Scandinavian Journal of Surgery最新文献

{"title":"Current practices and perspectives on gender-affirming breast and chest wall surgery in the Nordic region: An overview.","authors":"Isak Gran, Antti Mikkola, Martin Sollie, Rikke Holmgaard, Kaisu Ojala, Hannes Sigurjonsson, Matteo Amoroso, Pehr Sommar, Louise Frisén, Jenny Löfgren, Helena Sackey","doi":"10.1177/14574969251376097","DOIUrl":"https://doi.org/10.1177/14574969251376097","url":null,"abstract":"<p><p>This narrative review provides an in-depth description of gender-affirming breast surgery within the context of publicly funded healthcare systems in the Nordic countries. A comprehensive literature search was conducted in collaboration with two information specialists, focusing on original research, reviews, and clinical guidelines published in English. The prevalence of transgender and non-binary individuals in the Nordic region ranges from 0.04% to 0.6%, depending on the country and study methodology. Gender-affirming treatment, including hormone therapy and surgical interventions such as breast augmentation and mastectomy, plays a critical role in reducing gender dysphoria and improving psychological well-being, with low rates of reported regret. Transfeminine individuals often pursue breast augmentation with implants or autologous fat grafting; procedures tailored to their unique anatomical considerations. These surgeries are associated with improved health-related quality of life and high levels of satisfaction. Surgical planning involves careful consideration of implant type, placement, and incision strategy. Transmasculine individuals commonly undergo chest masculinization, with techniques adapted to breast size, ptosis, skin quality, and individual goals. Both implant-based and mastectomy procedures are generally safe, though complications such as capsular contracture, hematoma, or wound healing disturbances may occur. Although regret is rare, it underscores the need for comprehensive assessment, informed consent, and mental health support throughout the transition process. Breast cancer screening guidelines remain inconsistent, with barriers to access due to legal gender markers and varying levels of provider knowledge While Nordic countries vary in their approaches, all aim to balance medical necessity, individual autonomy, and healthcare equity. Future priorities include refining surgical protocols, expanding research on long-term outcomes, and addressing systemic barriers to ensure inclusive, evidence-based care for all gender-diverse individuals.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"14574969251376097"},"PeriodicalIF":1.8,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180090","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":"The impact of surgeon experience on lung cancer operations: A retrospective propensity-matched cohort study.","authors":"Olli E Mustonen, Anne K Niskakangas, Topias H Karjula, Iiris L Puro, Olli Helminen, Fredrik Yannopoulos","doi":"10.1177/14574969251359866","DOIUrl":"https://doi.org/10.1177/14574969251359866","url":null,"abstract":"<p><strong>Background and aims: </strong>To compare the clinical and oncological results of anatomical resection of primary non-small cell lung cancers performed by resident and specialist surgeons as the lead surgeon in a medium-volume, mixed-practice hospital.</p><p><strong>Methods: </strong>We retrospectively collected individual patient record data. Between 1 January 2000 and 31 December 2020, a total of 959 primary lung cancer cases underwent intention-to-treat surgical resection at the Oulu University Hospital. Of these surgeries, 108 were performed by a resident surgeon as the lead surgeon. Propensity score matching was used to find similar unique resident-led cases to compare with unique specialist-led cases in a 1:2 ratio.</p><p><strong>Results: </strong>After propensity score matching, 65 resident-led cases were eligible for comparison to 130 specialist-led cases. Intra-operative complications were similar in both groups; resident-led cases had a complication rate of 12.3%, whereas specialist-led cases had a complication rate of 8.5% (p = 0.445). The incidence of major Clavien-Dindo complications (>IIIa) was 12.3% and 15.4% (p = 0.668), respectively. In the Kaplan-Meier analysis, the overall survival rate at 1, 3, and 5 years was 90.0%, 71.3%, and 65.3%, respectively, in resident-led cases and 88.2%, 66.6%, and 54.5%, respectively, in specialist-led cases (p = 0.389). Disease-specific survival at 1, 3, and 5 years was 90.0%, 77.6%, and 71.1%, respectively, in resident-led cases and 91.4%, 76.3%, and 76.3%, respectively, in specialist-led cases (p = 0.931).