Gender variations in 30-day outcomes following cholecystectomy in patients with biliary acute pancreatitis.

Background: Biliary acute pancreatitis (BAP) can be associated with severe morbidity and mortality. This study aims to evaluate whether gender is associated with worse 30-day postoperative outcomes following cholecystectomy for BAP.

Methods: Patients in the ACS-NSQIP database (2014-2017) with a diagnosis of BAP who underwent cholecystectomy were stratified into two groups: male and female.

Prophylactic Enoxaparin Dosing Using Anti-Factor Xa Levels in Hepatic Surgery Patients: A Pilot Study.

This study examines the safety and efficacy of using peak anti-Xa levels to achieve prophylactic enoxaparin (Lovenox, Sanofi-Aventis) levels in patients who underwent hepatic surgery. Prospectively enrolled patients undergoing major and minor hepatic procedures received postoperative enoxaparin dosing. The enoxaparin dose was adjusted to attain a peak anti-Xa level ≥ 0.

Medical student perceptions of assessments of clinical reasoning in a general surgery clerkship.

Background: Components factoring into general surgery clerkship grades vary by institution, and while evaluators attempt to remain unbiased when evaluating medical student performance, subjectivity and implicit bias remain an issue. Our institution recently implemented a case-based structured oral examination to provide the general surgery clerkship director objective insight into students' clinical reasoning skills. We hypothesized that medical students believe this exam, along with graded clinical documentation and the Observed Standardized Clinical Encounter (OSCE), are fair assessments and increase students' awareness of their clinical reasoning skills.

Influence of Applicant Interview Format Choice on Demographics and Outcomes from the Residency Match.

Background: Studies of virtual interviews (VI) for residency lack contemporaneous In-person Interview (IPI) comparators, leaving uncertain the impact of interview mode on the match process. The study aims to evaluate the effect of allowing candidates to choose interview format, the VI versus IPI, on demographic characteristics of candidates and on rank order list (ROL) position.

Study Design: A Cohort study of residency applicants (2022-2023 recruiting season) to a general surgery training program.

Psychologic assessment in patients undergoing bariatric surgery.

Background: Psychological Clearance level (PCL) for patients undergoing metabolic and bariatric surgery (MBS) is a critical step for successful postoperative outcomes. This study aims to assess the relationship between the level of psychologic fitness and postoperative outcomes in patients undergoing MBS.

Methods: We retrospectively analyzed the data of patients who underwent MBS (laparoscopic sleeve gastrectomy [LSG] and laparoscopic Roux-en-Y Gastric Bypass [LRYGB]) and completed two years follow-up, between 2012 and 2019, in a single medical center.

Type-O Blood Is Not Associated With Elevated Mortality After Trauma: A North American Cohort Study.

Background: Recent studies have presented contradictory findings on the relationship between blood type and mortality in trauma patients. Using the largest population in a study of this type to date, we hypothesized that ABO genotype and Rhesus status would influence trauma-related mortality and morbidity given the relationship between blood type and hemostasis.

Methods: Data from all trauma patients admitted to level I and level II trauma centers in one city over a five-year period was retrospectively analyzed.

Do Surgery Residents Prepare Enough for Surgical Cases?

Importance: This study aimed to identify both modifiable and nonmodifiable factors that affect intraoperative-specific surgical education and performance, with an overall goal of increasing cognizance of such factors to improve surgical training.

Objective: To determine whether surgery residents prepare adequately for participation in surgical cases and to examine specific variables that affect resident preparation.

Design: This study is a retrospective survey-based study that included data from 1945 postoperative case evaluations completed by 59 different general surgery residents over a period of 8 years (2014-2022).

Are There Racial Differences in the Rate of Surgical Site Infection Based on Surgical Subspecialty?

Surgical site infection (SSI) is a common, morbid post-operative complication. We hypothesized the presence of racial differences in SSI rates, comparing black/African American (BAA) to white non-Hispanic (WNH) patients. Using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database (2017), BAA and WNH surgery patients across 10 surgical specialties were identified: general surgery (GS), vascular surgery (VS), cardiac surgery (CS), thoracic surgery (TS), orthopedics (OS), neurosurgery (NS), urology (US), otolaryngology (ENT), plastic surgery (PS), and gynecology (GYN).

Scholarly Activity and Gender of an Applicant for a General Surgery Residency.

Introduction: Applying to general surgery residency is undoubtedly a competitive process. Participation in scholarly activity (SCA) has been cited as a criterion when selecting applicants for interview and in the ranking process. This study aims to evaluate the association between gender of applicants to surgery residency and SCA and to characterize trends in SCAs over time.

Applicants Performance in Interview for a General Surgery Residency Pre- and During Coronavirus Disease-19 Pandemic.

