The final cut: a multi-centre cohort study evaluating outcomes of robotic completion cholecystectomy.

Background: Subtotal and abandoned cholecystectomies are on the rise due to the increase of laparoscopic cholecystectomies performed in the emergency setting. Persistent biliary symptoms postoperatively may necessitate a completion cholecystectomy (CC) which is a technically challenging procedure. The literature describing outcomes of minimally invasive CC is scarce and consisting of small studies only.

Propionate Induces Energy Expenditure via Browning in Mesenteric Adipose Tissue.

Background: Short-chain fatty acids, such as propionate, are produced from the fermentation of dietary fibre by gut microbiota and modulate adipose tissue metabolism to influence whole-body metabolic processes. Abdominal adipose tissue, critical in glucose and lipid homeostasis, is categorised into mesenteric, omental, and subcutaneous types based on its location. Adipose tissues display different metabolic phenotypes due to their distinct adipocyte lineages-white, brown, and beige.

Implications of the microbiome after pancreatic cancer resection with regard to morbidity and mortality.

Pancreatic ductal adenocarcinoma (PDAC) is an aggressive disease with an extremely poor prognosis. The most common complications after a pancreaticoduodenectomy (PD) include surgical site infection (SSI), postoperative pancreatic fistula (POPF), and delayed gastric emptying (DGE). The potential role and mechanisms of microbial colonization of key surgical sites resulting in perioperative complications after PD remain to be fully elucidated.

MicroRNAs as Bile-based biomarkers in pancreaticobiliary cancers (MIRABILE): a cohort study.

Background: Biliary obstruction can be due to both malignant and benign pancreaticobiliary disease. Currently, there are no biomarkers that can accurately help make this distinction. MicroRNAs (miRNAs) are stable molecules in tissue and biofluids that are commonly deregulated in cancer.

Gastrointestinal Permeability After Bariatric Surgery: A Systematic Review.

Gastrointestinal permeability refers to the movement of substances across the gut wall. This is mediated by endotoxemia (bacterial products entering the systemic circulation), and is associated with metabolic disease. The effect of bariatric surgery on permeability remains uncertain; the associated dietary, metabolic and weight changes are suggested to influence, or trigger, altered permeability.

The microbial composition of pancreatic ductal adenocarcinoma: a systematic review of 16S rRNA gene sequencing.

Background: Pancreatic cancer, specifically pancreatic ductal adenocarcinoma (PDAC), continues to pose a significant clinical and scientific challenge. The most significant finding of recent years is that PDAC tumours harbour their specific microbiome, which differs amongst tumour entities and is distinct from healthy tissue. This review aims to evaluate and summarise all PDAC studies that have used the next-generation technique, 16S rRNA gene amplicon sequencing within each bodily compartment.

Impact of tertiary lymphoid structures on prognosis and therapeutic response in pancreatic ductal adenocarcinoma.

Background: Pancreatic ductal adenocarcinoma (PDAC) is known to have a heterogeneous desmoplastic tumour microenvironment (TME) with a large number of immunosuppressive cells. Recently, high B-cell infiltration in PDAC has received growing interest as a potential therapeutic target.

Methods: Our literature review summarises the characteristics of tumour-associated tertiary lymphoid structures (TLSs) and highlight the key studies exploring the clinical outcomes of TLSs in PDAC patients and the direct effect on the TME.

The Roles and Interactions of and in Oral and Gastrointestinal Carcinogenesis: A Narrative Review.

Epidemiological studies have spotlighted the intricate relationship between individual oral bacteria and tumor occurrence. and , which are known periodontal pathogens, have emerged as extensively studied participants with potential pathogenic abilities in carcinogenesis. However, the complex dynamics arising from interactions between these two pathogens were less addressed.

Bile Microbiome Signatures Associated with Pancreatic Ductal Adenocarcinoma Compared to Benign Disease: A UK Pilot Study.

Pancreatic ductal adenocarcinoma (PDAC) has a very poor survival. The intra-tumoural microbiome can influence pancreatic tumourigenesis and chemoresistance and, therefore, patient survival. The role played by bile microbiota in PDAC is unknown.

Pancreatic Exocrine Insufficiency and the Gut Microbiome in Pancreatic Cancer: A Target for Future Diagnostic Tests and Therapies?