</p><p><strong>Conclusion: </strong>There was no difference in intra- and post-operative complication rate based on surgeon expertise. Both short-term and long-term results were comparable between resident- and specialist-led surgeries.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"14574969251359866"},"PeriodicalIF":1.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070986","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":"Establishing a robotically assisted lung cancer surgery program in a low-volume center: Does a surgeon's previous experience with video-assisted thoracoscopy affect short-term outcomes?","authors":"Vilma Viitala, Tuomas Mäkelä, Joonas H Kauppila, Olli Helminen, Fredrik Yannopoulos","doi":"10.1177/14574969251364993","DOIUrl":"https://doi.org/10.1177/14574969251364993","url":null,"abstract":"<p><strong>Background and aims: </strong>The aim of this study was to compare the safety and efficacy of establishing a robotic-assisted thoracoscopic surgery (RATS) program in a low-volume center with mixed cardiothoracic practice and surgeons with different background experiences-video-assisted (VA) versus open thoracotomy (OT).</p><p><strong>Methods: </strong>Between January 2015 and June 2023, the center performed 460 anatomical lung resections. The RATS program was established in October 2021, and two surgeons, OT and VA, were selected as RATS surgeons. Before this, surgeon OT performed mostly open thoracic surgery, and surgeon VA had notably more thoracoscopic experience. The primary outcomes were the learning curves of surgeon OT and VA for lymph node yield, operative time, blood loss, and complications after starting the RATS program. A Risk-Adjusted Cumulative Sum (RA-CUSUM) method was used to determine learning curves.</p><p><strong>Results: </strong>Surgeons OT and VA showed similar learning curves in lymph node yield with surgeon OT having a peak at case number 23 and surgeon VA at 19. Operative time improved with surgeon VA after 15 cases and with surgeon OT after 30 cases. RA-CUSUM analysis showed no increased bleeding cases when comparing the baseline risk and the median bleeding values of the center. With both surgeons, there were significantly fewer overall complications when using RATS than with other surgical techniques.</p><p><strong>Conclusion: </strong>According to this study, training surgeons with either open or thoracoscopic background experience to perform robotic-assisted lung cancer surgery is safe and does not compromise short-term operative outcomes. This study is a retrospective registry study and has been approved by the Northern Ostrobothnia Research Ethics Committee with license number EETTMK 5/2019; hence, no clinical trial registry number is associated with this study.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"14574969251364993"},"PeriodicalIF":1.8,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056152","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":"Gender-affirming healthcare in the Nordic countries: An overview.","authors":"Isak Gran, Cecilia Dhejne, Antti Mikkola, Martin Sollie, Pehr Sommar, Rikke Holmgaard, Kaisu Ojala, Hannes Sigurjonsson, Louise Frisén, Jenny Löfgren, Helena Sackey","doi":"10.1177/14574969251371862","DOIUrl":"https://doi.org/10.1177/14574969251371862","url":null,"abstract":"<p><p>This narrative review examines gender-affirming healthcare in the Nordic countries, highlighting historical developments, legal frameworks, epidemiological trends, and current clinical practices. Transgender healthcare dates back to the early 20th century and gained international attention in the early 1950s following one of the first widely publicized gender-affirming surgeries performed in Denmark. Since then, care models have evolved, supported by policy, research, and clinical practice across Europe and North America.All Nordic countries, Denmark, Finland, Iceland, Norway, and Sweden, provide publicly funded gender-affirming healthcare, although service structures differ. Legal gender recognition has shifted toward self-identification in Denmark, Finland, Iceland, Norway, and from July 2025, also Sweden by removing medical or psychiatric prerequisites.In parallel, epidemiological data reveal an increased healthcare utilization, particularly among youth assigned female at birth. Elevated rates of mental health challenges highlight the need for integrated psychosocial support. Clinical care typically follows a multidisciplinary model including psychiatric and medical assessment, hormone therapy, and surgery when indicated. Access to chest and genital surgery requires a formal diagnosis and is with few exceptions restricted to adults. Evidence supports the positive impact of gender-affirming treatment on gender congruence and health-related quality of life. Regret after gender-affirming surgery is rare but does occur, underscoring the importance of individualized care and thorough informed consent.Ongoing challenges include long wait times, unequal access for non-binary individuals, and a growing number of individuals seeking private or cross-border care. Future efforts should focus on expanding public services, strengthening research, and promoting equitable, evidence-based care that reflects the diversity of gender identities.