Inferior Mesenteric Vein-Caval Shunt for Extrahepatic Portal Venous Obstruction With Portal Cavernomatous Cholangiopathy: A Hobson's Choice.

Proximal splenorenal shunt is the most commonly performed shunt in patients with extrahepatic portal venous obstruction (EHPVO). Sometimes, due to various anatomical and intraoperative factors, other rarely used shunts may be required. We present the case of a 27-year-old male who was diagnosed with EHPVO with complicated portal cavernomatous cholangiopathy.

Neoadjuvant Chemotherapy vs Chemoradiotherapy for Malignancy of Esophagus: A Prospective Comparative Study.

Introduction: Neoadjuvant chemoradiation (NACRT) followed by surgery has become the standard of care for esophageal squamous cell carcinoma (ESCC). This study compared the tolerability and oncological benefit of neoadjuvant chemotherapy (NACT) with those of NACRT for the treatment of ESCC.

Methods: A prospective quasi-experimental comparative study was conducted from July 2019 to August 2023 to assess the efficacy of the NACT regimen of two cycles of paclitaxel and carboplatin as an alternative to standard NACRT.

Robotic versus open pancreatoduodenectomy for periampullary neoplasm: a propensity matched analysis of peri-operative and oncologic outcomes.

Introduction: Though open pancreatoduodenectomy (OPD) is the gold standard, robotic pancreatoduodenectomy (RPD) is on the rise due to its technical ease with robotic armamentarium and claim to decrease morbidity in the perioperative period. This study compares the perioperative and oncologic outcomes of RPD performed for periampullary neoplasms (PANs) with OPD.

Method: This is a retrospective study conducted from January 2018 to December 2023 for all the patients who underwent either OPD or RPD for PANs.

Clinico-Epidemiological Analysis of Small Bowel Obstruction in Adults at a Tertiary Care Center in India.

Background: Acute small bowel obstruction (SBO) is a common surgical emergency. The study aims to provide a comprehensive clinical-epidemiological description of SBO in adults at a tertiary care center in western India.

Methods: This hospital-based cross-sectional study was conducted from July 2020 to June 2022 and enrolled 88 SBO patients requiring surgical intervention.

Adjuvant therapy may improve overall survival in high-risk periampullary adenocarcinomas patients - A match-pair analysis from a multi-institutional cohort study (The MIPPAP study).

Background: The role of adjuvant therapy in resected periampullary adenocarcinomas is equivocal due to contrasting data and limited prospective trials.

Methods: The Multicentre Indian Pancreatic & Periampullary Adenocarcinoma Project (MIPPAP), included data from 8 institutions across India. Of the 1679 pancreatic resections, 736 patients with T3/T4 and/or Node positive adenocarcinomas (considered as high risk for recurrence) were included for analysis.

Gallbladder perforation: Diagnostic accuracy of new CT difficulty score in predicting complicated laparoscopic cholecystectomy.

Purpose: To formulate and evaluate the diagnostic performance and utility of a new CT difficulty score in predicting difficult laparoscopic surgery in cases of gallbladder (GB) perforation.

Methods: This prospective single centre study included a total of 48 diagnosed cases of GB perforation on CT between December 2021 and June 2023, out of which 24 patients were operated. A new 6-point CT difficulty scoring system was devised to predict difficult laparoscopic approach, based on patterns of inflammation around the perforated GB that were found to be surgically relevant.

Diagnostic performance of F-18 FDG PET/CT in differentiating autoimmune pancreatitis from pancreatic cancer: a systemic review and meta-analysis.

Objectives: This study aims to evaluate the utility of F-18 FDG PET/CT in the non-invasive diagnosis of autoimmune pancreatitis (AIP) and differentiating it from pancreatic cancer (CaP) based on the amount and pattern of FDG uptake, as well as involvement of extra-pancreatic sites.

Methods: A systematic search was conducted using PubMed, Scopus, Cochrane Library and Google Scholar. Only those studies that compared the findings of F-18 FDG PET/CT in terms of SUVmax, pattern of FDG uptake and presence of FDG-avid extra-pancreatic sites in both AIP and CaP were included.

Impact of nasogastric tube exclusion after minimally invasive esophagectomy for esophageal cancer: a single-center retrospective study in India.

Purpose: This study examines the impacts of omitting nasogastric tube (NGT) placement following cervical esophagogastric anastomosis (CEGA) in Enhanced Recovery After Surgery (ERAS) protocols, comparing outcomes to those from early NGT removal.

