{"title":"Trace element-enriched collagen peptide beverage is associated with a lower incidence of chemotherapy-induced diarrhea during DCF therapy for esophageal squamous cell carcinoma: A retrospective exploratory study.","authors":"Akira Saito, Takeshi Yamashita, Satoru Goto, Tomotake Ariyoshi, Kentaro Motegi, Masahiro Kohmoto, Koji Otsuka, Masahiko Murakami, Takeshi Aoki","doi":"10.1007/s00595-026-03339-4","DOIUrl":"10.1007/s00595-026-03339-4","url":null,"abstract":"<p><strong>Purpose: </strong>Neoadjuvant docetaxel, cisplatin, and 5-fluorouracil (DCF) therapy is commonly used for esophageal squamous cell carcinoma in Japan, but it often causes chemotherapy-induced diarrhea (CID), thus impairing the quality of life. We investigated the association between a trace element-enriched collagen peptide beverage (CP10) and CID during DCF therapy.</p><p><strong>Methods: </strong>This retrospective study included 94 patients who underwent radical esophagectomy following DCF therapy (January 2023-December 2025). During the first DCF cycle, 26 patients consumed CP10 daily (CP+ group), whereas 68 did not (CP- group). The primary endpoint was CID incidence during the first DCF cycle, assessed using the Common Terminology Criteria for Adverse Events. A multivariable logistic regression analysis was performed to adjust for any potential confounders.</p><p><strong>Results: </strong>Grade ≥ 1, ≥2, and ≥ 3 CID occurred in 15%, 15%, and 12% of the CP+ group versus 46%, 38%, and 32% of the CP- group, respectively. CP10 use was associated with a lower incidence of CID across all severity grades. In the multivariable analysis, this association remained statistically significant for grade ≥ 1 CID (adjusted OR 0.22, 95% CI 0.05-0.74; P = 0.013). Sensitivity analyses yielded consistent estimates (adjusted OR 0.15-0.28).</p><p><strong>Conclusion: </strong>CP10 use was associated with a lower incidence of CID during DCF therapy.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"2248-2254"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148176858","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}
Surgery TodayPub Date : 2026-10-01Epub Date: 2026-06-09DOI: 10.1007/s00595-026-03359-0
Fatih Kizilyel, Bedirhan Bugra Bayici, Safa Ozcelik, Mehmet Rum
{"title":"Early postoperative \"grey zone\" gradients following aortic valve replacement surgery: the clinical course and mechanical stress biomarker profile.","authors":"Fatih Kizilyel, Bedirhan Bugra Bayici, Safa Ozcelik, Mehmet Rum","doi":"10.1007/s00595-026-03359-0","DOIUrl":"10.1007/s00595-026-03359-0","url":null,"abstract":"<p><strong>Purpose: </strong>Surgeons frequently encounter early postoperative intermediate transvalvular gradients (20-40 mmHg, \"grey zone\") after aortic valve replacement (AVR). We investigated whether these gradients compromise short-term clinical stability or represent a transient, clinically compensated phase, marked by systemic mechanical stress.</p><p><strong>Methods: </strong>We retrospectively evaluated 141 consecutive isolated AVR patients, stratified by pre-discharge mean gradients: Group 1 (> 20 mmHg, n = 66) and Group 2 (≤ 20 mmHg, n = 75). We analyzed short-term clinical outcomes and systemic mechanical stress markers (neutrophil-to-lymphocyte ratio [NLR] and lactate dehydrogenase [LDH] levels).</p><p><strong>Results: </strong>The operative characteristics were similar between the groups. Group 1 exhibited elevated median NLR (3.8 vs. 2.1, p < 0.001) and LDH (304.0 vs. 115.5 U/L, p < 0.001) levels. Despite this biochemical activation, the short-term mortality and reoperation rates were comparable between the two groups. Although Group 1 experienced more frequent non-valvular readmissions (13.6% vs. 2.6%, p = 0.024), their mean gradients demonstrated significant spontaneous regression by 6 months (23.5 to 19.8 mmHg, p < 0.01).</p><p><strong>Conclusion: </strong>Early \"grey zone\" gradients are associated with a distinct mechanical stress profile characterized by elevated NLR and LDH levels but do not appear to compromise short-term valvular stability. The spontaneous gradient regression and absence of excess mortality support a safe \"watchful waiting\" approach, thus avoiding premature reinterventions while maintaining close clinical surveillance.