Training and Discipline.","authors":"Gustavo L Carvalho, Ioram S Sette, Eduardo Moreno Paquentin","doi":"10.1097/SLE.0000000000001509","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001509","url":null,"abstract":"<p><strong>Background: </strong>Bile duct injury is the most feared complication of cholecystectomy: more common than high-income registries suggest, catastrophic and lasting. The robot did not invent this danger; it revived an old one. Its adoption is outpacing any proof that it protects the common bile duct. The deeper question is what that signal teaches about what protects patients when a new platform enters the operating room.</p><p><strong>Methods: </strong>A narrative synthesis of the comparative evidence, the randomized and registry data on minilaparoscopy, and the preclinical work on surgical autonomy. Every pooled event count was checked against its primary source, with Poisson CIs and a leave-one-out sensitivity analysis.</p><p><strong>Results: </strong>More than a million patients, in national files and an independent registry, point one way: robotic cholecystectomy carries a reproducible excess of bile duct injury over laparoscopy. It survives the analysis built to strip away case selection (instrumental-variable relative risk: 1.88; 95% CI: 1.14-2.63), holds across every risk stratum, and the robot's injury rate in its easiest patients exceeds laparoscopy's in its hardest. In contemporary practice, it narrowed but did not close. The robot does well away from the duct, converting to open surgery less than half as often. The fault is not the machine. Its advantages in ergonomics, vision, and precision are the trap. It has become the beginner's operation; its learning curve runs long (87% of surgeons are still inside it), and it removes the tactile feedback that once checked a careless pull. Overconfidence is easy to suspect and hard to prove: only 8% of the most-watched online videos showed an adequate Critical View of Safety (CVS), and fluorescence identifies the duct without preventing injury. What guards the duct is not the platform but training and discipline: the CVS earned, the judgment to abandon it when the anatomy refuses, and the timely bail-out. Minilaparoscopy proves the point: it reports 0.018% across 16,272 verified cases, an enthusiast-reported literature not directly comparable with administrative cohorts, and randomized trials show small ports earn no protective credit. The discipline, not the millimeters, does the work.</p><p><strong>Conclusions: </strong>This is no verdict against robotics. Safety has always lived in training and discipline, never in the instrument, and any platform that loosens them is punished at the bile duct. Minilaparoscopy earns its place because it compels that discipline. Autonomous systems, trained so far only on anatomically ordinary gallbladders, inherit the same demand. The platform keeps changing. The lesson does not.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025980","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":"Thirty-Day Major Clinical Reintervention After Gastrostomy Tube Placement: An Adjudicated Multihospital Comparison of Endoscopic, Laparoscopic, Open, and Radiologic Routes.","authors":"Ramsey M Dallal, Anthony Ciro, Michael E Goldberg, Emery Cuellar, Jay Strain","doi":"10.1097/SLE.0000000000001507","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001507","url":null,"abstract":"<p><strong>Background: </strong>Reported complication rates after gastrostomy tube (GT) placement vary widely, largely because studies count routine tube care as an adverse event. The incidence, timing, and determinants of clinically meaningful GT failure therefore remain uncertain, as does whether placement route changes the risk of catastrophic failure.