Emergency General Surgery - The Eastern Association for the Surgery of Trauma

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Eastern Association for the Surgery of Trauma

Emergency General Surgery

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A randomized clinical trial evaluating the efficacy of quality of life of antibiotic-only treatment of acute uncomplicated appendicitis: Results of the COMMA trial.

O'Leary DP, Walsh SM, Bolger J, Baban C, Humphreys H, O'Grady S, Hegarty A, Lee AM, Sheehan M, Alderson J, Dunne R, Morrin MM, Lee MJ, Power C, McNamara D, McCawley N, Robb W, Burke J, Sorensen J, Hill AD.

Ann Surg. 2021 Aug 1;274(2):240-247.

Rationale for inclusion: Patients with acute, uncomplicated appendicitis treated with antibiotics only experienced higher recurrence rates and an inferior quality of life compared to those treated with laparoscopic appendectomy.

CAVEAT: Single center study.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Long-term outcomes of Hartmann's procedure versus primary anastomosis for generalized peritonitis due to perforated diverticulitis: follow-up of a prospective multicenter randomized trial (DIVERTI).

Loire M, Bridoux V, Mege D, Mathonnet M, Mauvais F, Massonnaud C, Regimbeau JM, Tuech JJ.

Int J Colorectal Dis . 2021 Oct;36(10):2159-2164.

Rationale for inclusion: Median 9 year follow up shows lower long-term complications with primary anastomosis, including lower incisional hernia and reoperation rate, and higher quality of life scores compared to Hartmann's procedure, and equivalent survival between the groups.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Internal hernia after one anastomosis gastric bypass (OAGB): lessons learned from a retrospective series of 3368 consecutive patients undergoing OAGB with a biliopancreatic limb of 150 cm.

Petrucciani N, Martini F, Kassir R, Juglard G, Hamid C, Boudrie H, Van Haverbeke O, Liagre A.

Obes Surg . 2021 Jun;31(6):2537-2544.

Rationale for inclusion: One anastomosis gastric bypass is a recent bariatric procedure that also carries risk of internal hernia. It can occur years after index operation, CT scan is common mode of diagnosis, and majority are managed via laparoscopy.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Multiple organ failure might be an indication for prophylactic antifungal therapy in acute pancreatitis.

Ning C, Zhu S, Zhou S, Lin C, Li J, Cao X, Bonsu A, Shen D, Liu Z, Huang G.

Infection. 2021 Aug;49(4):769-774.

Rationale for inclusion: Large retrospective study that provides indications for antifungal therapy in acute pancreatitis.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Managing acute uncomplicated appendicitis in frail geriatric patients: A second hit may be too much.

Chehab M, Ditillo M, Khurrum M, Gries L, Asmar S, Douglas M, Bible L, Kulvatunyou N, Joseph B.

J Trauma Acute Care Surg. 2021 Mar 1;90(3):501-506.

Rationale for inclusion: Retrospective propensity-score matched review of the Nationwide Readmissions Database of frail geriatric patients. 1 in 6 patients failed antibiotic treatment alone, with resultant more complications and higher mortality.

CAVEAT: Inclusion criteria was age >65 years and frailty was assessed using a five-factor modified frailty index.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Multicenter study of the treatment of appendicitis in America: Acute, Perforated and Gangrenous (MUSTANG), an EAST multicenter study

Yeh D, Eid AI, Young KA, Wild J, Kaafarani HM, Ray-Zach M, Kana'an T, Lawless R, Cralley AL, Crandall M. EAST Appendicitis Study Group.

Ann Surg. 2021 Mar 1;273(3):548-556.

Rationale for inclusion: Large multicenter prospective observational study of patients with appendicitis in America. Of the patients treated with antibiotic therapy alone, 16% required appendectomy during index hospitalization and 5% underwent appendectomy within 30 days with a cumulative failure rate of 21%.

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Laparoscopic lavage vs primary resection for acute perforated diverticulitis: long-term outcomes from the Scandinavian diverticulitis (SCANDIV) randomized clinical trial.

Azhar N, Johanssen A, Sundstrom T, Folkesson J, Wallon C, Korner H, Blecic L, Forsmo HM, Oresland T, Yaqub S, Buchwald P, Schultz JK.

JAMA Surg. 2021 Feb;156(2):121-7.

Rationale for inclusion: 5-year follow up on previously reported RCT shows similar rates of severe complications, but higher recurrence of diverticulitis in the laparoscopic lavage group, 30% of whom went on to sigmoid resection. Stoma prevalence was lower in laparoscopic lavage group.

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Effect of oral moxifloxacin vs intravenous ertapenem plus oral levofloxacin for treatment of uncomplicated acute appendicitis: The APPAC II randomized clinical trial.

Sippola S, Haijanen J, Grönroos J, Rautio T, Norström P, Rantanen T, Pinta T, Ilves I, Mattila A, Rintala J, Löyttyniemi E, Hurme S, Tammilehto V, Marttila H, Meriläinen S, Laukkarinen J, Sävelä E, Savolainen H, Sippola T, Aarnio M, Paajanen H, Salminen P.