Introduction: The coronavirus disease-19 (COVID-19) pandemic has created a shift from traditional in-person interviews for a residency position to a virtual platform over the last 2 y (2020-2021). With this significant shift, there is controversy about how this may affect applicant performance. We hypothesized that applicants scored higher during virtual interviews than in-person interviews.

Shared Decision-Making in Pancreatic Surgery.

Objective: The objective of this study is to determine the factors influencing pancreatic surgery patients' perceptions of the shared decision-making process (SDM).

Background: Decision-making in pancreatic surgery is complicated by the risk of morbidity and mortality and risk of early recurrence of disease. Improvement in SDM has the potential to improve the receipt of goal- and value-concordant care.

Towards reliable hepatocytic anatomy segmentation in laparoscopic cholecystectomy using U-Net with Auto-Encoder.

Background: Most bile duct (BDI) injuries during laparoscopic cholecystectomy (LC) occur due to visual misperception leading to the misinterpretation of anatomy. Deep learning (DL) models for surgical video analysis could, therefore, support visual tasks such as identifying critical view of safety (CVS). This study aims to develop a prediction model of CVS during LC.

The importance of USMLE step 2 on the screening and selection of applicants for general surgery residency positions.

Background: As announced by the Federation of State Medical Boards (FSMB) and National Board of Medical Examiners (NBME), the United States Medical Licensing Examination (USMLE) Step 1 score reporting has transitioned to pass/fail outcomes instead of the traditional numeric score after January 26, 2022. USMLE Step 1 scores have been used widely as a crucial tool in screening and selecting applicants for residency programs. This study aims to determine the role of USMLE Step 2 in the selection of applicants for general surgery residency.

Thirty day postoperative outcomes following laparoscopic adrenalectomy for functional adrenal tumors.

Background: Functional adrenal tumors (FATs) are rare and if left untreated, there is a substantial risk of morbidity and mortality due to uncontrolled excess hormone secretion. The three most common FATs are cortisone-producing tumors (hypercortisolism), aldosterone-producing tumors (hyperaldosteronism), and catecholamines-producing tumors (pheochromocytomas). The study aims to evaluate demographic characteristics and 30-day outcomes after laparoscopic adrenalectomy of FATs.

3D Autonomous Surgeon's Hand Movement Assessment Using a Cascaded Fuzzy Supervisor in Multi-Thread Video Processing.

The purpose of the Fundamentals of Laparoscopic Surgery (FLS) training is to develop laparoscopic surgery skills by using simulation experiences. Several advanced training methods based on simulation have been created to enable training in a non-patient environment. Laparoscopic box trainers-cheap, portable devices-have been deployed for a while to offer training opportunities, competence evaluations, and performance reviews.

Inaccuracy of surgical irrigation fluid temperature hand assessment.

Introduction: Fluids are often used for irrigation during surgical procedures. The temperature of the fluid directly affects the exposed tissue and body temperature. The recommended practice is to use euthermic fluids to be homeostatic and optimise patient care.

Trends of the Extra-Hepatic Biliary Cancer and Its Surgical Management: A Cross-Sectional Study From the National Cancer Database.

Introduction Biliary cancers are rare cancers with poor prognoses. In this study, we aimed to evaluate trends in early detection and surgical treatment and approaches in extra-hepatic biliary tract cancers (EBCs) over 13 years in the US. Methods The most recent data on patients diagnosed with EBC between 2004 and 2016 were extracted from the National Cancer Database (NCDB).

Resident Autonomy and Performance Independence in Surgical Training Are Time- and Skill-Dependent.

Introduction: Appropriate faculty supervision and conditional independence of residents during training are required for autonomous and independent postgraduate practice. However, there is a growing concern that competence for transition to independent practice is not universally met. We hypothesize that surgery residents play a significant and active role in achieving their own independent status.

A Cohort Study of an Enhanced Recovery Pathway for Pancreatic Surgery at a Community Hospital.

Background: Enhanced recovery after surgery (ERAS) pathways have been shown to improve pancreatic surgery outcomes, though feasibility in a community hospital remain unclear. We hypothesized that an ERAS protocol would reduce hospital length of stay (LOS) without increased morbidity.

Methods: An ERAS pathway was initiated for patients undergoing pancreatic surgery at a community cancer center and compared to a historical cohort.

Utilizing Percutaneous Cholecystostomy Tube as a Temporary Minimally Invasive Approach for Acute Cholecystitis during Third Trimester of a High-Risk Pregnancy.

Laparoscopic cholecystectomy (LC) is the treatment modality of choice for symptomatic cholelithiasis and cholecystitis during pregnancy and is associated with shorter length of stay, shorter operative times, and fewer complications compared to open cholecystectomy. However, in high-risk pregnant patients, LC can be challenging. Percutaneous cholecystostomy tube (PCT) offers a temporary management option during the peripartum period until interval LC is performed.