Pancreatic exocrine insufficiency (PEI) is common amongst pancreatic cancer patients and is associated with poorer treatment outcomes. Pancreatic enzyme replacement therapy (PERT) is known to improve outcomes in pancreatic cancer, but the mechanisms are not fully understood. The aim of this narrative literature review is to summarise the current evidence linking PEI with microbiome dysbiosis, assess how microbiome composition may be impacted by PERT treatment, and look towards possible future diagnostic and therapeutic targets in this area.

The Role of the Multiparametric MRI LiverMultiScan in the Quantitative Assessment of the Liver and Its Predicted Clinical Applications in Patients Undergoing Major Hepatic Resection for Colorectal Liver Metastasis.

Liver biopsy remains the gold standard for the histological assessment of the liver. With clear disadvantages and the rise in the incidences of liver disease, the role of neoadjuvant chemotherapy in colorectal liver metastasis (CRLM) and an explosion of surgical management options available, non-invasive serological and imaging markers of liver histopathology have never been more pertinent in order to assess liver health and stratify patients considered for surgical intervention. Liver MRI is a leading modality in the assessment of hepatic malignancy.

Advances in Immunotherapeutics in Pancreatic Ductal Adenocarcinoma.

Pancreatic ductal adenocarcinoma (PDAC) accounts for up to 95% of all pancreatic cancer cases and is the seventh-leading cause of cancer death. Poor prognosis is a result of late presentation, a lack of screening tests and the fact some patients develop resistance to chemotherapy and radiotherapy. Novel therapies like immunotherapeutics have been of recent interest in pancreatic cancer.

Graphene Sensor Arrays for Rapid and Accurate Detection of Pancreatic Cancer Exosomes in Patients' Blood Plasma Samples.

Biosensors based on graphene field effect transistors (GFETs) have the potential to enable the development of point-of-care diagnostic tools for early stage disease detection. However, issues with reproducibility and manufacturing yields of graphene sensors, but also with Debye screening and unwanted detection of nonspecific species, have prevented the wider clinical use of graphene technology. Here, we demonstrate that our wafer-scalable GFETs array platform enables meaningful clinical results.

A Comprehensive Review of the Current and Future Role of the Microbiome in Pancreatic Ductal Adenocarcinoma.

Pancreatic ductal adenocarcinoma (PDAC) is expected to become the second most common cause of cancer death in the USA by 2030, yet progress continues to lag behind that of other cancers, with only 9% of patients surviving beyond 5 years. Long-term survivorship of PDAC and improving survival has, until recently, escaped our understanding. One recent frontier in the cancer field is the microbiome.

Design of a Proficiency-Based Skills Training Curriculum for Our Newly Validated 3-Dimensional (3D) Laparoscopic Models, Using MISTELS.

: There are presently no courses or training curricula for surgical simulation that include training with 3-Dimensional (3D) laparoscopic platforms. Our aim is to create an expert led design of a proficiency-based skills training curriculum for our newly validated 3D laparoscopic models, using MISTELS compensating speed for precision and accuracy. : In this study, 5 tasks were performed by 12 expert surgeons of different specializations on low-cost, portable models designed for 3D display.

Eye-Tracking Technology in Surgical Training.

The aim of this review was to amalgamate literature on the use of eye tracking methodology as an adjunct to surgical training. The PRISMA Guidelines were used to undertake this systematic review. Our review studies has shown that recording a surgeon's eye movements; time to first fixation and gaze pattern through the use of eye tracking technology would be beneficial for surgical training.

Financial Burden Secondary to Delay in Cholecystectomy Following Mild Biliary Pancreatitis.

Aim Of The Study: The guidelines recommend that patients with mild gallstones pancreatitis should undergo a definitive management for gallstones during the same admission or within the next two weeks. The aim of this study was to estimate the financial cost resulting from a delay in surgical management following mild gallstones pancreatitis. This includes the costs of readmissions with biliary events and the subsequent investigations required during these admissions.

Non-healing gastro-duodenal ulcer: A rare presentation of primary abdominal tuberculosis.

Introduction: We present a case of primary gastrointestinal tuberculosis that has culminated in ulcer formation, in the absence of pulmonary involvement in an immunocompetent patient.

Presentation Of Case: A 28-year-old Asian male presented to casualty with a 1-week history of epigastric cramping abdominal pain and several episodes of non-bilious vomiting. The patient deteriorated clinically, becoming more cachectic and given his unexplained weight loss, an oesophageal-gastro-duodenal endoscopic imaging confirmed a duodenal ulcer.