Graduated Autonomy of Laparoscopic Liver Resection Based on Liver Resection Complexity: A Western and Eastern Bi-Institution Study for Learning Curve.

Introduction: Laparoscopic liver resection (LLR) requires a high degree of expertise in both hepatobiliary and minimally invasive surgery. Our group previously reported a 3-level LLR complexity classification based on intra-postoperative outcomes: grade I (low), grade II (intermediate), and grade III (high). We evaluated the learning curve effect in each complexity grade to assess the experience needed for a surgeon to safely progress through the grades.

Debulking hepatectomy for colorectal liver metastasis: Analysis of risk factors for progression free survival.

Background: The study explores the role of liver debulking surgery in cases of unresectable colorectal liver metastases (CRLM), challenging the traditional notion that surgery is not a valid option in such scenarios.

Materials And Methods: Patients with advanced but resectable disease who underwent surgery with a curative intent (Group I) and those with advanced incompletely resectable disease who underwent a "debulking" hepatectomy (Group II) were compared.

Results: There was no difference in the intra-operative and post-operative results between the two groups.

Impact of Preoperative Protein Sparing Modified Fast Diet on Bariatric Surgery.

Introduction: Bariatric surgery can become technically challenging in the setting of liver steatosis and hepatomegaly. The protein sparing modified fast (PSMF) diet helps in achieving rapid weight loss. The aim of this study is to explore the results of a preoperative PSMF diet on liver volume and steatosis as well as on intraoperative and postoperative complications in patients with hepatomegaly undergoing Roux-en-Y gastric bypass (RYGB).

Peritoneal Metastases of Colorectal Origin Treated with Complete Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy: The Efficiency of Mitomycin C.

Background: Survival of patients affected by colorectal cancer peritoneal metastases (CRC-PM) can be improved with combined complete cytoreductive surgery (CCRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Two chemotherapeutic agents are mainly used: mitomycin C (MMC) and oxaliplatin. A recent prospective randomized clinical trial showed that oxaliplatin-based HIPEC does not improve survival compared with CCRS alone.

Gastroesophageal Cancer After Gastric Bypass Surgeries: a Systematic Review and Meta-analysis.

Data comparing the occurrence of gastroesophageal cancer after gastric bypass procedures are lacking and are only available in the form of case reports. We perform in this study a systematic review and a meta-analysis of all the reported cases of gastroesophageal cancer following Roux-en-Y gastric bypass (RYGB) and loop gastric bypass-one anastomosis gastric bypass/mini gastric bypass (LGB-OAGB/MGB). We conducted a systematic review of all the reported cases in articles referenced in PubMed/Medline, Cochrane, and Scholar Google.

Combined Superior Mesenteric Artery Syndrome and Nutcracker Syndrome in a Young Patient: A Case Report and Review of the Literature.

BACKGROUND Superior mesenteric artery syndrome is the compression of the third portion of the duodenum between the superior mesenteric artery and the aorta causing abdominal pain and vomiting. Nutcracker syndrome is the compression of the left renal vein between the superior mesenteric artery and the aorta causing symptoms related to renal congestion. Both entities, although well described in the literature, are individually rare, and even though they might share a common etiology, their co-existence has been reported in only a few case reports.

Pitfalls of Diagnosing Left Lower Quadrant Pain Causes: Making the Uncommon Common Again.

BACKGROUND Left-sided acute appendicitis, although well described in the literature, is still an easily missed diagnosis. Midgut malrotation and situs inversus are 2 known leading conditions that contribute to misdiagnosis of appendicitis. CASE REPORT Here is the case of a 27-year-old male without any previous medical history, who presented with left lower quadrant tenderness and was misdiagnosed with gastroenteritis as an outpatient and sent home; the patient presented the next day to the emergency department where he was found to have acute appendicitis with situs inversus.

Gastrobronchial Fistula Following a Laparoscopic Sleeve Gastrectomy.

BACKGROUND Bariatric operations have been gaining more ground over the past decade. The most commonly used bariatric operation is the laparoscopic sleeve gastrectomy. A complication of laparoscopic sleeve gastrectomy is gastric leak; which can rarely cause a primary subphrenic abscess and a secondary diaphragm rupture that will lead eventually to a gastrobronchial fistula.

Weight Regain After Sleeve Gastrectomy: A Look at the Benefits of Re-sleeve.

Introduction Laparoscopic sleeve gastrectomy (LSG) has become one of the most commonly performed weight loss procedures due to its simpler technique and lower complication rate as compared to the Roux-en-Y gastric bypass and duodenal switch. However, weight regain is seen in patients with a large gastric fundus. In these cases, a revision laparoscopic sleeve gastrectomy (reLSG) aiming at resecting the excess pouch is a promising option for correction.

An Unusual Case of Intestinal Malrotation Causing Duodenal Obstruction by a Looped Appendix.

BACKGROUND Bowel obstruction is a mechanical or functional obstruction of the intestines which prevents the normal movement of the products of digestion. Intestinal malrotation is one of the rarest causes of mechanical bowel obstruction. In adults, the incidence rate is 0.