High-level STING expression in tumour and inflammatory cells is linked to microsatellite instability and favourable tumour parameters in a cohort of over 1,900 colorectal cancer patients.

The stimulator of interferon genes (STING) is expressed on various cell types and tumour entities, where it might enhance antitumoural effects of the immune system and impact tumour angiogenesis. However, the clinical significance of STING expression in tumour cells as compared to tumour-associated inflammatory cells is not fully resolved. To evaluate the clinical significance of STING expression in different cell types of colorectal cancer (CRC), 1,905 patients were analysed by multiplex fluorescence immunohistochemistry in a tissue microarray format in combination with a deep learning algorithm for automated cell detection.

DiaBar: Predicting type 2 diabetes remission post-metabolic surgery utilizing mRNA expression profiles from subcutaneous adipose tissue.

Background: Subcutaneous adipose tissue (SAT) is a metabolic organ, which is involved in the pathogenesis of type 2 diabetes (T2D). Methods to predict diabetes remission after metabolic surgery exist, however their prediction accuracy still needs improvement. We hypothesized, that gene expression profiles in the SAT could predict diabetes remission after metabolic surgery more accurately than any current methods.

Treatment Pathways and Outcomes in Patients with BMI ≥ 50 kg/m: Conservative Treatment, Immediate Surgery or Stepwise Surgical Approach.

Background: Bariatric surgery is the most effective treatment for patients with BMI ≥ 50 kg/m, yet preoperative conservative therapy is often mandated. The benefit remains controversial. This study compared outcomes of conservative treatment, immediate surgery, and surgery after conservative therapy in patients with BMI ≥ 50 kg/m.

Emergent open distal pancreatosplenectomy-symptomatic giant splenic artery aneurysm: a case report.

Splenic-artery aneurysms (SAAs) are rare but potentially life-threatening vascular lesions with a high risk of rupture, especially when symptomatic or thrombosed. Timely diagnosis and appropriate intervention are essential to prevent fatal haemorrhagic events. This case report details the management of a 60-year-old male with a giant SSA, emphasizing the necessity of urgent surgical intervention and the advantages of an open approach for rapid vascular and haemorrhage control.

Conversion of Robotic Distal Pancreatectomy: Predictors and Outcomes in an International Multicenter Study.

Objective: The aim of this study was to identify risk factors for conversion and assess its consequences on clinical outcomes after robotic distal pancreatectomy (RPD).

Summary Of Background Data: RDP has gained popularity due to its lower conversion rate (3-8%) when compared to laparoscopic distal pancreatectomy (10-20%).

Methods: This retrospective multicenter study included RDPs performed at 16 international centers from May 2007 to March 2024.

Surgery of Early-Stage Pancreatic Cancer.

Background: Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal malignancies, with early detection and surgical resection being the only potentially curative treatment option. Despite advancements in diagnostics and surgical techniques, the prognosis of early-stage PDAC remains poor. Understanding the indications, approaches and perioperative management are crucial for improving patient survival.

International validation of the distal pancreatectomy fistula risk score: evaluation in minimally invasive and open surgery.

Background: Postoperative pancreatic fistula (POPF) remains the most severe complication following distal pancreatectomy (DP). The preoperative distal fistula risk score (D-FRS) was introduced to predict the POPF risk. The aim of this study was to externally validate the D-FRS in an international expert center cohort.

Pancreatic resection with perioperative drug repurposing of propranolol and etodolac - the phase II randomized controlled PROSPER trial.

Purpose: The perioperative period is characterized by psychological stress and inflammatory reactions that can contribute to disease recurrence or metastatic spread. These reactions are mediated particularly by catecholamines and prostaglandins. The PROSPER trial aimed to evaluate whether a perioperative drug repurposing with a non-selective betablocker (propranolol) and a COX-2 inhibitor (etodolac) is feasible and safe in the setting of pancreatic cancer surgery.

[Postoperative chyle leakage after abdominal surgery-Diagnostic and therapeutic strategies].

A postoperative chyle leakage (CL) is caused by intraoperative damage to the main lymphatic vessels or their tributaries. It is characterized by the secretion of a triglyceride-rich fluid, which classically has a characteristic milky appearance in a percutaneous drain. In visceral surgery CLs mostly occur after pancreatic and esophageal surgery but rarely occur after colorectal, liver or gastric surgery.

Predicting postoperative pancreatic fistula after robotic pancreatoduodenectomy using International Study Group on Pancreatic Surgery and fistula risk scores: European multicentre retrospective cohort study.

Background: Postoperative pancreatic fistula represents the leading cause of morbidity and mortality after robotic pancreatoduodenectomy. Various scores have been proposed to stratify patients based on their postoperative pancreatic fistula risk, including three fistula risk scores, and two International Study Group for Pancreatic Surgery scores. This study compares the performance of these scores in patients undergoing robotic pancreatoduodenectomy.

