Pancreas-sparing duodenectomy for duodenal polyposis

“Pancreas-sparing duodenectomy, although technically demanding, eliminates the need for pancreatic resection. Pancreas-sparing duodenectomy is associated with good absorptive capacity, weight gain, and quality of life. Furthermore, it may reduce the risk of subsequent malignancy. Long-term surveillance, however, is still required. Pancreas-sparing duodenectomy is contraindicated in the setting of malignancy.”

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Effects of delay of emergent transfer of patients requiring surgery.

“Emergency general surgery (EGS) patients require greater resources and have increased rates of morbidity and mortality. Previous work has shown mortality differences in colectomy patients between direct admissions and transfers patients based on source, including emergency department, inpatient, and nursing home transfers. We hypothesize that patient transfer status negatively effects morbidity, mortality, and resource utilization in a mixed population of EGS patients.
This study demonstrates significant increases in mortality, morbidity, and resource utilization in EGS transfer patients who were not attributable to case mix, demographics, and comorbid status alone. These data point to potential financial and quality assessment challenges for tertiary referral centers.”

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Challenges of Endoscopic Vacuum Therapy of Upper Gastrointestinal Anastomotic Leaks

Anastomotic leaks after digestive surgery have an important impact on surgical outcome. They represent a real therapeutic challenge because of the high morbidity and mortality rates. Multiple treatment options exist, often combining interventional radiology and endoscopy and even redo surgery. To improve patient outcomes, it is of the utmost importance to provide an individualized patient-tailored treatment plan after multidisciplinary discussion. EVT is nowadays recognized as an effective and useful endoscopic approach to treat leaks or perforations in both the upper and lower gastrointestinal tract. Moreover, it has become one of the most effective treatment options overall with a very good safety profile. However, it is a time-consuming endeavour requiring engagement from the endoscopist and understanding from the patient.

Supplementary Materials: The following supporting information can be downloaded at: https:
//www.mdpi.com/article/10.3390/life13061412/s1
, Video S1: Procedure of EVT in a patient with anastomotic leak after oesophagectomy.

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Analysis of hematoma after mastectomy with immediate reconstruction

“Although the risk of postoperative bleeding is inherent to all surgical subspecialties, the development of a hematoma after mastectomy with implant reconstruction involves unique risk factors, including the routine involvement of 2 distinct surgical teams. However, despite numerous studies reporting their outcomes following these operations, a rigorous analysis of individual andcoperative factors that contribute to postoperative hematoma formation
has never been documented.”

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Risk of breast hematoma after mastectomy with reconstruction.

“Among patients undergoing lumpectomy and Sentinel Lymph Node Biopsy with multimodal analgesia, the risk of hematoma in the 30-day postoperative period, including hematoma requiring reoperation and in-office aspiration or drainage, was low overall and not statistically significantly higher despite increased use of intraoperative ketorolac and implementtion of a standard discharge regimen of NSAIDs in lieu of opioids.”

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Prophylactic angiographic embolisation after endoscopic control of bleeding

“Acute upper gastrointestinal bleeding (AUGIB) is one of the most common emergencies in gastroenterology. Despite major improvements in its management, AUGIB continues to be associated with significant morbidity and mortality. Bleeding peptic ulcers are one of the principal causes of AUGIB. Endoscopic therapy to bleeding ulcers reduces further bleeding and improves patients’ outcomes.”

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