</p><p><strong>Clinical trial registration: </strong>This study was not registered as a clinical trial because it was a retrospective observational study.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"2286-2294"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206272","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":"Poor-contrast areas in lymph nodes on contrast-enhanced computed tomography scan/magnetic resonance imaging are predictive of lymph node metastasis in patients with resected intrahepatic cholangiocarcinoma.","authors":"Kei Hagiwara, Kenichiro Araki, Norio Kubo, Takamichi Igarashi, Mariko Tsukagoshi, Kei Shibuya, Hiroyasu Asanaga, Natsumi Katsumata, Masashi Ebara, Azusa Tokue, Aya Takase, Ken Shirabe","doi":"10.1007/s00595-026-03365-2","DOIUrl":"10.1007/s00595-026-03365-2","url":null,"abstract":"<p><strong>Purpose: </strong>Intrahepatic cholangiocarcinoma (ICC) with pathological lymph node metastasis (LNM) is associated with a poor prognosis. The standard treatment for ICC is surgical resection; however, the importance of prophylactic lymph node dissection (LND) is unclear. This study examined the predictive value of preoperative imaging for LNM from ICC.</p><p><strong>Methods: </strong>Forty patients with ICC underwent preoperative diagnostic imaging using contrast-enhanced computed tomography (CT), gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI), and positron emission tomography (PET)-CT, followed by liver resection with LND. Lymph node (LN) size (≥ 10 mm) and the presence of poor-contrast areas in LNs were evaluated using CT and EOB-MRI. Visually assessed positive LNs were evaluated by PET-CT.</p><p><strong>Results: </strong>LN size measured on CT and EOB-MRI could not predict pathological LNM. However, poor-contrast areas in LNs measured on CT (sensitivity, 55.0%; specificity, 95.0%) and EOB-MRI (sensitivity, 75.0%; specificity, 95.0%) could predict pathological LNM (pLNM), as could visually assessed positive LNs measured on PET-CT (sensitivity, 50.0%; specificity, 100.0%). LNs with poor-contrast areas measured on CT or MRI were an independent predictor of pLNM.</p><p><strong>Conclusion: </strong>LNM was predicted by evaluating LNs with poor-contrast areas using contrast-enhanced CT or EOB-MRI. Thus, LNM risk should be assessed using EOB-MRI or/and contrast-enhanced CT scans before surgery.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"2303-2310"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148219873","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 for postoperative complications after colorectal surgery in patients aged ≥ 80 years: A multicenter retrospective study.","authors":"Hirofumi Hasuda, Ryota Nakanishi, Taichiro Nagai, Hirotada Tajiri, Mitsuhiko Ota, Yoshihisa Sakaguchi, Koji Ando, Masahiko Sugiyama, Hideo Uehara, Yoshihiko Fujinaka, Daisuke Yoshida, Keitaro Edahiro, Eiji Oki, Tomoharu Yoshizumi","doi":"10.1007/s00595-026-03299-9","DOIUrl":"10.1007/s00595-026-03299-9","url":null,"abstract":"<p><strong>Purpose: </strong>To identify the perioperative risk factors for postoperative complications in patients aged ≥ 80 years.</p><p><strong>Methods: </strong>We retrospectively analyzed 2,072 consecutive patients who underwent colorectal surgery at seven institutions between January 2021 and December 2023 and compared the perioperative outcomes between patients aged ≥ 80 (n = 464) and ≤ 79 years (n = 1,608).</p><p><strong>Results: </strong>Patients aged ≥ 80 years had an American Society of Anesthesiologists Physical Status (ASA-PS) score of ≥ 3 (P < 0.0001) and more comorbidities. Minimally invasive surgery was performed less frequently (P < 0.0001), with a shorter surgical duration (P = 0.0003) and greater intraoperative bleeding (P = 0.04). Postoperative pneumonia (P = 0.0005) and urinary disorder complications after rectal surgery (P = 0.03) were more frequent in patients aged ≥ 80 years. A multivariate analysis identified male sex (P = 0.02), ASA-PS ≥ 3 (P = 0.005), and intraoperative bleeding (P = 0.02) as independent risk factors for pneumonia. Intraoperative bleeding (P = 0.002) and anastomosis (P = 0.03) were significant risk factors for urinary disorders after rectal surgery. Minimally invasive surgery in older adults resulted in a longer surgical duration (P < 0.0001), less bleeding (P < 0.0001), and fewer complications than conventional surgery.