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"14574969251371862"},"PeriodicalIF":1.8,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030871","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":"Intraoperative dexamethasone after pancreatoduodenectomy in pancreatic ductal adenocarcinoma: A retrospective cohort study.","authors":"Piia Peltoniemi, Harri Mustonen, Katarina Johansson, Inkeri Lehto, Hanna Seppänen, Pertti Pere","doi":"10.1177/14574969251371868","DOIUrl":"https://doi.org/10.1177/14574969251371868","url":null,"abstract":"<p><strong>Background and aims: </strong>The anti-inflammatory effects of dexamethasone may reduce the inflammatory response after pancreatoduodenectomy. The aim of this retrospective observational study was to evaluate the association between intraoperative dexamethasone and postoperative complications in patients undergoing pancreatoduodenectomy with a special focus on patients with pancreatic ductal adenocarcinoma (PDAC).</p><p><strong>Methods: </strong>All eligible patients undergoing pancreatoduodenectomy in our hospital between January 2018 and December 2021 (n = 319) were included comparing the postoperative outcomes in patients who received intraoperative dexamethasone (n = 178) to patients not given any intraoperative glucocorticoids (n = 142).</p><p><strong>Results: </strong>PDAC was the most common diagnosis (n = 166) and of these patients 92 received intraoperative dexamethasone and 74 no glucocorticoids. Patients with PDAC who received dexamethasone experienced fewer severe Clavien-Dindo complications than those not receiving glucocorticoids (n = 13/92 (14.1%) vs n = 21/74 (28.4%), <i>P</i> = 0.033). Multivariable analyses confirmed that a single dose of dexamethasone was associated with a reduced risk of severe complications in this patient group (odds ratio (OR) 0.40, 95% confidence interval [CI] 0.18-0.91, <i>P</i> = 0.030). When considering all pancreatoduodenectomy patients, no statistically significant differences in postoperative complications were observed. The incidence of postoperative infections was similar between the groups, although postoperative C-reactive protein (CRP) levels were lower in pancreatoduodenectomy patients who received dexamethasone (CRP on the second postoperative day: 102 (69-146) vs 159 (112-208) mg/l, <i>P</i> < 0.001). Patients who received dexamethasone experienced postoperative fever less frequently than those not given an intraoperative glucocorticoid (<i>n</i> = 68/178 (38.4%) vs <i>n</i> = 73/141 (51.8%), <i>P</i> = 0.023). Dexamethasone had no statistically significant influence on overall survival of PDAC patients.</p><p><strong>Conclusion: </strong>A single dose of dexamethasone was not associated with decreased postoperative complications across all pancreatoduodenectomy patients. However, within the PDAC subgroup, there were fewer Clavien-Dindo ⩾ 3 complications after dexamethasone compared to no glucocorticoid administration.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"14574969251371868"},"PeriodicalIF":1.8,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030814","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":"Analysis of negligence claims after carotid artery interventions over 20 years in Sweden.","authors":"D Bergqvist, P Gustafson, L Hafström","doi":"10.1177/14574969251355061","DOIUrl":"https://doi.org/10.1177/14574969251355061","url":null,"abstract":"<p><strong>Background: </strong>In recent years, as new strategies have been developed, there has been a reduction of invasive interventions for prevention or treatment of ischaemic cerebral events. Furthermore, surgical treatment has been centralized to major vascular centra.</p><p><strong>Aim: </strong>This study analyzed registered malpractice claims to the insurance during two decades. Treatment policies (more pharmacological treatment, less intervention for asymptomatic carotid artery disease) and claiming patterns changed (Introduction of Patient Safety Act 2011).