Articles

2019 WSES guidelines for the management of severe acute pancreatitis

Although most patients with acute pancreatitis have the mild form of the disease, about 20–30% develops a severe form, often associated with single or multiple organ dysfunction requiring intensive care. Ident...

Authors: Ari Leppäniemi, Matti Tolonen, Antonio Tarasconi, Helmut Segovia-Lohse, Emiliano Gamberini, Andrew W. Kirkpatrick, Chad G. Ball, Neil Parry, Massimo Sartelli, Daan Wolbrink, Harry van Goor, Gianluca Baiocchi, Luca Ansaloni, Walter Biffl, Federico Coccolini, Salomone Di Saverio…

Esophageal emergencies: WSES guidelines

The esophagus traverses three body compartments (neck, thorax, and abdomen) and is surrounded at each level by vital organs. Injuries to the esophagus may be classified as foreign body ingestion, caustic inges...

Authors: Mircea Chirica, Michael D. Kelly, Stefano Siboni, Alberto Aiolfi, Carlo Galdino Riva, Emanuele Asti, Davide Ferrari, Ari Leppäniemi, Richard P. G. ten Broek, Pierre Yves Brichon, Yoram Kluger, Gustavo Pereira Fraga, Gil Frey, Nelson Adami Andreollo, Federico Coccolini, Cristina Frattini…

REsiDENT 1 (Re-assessment of Appendicitis Evaluation during laparoscopic appendectomy: Do we End a Non-standardized Treatment approach and habit?): peritoneal irrigation during laparoscopic appendectomy—does the grade of contamination matter? A prospective multicenter resident-based evaluation of a new classification system

Laparoscopic appendectomy has progressively gained acceptance as the standard of care for acute appendicitis. Focusing on the incidence of postoperative intra-abdominal abscess after a laparoscopic appendectom...

Authors: Stefano Piero Bernardo Cioffi, Michele Altomare, Andrea Spota, Stefano Granieri, Stefania Cimbanassi and Osvaldo Chiara

Neutrophil heterogeneity and its role in infectious complications after severe trauma

Trauma leads to a complex inflammatory cascade that induces both immune activation and a refractory immune state in parallel. Although both components are deemed necessary for recovery, the balance is tight an...

Authors: Lillian Hesselink, Roy Spijkerman, Karlijn J. P. van Wessem, Leo Koenderman, Luke P. H. Leenen, Markus Huber-Lang and Falco Hietbrink

Optimal management of malignant left-sided large bowel obstruction: do international guidelines agree?

Approximately 20% of patients diagnosed with colorectal cancer will present with left-sided large bowel obstruction. The optimal management of this cohort of patients remains unclear. We aimed to review intern...

Authors: Peter John Webster, Joanna Aldoori and Dermot Anthony Burke

Educational value of surgical videos on YouTube: quality assessment of laparoscopic appendectomy videos by senior surgeons vs. novice trainees

To prepare for surgery, surgeons often recur to surgical videos, with YouTube being reported as the preferred source. This study aimed to compare the evaluation of three surgical trainees and three senior surg...

Authors: Nicola de’Angelis, Paschalis Gavriilidis, Aleix Martínez-Pérez, Pietro Genova, Margherita Notarnicola, Elisa Reitano, Niccolò Petrucciani, Solafah Abdalla, Riccardo Memeo, Francesco Brunetti, Maria Clotilde Carra, Salomone Di Saverio and Valerio Celentano

The intra-neuroendoscopic technique (INET): a modified minimally invasive technique for evacuation of brain parenchyma hematomas

Minimally invasive endoscopic hematoma evacuation is widely used in the treatment of intracerebral hemorrhage. However, this technique still has room for improvement. The intra-neuroendoscopic technique (INET)...

Authors: Yujuan Zhang, Ai-Jun Shan, Yu-Ping Peng, Pengfei Lei, Jianzhong Xu, Xianliang Zhong and Bo Du

Bowel obstruction: a narrative review for all physicians

Small and large bowel obstructions are responsible for approximately 15% of hospital admissions for acute abdominal pain in the USA and ~ 20% of cases needing acute surgical care. Starting from the analysis of...

