Comparative effectiveness of Roux-en-Y gastric bypass and sleeve gastrectomy in achieving diabetes remission in patients with diabetes-related vascular diseases: A multicentred study.

Metabolic and bariatric surgeries (MBS), including Roux-en-Y Gastric Bypass (RYGB) and Sleeve Gastrectomy (SG), have proven effective in promoting long-term diabetes remission among patients with type-2 diabetes (T2D). In this multicentre retrospective cohort study, we investigated the effectiveness of RYGB and SG in achieving diabetes remission, specifically among patients with T2D and vascular complications, while accounting for similar baseline diabetes severity. Although various scores predict diabetes remission after bariatric surgery, they do not consider diabetes-related vascular complications, which can influence outcomes even in patients with similar baseline T2D severity.

Effect of Limb Length on Weight Loss Outcomes Following Biliopancreatic Diversion with Duodenal Switch: A Multi-Centered Study.

Purpose: The effectiveness of biliopancreatic diversion with duodenal switch (BPD/DS) for weight loss is well established, yet there remains ongoing debate over optimal limb lengths to maximize weight loss without compromising safety. We aimed to evaluate the impact of BPD/DS limb lengths on weight loss outcomes and comorbidity resolution.

Material And Methods: A multicenter review of patients who underwent primary BPD/DS between 2008 and 2022.

Internal hernia in patients after duodenal switch: A multi-centred comparative analysis.

Biliopancreatic diversion with duodenal switch (BPD-DS) and single anastomosis duodeno-ileostomy with sleeve (SADI-S) are associated with superior and sustained weight loss outcomes. Despite their growing popularity, long-term safety profiles, particularly the risk of internal hernia (IH), remain underexplored. This study aimed to evaluate the incidence and characteristics of IH following BPD-DS and SADI-S procedures, comparing their clinical presentation, diagnostic methods, and outcomes.

Surgical and oncologic outcomes for liver resections of cystic neuroendocrine tumor liver metastasis.

Background: Cystic neuroendocrine tumor liver metastases (NETLM) are rare and dynamics in the liquid compartment often misinterpreted as rapid progression, affecting selection for liver resection candidates. This study retrospectively evaluates surgical and oncologic outcomes in patients with cystic versus solid NETLM from small bowel and pancreatic primaries.

Methods: Between 2000 and 2020, 12 patients with cystic NETLM were identified among 464 patients who underwent >90 % tumor cytoreduction debulking hepatectomy at the Mayo Clinic.

Impact of proton pump inhibitors on pathologic response rates following fluoropyrimidine-based neoadjuvant chemotherapy in pancreatic cancer patients.

Background: Proton pump inhibitors (PPIs) negatively impact fluoropyrimidine-based chemotherapy efficacy in colorectal cancer. This study assessed PPI impact on major pathologic response (mPR) rates of pancreatic adenocarcinoma (PDAC) patients receiving fluoropyrimidine-based chemotherapy.

Methods: An institutional retrospective review of resected PDAC patients receiving neoadjuvant fluoropyrimidine-based chemotherapy (98% FOLFIRINOX) from 2011 to 2021 was conducted.

Financial Toxicity of Long-Term Survivors Who Underwent Pancreatoduodenectomy for Pancreatic Ductal Adenocarcinoma.

Background: Pancreatoduodenectomy (PD) for pancreatic cancer has a profound impact on patients' lives. However, the long-term financial implications are poorly understood.

Objective: Assess the financial burden of long-term survivors who underwent PD.

Impact of metabolic and bariatric surgery on weight loss and insulin requirements in type 1 and insulin-treated type 2 diabetes.

Metabolic and Bariatric Surgery (MBS) is effective in improving metabolic outcomes and reducing weight in patients with obesity and diabetes, with less explored benefits in type 1 diabetes (T1D). This study aimed to evaluate the impact of MBS on weight loss and insulin requirements in T1D patients compared to insulin-treated type 2 diabetes (T2D) patients over a 5-year period. This retrospective analysis included patients who underwent primary sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) with a confirmed preoperative diagnosis of either T1D or insulin-treated T2D.

Relationships of primary productivity with anuran abundance, richness, and community composition in tropical streams.

The relationship between primary productivity and diversity has been demonstrated across taxa and spatial scales, but for organisms with biphasic life cycles, little research has examined whether productivity of larval and adult environments influence each life stage independently, or whether productivity of one life stage's environment outweighs the influence of the other. Experimental work demonstrates that tadpoles of stream-breeding anurans can exhibit a top-down influence on aquatic primary productivity (APP), but few studies have sought evidence of a bottom-up influence of primary productivity on anuran abundance, species richness and community composition, as seen in other organisms. We examined aquatic and terrestrial primary productivity in two forest types in Borneo, along with amphibian abundance, species richness, and community composition at larval and adult stages, to determine whether there is evidence for a bottom-up influence of APP on tadpole abundance and species richness across streams, and the relative importance of aquatic and terrestrial primary productivity on larval and adult phases of anurans.

Failed recovery after pancreatoduodenectomy: A significant problem even without surgical complications.