</p><p><strong>Material and methods: </strong>During a 20-year period (2000-2019), 184 malpractice claims related to invasive treatment of carotid artery cerebral circulatory disorders were registered in the files of the Swedish National Insurance Company. These were analyzed in two 10-year cohorts regarding the indication for intervention, the intervention itself, and the sufferers' reasons motivating the claims and the final decision as judged by the Insurance Company's medical and juridical experts.</p><p><strong>Results: </strong>The claim rate was on a 1% level (of all carotid artery interventions), no difference between the two decades. Between the first and second decade, claims concerning intervention for asymptomatic carotid artery disease decreased with 26%. In 51% of the claims, the damage was considered avoidable and the claimants were compensated for their financial losses. Motor nerve lesions were compensated for in 78% and stroke in 40%. Thrombolysis as a claimed procedure increased from 2 to 10 between the periods.</p><p><strong>Conclusion: </strong>During a 20-year period, negligence claims after interventions for asymptomatic carotid artery disease or manifest carotid artery cerebral ischemia were stable at a 1% level of all interventions. The compensation rate was around 50%. Dominating injuries to be claimed and compensated for were perioperative motor cranial nerve injuries and postoperative stroke. Despite changes in treatment policy, the claim and compensation rate were stable.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"14574969251355061"},"PeriodicalIF":1.8,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030777","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":"Claims filed after perceived malpractice in management of acute appendicitis: An observational nationwide cohort study.","authors":"Benedicte Skjold-Ødegaard, Geir S Braut, Hege L Ersdal, Kjetil Søreide","doi":"10.1177/14574969251363823","DOIUrl":"https://doi.org/10.1177/14574969251363823","url":null,"abstract":"<p><strong>Background and aims: </strong>Acute appendicitis is the most common surgical emergency worldwide. Obtaining a correct diagnosis and timely management can be challenging even in modern medicine. Hence, appendicitis is still considered a \"high-risk\" diagnosis for litigation and claims of malpractice. Few studies have investigated the pattern and outcome of claims for appendicitis in a contemporary universal health care system. The aim of this study is to analyze compensation claims related to the investigation and treatment of appendicitis in Norway.</p><p><strong>Methods: </strong>An observational study based on claims from the Norwegian System of Patient Injury Compensation (NPE) from 2005 to 2023. Population rates of appendicitis treatment were obtained from the Norwegian Patient Registry (NPR; data from 2016 to 2023) and Statistics Norway (SSB).</p><p><strong>Results: </strong>Altogether 207 compensation claims were filed for appendicitis and 56 (27%) received compensation. The probability of receiving compensation was not influenced by age, gender, or geographical location. The most common reasons for compensation granted were delayed diagnosis (n = 25, 45%) and delayed treatment (n = 5, 9%). The most common reasons for the 151 (73%) denied claims were predictable complication (n = 48, 32%) and condition caused by an unrelated disease (n = 40, 26%). Out of the 59,450 appendectomies performed, 96 claims were filed to NPE, giving a claim rate of 0.16% or 1 claim for every 620 appendectomies. For the entire study period, there was a total payout of 27.2 mill NOK (approximately 2.4 mill EUR) with a mean of 460,000 NOK (approximately 40,000 EUR) and a median of 75,000 NOK (approximately 6,600 EUR) per claim.</p><p><strong>Conclusion: </strong>In acute appendicitis, about a quarter of claims are compensated due to malpractice. More than half of the approved claims involved delays in diagnosis or treatment, which can be related to the clinical challenges of diagnosing appendicitis.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"14574969251363823"},"PeriodicalIF":1.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024679","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":"The effect of clinical ERCP experience using a virtual reality simulator and salivary biochemical stress markers.","authors":"Nikola Boyanov, Konstantinos Georgiou, Tanya Deneva, Katina Shtereva, Katerina Madzharova, Gabriel Sandblom, Lars Enochsson","doi":"10.1177/14574969251363820","DOIUrl":"https://doi.org/10.1177/14574969251363820","url":null,"abstract":"<p><strong>Background and aims: </strong>Whereas the value of endoscopic retrograde cholangiopancreatography (ERCP) training in clinical practice is well known, the impact on stress markers and performance in a virtual reality (VR) simulator is not. The primary aim of the study was to see how the number of clinical ERCPs performed during a 1-year period influenced VR-ERCP performance. A secondary aim was to compare differences in salivary stress marker levels, between the first and final simulator attempts.