JAMA. 2021 Jan 26;325(4):353-362.

Rationale for inclusion: Multicenter randomized clinical trial evaluated patients with uncomplicated acute appendicitis treated with either 7 days of oral antibiotics or 2 days of IV antibiotics followed by 5 days of oral antibiotics. Results showed that oral antibiotics alone resulted in treatment success rates greater than 65%, but failed to demonstrate noninferiority comparted to IV antibiotics.

CAVEAT: Predefined noninferiority margin for clinical importance in the sample size calculations were set arbitrarily.

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Appendectomy versus conservative treatment with antibiotics for patients with uncomplicated acute appendicitis: a propensity score-matched analysis of patient-centered outcomes (the ACTUAA prospective trial).

Podda M, Poillucci G, Pacella D, Mortola L, Canfora A, Aresu S, Pisano M, Erdas E, Pisanu A, Cillara N. ACTUAA Study Collaborative Working Group.

Int J Colorectal Dis. 2021 Mar;36(3):589-598.

Rationale for inclusion: Prospective multicenter study to comparing antibiotic therapy to appendectomy showed a statistically significant higher complication-free treatment success in the appendectomy group. 65% of patients treated with antibiotics were symptom-free at 1 year without increased risk of adverse evets, had less pain and shorter period of absence from work compared to the appendectomy group.

CAVEAT: Smaller sample size.

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Trends in appendicitis among pregnant women, risk for cardiac arrest, and maternal-fetal mortality.

Dongarwar D, Taylor J, Ajewole V, Anene N, Omoyele O, Ogba C, Oluwatoba A, Giger D, Thuy A, Argueta E, Naik E, Salemi J, Spooner K, Olaleye O, Salihu H.

World J Surg. 2020 Dec;44(12):3999-4005.

Rationale for inclusion: Large, retrospective review of appendicitis in pregnancy using NIS data, identifying the increased risk of both fetal loss (2x increase) and inpatient maternal mortality (5x increase) compared to pregnant mothers without appendicitis. Increased fetal loss and mortality associated with underlying pre-existing conditions. This highlights the potential morbidity and mortality of appendicitis in pregnancy.

CAVEAT: No data regarding operative vs non-operative outcomes provided.

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Superior primary fascial closure rate and lower mortality after open abdomen using negative pressure wound therapy with continuous fascial traction.

Rasilainen S, Mentula P, Salminen P, Koivukangas V, Hyöty M, Mäntymäki LM, Pinta T, Haikonen J, Rintala J, Rantanen T, Strander T, Leppäniemi A.

J Trauma Acute Care Surg. 2020 Dec;89(6):1136-1142.

Rationale for inclusion: Multicenter retrospective analysis of 676 patients. Outcomes showed superior role for vacuum-assisted closure with continuous mesh-mediate fascial traction in terms of successful primary fascial closure and increased survival rates following open abdomen.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

A randomized trial comparing antibiotics with appendectomy for appendicitis.

CODA Collaborative; Flum DR, Davidson GH, Monsell SE, Shapiro NI, Odom SR, Sanchez SE, Drake FT, Fischkoff K, Johnson J, Patton JH, Evans H, Cuschieri J, Sabbatini AK, Faine BA, Skeete DA, Liang MK, Sohn V, McGrane K, Kutcher ME, Chung B, Carter DW, Ayoung-Chee P, Chiang W, Rushing A, Steinberg S, Foster CS, Schaetzel SM, Price TP, Mandell KA, Ferrigno L, Salzberg M, DeUgarte DA, Kaji AH, Moran GJ, Saltzman D, Alam HB, Park PK, Kao LS, Thompson CM, Self WH, Yu JT, Wiebush A, Winchell RJ, Clark S, Krishnadasan A, Fannon E, Lavallee DC, Comstock BA, Bizzel B, Heagerty PJ, Kessler LG, Talan DA.

N Engl J Med. 2020 Nov 12;383(20):1907-1919.

Rationale for inclusion: Randomized clinical trial comparing 10-day course of antibiotic therapy to appendectomy for treatment of appendicitis. Antibiotics were noninferior to appendectomy based on 30-day health status survey, however 30% of participants underwent appendectomy within 90 days in the antibiotic group.

CAVEAT: Data only includes 90-day follow up and likely underrepresents recurrence and long-term complications.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Development of a nomogram to predict small bowel obstruction using point-of-care ultrasound in the emergency department.

Shokoohi H, Boniface KS, Loesche MA, Duggan NM, King JB.

Am J Emerg Med. 2020 Nov;38(11):2356-2360.

Rationale for inclusion: Analysis of prospectively collected data on patients with SBO. A unique nomogram incorporating patient age, physician pretest probability of SBO, POCUS measurements of small bowel diameter and presence of free intraperitoneal fluid had good predictive ability for diagnosing SBO.

