Textbook Outcomes and Minimally Invasive Techniques in Resectable Gallbladder Cancer: A Global Cohort Study.

Introduction: Surgery for resectable gallbladder cancer (GbC) encompasses complex operative management, and evaluating surgical quality through textbook outcome (TO) is crucial. This study aimed to assess TO incidence and impact in a global cohort, identify independent predictors, and evaluate TO rates of minimally invasive (MI) techniques, including robotic (ROB) and laparoscopic (LPS).

Materials And Methods: This cohort study included patients undergoing curative-intent hepatectomy and lymphadenectomy for GbC (T1b-T3) from 2012 to 2023 in 41 hospitals.

The Role of Rapid and Advanced Microbiological Methods in Critical Care: 2025 EMANUELE RUSSO Delphi Consensus.

Scope: Interpretation of rapid and advanced microbiological test results remains nonstandardized, with no existing reference guidelines. This study aimed to analyze the existing evidence and provide expert guidance on the use of these techniques in critically ill patients.

Methods: A Delphi consensus process was conducted by a multidisciplinary panel of experts, including microbiologists, infectious disease specialists, intensivists, surgeons, and pulmonologists.

Education and training of surgical residents in upper gastrointestinal surgery: a European survey.

Educating and training young surgeons is a complex challenge that requires a structured pathway. Upper gastrointestinal (UGI) surgery is becoming a highly attractive subspecialty, yet it is not universally recognized. Currently, there are no standardized guidelines or curricula for UGI surgical training across Europe and a wide disparity among countries remains.

Minimally invasive approach for inguinoscrotal hernia repair. A systematic literature review.

Background: This systematic review reports the presently available evidence regarding the results of the minimally invasive surgery (MIS) approach for the treatment of inguinoscrotal hernias (ISHs).

Methods: After PROSPERO registration (CRD-42023493129), a search was performed in the MEDLINE, Embase, and Web of Science databases.

Results: One-thousand-fifty-two patients were included (78.

The Italian national consensus conference on the diagnosis and treatment of Rectus Abdominis diastasis in Post-gravidic Women.

Purpose: Rectus Abdominis diastasis (RAD) is a prevalent condition, particularly in post-gravidic women, with functional and esthetic impact. This Delphi consensus, led by general surgeons, aimed to establish evidence-based recommendations for the diagnosis and management of RAD in post-gravidic women.

Methods: A Delphi process was conducted under the auspices of the Italian Society of Hernia and Abdominal Wall Surgery (ISHAWS), the national chapter of the European Hernia Society (EHS).

The role of emergency resuscitative thoracotomy in blunt trauma: a systematic review.

Introduction: Emergency resuscitative thoracotomy (ERT) is a potentially life-saving procedure for selected trauma patients presenting in extremis with pending or already witnessed cardiopulmonary collapse. Outcome mostly in blunt trauma is believed to be poor. Our aim was to identify all studies reported over the past fourteen years and compare reported outcomes for blunt trauma.

The ACTIVE study: surgical outcomes for minimally invasive and open approach to incisional ventral hernias in a non-elective setting.

Background: Surgical repair of incisional ventral hernias (VH) is a standard procedure globally, with an increasing role in minimally invasive techniques. This study aims to evaluate postoperative outcomes in emergency repairs for VH, comparing surgical features of open and laparoscopic approaches.

Methods: A retrospective multicentric study (ACTIVE study) was created to evaluate the surgical outcome of VH repair in emergency settings.

A systematic review of the predictive factors for the recurrence of acute pancreatitis.

Purpose: Acute Pancreatitis (AP) is a prevalent clinical pancreatic disorder characterized by acute inflammation of the pancreas, frequently associated with biliary or alcoholic events. If not treated with cholecystectomy after the first episode, patients may experience a recurrence of AP, with consequent need for emergency surgery and increased risk of death. Analyzing the risk factors that may contribute to the recurrence of Biliary and Alcoholic Pancreatitis (BAP and AAP), future research can be driven toward new solutions for preventing and treating this pancreatic disease.

Minimally invasive approach in emergency for the treatment of acute incarcerated/strangulated ventral hernias. A systematic review and meta-analysis.

Background: This study aims to report the currently available evidence on minimally invasive surgery (MIS) in emergency settings for treating acute incarcerated/strangulated ventral, primary, or incisional hernias and compare it with the open approach.

Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement.

Results: Six articles were included.

Systematic review on the use of artificial intelligence to identify anatomical structures during laparoscopic cholecystectomy: a tool towards the future.

Purpose: Bile duct injury (BDI) during laparoscopic cholecystectomy (LC) is a dreaded complication. Artificial intelligence (AI) has recently been introduced in surgery. This systematic review aims to investigate whether AI can guide surgeons in identifying anatomical structures to facilitate safer dissection during LC.

Diagnosis and management of caustic ingestion: an interdisciplinary nationwide cross-sectional survey from the Italian society of endoscopic surgery and new technologies (SICE), the Italian society of digestive endoscopy (SIED), the world society of emergency surgery-Italy chapter (WSESit), and the Italian society of surgical endoscopy and digestive diseases (ISSE).

Caustic ingestion (CI) in adults represents a potentially life-threatening condition. Diagnosis and management of CI in real life remain challenging. The aim of the survey is to evaluate on a national scale the multidisciplinary management of these patients.