</p><p><strong>Methods: </strong>We studied patients undergoing a first or clean index GT placement at 21 hospitals and ambulatory sites within one integrated health system between April 3, 2017 and July 29, 2025. Route was adjudicated as percutaneous endoscopic gastrostomy (PEG), minimally invasive surgical gastrostomy (MIS; laparoscopic or robotic), open surgical gastrostomy, or interventional radiology (IR)-guided gastrostomy. The primary outcome, defined before analysis, was GT-specific major clinical reintervention within 30 days: any unplanned operative or invasive therapeutic procedure attributable to GT failure. Routine tube maintenance was excluded by definition. Candidate events were identified by a high-sensitivity text and CPT screen, then independently adjudicated by 2 surgeons. Associations were estimated with Firth penalized logistic regression adjusted for age category, sex, and body mass index category, with PEG and MIS combined as the reference route. Operator comparisons were prespecified within PEG cases only.</p><p><strong>Results: </strong>Among 6141 clean index placements [PEG 4821 (78.5%), IR 707 (11.5%), open 386 (6.3%), MIS 227 (3.7%)], 69 patients had a GT-specific major clinical reintervention within 30 days (1.12%; 95% CI: 0.88-1.42), or one event per 89 placements. Crude rates were 1.00% (PEG), 0.44% (MIS), 2.59% (open), and 1.41% (IR). Events clustered early (median: 6 d; IQR: 3-11), with 43 of 69 (62%) in the first week and 9 (13%) after day 14. After adjustment, open placement was associated with higher odds of major reintervention than PEG/MIS (OR: 2.25; 95% CI: 1.13-4.47; P=0.02), an absolute difference of 1.6 percentage points, or one extra event per 62 open placements. IR placement was not (OR: 1.28; 95% CI: 0.65-2.52), nor was any patient characteristic. Within PEG cases, gastroenterology and surgery did not differ significantly (OR: 0.58; 95% CI: 0.31-1.06). The open association persisted across 5 prespecified sensitivity analyses.</p><p><strong>Conclusions: </strong>With routine tube care excluded and events adjudicated, major GT failure requiring reintervention within 30 days follows roughly 1 in 89 placements. Open placement carried about twice the odds of the endoscopic and laparoscopic routes, whereas radiologic placement did not differ despite serving more difficult anatomy. Where all routes are feasible, an open approach should not be chosen as the presumed safer one.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026033","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":"Postoperative PLR Slope for Early Warning of Colorectal Anastomotic Leakage.","authors":"Zhenlin Chen, Xin Lin, Zhaojie Ruan","doi":"10.1097/SLE.0000000000001506","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001506","url":null,"abstract":"<p><strong>Background: </strong>Anastomotic leakage (AL) after colorectal resection is often confirmed between postoperative days (PODs) 4 and 8. We evaluated whether the POD1-to-3 platelet-to-lymphocyte ratio (PLR) \"rising slope\" in routine blood counts provides an earlier warning of ISREC grade B/C AL.</p><p><strong>Methods: </strong>In a prospective single-center cohort (2021 to 2025), analyses used a POD3 landmark among patients who were alive and without an AL diagnosis through POD3. PLR slope was derived from POD1 to 3 blood draw timestamps and modeled at 10 PLR units/day. Thirty-day International Study Group of Rectal Cancer (ISREC) grade B/C AL was adjudicated blinded using CT with IV contrast (± rectal contrast when feasible) and/or endoscopy/operative findings. First logistic regression with bootstrap optimism correction estimated the association and AUC. A sensitivity-first operating threshold, selected using nested resampling and CRP/NLR comparators, was evaluated.</p><p><strong>Results: </strong>A total of 101 participants developed 30-day AL after the POD3 landmark assessment. PLR slope was associated with AL (OR=1.31 per 10 units/day; 95% CI: 1.02-1.89; P=0.039) with AUC 0.74 (95% CI: 0.58-0.86) and optimism-corrected AUC 0.72. The sensitivity-first threshold achieved sensitivity 83.0%, specificity 61.0%, PPV 12.0%, and NPV 98.3%, with a median lead-time of 2 days (IQR=1 to 3) from POD3 assessment to radiologic confirmation. In the CRP subset, AUCs were 0.67 for CRP POD3, 0.70 for CRP slope, and 0.62 for NLR POD3 (all P>0.20 vs. PLR slope). Decision-curve analysis favored PLR-slope triage over imaging-all-or-none triage across 5% to 12% threshold probabilities.</p><p><strong>Conclusions: </strong>In our study, the POD1-to-3 PLR slope is a low-cost, POD3-available rule-out adjunct that may provide earlier warning before radiologic confirmation of clinically relevant AL. Multicenter validation is required to confirm generalizability, finalize operating thresholds, and quantify downstream imaging and outcome trade-offs.