Development of a hypoxia-responsive macrophage prognostic model using single-cell and bulk RNA sequencing in pancreatic cancer.

Objective: Pancreatic ductal adenocarcinoma (PDAC) is characterized by a low survival rate and limited responsiveness to current therapies. The role of hypoxia in the tumor microenvironment is critical, influencing tumor progression and therapy resistance. The aim of this study was to implement the complex dynamics of the hypoxic tumor microenvironment in PDAC in a hypoxia-related prognosis model.

Patients' Expectations and Perspectives on Follow-up Care after Bariatric Surgery in Germany.

Background: Bariatric surgery is the most effective treatment for patients with obesity. After surgery, lifelong follow-up care is recommended to improve weight-loss outcomes. However, follow-up attendance is low, and the reasons have yet to be determined.

Patient-derived tumor organoids highlight the potential of precision medicine in managing pancreatic ductal adenocarcinoma.

Pancreatic ductal adenocarcinoma (PDAC) ranks among the most lethal cancers, with only 20% of patients qualifying for curative treatment at diagnosis. Three-dimensional tumor organoids capturing patient-specific features of PDAC serve as a valuable disease model. We employed this technology to assess drug sensitivities of patient-derived tumor organoids to clinically relevant drugs and combinations, evaluated culture success rates, and correlated in vitro data with clinicopathological and follow-up information.

Deficiency of MTAP Is Frequent and Mostly Homogeneous in Pancreatic Ductal Adenocarcinomas.

Background: The complete loss of S-methyl-5'-thioadenosine phosphorylase (MTAP) expression, often due to homozygous 9p21 deletion, creates a druggable vulnerability in cancer cells.

Methods: A total of 769 primary pancreatic ductal adenocarcinomas were analyzed on tissue microarrays with MTAP immunohistochemistry (IHC) and 9p21 fluorescence in situ hybridization (FISH). Intratumoral heterogeneity was assessed on a "heterogeneity" TMA containing up to nine samples from different areas of 236 primary tumor and nodal metastases, and whole sections of all tumor blocks from 19 cancers.

Effects of training in pairs versus training alone on reaching proficiency in minimally invasive Roux-en-Y-gastric bypass on a virtual reality trainer in medical students: a randomized-controlled trial.

Background: Minimally invasive surgery (MIS) is the standard approach in bariatric surgery. The most common bariatric procedures are sleeve gastrectomy and Roux-en-Y-Gastric Bypass (RYGB). Simulation training, including virtual reality (VR), is useful when learning MIS.

Global survey on surgeon preference and current practice for pancreatic neck and body cancer with portomesenteric venous involvement.

Background: Evidence regarding the optimal surgical approach for pancreatic neck/body cancer with portomesenteric vein (PV) involvement is scarce. We aimed to clarify the current practice using an international survey.

Methods: An online survey was distributed to members of nine international associations and study groups.

Intraoperative hemodynamic management during pancreatoduodenectomy - an analysis of 525 patients.

Importance: Optimization of perioperative hemodynamic management during major pancreatic surgery can reduce postoperative complications.

Objective: In this study, we aimed to investigate the effect of intraoperative hemodynamic management, in consideration of both anesthesiologic and surgery-related aspects on major short-term complications following partial pancreatoduodenectomy (PD).

Design, Setting And Participants: Data of 525 patients undergoing PD between January 2017 and December 2018 at the Heidelberg University Hospital were retrospectively analyzed.

Overexpression of Tn antigen induces chronic pancreatitis in mice.

Altered O-glycosylation is a key contributor to various pathophysiological processes. Notably, the expression of the Tn antigen is primarily attributed to dysfunction of the chaperone Cosmc, while the overexpression of polypeptide N-acetylgalactosaminyltransferases (GalNAc-Ts) has also been implicated in numerous diseases. We generated a transgenic mouse model with conditional Cosmc-knockout and simultaneous overexpression of polypeptide N-acetylgalactosaminyltransferase 2 (GalNT2) mediated by the pancreas-specific transcription factor 1a (Ptf1a)-Cre mouse strain to investigate the effect of Tn antigen overexpression on the pancreas in vivo.

Artificial intelligence for intraoperative video analysis in robotic-assisted esophagectomy.

Background: Robotic-assisted minimally invasive esophagectomy (RAMIE) is a complex surgical procedure for treating esophageal cancer. Artificial intelligence (AI) is an uprising technology with increasing applications in the surgical field. This scoping review aimed to assess the current AI applications in RAMIE, with a focus on intraoperative video analysis.

Cognitive learning versus practical "hands-on" training for acquisition of laparoscopic surgical skills: an optimal combination study.

Background: Most minimally invasive surgery (MIS) training curricula involve practical training (PT) and cognitive learning (CL) to different extents. It has been proven that acquiring and training specific skills through CL can improve MIS skills. This study aimed to discover the most efficient combination of these two approaches and examine their effects on acquiring MIS skills in novices.