Authors: Fausto Catena, Belinda De Simone, Federico Coccolini, Salomone Di Saverio, Massimo Sartelli and Luca Ansaloni

Damage control surgery for perforated diverticulitis with diffuse peritonitis: saves lives and reduces ostomy

Over the last decade, damage control surgery (DCS) has been emerging as a feasible alternative for the management of patients with abdominal infection and sepsis. So far, there is no consensus about the role o...

Authors: Dario Tartaglia, Gianluca Costa, Antonio Camillò, Maurizio Castriconi, Mauro Andreano, Michele Lanza, Pietro Fransvea, Paolo Ruscelli, Massimiliano Rimini, Christian Galatioto and Massimo Chiarugi

Melatonin treatment of pigs with acute pancreatitis reduces inflammatory reaction of pancreatic tissue and enhances fitness score of pigs: experimental research

Severe acute pancreatitis is associated with high morbidity and mortality. Melatonin is known as the activator of antioxidant enzymes. The main purpose of this study was to evaluate the clinical effect of mela...

Authors: Katharina Grupp, Johannes Erbes, Annika Poppe, Karin Wodack, Andreas Gocht, Constantin Trepte, Jan Havel, Oliver Mann, Jakob R. Izbicki and Kai Bachmann

Management of intrathoracic and cervical anastomotic leakage after esophagectomy for esophageal cancer: a systematic review

Anastomotic leakage (0–30%) after esophagectomy is a severe complication and is associated with considerable morbidity and mortality. The aim of this study was to determine which treatment for anastomotic leak...

Authors: Moniek H. P. Verstegen, Stefan A. W. Bouwense, Frans van Workum, Richard ten Broek, Peter D. Siersema, Maroeska Rovers and Camiel Rosman

Challenges faced by acute care surgeons in China

The aim of this article is to describe briefly about Chinese ACS surgeons’ work status. It is an undeniable fact that the analysis of ED and ACS resources shows negative tendencies and high work overload, resu...

Authors: Dequan Xu, Limin Hou and Haoxin Zhou

The role of the intra-abdominal view in complicated intra-abdominal infections

The prognostic role of what a surgeon observes in the abdomen of patients with complicated intra-abdominal infection (cIAI) is largely unknown. The aim of this prospective study was to systemically analyze com...

Authors: Matti Tolonen, Ville Sallinen, Ari Leppäniemi, Minna Bäcklund and Panu Mentula

Prediction of arterial extravasation in pelvic fracture patients with stable hemodynamics using coagulation biomarkers

Determining the presence of an active arterial hemorrhage in the acute phase is important as a treatment strategy in patients with pelvic fracture. The purpose of this study was to evaluate whether coagulation...

Authors: Makoto Aoki, Takayuki Ogura, Shuichi Hagiwara, Mitsunobu Nakamura and Kiyohiro Oshima

The impact of polytrauma on sRAGE levels: evidence and statistical analysis of temporal variations

According to recently published findings, levels of the soluble receptor of advanced glycation end products (sRAGE) and its clearance from the blood may reflect the evolution of lung damage during hospitalizat...

Authors: Lukas L. Negrin, Robin Ristl, Gabriel Halat, Thomas Heinz and Stefan Hajdu

Intra-operative gallbladder scoring predicts conversion of laparoscopic to open cholecystectomy: a WSES prospective collaborative study

Laparoscopic cholecystectomy, the gold-standard approach for cholecystectomy, has surprisingly variable outcomes and conversion rates. Only recently has operative grading been reported to define disease severi...

Authors: Michael Sugrue, Federico Coccolini, Magda Bucholc and Alison Johnston

Development and validation of a novel predictive score for sepsis risk among trauma patients

Patients suffering from major trauma often experience complications such as sepsis. The early recognition of patients at high risk of sepsis after trauma is critical for precision therapy. We aimed to derive a...

Authors: Hong-xiang Lu, Juan Du, Da-lin Wen, Jian-hui Sun, Min-jia Chen, An-qiang Zhang and Jian-xin Jiang

2017 WSES and SICG guidelines on acute calcolous cholecystitis in elderly population

Gallstone disease is very common afflicting 20 million people in the USA. In Europe, the overall incidence of gallstone disease is 18.8% in women and 9.5% in men. The frequency of gallstones related disease in...