Methods: In a retrospective cohort of esophagectomy patients treated for esophageal cancer, participants were divided into two groups: group 1 had the NGT inserted post-CEGA and removed by postoperative day 3, while group 2 underwent the procedure without NGT placement. We primarily investigated anastomotic leak rates, also analyzing hospital stay duration, pulmonary complications, and NGT reinsertion.

Jejunal mucinous adenocarcinoma: Unusual presentation of a rare pathology.

Mucinous adenocarcinoma of jejunum is a rare tumor of the gastrointestinal tract. Patients usually present after fifth decade of their life with non-specific symptoms. Delayed diagnosis is commonplace and often the reason for advanced disease and poor prognosis.

Thoracoscopy-Assisted Esophagectomy for Esophageal Leiomyomatosis.

Introduction: Diffuse esophageal leiomyomatosis is a rare esophageal tumor characterized by circumferential thickening of smooth muscle layers of the entire esophagus. CLINICAL CASE: Herein, we describe the case of a 19-year-old girl, who presented with a history of long-standing dysphagia. On evaluation she was found to have diffuse esophageal leiomyomatosis and was managed successfully by thoracoscopy-assisted esophagectomy with intra-nodal indocyanine green injection.

Open injury, robotic repair-moving ahead! Total robotic Roux-en-Y hepaticojejunostomy for post-open cholecystectomy Bismuth type 2 biliary stricture using indocyanine green dye.

Hepaticojejunostomy is currently the best treatment for post-cholecystectomy biliary strictures. Laparoscopic repair has not gained popularity due to difficult reconstruction. We present case of 43-year-old-female with Bismuth type 2 stricture following laparoscopic converted open cholecystectomy with bile duct injury done elsewhere.

Gangliocytic Paraganglioma of the Duodenum: A Masquerader.

Gangliocytic paraganglioma (GP) is a rare tumor that most commonly arises from the duodenum and is characterized pathologically by 3 cell types: epithelioid, spindle, and ganglion cells. GP is often difficult to differentiate from a neuroendocrine tumor on the basis of preoperative imaging, and the diagnosis is based on final histopathologic and immunohistochemical analysis. We report the case of a 28-year-old male who presented with pain in the abdomen, bilious vomiting, and weight loss.

Carcinosarcoma of the Esophagus-A Diagnostic Challenge.

Esophageal carcinosarcoma is an uncommon histologic variant of esophageal malignancy, occurring in approximately 0.5% to 2.8% of patients.

Bottle Gourd Juice: Poison or Panacea.

Ingestion of toxic bottle gourd juice, particularly the bitter one, may pose a significant risk to life if not treated in time. Notwithstanding its usefulness, people drink it routinely without concern for fruit quality, extraction hygiene, and mixture with other fruits. We report two cases of bottle gourd juice poisoning with severe abdominal pain and hematemesis.

Short-term outcomes of enhanced recovery after surgery protocol in minimally invasive oesophagectomy: A prospective study.

Background: Although fast-track treatment pathways are well established in colorectal surgeries, their role in oesophageal resections has not been well studied. This study aims to prospectively evaluate the short-term outcomes of enhanced recovery after surgery (ERAS) protocol in patients undergoing minimally invasive oesophagectomy (MIE) for oesophageal malignancy.

Patients And Methods: We studied a prospective cohort of 46 consecutive patients from January 2019 to June 2022 who underwent MIE for oesophageal malignancy.

Spontaneous hepatic arterioportal fistula in extrahepatic portal vein obstruction: Combined endovascular and surgical management.

Hepatic arterioportal fistulae are abnormal communications between the hepatic artery and portal vein. They are reported to be congenital or acquired secondary to trauma, iatrogenic procedures, hepatic cirrhosis, and hepatocellular carcinoma, but less likely to occur spontaneously. Extrahepatic portal venous obstruction (EHPVO) can lead to pre-hepatic portal hypertension.

Laparoscopic Witzel feeding jejunostomy: a procedure overlooked!

Purpose: Feeding jejunostomy (FJ) is a critical procedure to establish a source of enteral nutrition for upper gastrointestinal disorders. Minimally invasive surgery has the inherent benefit of better patient outcomes, less postoperative pain, and early discharge. This study aims to describe our total laparoscopic technique of Witzel FJ and to compare its outcome with its open counterpart.

Duplicated extrahepatic bile duct (type Vb): An important rare anomaly.

Congenital duplication of the extrahepatic bile duct (DEBD) is an unusual anomaly of the biliary system. It occurs due to inability of the embryological duplex biliary system to regress. DEBD has various subtypes depending on the morphology and opening of the aberrant common bile duct.