Impact of Preoperative Chemotherapy Features on Patient Outcomes after Hepatectomy for Initially Unresectable Colorectal Cancer Liver Metastases: A LiverMetSurvey Analysis.

Background: Prognostic factors have been extensively reported after resection of colorectal liver metastases (CLM); however, specific analyses of the impact of preoperative systemic anticancer therapy (PO-SACT) features on outcomes is lacking. Methods: For this real-world evidence study, we used prospectively collected data within the international surgical LiverMetSurvey database from all patients with initially-irresectable CLM. The main outcome was Overall Survival (OS) after surgery.

Stratification of Major Hepatectomies According to Their Outcome: Analysis of 2212 Consecutive Open Resections in Patients Without Cirrhosis.

Objective: To stratify major hepatectomies (MajHs) according to their outcomes.

Summary Of Background Data: MajHs are associated with non-negligible operative risks, but they include a wide range of procedures. Detailed depiction of the outcomes of different MajHs is the basis for a new classification of liver resections.

Clube Português do Pâncreas Recommendations for Chronic Pancreatitis: Medical, Endoscopic, and Surgical Treatment (Part II).

Chronic pancreatitis (CP) is a complex disease that should be treated by experienced teams of gastroenterologists, radiologists, surgeons, and nutritionists in a multidisciplinary environment. Medical treatment includes lifestyle modification, nutrition, exocrine and endocrine pancreatic insufficiency correction, and pain management. Up to 60% of patients will ultimately require some type of endoscopic or surgical intervention for treatment.

Minor Hepatectomies: Focusing a Blurred Picture: Analysis of the Outcome of 4471 Open Resections in Patients Without Cirrhosis.

Objective: To elucidate minor hepatectomy (MiH) outcomes.

Summary Background Data: Liver surgery has moved toward a parenchyma-sparing approach, favoring MiHs over major resections. MiHs encompass a wide range of procedures.

Clube Português do Pâncreas Recommendations for Chronic Pancreatitis: Etiology, Natural History, and Diagnosis (Part I).

Chronic pancreatitis (CP) is a heterogeneous disease, with different causes and often a long delay between onset and full classic presentation. Clinical presentation depends on the stage of the disease. In earlier stages, recurrent episodes of acute pancreatitis are the major signs dominating clinical presentation.

Incisional hernia in hepatobiliary and pancreatic surgery: incidence and risk factors.

Purpose: The occurrence of incisional hernia (IH) is one of the main complications after open abdominal surgery. However, its incidence in hepatobiliary and pancreatic surgery is not known. Studies on hepatectomy and necrotizing pancreatitis show that the incidence can reach up to 42%.

The open abdomen: analysis of risk factors for mortality and delayed fascial closure in 101 patients.

Introduction: The core concepts of damage control and open abdomen in trauma surgery have been expanding for emergent general surgery. Temporary closures allow ease of access to the abdominal cavity for source control.The aim of the current study was to assess the outcomes of patients who underwent open abdomen management for acute abdominal conditions and evaluate risk factors for worse outcomes and inability of fascial closure during the initial hospitalization.

Validation of a Difficulty Grading Score in Laparoscopic Splenectomy.

Introduction: Laparoscopic splenectomy (LS) is the gold standard for the treatment of many spleen-related disorders. However, in the presence of splenomegaly, the rate of conversion to open surgery can be as high as 33.9% and is associated with longer operative times and higher costs.

Virtual Reality Simulation as a Tool to Monitor Surgical Performance Indicators: VIRESI Observational Study.

Introduction: Virtual reality simulation is a topic of discussion as a complementary tool to traditional laparoscopic surgical training in the operating room. However, it is unclear whether virtual reality training can have an impact on the surgical performance of advanced laparoscopic procedures. Our objective was to assess the ability of the virtual reality simulator LAP Mentor to identify and quantify changes in surgical performance indicators, after LAP Mentor training for digestive anastomosis.

CA 19-9 as a Marker of Survival and a Predictor of Metastization in Cholangiocarcinoma.

Background: Cholangiocarcinoma is the second most frequent primitive liver malignancy and is responsible for 3% of the malignant gastrointestinal neoplasms. The aims of this study were to determine the association of serum levels of CA 19-9 at diagnosis with other clinical data and serum liver function tests and to identify possible factors that influence the survival rates during follow-up.

Methods: Retrospective observational study of 89 patients with a diagnosis of cholangiocarcinoma followed at the Department of Gastroenterology during 5 years.

Meckel's diverticulum perforation by a fish bone: A case report.

Introduction: Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract. The perforation of a Meckel's diverticulum by a foreign body is a very rare complication.