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026009","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":"Long-term Outcomes and Quality of Life Following Laparoscopic One-anastomosis Gastric Bypass: Single-center Experience.","authors":"Anna Kirshtein, Boris Kirshtein, Yehuda Hershkovitz, Oded Zmora, Hasan Kais","doi":"10.1097/SLE.0000000000001508","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001508","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic one-anastomosis gastric bypass (OAGB) has become one of the leading bariatric procedures for severe obesity in Israel over the past 8 years. While short-term outcomes have been widely reported in the literature, long-term data remain limited. This study summarizes 7-year outcomes and quality of life (QoL) following OAGB.</p><p><strong>Methods: </strong>A retrospective review was conducted of consecutive patients who underwent OAGB between January and December 2016 at Shamir Medical Center. Data were collected from a prospective bariatric database and analyzed retrospectively. All patients participated in a structured phone interview in late 2024, with a mean follow-up period of 7 years. Surgical outcomes were evaluated based on pre- and postoperative comorbidities, early and late complications, weight loss, patient satisfaction, and QoL using the Bariatric Analysis and Reporting Outcome System (BAROS) II.</p><p><strong>Results: </strong>Eighty patients were included in the final analysis: 55 females (68.8%) and 25 males (31.2%), with a mean age of 44.3 years (range: 20-68). The mean preoperative weight was 103.2 kg, and the mean BMI was 40.9 kg/m². The mean operative time was 101.9 minutes, and the average hospital stay was 3.3 days. Major complications within 30 days occurred in 5.1% of cases. The mean BMI decreased to 28.1 kg/m² at 1.7 years and remained stable throughout the follow-up period. Mean %EWL was 80.2% at 6 months and 74.6% at 7 years postoperatively. Resolution of type 2 diabetes, hypertension, obstructive sleep apnea, and hyperlipidemia was observed in over 80% of patients with preoperative comorbidities. QoL improved over the 7-year follow-up.</p><p><strong>Conclusion: </strong>OAGB is a technically straightforward and safe procedure with short operative and hospitalization times. It provides sustained weight loss, high resolution of comorbidities, and long-term improvement in quality of life.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931072","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":"Immunosuppressant Dosing and Trough Levels in Transplant Patients That Have Duodenal Bypass Bariatric Surgery.","authors":"Richard Betancourt, Tala Abedalqader, Nour El Ghazal, Tony Boutros, Joseph Klim, Simon J Laplante, Tayyab S Diwan, Omar M Ghanem","doi":"10.1097/SLE.0000000000001504","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001504","url":null,"abstract":"<p><strong>Background: </strong>Obesity is associated with increased complications after solid organ transplantation (SOT). While metabolic and bariatric surgery (MBS) improves survival, metabolic, and graft outcomes in transplant patients, we aim to clarify the risk that duodenal bypass MBS (DB-MBS) has on immunosuppression and acute rejection.</p><p><strong>Methods: </strong>A single-center retrospective cohort study was conducted on patients who underwent SOT and DB-MBS between 2003 and 2025. Immunosuppressant regimens and biopsy-confirmed acute rejection details were collected for 3 years after each procedure. Immunosuppressant dosing and trough levels were normalized to individual target levels and evaluated with linear-mixed effects models.</p><p><strong>Results: </strong>The cohort included 19 patients. There were no statistically significant differences in immunosuppression outcomes when DB-MBS is performed before (dosing P=0.821, trough P=0.916) and after (dosing P=0.368, trough P=0.317) SOT. The 3-year acute rejection incidence was 21.1%.</p><p><strong>Conclusion: </strong>The presence and timing of DB-MBS did not significantly alter immunosuppression dosing and trough levels.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930997","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}