</p><p><strong>Conclusion: </strong>Postoperative pneumonia and urinary complications after rectal surgery are common in older adult patients. Minimally invasive approaches may reduce the risk of complications.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"2396-2405"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296345","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":"Preoperative sarcopenia diagnosed based on the asian working group criteria and Short-term outcomes in older patients undergoing resection of early-stage non-small cell lung cancer.","authors":"Misa Toyota, Yohei Oshima, Toshi Menju, Yuji Yoshioka, Ryota Hamada, Tsugumi Asano, Ayumi Otagaki, Yuto Niwa, Tomohiko Yamaguchi, Manabu Nankaku, Haruka Yamaki, Naoya Tanabe, Susumu Sato, Satona Tanaka, Daisuke Nakajima, Toyofumi F Chen-Yoshikawa, Ryosuke Ikeguchi","doi":"10.1007/s00595-026-03396-9","DOIUrl":"10.1007/s00595-026-03396-9","url":null,"abstract":"<p><strong>Purpose: </strong>Sarcopenia is a common comorbidity in older adults. This study aimed to clarify the association between preoperative sarcopenia, based on the Asian Working Group 2025 (AWGS2025) criteria, and postoperative outcomes in older patients with early stage non-small cell lung cancer.</p><p><strong>Methods: </strong>This retrospective study included patients aged ≥ 75 years who underwent lung resection for clinical stage I lung cancer. Sarcopenia was diagnosed based on grip strength and bioelectrical impedance-derived muscle mass measured according to the AWGS2025 criteria. The primary outcomes were postoperative pulmonary complications (PPCs), defined as Clavien-Dindo classification Grade ≥ 2 within 30 days, and unplanned readmission within 90 days after surgery. A logistic regression analysis was used to identify the factors associated with postoperative outcomes.</p><p><strong>Results: </strong>Among the 107 patients, 28 (26%) were diagnosed with sarcopenia. The incidence of PPCs (32% [9/28] vs. 8% [6/79], P = 0.003) and unplanned readmission (18% [5/28] vs. 3% [2/79], P = 0.013) was higher in the sarcopenia group. Sarcopenia independently predicted PPCs (odds ratio [OR], 5.00; P = 0.020) and unplanned readmissions (OR, 9.17; P = 0.019).</p><p><strong>Conclusions: </strong>Preoperative sarcopenia, diagnosed using the AWGS2025 criteria, is closely associated with PPCs and unplanned readmissions in older patients. Preoperative screening may facilitate risk stratification and improve perioperative care.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"2534-2542"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391749","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":"Safety and outcomes of hemodilutional autologous transfusion in intermediate- to advanced-level liver resection: a prospective observational study.","authors":"Yoichiro Uchida, Tomoaki Yoh, Shuji Kawamoto, Chikashi Takeda, Eriko Kusudo, Takamichi Ishii, Moritoki Egi, Etsuro Hatano","doi":"10.1007/s00595-026-03493-9","DOIUrl":"https://doi.org/10.1007/s00595-026-03493-9","url":null,"abstract":"<p><strong>Purposes: </strong>This prospective observational study evaluated the safety and perioperative outcomes of hemodilutional autologous transfusion (HAT) in patients undergoing intermediate- to advanced-level liver resection (LR).</p><p><strong>Methods: </strong>Between 2022 and 2023, 50 patients scheduled for intermediate- to advanced-level LR were prospectively enrolled. The primary endpoint was the rate of intraoperative allogeneic blood transfusion. Secondary endpoints included total intraoperative blood loss, postoperative complications, postoperative allogeneic transfusion rate, and post-hepatectomy liver failure. Safety analyses of HAT-related adverse events were also performed. A historical cohort of 71 patients who met the identical eligibility criteria between 2020 and 2021 was used for the sensitivity analyses.