Disease progression of side-branch intraductal papillary mucinous neoplasms following solid organ transplant.

Background: Branch-duct intraductal papillary mucinous neoplasms (BD-IPMNs) are becoming more prevalent with advanced medical imaging and account for most of pancreatic cystic neoplasms (PCNs). Most incidental lesions should be surveyed, with resection reserved for specific, high-risk cases. Solid organ transplantation candidates may be high risk of resection before transplant and will require systemic immunosuppression after transplant, which has been theorized to alter the natural history of the IPMN.

Natural history and growth prediction model of pancreatic serous cystic neoplasms.

Objective: Serous cystic neoplasms (SCN) are benign pancreatic cystic neoplasms that may require resection based on local complications and rate of growth. We aimed to develop a predictive model for the growth curve of SCNs to aid in the clinical decision making of determining need for surgical resection.

Methods: Utilizing a prospectively maintained pancreatic cyst database from a single institution, patients with SCNs were identified.

Intramucosal Extent as a Marker for Advanced Disease and Survival in Gallbladder Adenocarcinoma.

Background: Gallbladder cancer (GBC) is the most common biliary tract malignancy and has a poor prognosis. The clinical significance of focal vs diffuse GBC remains unclear.

Methods: A retrospective review was conducted on all patients with non-metastatic GBC at a quaternary care center.

Long term assessment of antibiotic prophylaxis and biliary microbiome in pancreaticoduodenectomy.

Introduction: Surgical site infections (SSI) can represent a major complication of pancreaticoduodenectomy (PD). We summarize the outcomes of process improvement efforts to reduce the SSI rates in PD that includes replacing Cefazolin with Ceftriaxone-Metronidazole as antibiotic prophylaxis. Additional efforts included current assessment of biliary microbiome and potential prophylactic failures based on bile cultures and suspected antibiotic allergies.

Lessons learned and keys to success: Provider experiences during the implementation of virtual oncology tumor boards in the era of COVID-19.

Background And Objectives: The COVID-19 pandemic required rapid adaptation of multidisciplinary tumor board conferences to a virtual setting; however, there are little data describing the benefits and challenges of using such a platform.

Methods: An anonymous quality improvement survey was sent to participants of tumor board meetings at a large academic institution. Participants answered questions pertaining to the relative strengths and weaknesses of in-person and virtual settings.

Correlation between physical status measures and frailty score in patients undergoing pancreatic resection.

Background: This study aimed to assess the correlation between validated measures of physical status in a prehabilitation regimen with an established frailty score and analyze changes in these measures after completion of a directed prehabilitation program among patients undergoing elective pancreatic resection.

Methods: Adult patients undergoing pancreatic resection from 2019-2021 were enrolled in a pilot prehabilitation program. Three validated measures of physical status were used: the 6-minute walk test, grip strength, and chair-stand test.

Clinical Significance of Postoperative Antibiotic Treatment for Positive Islet Cultures After Total Pancreatectomy With Islet Autotransplantation.

Objectives: Islet cultures are routinely performed in total pancreatectomy with islet autotransplantation (TPIAT), and the need for empiric antibiotic treatment based on culture results is unknown. We evaluated the effect of postoperative antibiotic treatment for positive islet cultures on clinical infection.

Methods: Seventy-nine patients undergoing TPIAT were reviewed.

Effect of pre-operative opioid exposure on surgical outcomes in elective laparoscopic cholecystectomy.

Background: The effects of varying levels of pre-operative opioids on post-operative outcomes following elective laparoscopic cholecystectomy is largely unknown.

Methods: Patients who underwent elective laparoscopic cholecystectomy from 2012 to 2019 were reviewed and categorized by the number of outpatient opioid prescriptions received in the 90 days preceding surgery: none (Naïve), one (1 Rx), two (2 Rx), or three or more (Chronic). Operative time, hospital length of stay, and 30-day readmission rate were analyzed.

Factors that Minimize Curative Resection for Gallbladder Adenocarcinoma: an Analysis of Clinical Decision-Making and Survival.

Background: Gallbladder adenocarcinoma has a poor prognosis as it is often diagnosed incidentally, and patients have a high risk for residual and occult metastatic disease. Expert guidelines recommend definitive surgery for ≥T1b tumors; however, surgical management is inconsistent. This study evaluates the factors that affect the completion of radical resection with portal lymphadenectomy and its impact on survival.

Short- and long-term surgical outcomes of total pancreatectomy with islet autotransplantation: A comparative analysis of surgical technique and intraoperative heparin dosing to optimize outcomes.

Background: Total pancreatectomy with islet autotransplantation (TP-IAT) is an uncommon surgical procedure with unique perioperative management. We evaluated the short- and long-term morbidity and mortality of TP-IAT to optimize surgical technique and heparin dosing during islet autotransplantation.

Methods: Eighty patients with chronic pancreatitis undergoing TP-IAT were reviewed.

Radiographic feasibility study of cortical bone trajectory and traditional pedicle screw dual trajectories.

OBJECTIVE In 2009, Santoni and colleagues described a novel technique of posterior instrumentation; the cortical bone trajectory (CBT) was described as a caudocephalad and medial-to-lateral trajectory. Reported indications for CBT fixation include patients with osteoporosis, single-level degenerative disease, or adjacent-segment disease (ASD). In cases of revision surgery, it is technically possible and beneficial to place a traditional pedicle screw and a CBT screw at the same spinal level and side.