CAVEAT: Small study, nomogram not externally validated.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

The worst-case scenario: Bridging repair with a biologic mesh in high-risk patients with very large abdominal wall hernias - a prospective multicenter study.

Velmahos GC, Demetriades D, Mahoney E, Burke P, Davis K, Larentzakis A, Fikry K, El Moheb M, Kovach S, Schreiber M, Hassan M, Albrecht R, Dennis A.

Surgery. 2021 Feb;169(2):318-324.

Rationale for inclusion: This is a prospective, multicenter study that demonstrates acceptable outcomes for neonatal bovine dermis mesh (SurgiMend) in patients with very large hernias who cannot undergo midline fascial closure.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Preoperative risk factors for short-term postoperative mortality of acute mesenteric ischemia after laparotomy: A Systemic Review and Meta-Analysis.

Wu W, Liu J, Zhou Z.

Emerg Med Int. 2020 Oct 5;2020:1382475.

Rationale for inclusion: Meta-analysis including 20 studies and 5011 patients that identifies preoperative risk factors associated with mortality following laparotomy for acute mesenteric ischemia. Understanding these risk factors may help improve perioperative decision making.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Laparoscopic versus open adhesiolysis for adhesive small bowel obstruction (LASSO): an international, multicentre, randomised, open-label trial

Sallinen V, Di Saverio S, Haukijarvi E, Juusela R, Wikstrom H, Koivukangas V, Catena F, Enholm B, Birindelli A, Leppaniemi A, Mentula P.

Lancet Gastroenterol Hepatol . 2019 Apr;4(4):278-286.

Rationale for inclusion: First multicenter randomized open label trial of aSBO managed laparoscopical vs open. Included only suspected single band obstructions. Decreased LOS, safety of laparoscopic approach in select patients.

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Association of Surgical Intervention for Adhesive Small-Bowel Obstruction With the Risk of Recurrence

Behman R, Nathens AB, Mason S, Byrne JP, Hong NL, Pechlivanglou P, Karanicolas P.

JAMA Surg. 2019 May 1;154(5):413-420.

Rationale for inclusion: Longitudinal propensity matched restrospective cohort study using a health administrative data base, very large sample size. Initial operartive management of aSBO decreases recurrences.

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Population Level Analysis of Adhesive Small Bowel Obstruction: Sustained Advantage of a Laparoscopic Approach

Udelsman BV, Chang DC, Parina R, Talamini MA, Lillemoe KD, Witkowski ER.

Ann Surg . 2020 May;271(5):898-905.

Rationale for inclusion: Population based study summarizing incidence of sbo after common open and laparoscpic procedures (chole/appy/RNGB/colectomy). Lap lower incidence than open.

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Robotic Inguinal vs Transabdominal Laparoscopic Inguinal Hernia Repair: The RIVAL Randomized Clinical Trial

Prabhu AS, Carbonell A, Hope W, Warren J, Higgins R, Jacob B, Blatnik J, Haskins I, Alkhatib H, Tastaldi L, Fafaj A, Tu C, Rosen MJ.

JAMA Surg . 2020 May 1;155(5):380-387.

Rationale for inclusion: First RCT comparing laparoscopic vs robotic TAPP. No difference in clinical outcomes but robotic more expansive and longer operating time.

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Evidence-based Reviews in Surgery Long-term outcome of surgery versus conservative management for reccurent and ongoing complaints after an episode of diverticulitis: five-year follow-up results of a multicenter randomized controlled trial (DIRECT-Trial).

Patel SV, Hendren S, Zaborowski A, Winter D.

Ann Surg. 2020 Aug;272(2):284-7.

Rationale for inclusion: Review of multicenter trial showing improved quality of life at 5-year follow-up in patients who undergo elective sigmoid resection compared to conservative management of ongoing symptomatic/recurrent left-sided diverticulitis. This highlights another consideration when making individualized recommendations regarding elective resection.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Outcomes following early versus delayed cholecystectomy performed for acute cholangitis.

Discolo A, Reiter S, French B, Hayes D, Lucas G, Tan L, Scanlan J, Martinez R.

Surg Endosc. 2020;34(7):3204-3210.

Rationale for Inclusion: Retrospective review confirming that index admission cholecystectomy is safe and not associated with prolonged OR time or conversion rate, regardless of Tokyo grade over delayed cholecystectomy

CAVEAT: Single center database

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Short-term outcomes of laparoscopic approach to colonic obstruction for colon cancer

Moghadamyeghaneh Z, Talus H, Ballantyne G, Stamos MJ, Pigazzi A.

Surg Endosc. 2021 Jun;35(6):2986-2996.