Case Presentation: A 61-year-old male presented to the Emergency Department with complaints with abdominal pain and fever, and abdominal rebound tenderness on physical examination.

Gallstones and Bariatric Surgery: To Treat or Not to Treat?

Background: Obesity and rapid weight loss after bariatric surgery are risk factors for gallstone disease.

Objectives: The present study sought to evaluate the feasibility of selective concomitant cholecystectomy only in patients with symptomatic disease and study risk factors for the development of symptomatic gallstones after bariatric surgery.

Methods: Between January 2010 and December 2012, 734 consecutive patients presenting to our institution underwent bariatric surgery.

Spotlight on esophageal perforation: A multinational study using the Pittsburgh esophageal perforation severity scoring system.

Objective: The Pittsburgh group has suggested a perforation severity score (PSS) for better decision making in the management of esophageal perforation. Our study aim was to determine whether the PSS can be used to stratify patients with esophageal perforation into distinct subgroups with differential outcomes in an independent study population.

Methods: In a retrospective study cases of esophageal perforation were collected (study-period, 1990-2014).

Nonrecurrent Laryngeal Nerve and Associated Anatomical Variations: The Art of Prediction.

Introduction: A nonrecurrent laryngeal nerve (NRLN) is a rare anatomical variation in which the nerve enters the larynx directly off the cervical vagus nerve.

Case Report: We present 2 patients who underwent thyroid surgery for benign disease. Intraoperatively, type 2a and 1 NRLN were identified.

Gastrointestinal stromal tumor of the stomach and hepatocellular carcinoma: An unusual association.

Introduction: Gastrointestinal stromal tumors (GIST) are uncommon, potentially malignant tumors, that arise in the wall of the gastrointestinal tract. Up to 50% can develop metastasis, mainly in the liver, but the occurrence of synchronous primary liver tumors is a rare event in these patients.

Presentation Of Case: The authors report a case of the association of gastric GIST and hepatocellular carcinoma (HCC) in a non-cirrhotic liver in a 76 year-old patient.

The good, the bad and the ugly: surgical resection for non-colorectal, non-neuroendocrine liver metastases.

Background/aims: The aim of this retrospective study was to analyze outcomes after partial hepatectomy for non-colorectal non-neuroendocrine metastases (mNCRNNE) and to identify prognostic factors associated with survival.

Methodology: Patient demographics, tumor characteristics, treatment and outcome of 30 consecutive patients operated between January 1995 and June 2012 were analyzed. The Kaplan-Meier method was used to analyze survival and Cox regression models were applied to identify independent prognostic variables.

Gastric stump cancer: more than just another proximal gastric cancer and demanding a more suitable TNM staging system.

Background: Considerable controversy persists about the biological behavior of gastric stump cancer (GSC). The aim of this study is to clarify if this cancer is just another proximal gastric cancer or if it emerges as a distinctive clinicopathologic entity.

Methods: This review of a prospectively collected gastric cancer database identified 73 patients with GSC in a single institution between January 1980 and June 2012 and compared them with 328 patients with proximal gastric cancer (PGC) and 291 patients with esophagogastric junction cancer (EGJC).

Methodological assessment of HCC literature.

Despite the fact that the hepatocellular carcinoma (HCC) represents a major health problem, very few interventions are available for this disease, and only sorafenib is approved for the treatment of advanced disease. Of note, only very few interventions have been thoroughly evaluated over time for HCC patients compared with several hundreds in other, equally highly lethal, tumours. Additionally, clinical trials in HCC have often been questioned for poor design and methodological issues.

Three decades of clinical-pathological trends in gastric cancer: prospective data from a Portuguese hospital.

Introduction: Gastric cancer is a heterogeneous disease, whose pathological and clinical patterns have changed in the last decades. In most western countries, decreases in incidence and mortality and a proximal migration have been reported. The clinical and pathological trends in an European country with high prevalence of gastric cancer were reviewed, based on the patients treated at a University Hospital.

Gastric bypass is a cost-saving procedure: results from a comprehensive Markov model.

Background: Obesity is a growing public health problem in industrialized countries and is directly and indirectly responsible for almost 10% of all health expenditures. Bariatric surgery is the best available treatment, however, associated with important economical expenditures. So, cost-effectiveness analysis of the available surgical options is paramount.

Prognostic factors for traumatic bowel injuries: killing time.

Background: Intestinal rupture/perforation after abdominal trauma is a rare complication, but it is related to significant morbidity and mortality. Our objective is to identify determinants of prognosis in patients surgically treated for a bowel injury (small bowel and colon) after abdominal trauma.

Methods: The present study is a retrospective analysis of 102 patients seen at our hospital during a 10-year period in whom laparotomy for traumatic bowel injury was performed.