</p><p><strong>Methods: </strong>Thirty-one endoscopists completed three VR-ERCP procedures of increasing difficulty. The times taken to complete the different steps of the procedures were recorded. Saliva chromogranin A, cortisol, and α-amylase were measured before and after each phase of the cystic leakage procedure. Participants then did 1 year of clinical ERCP training at their respective centers. The remaining cohort (26/31) was divided into two subgroups according to their level of clinical training. They then completed the same VR-ERCP procedures. Differences in time before and after each phase as well as stress marker levels during the cystic leakage procedure were assessed.</p><p><strong>Results: </strong>Those with >100 ERCPs of clinical training improved times to completion of all 15 phases in the VR-ERCP procedures (p < 0.05) in contrast to the group with 20-50 ERCPs who only improved in 11/15. Differences in increases in salivary stress marker levels of chromogranin A before and after each phase of the cystic leakage procedure, adjusted for number of ERCPs, showed significant reductions in four of the five phases measured.</p><p><strong>Conclusion: </strong>Clinical ERCP training enhances subsequent performance in terms of time to completion in a VR-ERCP simulator. Additional intended use of simulators could be used as a benchmark for clinical progress. Saliva markers may be feasible to use in measuring stress reactions in a training setting.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"14574969251363820"},"PeriodicalIF":1.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024668","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":"Factors influencing non-surgical management of acute cholecystitis.","authors":"Jacob Ahlin, Kerstin Bewö, My Blohm","doi":"10.1177/14574969251371892","DOIUrl":"https://doi.org/10.1177/14574969251371892","url":null,"abstract":"","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"14574969251371892"},"PeriodicalIF":1.8,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016518","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":"Early implementation of laparoscopic left-sided pancreatectomy in a tertiary low-volume hospital.","authors":"Karin Johansen, Gudjón Birgisson, Kristín H Haraldsdóttir","doi":"10.1177/14574969251343471","DOIUrl":"10.1177/14574969251343471","url":null,"abstract":"<p><strong>Background and aims: </strong>Current international guidelines recommend a center volume of at least 20 minimally invasive pancreatic procedures a year to perform laparoscopic left pancreatectomy. Iceland is a small, isolated country that is unavoidably low volume in terms of pancreatic surgery. To ensure good quality of care, there is a long tradition of surgeons training abroad, but this system has not been formally evaluated. The aim of this study was to evaluate the outcomes of laparoscopic and open left pancreatectomy over the last 20 years in Iceland.</p><p><strong>Methods: </strong>This was a national retrospective cohort study including all patients who underwent left-sided pancreatic resection in Iceland from 2003 to 2022.</p><p><strong>Results: </strong>A total of 244 patients underwent a pancreatic procedure during the study period. Eighty of these underwent left-sided resections, 41 of whom had a laparoscopic left pancreatectomy (LLP). Resection rates increased over the study period, and a significantly larger proportion of patients underwent LLP in the latter half of the study period. The laparoscopy group had statistically significantly lower rates of splenectomy (<0.001) and blood loss (<0.001) compared with open surgery. The morbidity rate of severe complications (Clavien-Dindo grade IIIa or higher) was 23%. The in-hospital and 90-day mortality rates were 1% and 4%, respectively.</p><p><strong>Conclusions: </strong>Overall, the operative and postoperative outcomes of left-sided pancreatic resections in a low-volume setting in Iceland were comparable to current reported studies from other Western countries.</p><p><strong>Clinical trial registration number: </strong>NCT06738914.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"334-341"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144236","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}