Authors: Michele Pisano, Marco Ceresoli, Stefania Cimbanassi, Kurinchi Gurusamy, Federico Coccolini, Giuseppe Borzellino, Gianluca Costa, Niccolò Allievi, Bruno Amato, Djamila Boerma, Pietro Calcagno, Luca Campanati, Fabio Cesare Campanile, Alberto Casati, Osvaldo Chiara, Antonio Crucitti…

Preserve encephalus in surgery of trauma: online survey. (P.E.S.T.O)

Traumatic brain injury (TBI) is a global health problem. Extracranial hemorrhagic lesions needing emergency surgery adversely affect the outcome of TBI. We conducted an international survey regarding the acute...

Authors: Edoardo Picetti, Ronald V. Maier, Sandra Rossi, Andrew W. Kirkpatrick, Walter L. Biffl, Philip F. Stahel, Ernest E. Moore, Yoram Kluger, Gian Luca Baiocchi, Luca Ansaloni, Vanni Agnoletti and Fausto Catena

2019 update of the WSES guidelines for management of Clostridioides (Clostridium) difficile infection in surgical patients

In the last three decades, Clostridium difficile infection (CDI) has increased in incidence and severity in many countries worldwide. The increase in CDI incidence has been particularly apparent among surgical pa...

Authors: Massimo Sartelli, Stefano Di Bella, Lynne V. McFarland, Sahil Khanna, Luis Furuya-Kanamori, Nadir Abuzeid, Fikri M. Abu-Zidan, Luca Ansaloni, Goran Augustin, Miklosh Bala, Offir Ben-Ishay, Walter L. Biffl, Stephen M. Brecher, Adrián Camacho-Ortiz, Miguel A. Caínzos, Shirley Chan…

Open conversion for laparoscopically difficult cholecystectomy is still a valid solution with unsolved aspects

The difficult laparoscopic cholecystectomy remains a surgical challenge for surgeons who must decide between laparoscopic continuation and open conversion. The balance between the lack of open surgery training...

Authors: M. Mannino, A. Toro, M. Teodoro, F. Coccolini, M. Sartelli, L. Ansaloni, F. Catena and I. Di Carlo

Pre-hospital plasma in haemorrhagic shock management: current opinion and meta-analysis of randomized trials

Trauma-induced coagulopathy is one of the most difficult issues to manage in severely injured patients. The plasma efficacy in treating haemorrhagic-shocked patients is well known. The debated issue is the tim...

Authors: Federico Coccolini, Giacinto Pizzilli, Davide Corbella, Massimo Sartelli, Vanni Agnoletti, Vanessa Agostini, Gian Luca Baiocchi, Luca Ansaloni and Fausto Catena

Medications and patient safety in the trauma setting: a systematic review

Medication errors account for the most common adverse events and a significant cause of mortality in the USA. The Joint Commission has required medication reconciliation since 2006. We aimed to survey the lite...

Authors: Jonathan H. DeAntonio, Tammy Nguyen, Gregory Chenault, Michel B. Aboutanos, Rahul J. Anand, Paula Ferrada, Stephanie Goldberg, Stefan W. Leichtle, Levi D. Procter, Edgar B. Rodas, Alan P. Rossi, James F. Whelan, V. Ramana Feeser, Michael J. Vitto, Beth Broering, Sarah Hobgood…

Feasibility of ultrasound measurement in a human model of acute compartment syndrome

Early diagnosis of acute compartment syndrome (ACS) of the leg is essential to improve the outcome. Direct invasive measurement is currently recommended to measure intracompartmental pressure. A non-invasive a...

Authors: Jakob Mühlbacher, Reinhard Pauzenberger, Ulrika Asenbaum, Tobias Gauster, Stephan Kapral, Harald Herkner and Andreas Duma

Transcatheter arterial embolization versus surgery for refractory non-variceal upper gastrointestinal bleeding: a meta-analysis

Nowadays, very few patients with non-variceal upper gastrointestinal bleeding fail endoscopic hemostasis (refractory NVUGIB). This subset of patients poses a clinical dilemma: should they be operated on or ref...