Machine learning for the rElapse risk eValuation in acute biliary pancreatitis: The deep learning MINERVA study protocol.

Background: Mild acute biliary pancreatitis (MABP) presents significant clinical and economic challenges due to its potential for relapse. Current guidelines advocate for early cholecystectomy (EC) during the same hospital admission to prevent recurrent acute pancreatitis (RAP). Despite these recommendations, implementation in clinical practice varies, highlighting the need for reliable and accessible predictive tools.

COVID-19 infection is a significant risk factor for death in patients presenting with acute cholecystitis: a secondary analysis of the ChoCO-W cohort study.

Background: During the coronavirus disease (COVID-19) pandemic, there has been a surge in cases of acute cholecystitis. The ChoCO-W global prospective study reported a higher incidence of gangrenous cholecystitis and adverse outcomes in COVID-19 patients. Through this secondary analysis of the ChoCO-W study data, we aim to identify significant risk factors for mortality in patients with acute cholecystitis during the COVID-19 pandemic, emphasizing the role of COVID-19 infection in patient outcomes and treatment efficacy.

Minimally invasive approach to peritonitis from left colonic perforation: a retrospective multicenter observational study.

Background: Laparoscopic procedures have nowadays become the gold standard in multiple abdominal diseases, but in the emergency setting, especially in major surgery, laparoscopy still represents an obstacle for most surgeons. This multicentric study aims to define the surgical approach for emergency resective surgery in left colonic perforation peritonitis, determine the factors influencing the choice between MIS and open surgery, and identify factors associated with laparotomic conversion.

Methods: Retrospective data from 516 patients treated for left colonic perforation between January 2019 and December 2023 across six Italian centers was collected.

Indocyanine green fluorescence-guided surgery in the emergency setting: the WSES international consensus position paper.

Background: Decision-making in emergency settings is inherently complex, requiring surgeons to rapidly evaluate various clinical, diagnostic, and environmental factors. The primary objective is to assess a patient's risk for adverse outcomes while balancing diagnoses, management strategies, and available resources. Recently, indocyanine green (ICG) fluorescence imaging has emerged as a valuable tool to enhance surgical vision, demonstrating proven benefits in elective surgeries.

Acute appendicitis and its treatment: a historical overview.

Purpose: Acute appendicitis (AA) is the leading cause of acute abdomen worldwide, with an incidence of 90-100 cases per 100,000 individuals annually and a lifetime risk of 7-12%. Despite its prevalence, historical accounts of AA are limited, particularly when compared to conditions like haemorrhoids, likely due to the appendix's internal location. This article traces the historical evolution of AA treatment from ancient times to the present, highlighting key contributions.

Cost-effectiveness of robotic compared with laparoscopic rectal resection. Results from the Spanish prospective national trial ROBOCOSTES.

Objective: The costs related to robotic surgery are known to be greater than those associated with laparoscopy. However, the potential for better outcomes of the former could lead to a cost-effectiveness advantage. The aim of this study is therefore to highlight the difference in cost-effectiveness between robotic and laparoscopic rectal resection.

Validity and Reliability of Patient Activation Measure (PAM13-I) Italian Version Among Patient Undergoing Elective Surgery.

The patient activation measure (PAM), a recognized measure of how active patients are in their care, is one of the most extensively used, widely translated, and tested instruments worldwide in measuring patient activation. This study aimed to assess the psychometric properties and construct validity of the Italian version of the 13-item Patient Activation Measure (PAM13-I) among patients undergoing elective laparoscopic cholecystectomy. A multicenter study was conducted across 111 surgical units in Italy.

Implementation of intraoperative procedures to prevent anastomotic leak in low anterior rectal resections: a pilot study for a novel technique to evaluate anastomotic vascularization.

Introduction: Altered vascular microcirculation is recognized as a risk factor for anastomotic leakage (AL) in colorectal surgery. However, few studies evaluated its impact on AL using different devices, with heterogeneous results. The present study reported the initial experience measuring gut microcirculatory density and flow with the aid of incidence dark-field (IDF) videomicroscopy (Cytocam, Braedius, Amsterdam, The Netherlands) comparing its operative outcome using a propensity score matching (PSM) model based on age, gender, and Charlson Comorbidity Index (CCI).

Mild acute biliary pancreatitis: still a surgical disease. A post-hoc analysis of the MANCTRA-1 international study.

Background: The current standard of care for mild acute biliary pancreatitis (MABP) involves early laparoscopic cholecystectomy (ELC) to reduce the risk of recurrence. The MANCTRA-1 project revealed a knowledge-to-action gap and higher recurrence rates in patients admitted to medical wards, attributable to fewer ELCs being performed. The project estimated a 35% to 70% probability of narrowing this gap by 2025.

Clinical update on acute cholecystitis and biliary pancreatitis: between certainties and grey areas.

Acute calculous cholecystitis (ACC) and acute biliary pancreatitis (ABP) are significant complications of gallstone disease. This review aims to provide a comprehensive analysis of current management practices for ACC and ABP. The Tokyo Guidelines (TG) and World Society of Emergency Surgery (WSES) guidelines recommend early laparoscopic cholecystectomy (ELC) as the treatment of choice for ACC.