The impact of COVID-19 on pancreaticoduodenectomy outcomes in a hepatopancreatobiliary centre of excellence.

Background: At the beginning of the COVID-19 pandemic, access to "planned" surgical care was restricted as the health care system responded to the coronavirus. We hypothesized that the pandemic resulted in diagnostic and therapeutic delays, leading to stage migration among patients with malignancies treated with a Whipple procedure.

Methods: This study is a retrospective review of adults who underwent surgical exploration for a planned pancreaticoduodenectomy for malignancy at St.

Laparoscopic subtotal cholecystectomy for the difficult gallbladder: Evolution of technique at a single teaching hospital.

Background: We have developed an algorithmic approach to laparoscopic cholecystectomy, including subtotal cholecystectomy, as a bailout strategy when the Critical View of Safety cannot be safely achieved due to significant inflammation and fibrosis of the hepatocystic triangle.

Methods: This is a retrospective cohort study comparing postoperative outcomes in patients with severe cholecystitis who underwent laparoscopic cholecystectomy or laparoscopic subtotal cholecystectomy at St. Joseph's Health Centre from May 2016 to July 2021, as well as against a historical cohort.

Closed incision negative pressure wound therapy following pancreaticoduodenectomy for prevention of surgical site infections in high-risk patients.

Background: Surgical site infection (SSI) is one of the most common sources of morbidity after pancreaticoduodenectomy. Surgical site infections are associated with readmissions, prolonged length of stay, delayed initiation of adjuvant chemotherapy and negative effects on quality of life. Incisional vacuum-assisted closure (iVAC) devices applied on closed incisions may reduce SSI rates.

Evaluating a pilot, structured, face-to-face, antimicrobial stewardship, prospective audit-and-feedback program in emergency general surgery service in a community hospital.

Background: Prospective audit and feedback (PAF) is an established practice in critical care settings but not in surgical populations. We pilot-tested a structured face-to-face PAF program for our acute-care surgery (ACS) service.

Methods: This was a mixed-methods study.

Comparing the Warshaw technique with vessel-preservation in laparoscopic spleen preserving distal pancreatectomy: is there a better approach?

Background: Laparoscopic spleen-preserving distal pancreatectomy (LSPDP) can be accomplished with either resection of the splenic vessels via the Warshaw Technique (WT) or via preservation of the splenic vessels (SVP). Our study aims to compare outcomes for the two methods of LSPDP.

Methods: We performed a retrospective chart review with intent-to-treat analysis of adults undergoing LSPDP at a single institution from 2009 to 2021.

Thinking Your Way Through a Difficult Laparoscopic Cholecystectomy: Technique for High-Quality Subtotal Cholecystectomy.

Laparoscopic subtotal cholecystectomy (LSC) is a bailout strategy to prevent bile duct injury in difficult gallbladder cases. It is associated with acceptable morbidity that is readily managed with postoperative interventions. Here we share our techniques for LSC.

Helping the Surgeon Recover: Peer-to-Peer Coaching after Bile Duct Injury.

Background: Bile duct injury sustained during laparoscopic cholecystectomy is associated with high morbidity and mortality, and can be a devastating complication for a general surgeon. We introduce a novel, individualized surgical coaching program for surgeons who recently injured a bile duct in laparoscopic cholecystectomy. We aim to explore the perception of coaching among these surgeons and to assess surgeons' experiences in the coaching program.

The inferior boundary of dissection as a novel landmark for safe laparoscopic cholecystectomy.

Background: Since the introduction of laparoscopic cholecystectomy over 30 years ago, rates of bile duct injury have remained elevated compared to the era of open cholecystectomy. We propose an anatomical landmark, the Inferior Boundary of Dissection, to help prevent dangerous dissection in the porta hepatis and provide clues as to when a critical view of safety may not be immediately achieved.

Methods: This landmarking approach is based on fundamentals of biliary anatomy and surface landmarks of the liver.

Risk factors for survival following recurrence after first liver resection for colorectal cancer liver metastases.

Background: Management of recurrence following liver resection for colorectal cancer metastases is a topic of debate. We determined risk factors for survival following recurrence after liver resection.

Methods: Long-term follow-up of patients in the PETCAM trial who had recurrence following liver resection.

Assessing tools for management of noncolorectal nonneuroendocrine liver metastases: External validation of a prognostic model.

Introduction: Selection criteria and benefits for resection of noncolorectal, nonneuroendocrine liver metastases (NCNNELM) remain debated. A prognostic score was developed by the Association Française de Chirurgie (AFC) for patient selection, but not validated. We performed a geographic external validation of this score.

The impact of perioperative blood transfusions on short-term outcomes following hepatectomy.

Background: Bleeding and need for red blood cell transfusions (RBCT) remain a significant concern with hepatectomy. RBCT carry risk of transfusion-related immunomodulation that may impact post-operative recovery. This study soughs to assess the association between RBCT and post-hepatectomy morbidity.

Patients' perceptions of palliative surgical procedures: a qualitative analysis.

Background: Patients with incurable malignancies can require surgical intervention. We prospectively evaluated patients treated with palliative surgery to qualitatively assess peri-operative outcomes.

Methods: Eligible patients were assessed at a tertiary care cancer center.

Outcomes after repeat hepatic resection for recurrent metastatic colorectal cancer: A population-based study.

Background: More than half of the patients undergoing resection for colorectal cancer liver metastases develop recurrent hepatic disease. We report management and outcomes of patients undergoing repeat hepatectomy in routine practice.

Methods: All cases of repeat hepatectomy for colorectal cancer liver metastases from 2002 to 2009 in the Canadian Province of Ontario were identified using the population-based Ontario Cancer Registry and linked treatment records.

The impact of peri-operative blood transfusions on post-pancreatectomy short-term outcomes: an analysis from the American College of Surgeons National Surgical Quality Improvement Program.

Background: Peri-operative red blood cell transfusions (RBCT) may induce transfusion-related immunomodulation and impact post-operative recovery. This study examined the association between RBCT and post-pancreatectomy morbidity.

Methods: Using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) registry, patients undergoing an elective pancreatectomy (2007-2012) were identified.

The impact of portal pedicle clamping on survival from colorectal liver metastases in the contemporary era of liver resection: a matched cohort study.

Introduction: Portal pedicle clamping (PPC) may impact micro-metastases' growth. This study examined the association between PPC and survival after a hepatectomy for colorectal liver metastases (CRLM).

Methods: A matched cohort study was conducted on hepatectomies for CRLM at a single institution (2003-2012).

The Impact of Perioperative Red Blood Cell Transfusions on Long-Term Outcomes after Hepatectomy for Colorectal Liver Metastases.

Background: Red blood cell transfusions (RBCTs) are associated with cancer recurrence following resection of colorectal cancer. Their impact after colorectal liver metastases (CRLM) resection remains debated. We sought to explore the association between perioperative RBCT and oncologic outcomes following resection of CRLM.

Patient perceptions of natural orifice translumenal surgery.

Natural orifice translumenal endoscopic surgery (NOTES) is on the forefront of surgical technique, but existing research has produced mixed results regarding factors associated with interest in the procedure. Our objective was to ascertain patient opinions at a Canadian centre regarding scarless surgery. A survey comprising demographic data (gender, age, body mass index [BMI]), interest in NOTES, impact of increased risk, as well as importance of further research and shorter recovery time was administered to volunteer patients at outpatient general surgery clinics.