Rationale for Inclusion: NSQIP database review evaluating the morbidity of laparoscopic approach to obstructive colon cancer surgery

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Impact of hospital volume on outcomes after emergency management of obstructive colon cancer: a nationwide study of 1957 patients

Aubert M, Mege D, Manceau G, Bridoux V, Lakkis Z, Venara A, Voron T, Abdalla S, Beyer-Berjot L, Sielezneff I, Sabbagh C, Karoui M; AFC (French Surgical Association) Working Group.

Int J Colorectal Dis. 2020 Oct;35(10):1865-1874.

Rationale for Inclusion: Large, retrospective review of association between volume of patients treated with outcomes

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Risk of emergency surgery or death after initial nonoperative management of complicated diverticulitis in Scotland and Switzerland.

Torney MSU, Moffa G, Kaech M, Haak F, Riss S, Deutschmann E, Bucher HC, Kettelhack C, Paterson HM.

JAMA Surg. 2020 Jul;155(7):600-6.

Rationale for inclusion: Population-based comparative study showed that despite 5-fold difference in elective interval resection following nonoperative management of acute episode, there was no difference in the rate of recurrent diverticulitis requiring emergent operation or inpatient death between the two groups. The findings should be taken into consideration when making individualized decisions regarding elective resection.

CAVEAT: Population-based comparative study showed that despite 5-fold difference in elective interval resection following nonoperative management of acute episode, there was no difference in the rate of recurrent diverticulitis requiring emergent operation or inpatient death between the two groups. The findings should be taken into consideration when making individualized decisions regarding elective resection.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Improved mortality in necrotizing pancreatitis with a multidsciplinary minimally invasive step-up approach: Comparison with a modern open necrosectomy cohort.

Luckhurst C, El Hechi M, Elsharkawy A, Eid A, Maurer L, Kaafarani H, Thabet A, Forcione D, Castillo C, Lillemoe K, Fagenholz.

J Am Coll Surg. 2020 Jun;230(6):873-883.

Rationale for inclusion: This is a recent observational cohort study that compares MIS-based minimally invasive approach vs an open necrosectomy and showed a 5-fold decrease in mortality.

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Incarcerated paraesophageal hernia and gastric volvulus: Management options for the acute care surgeon, an Eastern Association for the Surgery of Trauma master class video presentation.

Coleman C, Musgrove K, Bardes J, Dhamija A, Buenaventura P, Ghulam A, Wilson A, Grabo D.

J Trauma Acute Care Surg . 2020 Jun;88(6):e146-e148.

Rationale for inclusion: EAST master class video presentation providing instruction acute care surgeon management of the incarcerated paraesophageal hernia. Provides recommendations on initial management, as well as detailed, cadaver-based instruction for operative management.

CAVEAT: Expert opinion.

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Awake Emergency Department Thoracoscopic Investigation of Penetrating Diaphragmatic Injuries: A Novel Minimally Invasive Technique of Diagnosis

de Jongh R, Koto MZ.

J Laparoendosc Adv Surg Tech A . 2020 Dec;30(12):1334-1339.

Rationale for Inclusion: This paper evaluated a novel approach to traumatic diaphragmatic hernias, namely, a thoracoscopic approach performed on an awake patient.

CAVEAT: Not practice changing aside from rural areas or areas with markedly high penetrating trauma rates

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Predicting intestinal ischaemia in patients with adhesive small bowel obstruction: A simple score.

Bouassida M, Laamiri G, Zribi S, Slama H, Mroua B, Sassi S, Aboudi R, Mighri M, Bouzeidi K, Touinsi H.

World J Surg. 2020 May;44(5):1444-1449.

Rationale for inclusion: This retrospective study provides a simple scoring system to predict intestinal ischemia in patients with small bowel obstructions.

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Decreased length of stay after laparoscopic diaphragm repair for isolated diaphragm injury after penetrating trauma.

Chaudhry HH, Grigorian A, Lekawa ME, Dolich MO, Nguyen NT, Smith BR, Schubl SD, Nahmias JT.

Am Surg. 2020 May;86(5):493-8.

Rationale for inclusion: Comparative study using national cohort demonstrating decreased overall hospital LOS in patients undergoing laparoscopic repair of isolated diaphragm injury after stab wound compared to open repair, with similar rates of in-hospital complications.

CAVEAT: Retrospective database study.

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Validation of the American Association for the Surgery of Trauma grading system for acute mesenteric ischemia-More than anatomic severity is needed to determine risk of mortality.

Sindall ME, Davenport DL, Wallace P, Bernard AC.

J Trauma 2020 May;88(5):671-676.

Rationale for Inclusion: This study evaluating the correlation between the AAST grading scale for AMI and complication severity found that CT, pathology and clinical grades did not correlate with mortality or outcome severity.

CAVEAT: Single center retrospective chart review

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Vasodilator therapy and mortality in nonocclusive mesenteric ischemia: A Nationwide Observational Study.

Takiguchi T, Nakajima M, Ohbe H, Sasabuchi Y, Matsui H, Fushimi K, Kim S, Yokota H, Yasunaga H.

