Identification of robust associations between admission microbiome profiles and complications of acute pancreatitis.

Objective: Patients with acute pancreatitis show reduced gut microbiome diversity and high abundance of pathogenic bacteria compared with healthy subjects. Admission microbiome profiles are increasingly linked to severity, but methodology and study quality hamper interpretation. Our aim was to investigate whether admission microbiome analysis provides robust and reproducible associations with severity and complications of acute pancreatitis.

Effect of the number of door openings in the operating room on surgical site infections: individual-patient data meta-analysis.

Background: The effect of door openings in the operating room on surgical site infections remains a controversial topic and has led to strict door-opening policies. The aim of this individual-patient data meta-analysis was to evaluate the effect of the number of door openings in the operating room on surgical site infection.

Methods: MEDLINE (PubMed) and Embase (Ovid) were searched up to 2 December 2024.

Corrigendum to 'Systematic review and meta-analysis of goal-directed haemodynamic therapy algorithms during surgery for the prevention of surgical site infection'.

[This corrects the article DOI: 10.1016/j.eclinm.

Development and validation of a clinical decision tool for predicting long-term pain reduction following laparoscopic cholecystectomy in patients with symptomatic cholecystolithiasis: a prospective cohort study.

Background: The applicability of the recently reported predictors to predict pain reduction after laparoscopic cholecystectomy (LC) is limited by only predicting short-term outcomes. The aim of this study was to develop and externally validate a model to predict clinically relevant pain reduction 5 years after LC.

Materials And Methods: This study reports on 5-year follow-up data of two multicenter prospective trials in 25 hospitals.

Surgery for chronic pancreatitis across Europe (ESCOPA): prospective multicentre study.

Background: Randomized trials have demonstrated the superiority of surgery over endoscopy in patients with symptomatic chronic pancreatitis. However, large international studies quantifying the impact of surgery on chronic pancreatitis are lacking. The aim of this study was to evaluate current practice across Europe regarding indications, surgical techniques, and outcomes of surgery for chronic pancreatitis.

[Acute appendicitis - to cut or not to cut?].

Acute appendicitis has traditionally been seen as a progressive disease that necessitates surgery to prevent complications like perforation. However, recent studies emphasize the importance of distinguishing between complicated and uncomplicated appendicitis, rather than treating all cases the same. This evolving understanding has led to a paradigm shift in how uncomplicated appendicitis is diagnosed and treated, with options like antibiotic therapy being considered alternatives to immediate surgery.

Variable use of modern abdominal wall closure techniques at emergency laparotomy - an international, cross-sectional survey of surgical practice.

Purpose: Incisional hernias (IH) occur after 20-30% of laparotomies. Modern closure techniques including small bite closure and prophylactic mesh augmentation (PMA) demonstrate significant reduction in IH rates. European and American Hernia Society guidelines suggest use of small bite closure and consideration of PMA at elective laparotomy closure but do not make a recommendation for emergency surgery.

Triclosan-Containing Sutures for the Prevention of Surgical Site Infection: A Systematic Review and Meta-Analysis.

Importance: International guidelines recommend the use of triclosan-containing sutures for the prevention of surgical site infections. However, controversy still remains about triclosan-containing suture use in clinical practice since several new randomized clinical trials (RCTs) have shown contradicting results.

Objective: To update a previous systematic review and meta-analysis of the association of triclosan-containing sutures with surgical site infections and explore the potential added value of new RCTs.

Minimally invasive versus open lateral pancreaticojejunostomy in patients with painful chronic pancreatitis: systematic review.

Background: Patients with painful chronic pancreatitis combined with a dilated main pancreatic duct and a normal size pancreatic head are treated according to guidelines by lateral pancreaticojejunostomy (LPJ). This systematic review compared outcomes of minimally invasive LPJ and open LPJ.

Methods: From 1 January 2000 until 13 November 2023, series reporting on minimally invasive LPJ and open LPJ in patients with symptomatic chronic pancreatitis were included.

Antibiotic treatment versus appendicectomy for acute appendicitis in adults: an individual patient data meta-analysis.

Background: Randomised controlled trials (RCTs) have found antibiotics to be a feasible and safe alternative to appendicectomy in adults with imaging-confirmed acute appendicitis. However, patient inclusion criteria and outcome definitions vary greatly between RCTs. We aimed to compare antibiotics with appendicectomy for the treatment of acute appendicitis using individual patient data and uniform outcome definitions.

Systematic review and meta-analysis of goal-directed haemodynamic therapy algorithms during surgery for the prevention of surgical site infection.