Authors: Antonio Tarasconi, Gian Luca Baiocchi, Vittoria Pattonieri, Gennaro Perrone, Hariscine Keng Abongwa, Sarah Molfino, Nazario Portolani, Massimo Sartelli, Salomone Di Saverio, Arianna Heyer, Luca Ansaloni, Federico Coccolini and Fausto Catena

Is early appendectomy in adults diagnosed with acute appendicitis mandatory? A prospective study

Prompt appendectomy has long been the standard of care for acute appendicitis in order to prevent complications such as perforation, abscess formation, and diffuse purulent or fecal peritonitis, all resulting ...

Authors: Salma Abu Foul, Ella Egozi, Ahmad Assalia, Yoram Kluger and Ahmad Mahajna

Kunafa knife and play dough is an efficient and cheap simulator to teach diagnostic Point-of-Care Ultrasound (POCUS)

Point-of-Care Ultrasound (POCUS) is a useful diagnostic tool. Nevertheless, it needs proper training to reach its required level of competency. Educators who work in low-income countries find it difficult to p...

Authors: Fikri M. Abu-Zidan and Arif Alper Cevik

2018 WSES/SIS-E consensus conference: recommendations for the management of skin and soft-tissue infections

Skin and soft-tissue infections (SSTIs) encompass a variety of pathological conditions that involve the skin and underlying subcutaneous tissue, fascia, or muscle, ranging from simple superficial infections to...

Authors: Massimo Sartelli, Xavier Guirao, Timothy C. Hardcastle, Yoram Kluger, Marja. A. Boermeester, Kemal Raşa, Luca Ansaloni, Federico Coccolini, Philippe Montravers, Fikri M. Abu-Zidan, Michele Bartoletti, Matteo Bassetti, Offir Ben-Ishay, Walter L. Biffl, Osvaldo Chiara, Massimo Chiarugi…

Predictors of Change in Functional Outcome at six months and twelve months after Severe Injury: A Retrospective Cohort Study

There is increasing focus on long-term survival, function and quality-of-life for trauma patients. There are few studies tracking longitudinal changes in functional outcome over time. The goal of our study was...

Authors: Aidan Lyanzhiang Tan, Yi Chiong, Nivedita Nadkarni, Jolene Yu Xuan Cheng, Ming Terk Chiu and Ting Hway Wong

First clinical experiences of concurrent bleeding control and intracranial pressure monitoring using a hybrid emergency room system in patients with multiple injuries

The outcomes of multiple injury patients with concomitant torso hemorrhage and traumatic brain injury (TBI) are very poor. The hybrid emergency room system (HERS) is a trauma management system designed to comp...

Authors: Takahiro Kinoshita, Kazuma Yamakawa, Jumpei Yoshimura, Atsushi Watanabe, Yosuke Matsumura, Kaori Ito, Hiroyuki Ohbe, Kei Hayashida, Shigeki Kushimoto, Junichi Matsumoto and Satoshi Fujimi

Outcomes of selective nonoperative management of civilian abdominal gunshot wounds: a systematic review and meta-analysis

Although mandatory laparotomy has been standard of care for patients with abdominal gunshot wounds (GSWs) for decades, this approach is associated with non-therapeutic operations, morbidity, and long hospital ...

Authors: Aziza N. Al Rawahi, Fatma A. Al Hinai, Jamie M. Boyd, Christopher J. Doig, Chad G. Ball, George C. Velmahos, Andrew W. Kirkpatrick, Pradeep H. Navsaria and Derek J. Roberts

Three cases of resuscitative endovascular balloon occlusion of the aorta (REBOA) in austere pre-hospital environment—technical and methodological aspects

The present paper describes three cases where ER-REBOA® was used with partial aorta occlusion (AO), by performing a partial resuscitative endovascular balloon occlusion of the aorta or pREBOA, in an austere pr...

Authors: J. C. de Schoutheete, I. Fourneau, F. Waroquier, L. De Cupere, M. O’Connor, K. Van Cleynenbreugel, J. C. Ceccaldi and S. Nijs

Vacuum-assisted closure (VAC®) systems and microbiological isolation of infected wounds

Negative pressure wound therapy is now largely used to treat infected wounds. The prevention and reduction of healthcare-associated infections is a high priority for any Department of Health and great efforts ...