</p><p><strong>Results: </strong>Of the 50 patients, 48 underwent protocol-defined LR with HAT and were included in the analysis. The intraoperative allogeneic transfusion rate was 6.3%, and no HAT-related adverse events were observed. In sensitivity analyses using a historical cohort, no significant differences were observed in the primary and secondary endpoints. Among patients with massive intraoperative bleeding (≥ 1,000 mL), the prospective cohort tended to show a lower perioperative transfusion rate than the historical cohort (37.5% vs. 78.6%, P = 0.054).</p><p><strong>Conclusion: </strong>No clinically overt HAT-related adverse events were observed; however, the efficacy of HAT remains unproven and should be evaluated in future studies.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114886","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":"Association between Clostridium septicum and Streptococcus gallolyticus bacteremia and colorectal neoplasms.","authors":"Shinnosuke Kai, Takashi Ueda, Kazuhiko Nakajima, Miki Doi, Hitoshi Ogashiwa, Masanori Uno, Akiko Okada, Masaya Nakashima, Mayuko Fujisawa, Hiroyuki Watanabe, Yasushi Takenouchi, Kosuke Iijima, Shinichiro Shinzaki, Nobuko Imamura, Kozo Kataoka, Kei Kimura, Motoi Uchino, Yuki Horio, Ryuichi Kuwahara, Yasuhiro Nozaki, Yoshio Takesue","doi":"10.1007/s00595-026-03489-5","DOIUrl":"https://doi.org/10.1007/s00595-026-03489-5","url":null,"abstract":"<p><strong>Purpose: </strong>Colorectal cancer (CRC) is associated with Clostridium septicum (CS), Streptococcus gallolyticus (SG), and Fusobacterium nucleatum (FN) bacteremia. Further investigation of the mechanism of translocation and the time interval between bacteremia and a CRC diagnosis is required.</p><p><strong>Methods: </strong>Patients with bacteremia caused by the three organisms were studied. The organisms were identified using MALDI-TOF mass spectrometry.</p><p><strong>Results: </strong>Fourteen patients (CS [n = 1], SG [n = 11], and FN [n = 2]) were included among 2866 patients with bacteremia. Colorectal neoplasms were detected in two patients at the onset of bacteremia (advanced CRC in patient CS and carcinoma in adenoma in patient SG). Rectal cancer developed 31 months after incidental bacteremia in another patient with SG. Colonoscopy was not performed in 10 of 14 patients, including two patients with FN at the onset of bacteremia and during the follow-up period.</p><p><strong>Conclusion: </strong>Consistent with previous reports, we found three typical patterns associated with CRC in patients with CS and SG bacteremia. Because routine colonoscopy was not performed, the true association with CRC could not be determined for these organisms.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075800","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 for stoma-site incisional hernia after ileostomy reversal: impact of fascial suture material.","authors":"Taiki Kajiwara, Shinobu Ohnuma, Hideaki Karasawa, Hideyuki Suzuki, Gumpei Yoshimatsu, Yoshihiro Sato, Megumi Murakami, Ichiro Ise, Michiaki Unno","doi":"10.1007/s00595-026-03490-y","DOIUrl":"https://doi.org/10.1007/s00595-026-03490-y","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the incidence of stoma-site incisional hernia (SSIH) after ileostomy reversal and identify the associated risk factors, focusing on fascial suture materials.</p><p><strong>Methods: </strong>This single-center retrospective study included 194 patients who underwent ileostomy reversal for colorectal neoplasms (2010-2023) with ≥ 330 days of postoperative computed tomography follow-up. All fascial closures used interrupted absorbable sutures. SSIH was defined on computed tomography. Risk factors were evaluated using logistic regression, and inverse probability of treatment weighting (IPTW) was applied to assess the association between suture materials and SSIH.