Background: Surgical site infection (SSI) is the most common postoperative complication. Goal-directed haemodynamic therapy (GDHT) may help to prevent SSI, but recommendations for its use initially have been set at conditional because of low-certainty evidence at the time. An updated systematic review with SSI as the primary endpoint has not been performed since 2011, and important new evidence has emerged.

Patients' Ability to Self-Manage Their Surgical Wound to Prevent Wound Complications: A Cross-Sectional Study.

Aims: To provide insights into postdischarge patients' experiences and preferences regarding surgical wound care education at discharge in the Netherlands.

Background: Patient involvement in wound care practices postdischarge is beneficial for the prevention of surgical site infections and has become an essential component in reducing the burden on healthcare systems. Surgical wound care discharge education is crucial to achieve this.

Long-Term Outcomes of Early Surgery vs Endoscopy First in Chronic Pancreatitis: Follow-Up Analysis of the ESCAPE Randomized Clinical Trial.

Importance: Patients with painful chronic pancreatitis and a dilated pancreatic duct can be treated by early surgery or an endoscopy-first approach.

Objective: To compare long-term clinical outcomes of early surgery vs an endoscopy-first approach using follow-up data from the ESCAPE randomized clinical trial.

Design, Setting, And Participants: Between April 2011 and September 2018, 88 patients with painful chronic pancreatitis were randomly assigned to early surgery or an endoscopy-first approach in 30 hospitals in the Netherlands collaborating in the Dutch Pancreatitis Study Group as part of the ESCAPE randomized clinical trial.

Intravenous Lidocaine for Refractory Pain in Patients With Pancreatic Ductal Adenocarcinoma and Chronic Pancreatitis: A Multicenter Prospective Nonrandomized Pilot Study.

Introduction: Refractory pain is a major clinical problem in patients with pancreatic ductal adenocarcinoma (PDAC) and chronic pancreatitis (CP). New, effective therapies to reduce pain are urgently needed. Intravenous lidocaine is used in clinical practice in patients with PDAC and CP, but its efficacy has not been studied prospectively.

Restrictive Strategy vs Usual Care for Cholecystectomy in Patients With Abdominal Pain and Gallstones: 5-Year Follow-Up of the SECURE Randomized Clinical Trial.

Importance: The 1-year results of the SECURE trial, a randomized trial comparing a restrictive strategy vs usual care for select patients with symptomatic cholelithiasis for cholecystectomy, resulted in a significantly lower operation rate after restrictive strategy. However, a restrictive strategy did not result in more pain-free patients at 1 year.

Objective: To gauge pain level and determine the proportion of pain-free patients, operation rate, and biliary and surgical complications at the 5-year follow-up.

Clinical trial: The effectiveness of long-acting somatostatin analogue for output reduction of high-output intestinal fistula or small bowel enterostomy. A randomised controlled trial.

Background: High-output intestinal fistulas and small bowel enterostomies are associated with morbidity and mortality. Current standard treatment for output reduction consists of fluid and dietary restrictions and medical therapy. There is conflicting evidence regarding the use of somatostatin analogues for output reduction.

Topical antimicrobial treatment of mesh for the reduction of surgical site infections after hernia repair: a systematic review and meta-analysis.

Purpose: Use of mesh is essential in hernia repair. A common complication after hernia repair is surgical site infection (SSI), which poses a risk in spreading to the mesh, possibly causing mesh infection. Topical antimicrobial pretreatment of mesh may potentially reduce SSI risk in hernia repair and has shown promising results in in vitro and in vivo studies.

Incisional Wound Irrigation for the Prevention of Surgical Site Infection: A Systematic Review and Network Meta-Analysis.

Importance: Surgical site infections (SSIs) are common postoperative complications and associated with significant morbidity, mortality, and costs. Prophylactic intraoperative incisional wound irrigation is used to reduce the risk of SSIs, and there is great variation in the type of irrigation solutions and their use.

Objective: To compare the outcomes of different types of incisional prophylactic intraoperative incisional wound irrigation for the prevention of SSIs in all types of surgery.

Development and Validation of the Scoring System of Appendicitis Severity 2.0.

Importance: When considering nonoperative treatment in a patient with acute appendicitis, it is crucial to accurately rule out complicated appendicitis. The Atema score, also referred to as the Scoring System of Appendicitis Severity (SAS), has been designed to differentiate between uncomplicated and complicated appendicitis but has not been prospectively externally validated.

Objective: To externally validate the SAS and, in case of failure, to develop an improved SAS (2.