Authors: Valerio Cozza, Gilda Pepe, Marco Cintoni, Flavio De Maio, Giuseppe Tropeano, Sabina Magalini, Gabriele Sganga, Giovanni Delogu and Daniele Gui

LBP rs2232618 polymorphism contributes to risk of sepsis after trauma

Previous study revealed that rs2232618 polymorphism (Phe436Leu) within LBP gene is a functional variant and associated with susceptibility of sepsis in traumatic patients. Our aim was to confirm the reported a...

Authors: Hong-xiang Lu, Jian-hui Sun, Da-lin Wen, Juan Du, Ling Zeng, An-qiang Zhang and Jian-xin Jiang

Multi-organ protection of ulinastatin in traumatic cardiac arrest model

Post-cardiac arrest syndrome, which has no specific curative treatment, contributes to the high mortality rate of victims who suffer traumatic cardiac arrest (TCA) and initially can be resuscitated. In the pre...

Authors: Shaoyun Liu, Jiefeng Xu, Yuzhi Gao, Peng Shen, Senlin Xia, Zilong Li and Mao Zhang

Abdominopelvic trauma: from anatomical to anatomo-physiological classification

Abdominopelvic trauma has been for decades classified with the AAST-OIS (American Association for the Surgery of Trauma—Organ Injury Scale) classification. It has represented a milestone. At present, the medic...

Authors: Federico Coccolini, Fausto Catena, Yoram Kluger, Massimo Sartelli, Gianluca Baiocchi, Luca Ansaloni and Ernest Eugene Moore

Effect of resuscitative endovascular balloon occlusion of the aorta in hemodynamically unstable patients with multiple severe torso trauma: a retrospective study

Although resuscitative endovascular balloon occlusion of the aorta (REBOA) may be effective in trauma management, its effect in patients with severe multiple torso trauma remains unclear.

Authors: Hiroyuki Otsuka, Toshiki Sato, Keiji Sakurai, Hiromichi Aoki, Takeshi Yamagiwa, Shinichi Iizuka and Sadaki Inokuchi

Small bowel obstruction in the elderly: a plea for comprehensive acute geriatric care

Small bowel obstruction is one of the most frequent emergencies in general surgery, commonly affecting elderly patients. Morbidity and mortality from small bowel obstruction in elderly is high. Significant pro...

Authors: Ekin Ozturk, Marianne van Iersel, Martijn MWJ Stommel, Yvonne Schoon, Richard RPG ten Broek and Harry van Goor

Diagnostic point-of-care ultrasound (POCUS) for gastrointestinal pathology: state of the art from basics to advanced

The use of point-of-care ultrasound (POCUS) by non-radiologists has dramatically increased. POCUS is completely different from the routine radiological studies. POCUS is a Physiological, On spot, extension of ...

Authors: Fikri M Abu-Zidan and Arif Alper Cevik

A tribute to Ernest E. “Gene” Moore

Authors: Jeffry Kashuk, Walter Biffl, Yoram Kluger, Luca Ansaloni and Fausto Catena

Risk factors for mortality in the late amputation of necrotizing fasciitis: a retrospective study

Necrotizing fasciitis (NF) is a rapidly progressive infectious disease that primarily involves the fascia and subcutaneous tissue. If not promptly treated, it can lead to morbidity as well as mortality. It can...

Authors: Chia-Peng Chang, Cheng-Ting Hsiao, Chun-Nan Lin and Wen-Chih Fann

Resuscitative endovascular balloon occlusion of the aorta deployed by acute care surgeons in patients with morbidly adherent placenta: a feasible solution for two lives in peril

Morbidly adherent placenta (MAP), which includes accreta, increta, and percreta, is a condition characterized by the invasion of the uterine wall by placental tissue. The condition is associated with higher od...

Authors: Ramiro Manzano-Nunez, Maria F. Escobar-Vidarte, Claudia P. Orlas, Juan P. Herrera-Escobar, Samuel M. Galvagno, Juan J. Melendez, Natalia Padilla, Justin C. McCarty, Albaro J. Nieto and Carlos A. Ordoñez

Impact of initial temporary abdominal closure in damage control surgery: a retrospective analysis

Damage control surgery has revolutionized trauma surgery. Use of damage control surgery allows for resuscitation and reversal of coagulopathy at the risk of loss of abdominal domain and intra-abdominal complic...