Crit Care Med. 2020 May;48(5):e356-e361.

Rationale for inclusion: Large retrospective cohort study demonstrating vasodilatory therapy is associated with lower in-hospital mortality and prevalence of abdominal surgery in patients with nonocclusive mesenteric ischemia.

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Negative pressure wound therapy vs conventional wound treatment in subcutaneous abdominal wound healing impairment: The SAWHI randomized clinical trial.

Seidel D, Diedrich S, Herrle F, Thielemann H, Marusch F, Schirren R, Talaulicar R, Gehrig T, Lehwald-Tywuschik N, Glanemann M, Bunse J, Hüttemann M, Braumann C, Heizmann O, Miserez M, Krönert T, Gletschel S, Lefering R.

JAMA Surg. 2020 Jun 1;155(6):469-478.

Rationale for inclusion: This is the first multicenter, multinational, randomized clinical trial to demonstrate that negative pressure wound therapy is superior to conventional wound therapy in time to closure for subcutaneous abdominal wounds.

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Necrotizing Soft Tissue Infection: Time is Crucial, and the Admitting Service Matters

Kongkaewpaisan N, Hwabejire J, Lee JM, Narueponjirakul N, Meier K, Mendoza A, Saillant N, Rosenthal M, King D, Fagenholz P, Velmahos G, Kaafarani H.

Surg Infect (Larchmt). 2020 Dec;21(10):828-833.

Rationale for Inclusion: This study found that failure to admit patients with NSTI to an ACS service correlates with delayed operative intervention and may lead to higher mortality.

CAVEAT: Small, single center study

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Timing of Endoscopy for Acute Upper Gastrointestinal Bleeding

Lau JYW, Yu Y, Tang RSY, Chan HCH, Yip HC, Chan SC, Luk SWY, Wong SH, Lau LHS, Lui RN, Chan TT, Mak JWY, Chan FKL, Sung JJY.

N Engl J Med. 2020 Apr 2;382(14):1299-1308.

Rationale for Inclusion: A prospective randomized study that demonstrates no improvement in outcomes with upper endoscopy performed within 6 hours of onset of bleeding.

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Optimal Timing of Feeding After Endoscopic Hemostasis in Patients With Peptic Ulcer Bleeding: A Randomized, Noninferiority Trial (CRIS KCT0001019)

Gong EJ, Lee SJ, Jun BG, Seo HI, Park JK, Han KH, Kim YD, Jeong WJ, Cheon GJ, Park SY.

Am J Gastroenterol. 2020 Apr;115(4):548-554.

Rationale for Inclusion: Non-inferiority RCT that shows no difference between early feeding (<24shrs) vs after 48hrs

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Quality of life and patient satisfaction at 7-year follow-up of antibiotic therapy vs appendectomy for uncomplicated acute appendicitis: A secondary analysis of a randomized clinical trial.

Sippola S, Haijanen J, Viinikainen L, Grönroos J, Paajanen H, Rautio T, Norström P, Aarnio M, Rantanen T, Hurme S, Mecklin J, Sand J, Jartti A, Salminen P.

JAMA Surg. 2020 Apr 1;155(4):283-289.

Rationale for inclusion: Observational long-term follow-up of the APPAC multicenter RCT comparing appendectomy with antibiotics. Quality of life metrics between appendectomy and antibiotic patients were similar in both groups, but patient satisfaction was higher in the appendectomy group.

CAVEAT: Limitations of original APPAC trial including open appendectomy approach and longer duration of antibiotic treatment.

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Appendicitis in pregnancy: A post-hoc analysis of an EAST multicenter study.

Vasileiou G, Eid AI, Qian S, Pust G, Rattan R, Namias N, Larentzakis A, Kaafarani H, Yeh D.

Surg Infect (Larchmt). 2020 Apr;21(3):205-211.

Rationale for inclusion: Post-hoc analysis of EAST multicenter observational study identifying the increased likelihood of pregnant women to develop complicated appendicitis, be treated with abx rather than surgery, and to undergo negative appendectomy (3x higher than non-pregnant patients). The latter is likely due to the increased complexity of diagnosis and risk of delayed intervention in gravid patients. Overall outcomes were similar to non-pregnant controls.

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Delay in Source Control in Perforated Peptic Ulcer Leads to 6% Increased Risk of Death Per Hour: A Nationwide Cohort Study

Boyd-Carson H, Doleman B, Cromwell D, Lockwood S, Williams JP, Tierney GM, Lund JN, Anderson ID; National Emergency Laparotomy Audit Collaboration

World J Surg. 2020 Mar;44(3):869-875.

Rationale for Inclusion: This epidemiologic analysis of 3809 patients from a prospective registry of emergency laparotomies for PPU found that hourly delay to the OR was independently associated with an increased odds of death.

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Endoscopic management of leaks and fistulas after bariatric surgery: a systematic review and meta-analysis.