Background: The absence of surgical complications has traditionally been used to define successful recovery after pancreas surgery. However, patient-reported outcome measures as metrics of a challenging recovery may be superior to objective morbidity. This study aims to evaluate the use of patient-reported outcomes in assessing recovery after pancreas surgery.

Outcomes of Visceral Arterial Interposition Graft Reconstruction for Locally Advanced Pancreatic Cancer.

Objective: The aim of this study is to determine perioperative outcomes and the patency of interposition conduits for visceral arterial reconstruction in this setting.

Summary Background Data: Visceral arterial encasement in locally advanced pancreatic cancer was historically a contraindication for surgery. With modern effective neoadjuvant strategies, our recent experience has made advanced vascular resection and reconstruction feasible in selected patients.

Comprehensive outcomes after Roux-en-Y gastric bypass with a near-complete 15-year follow-up.

Background: Laparoscopic Roux-en-Y gastric bypass has a well-established safety and efficacy profile in the short and mid-term. Long-term outcomes remain limited in the literature, especially for follow-up periods of >10 years. The purpose of the study is to evaluate the long-term durability and safety of laparoscopic Roux-en-Y gastric bypass over a near-complete 15-year follow-up.

Neuroendocrine Tumors of Unknown Primary in the Setting of Cytoreductive Hepatectomy.

Background: Surgical cytoreduction for neuroendocrine tumor liver metastasis (NETLM) consistently shows positive long-term outcomes. Despite reservations in guidelines for surgery when the primary tumor is unidentified (UP-NET), this study compared the surgical and oncologic long-term outcomes between patients with these rare cases undergoing cytoreductive surgery and patients who had liver resection for known primaries.

Methods: The study identified 32 unknown primary liver metastases (UP-NETLM) in 522 retrospectively evaluated patients who underwent resection of well-differentiated NETLM between January 2000 and December 2020.

Implications of pregnancy on MCN of the pancreas: A multicentric case-control study.

Background: Mucinous cystic neoplasms (MCN) of the pancreas express estrogen and progesterone receptors. Several case reports describe MCN increasing in size during gestation. The aim of this study is to assess if pregnancy is a risk factor for malignant degeneration of MCN.

Value of Surgical Cytoreduction in Patients with Small Intestinal Neuroendocrine Tumors Metastatic to the Liver and Peritoneum.

Background: Cytoreductive hepatectomy can improve survival and symptoms of hormonal excess in patients with small intestinal neuroendocrine tumor (siNET) liver metastases, but whether to proceed when peritoneal metastases are encountered at the time of planned cytoreductive hepatectomy is controversial.

Methods: This was a retrospective review of patients who underwent surgical management of metastatic siNETs at Mayo Clinic between 2000 and 2020. Patients who underwent cytoreductive operation for isolated liver metastases or both liver and peritoneal metastases were compared.

Single anastomosis duodenal switch versus Roux-en-Y gastric bypass in patients with BMI ≥ 50 kg/m: a multi-centered comparative analysis.

Background: Roux-en-Y gastric bypass (RYGB) has consistently demonstrated excellent weight loss and comorbidity resolution. However, outcomes vary based on patient's BMI. Single anastomosis duodeno-ileostomy with sleeve (SADI-S) is a novel procedure with promising short-term results.

Outcomes of Neoadjuvant Chemotherapy for Invasive Intraductal Papillary Mucinous Neoplasm Compared with de Novo Pancreatic Adenocarcinoma.

Background: The management of invasive intraductal papillary mucinous cystic neoplasm (I-IPMN) does not differ from de novo pancreatic ductal adenocarcinoma (PDAC); however, I-IPMNs are debated to have better prognosis. Despite being managed similarly to PDAC, no data are available on the response of I-IPMN to neoadjuvant chemotherapy.

Methods: All patients undergoing pancreatic resection for a pancreatic adenocarcinoma from 2011 to 2022 were included.

Laparoscopic Median Arcuate Ligament Release: Surgical Technique and Clinical Outcomes.

Background: Median arcuate ligament syndrome (MALS) is characterized by a constellation of symptoms related to the compression of the celiac artery trunk. Laparoscopic release of the ligament has demonstrated its effectiveness in alleviating these symptoms while showing lower postoperative complication rates, reduced hospital stays, and improved clinical outcomes. This study describes a single institution's experience with this procedure and reports on the preoperative assessment, surgical technique, and clinical outcomes of patients with MALS.

The "double-fired" gastro-jejunostomy as a form of improved efficiency during Whipple procedure.

Background: Gastro-jejunostomy (GJ) after pylorus-resecting pancreatoduodenectomy (PD) is most commonly performed in a hand-sewn fashion. Intestinal stapled anastomosis are reported to be as effective as hand-sewn in terms of patency and risk of leakage in other indications. However, the use of a stapled gastro-jejunostomy hasn't been fully assessed in PD.

Management of Malnutrition and Hepatic Impairment After Duodenal Switch.

Background: Malnutrition and liver impairment after duodenal switch (DS) are possible and undesired complications, often conservatively treated. However, in specific cases, surgical revision may be necessary. This study aims to describe outcomes achieved by two bariatric surgery centers and address effectiveness and safety of revisional surgical procedures to resolve these complications.