</p><p><strong>Results: </strong>SSIH occurred in 21 patients (10.8%) at a median of 282 days, and five patients (23.8%) underwent hernia repair. In a multivariable analysis, higher body mass index (odds ratio [OR]: 1.24 per kg/m², p = 0.008) and use of braided absorbable sutures (OR: 2.90, p = 0.042) were associated with SSIH. IPTW analysis showed a consistent association with braided absorbable sutures (OR: 3.24, p = 0.013). In an exploratory model that included the calendar period, this association was attenuated.</p><p><strong>Conclusions: </strong>SSIH occurred in approximately 10% of patients after ileostomy reversal. A higher body mass index was consistently associated with SSIH. Fascial suture material may be a clinically relevant component of stoma-site closure; however, its independent effect requires further evaluation.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064425","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":"Clinical feasibility of direct cholangiography via a PTGBD tube during laparoscopic living-donor hepatectomy.","authors":"Takeo Toshima, Shinji Itoh, Atsuhisa Fukuta, Toshiharu Matsuura, Tatsuro Tajiri, Tomoharu Yoshizumi","doi":"10.1007/s00595-026-03494-8","DOIUrl":"https://doi.org/10.1007/s00595-026-03494-8","url":null,"abstract":"<p><strong>Purposes: </strong>Accurate biliary visualization is essential for laparoscopic living-donor hepatectomy. We evaluated the feasibility of PTGBD-based direct cholangiography through percutaneous gallbladder puncture during pure laparoscopic left lateral sectionectomy (Lap-LLS) in living donor liver transplantation (LDLT).</p><p><strong>Methods: </strong>From February 2023 to December 2025, 31 LDLTs using left lateral section grafts were performed at our institution. PTGBD-based transgallbladder direct cholangiography was performed to delineate the biliary anatomy and assess the bile duct transection line in relation to the hepatic duct bifurcation.</p><p><strong>Results: </strong>Direct cholangiography via gallbladder puncture was successfully performed in 30 donors, excluding the initial case, providing clear and repeatable visualization of the biliary anatomy. This technique enables reliable and repeated confirmation of safe bile duct division. No donor stump leakage, stricture, or recipient anastomotic leakage or stricture occurred postoperatively.</p><p><strong>Conclusions: </strong>PTGBD-based direct cholangiography is a feasible adjunct to pure Lap-LLS and it may facilitate precise bile duct division in minimally invasive LDLT.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040936","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":"Frey procedure with distal pancreatectomy: How to do it.","authors":"Masaharu Ishida, Hideaki Sato, Mika Ando, Yuichiro Umino, Mitsuhiro Shimura, Shuichi Aoki, Koetsu Inoue, Masahiro Iseki, Daisuke Douchi, Takayuki Miura, Shimpei Maeda, Masamichi Mizuma, Takashi Kamei, Shinichi Egawa, Michiaki Unno","doi":"10.1007/s00595-026-03410-0","DOIUrl":"https://doi.org/10.1007/s00595-026-03410-0","url":null,"abstract":"<p><p>Although the Frey procedure effectively treats chronic pancreatitis, late relapse can occur in the pancreatic tail. This paper details the essential steps of combining the Frey procedure with distal pancreatectomy (Frey + DP) to address this issue. The key surgical steps include distal pancreatectomy, longitudinal opening of the main pancreatic duct, pancreatic head coring, and longitudinal pancreaticojejunostomy. Comparing the outcomes of nine Frey + DP and 13 Frey-alone patients (2016-2024), Frey + DP had significantly longer operative times and higher estimated blood loss. However, the postoperative hospital stay, mortality, 1-year pain recurrence, and new-onset diabetes were comparable between the two groups. Although more invasive, Frey + DP definitively treats concurrent severe tail disease, mitigating the risk of late relapse and requiring difficult reoperations. Frey + DP is a safe and effective approach for patients with chronic pancreatitis with inflammatory lesions in both the pancreatic head and tail.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017921","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}
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