Rogalski P, Swidnicka-Siergiejko A, Wasielica-Berger J, Zienkiewicz D, Wieckowska B, Wroblewski E, Baniukiewicz A, Rogalska-Plonska M, Siergiejko G, Dabrowski A, Daniluk J.

SurgEndosc. 2021 Mar;35(3):1067-87.

Rationale for inclusion: Reviews efficacy of endoscopic management of postoperative leaks and fistulas following bariatric surgery. Acute care surgeons may encounter these complications and coordination with advanced endoscopist may be essential to successful management.

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Laparoscopic versus open approach for diffuse peritonitis from appendicitis ethiology: A subgroup analysis from the Physiologic parameters for Prognosis in Abdominal Sepsis (PIPAS) study.

Gomes CA, Sartelli M, Podda M, Di Saverio S, Coccolini F, Segovia-Lohse HA, De Simone B, Catena F.

Updates Surg. 2020 Mar;72(1):185-191.

Rationale for inclusion: Prospective multicenter trial of patients with diffuse peritonitis from perforated appendicitis. There was no statistically significant difference between laparoscopic and open techniques in terms of intra-abdominal abscess, postoperative peritonitis, rate of reoperation and mortality.

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Prophylactic biologic mesh reinforcement versus standard closure of stoma site (ROCSS): a multicentre, randomised controlled trial.

Reinforcement of Closure of Stoma Site (ROCSS) Collaborative and West Midlands Research Collaborate.

Lancet. 2020 Feb 8;395(10222):417-426.

Rationale for inclusion: Multicenter, randomized controlled trial demonstrating decrease in detectable incisional hernia 24 months after stoma closure without increased risk in wound infection, seroma formation or quality of life.

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Trends and risk factors for 30-day readmissions in patients with acute cholangitis: analysis from the national readmission database.

Parikh MP, Garg R, Chittajallu V, Gupta N, Sarvepalli S, Lopez R, Thota PN, Siddiki H, Bhatt A, Chahal P, Jang S, Stevens T, Vargo J, McCullough A, Sanaka MR.

Surg Endosc. 2021 Jan;35(1):223-231.

Rationale for Inclusion: Retrospective cohort of the national readmission data from 2010 to 2014 evidencing a 30 day elevated readmission rate for cholangitis and the benefit of early ERCP and cholecystectomy.

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Comparison of decompressing stoma vs stent as a bridge to surgery for left-sided obstructive colon cancer

Veld JV, Amelung FJ, Borstlap WAA, van Halsema EE, Consten ECJ, Siersema PD, Ter Borg F, van der Zaag ES, de Wilt JHW, Fockens P, Bemelman WA, van Hooft JE, Tanis PJ; Dutch Snapshot Research Group.

JAMA Surg. 2020 Jan 8;155(3):206–15.

Rationale for Inclusion: Population-based cohort study comparing the use of stents to emergency surgery (decompressive stoma) for obstructive colon cancer

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Perforated and bleeding peptic ulcer: WSES guidelines.

Tarasconi A, Coccolini F, Biffl W, Tomasoni M, Ansaloni L, Picetti E, Molfino S, Shelat V, Cimbanassi S, Weber D, Abu-Zidan F, Campanile F, Saverio S, Baiocchi G, Casella C, Kelly M, Kirkpatrick A, Leppaniemi A, Moore E, Peitzman A, Fraga G, Ceresoli M, Maier R, Wani I, Pattonieri V, Perrone G, Velma G, Sugrue M, Sartelli M, Kluger Y, Catena F.

World J Emerg Surg. 2020 Jan 7;15:3.

Rationale for inclusion: Using GRADE methodology, this paper makes recommendations for the diagnosis and management of peptic ulcer disease.

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Efficacy and Safety of Early vs Elective Colonoscopy for Acute Lower Gastrointestinal Bleeding

Niikura R, Nagata N, Yamada A, Honda T, Hasatani K, Ishii N, Shiratori Y, Doyama H, Nishida T, Sumiyoshi T, Fujita T, Kiyotoki S, Yada T, Yamamoto K, Shinozaki T, Takata M, Mikami T, Mabe K, Hara K, Fujishiro M, Koike K.

Gastroenterology. 2020 Jan;158(1):168-175.e6.

Rationale for Inclusion: Large, multicenter, randomized controlled trial to determine the efficacy and safety of early colonoscopy on outcomes of patients with acute lower gastrointestinal bleeding compared to colonoscopy done 24-96 hours after hospital admission

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Validation of prognostic scoring systems for predicting 30-day mortality in perforated peptic ulcer disease

Patel S, Kalra D, Kacheriwala S, Shah M, Duttaroy D.

Turk J Surg. 2019 Dec 16;35(4):252-258.

Rationale for Inclusion: Prospective observational study comparing various prognostic scoring systems.