Authors: Parker Hu, Rindi Uhlich, Frank Gleason, Jeffrey Kerby and Patrick Bosarge

Flexible versus rigid endoscopy in the management of esophageal foreign body impaction: systematic review and meta-analysis

Foreign body (FB) impaction accounts for 4% of emergency endoscopies in clinical practice. Flexible endoscopy (FE) is recommended as the first-line therapeutic option because it can be performed under sedation...

Authors: Davide Ferrari, Alberto Aiolfi, Gianluca Bonitta, Carlo Galdino Riva, Emanuele Rausa, Stefano Siboni, Francesco Toti and Luigi Bonavina

A combination of SOFA score and biomarkers gives a better prediction of septic AKI and in-hospital mortality in critically ill surgical patients: a pilot study

Sepsis is a syndrome characterized by a constellation of clinical manifestations and a significantly high mortality rate in the surgical intensive care unit (ICU). It is frequently complicated by acute kidney ...

Authors: Chao-Wei Lee, Hao-wei Kou, Hong-Shiue Chou, Hsu-huan Chou, Song-Fong Huang, Chih-Hsiang Chang, Chun-Hsing Wu, Ming-Chin Yu and Hsin-I Tsai

Implementation and adoption of advanced care planning in the elderly trauma patient

Geriatric trauma has high morbidity and mortality, often requiring extensive hospital stays and interventions. The number of geriatric trauma patients is also increasing significantly and accounts for a large ...

Authors: K. Verhoeff, P. Glen, A. Taheri, B. Min, B. Tsang, V. Fawcett and S. Widder

The long-term outcomes of early abdominal wall reconstruction by bilateral anterior rectus abdominis sheath turnover flap method in critically ill patients requiring open abdomen

In a previous study, we reported the usefulness of early abdominal wall reconstruction using bilateral anterior rectus abdominis sheath turnover flap method (turnover flap method) in open abdomen (OA) patients...

Authors: Masatoku Arai, Shiei Kim, Hiromoto Ishii, Jun Hagiwara, Shigeki Kushimoto and Hiroyuki Yokota

Introduction of a mass burn casualty triage system in a hospital during a powder explosion disaster: a retrospective cohort study

The triage system used during an actual mass burn casualty (MBC) incident is a major focus of concern. This study introduces a MBC triage system that was used by a burn center during an actual MBC incident fol...

Authors: Chip-Jin Ng, Shih-Hao You, I-Lin Wu, Yi-Ming Weng, Chung-Hsien Chaou, Cheng-Yu Chien and Chen-June Seak

Knowledge, awareness, and attitude towards infection prevention and management among surgeons: identifying the surgeon champion

Despite evidence supporting the effectiveness of best practices of infection prevention and management, many surgeons worldwide fail to implement them. Evidence-based practices tend to be underused in routine ...

Authors: Massimo Sartelli, Yoram Kluger, Luca Ansaloni, Federico Coccolini, Gian Luca Baiocchi, Timothy C. Hardcastle, Ernest E. Moore, Addison K. May, Kamal M. F. Itani, Donald E. Fry, Marja A. Boermeester, Xavier Guirao, Lena Napolitano, Robert G. Sawyer, Kemal Rasa, Fikri M. Abu-Zidan…

2017 WSES guidelines on colon and rectal cancer emergencies: obstruction and perforation

Obstruction and perforation due to colorectal cancer represent challenging matters in terms of diagnosis, life-saving strategies, obstruction resolution and oncologic challenge. The aims of the current paper a...

Authors: Michele Pisano, Luigi Zorcolo, Cecilia Merli, Stefania Cimbanassi, Elia Poiasina, Marco Ceresoli, Ferdinando Agresta, Niccolò Allievi, Giovanni Bellanova, Federico Coccolini, Claudio Coy, Paola Fugazzola, Carlos Augusto Martinez, Giulia Montori, Ciro Paolillo, Thiago Josè Penachim…