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Laparoscopic omental patch for perforated peptic ulcer disease reduces length of stay and complications, compared to open surgery: A SWSC multicenter study

Saleh AA, Esquivel EC, Lung JT, Eaton BC, Bruns BR, Barmparas G, Margulies DR, Raines A, Bryant C, Crane CE, Scherer EP, Schroeppel TJ, Moskowitz E, Regner J, Frazee R, Campion EM, Bartley M, Mortus J, Ward J, Almekdash MH, Dissanaike S.

Am J Surg. 2019 Dec;218(6):1060-1064.

Rationale for Inclusion: Multi-institutional, non-randomized study of 491 patients supporting laparoscropic graham patch.

CAVEAT: Not RCT

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Protocol driven management of suspected common duct stones: A Southwestern Surgical Congress multi-centered trial.

Hall C, Regner JL, Schroeppel T, Rodriguez J, McIntyre R, Wright F, Dissanaike S, Richmond R, Santos A, Frazee RC.

The American Journal of Surgery. 2019 Dec 1;218(6):1152-5.

Rationale for Inclusion: This study followed up a multi centertrial on the current practice in the preop evaluation for choledocholithiasis, demonstrating a wide practice variation in imaging and timing of surgery. Four centers then prospectively followed a algorithm utilizing a Bilirubin of four as a cut off for surgery or additional investigation (MRCP or ERCP). This protocol was found to be safe, with a low morbidity and mortality. It also reduced length of stay and number of MRCP's. The authors also demonstrated a low rate of missed choledocholithiasis requiring intervention.

CAVEAT: The study demonstrated a high rate of IOC. For surgeons that do not routinely perform this procedure, this algorithm may not be generizable and further study is needed.

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Laparoscopic Peritoneal Lavage vs Laparoscopic Sigmoidectomy in Complicated Acute Diverticulitis: A Multicenter Prospective Study

Tartaglia D, Di Saverio S, Stupalkowska W, Giannessi S, Robustelli V, Coccolini F, Ioannidus O, Nita GE, Munoz-Cruzado VM, Ciuro FP, Chiarugi M.

Int J Colorectal Dis. 2019 Dec; 34(12):2111-2120.

Rationale for Inclusion: Multicenter observational study showing laparoscopic peritoneal lavage has higher rate of recurrence and complications as compared to laparoscopic sigmoidectomy

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Enhanced recovery after surgery pathway for patients undergoing abdominal wall reconstruction

Clovin J, Rosen M, Prabhu A, Rosenblatt S, Petro C, Zolin S, Krpata D.

Surgery. 2019 Nov;166(5):849-853

Rationale for Inclusion: First study to demonstrate that an enhanced recovery protocol did not result in a change in outcomes inpatients undergoing complex abdominal wall reconstruction

CAVEAT: Small numbers

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Impact of a multidisciplinary care bundle for necrotizing skin and soft tissue infections: a retrospective cohort study

Urbina T, Hua C, Sbidian E, Bosc R, Tomberli F, Lepeule R, Winoc-Decousser J, Dessap AM, Chosidow O, de Prost N.

Ann Intensive Care. 2019; 9: 123.

Rationale for Inclusion: This study aimed to assess the impact of a multidisciplinary care bundle on management and outcome of patients with NSTIs. They found that implementation of a bundle was feasible but did not improve survival after adjusting for confounding factors.

CAVEAT: Retrospective study design

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Effect of timing on endovascular therapy and exploratory laparotomy outcome in acute mesenteric ischemia

Hsu A, Bhattacharya KR, Chan HK, Huber TC, Gardner B, Stone JR, Angle JF.

Ann Gastroenterol. 2019 Nov-Dec; 32(6): 600–604.

Rationale for Inclusion: Retrospective study demonstrating that emergent endovascular treatment prior to laparotomy may be associated with improved survival.

CAVEAT: small number of patients, retrospective study design

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Sedation and paralytic use in open abdomen patients-results from the EAST SLEEP Survey

Choi JH, Luo-Owen X, Brooks SE, Turay D, O'Bosky KR, Mukherjee K.

Surgery. 2019 Dec;166(6):1111-1116.

Rationale for Inclusion: Survey showing increase surgeon experience associated with deeper sedation depth and paralytic use, as well as delay in enteral nutrition and increase time between laparotomies.

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The use of synthetic mesh in contaminated and infected abdominal wall repairs: challenging the dogma - A long-term prospective clinical trial

Birolini C, de Miranda J, Tanaka E, Utiyama E, Rasslan S, Birolini D.

Hernia. 2020 Apr;24(2);307-323

Rationale for Inclusion: This is a prospective trial that challenges the belief that synthetic mesh should not be used in a contaminated setting and shows similar outcomes

CAVEAT: Small numbers

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Early versus standard colonoscopy a randomized controlled trial in patients with acute lower gastrointestinal bleeding: results of the BLEED study

van Rongen I, Thomassen BJW, Perk LE.

J Clin Gastroenterol. 2019 Sep;53(8):591-598.

Rationale for Inclusion: Randomized controlled trial evaluating the efficacy of <24 hrs vs 1-3 days colonoscopy to evaluate for lower GI bleeding

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Increased incidence of surgical site infection with a body mass index =35 kg/m2 following abdominal wall reconstruction with open component separation

Docimo S, Spaniolas K, Svestka M, Bates A, Sbayi S, Schnur J, Talamini M, Pryor A.

Surg Endosc. 2019 Aug;33:2503-7

Rationale for Inclusion: This study used the ACS-NSQIP database and a large patient sample to quantify the impact of BMI on surgical site infections following elective abdominal wall reconstruction. It is the largest study to date and is consistent with the results of previously published studies.

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Incisional hernia recurrence after open elective repair: expertise in abdominal wall surgery matters

Pereira J, Bravo-Salva A, Montcusi B, Perez-Farre S, Prado de Fresno L, Lopez-Cano M.

BMC Surg. 2019 Aug;19(103);1-6

Rationale for Inclusion: Prospective study suggesting that specialized centers have lower rates of hernia recurrence than standard general surgeons. This is similar to findings in studies regarding other types of surgeries that indicate better outcomes with specialization

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Long-term follow-up of the AVOD randomized trial of antibiotic avoidance in uncomplicated diverticulitis

Isacson D, Smedh K, Nikberg M, Chabok A.

Br J Surg. 2019 Oct; 106(11):1542-1548.

Rationale for Inclusion: Long term follow up on a randomized study comparing uncomplicated diverticulitis treated with or without antibiotics showing no long term outcomes

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Thirty-Day Outcomes After Open Revascularization for Acute Mesenteric Ischemia From the American College of Surgeons National Surgical Quality Improvement Program

Swerdlow NJ, Varkevisser R, Soden PA, Zettervall SL, McCallum JC, Li C, Wyers MC, Schermerhorn ML.

Ann Vasc Surg. 2019;61:148-155.

Rationale for Inclusion: NSQIP study evaluating 30-day mortality and preoperative risk factors for mortality after open revascularization for AMI.

CAVEAT: Large retrospective database study

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Effect of damage control laparotomy on major abdominal complications and lengths of stay: A propensity score matching and Bayesian analysis

Harvin JA, Sharpe JP, Croce MA, Goodman MD, Pritts TA, Dauer ED, Moran BJ, Rodriguez RD, Zarzaur BL, Kreiner LA, Claridge JA, Holcomb JB.

J Trauma Acute Care Surg. 2019 Aug;87(2):282-288.

Rationale for Inclusion: Prospective, quality improvement project comparing Patients that underwent definitive laparotomy vs patient the received damage control laparotomy and were judged as potential definitive laparotomy showing decrease hospital, ICU and ventilator days with definitive surgery

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A predictive grading scale for acute cholecystitis.

Siada S, Jeffcoach D, Cirks RC, Wolfe MM, Kwok AM, Sue LP, Davis JW.

Trauma Surg Acute Care Open. 2019;4(1).

Rationale for Inclusion: This retrospective review sought to improve on existing grading scales for acute cholecystitis. The system was based on intra-operative and pathological results to yield grade I: symptomatic cholelithiasis; grade II: acute/chronic cholecystitis; grade III: gangrenous/necrotizing cholecystitis; grade IV: gallbladder perforation or abscess. Overall, this proposed grading scale is an accurate predictor of duration of operation, conversion to open rate, hospital length of stay and cost of hospitalization.

CAVEAT: Limitations include retrospective review that can lead to selection and information bias.

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Mesh versus suture repair of umbilical hernia in adults: a randomized, double-blind, controlled, multicenter trial.

Kaufmann R, Halm JA, Eker HH, Klitsie PJ, Nieuwenhuizen J, van Geldere D, Simons MP, van der Harst E, van 't Riet M, van der Holt B, Kleinrensink GJ, Jeekel J, Lange JF.

Lancet . 2018 Mar 3;391(10123):860-869

Rationale for Inclusion: This randomized, double-blind controlled multicenter trial concluded that mesh repair should be used on all umbilical hernia repairs of size 1-4cm as mesh repair significantly reduces the rate of recurrence compared to suture primary repair.

Watch the EAST Minute Video

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Mesh OR patch for hernia on epigastric and umbilical sites (MORPHEUS-Trial): the complete two-year follow-up.

Ponten JEH, Leclercq WKG, Lettinga T, Heemskerk J, Konsten JLM, Bouvy ND, Nienhuijs SW.

Ann Surg . 2019 Jul;270(1):33-37.

Rationale for Inclusion: This is a randomized controlled, multicenter trial comparing flat preperitoneal polypropylene mesh repair versus patch repair. The flat polypropylene mesh repair resulted in lower complication rates but saw no difference in recurrence rates.

Watch the EAST Minute

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A comparative study of risk of pneumonia and mortalities between nasogastric and jejunostomy feeding routes in surgical critically ill patients with perforated peptic ulcer

Wu SC, Hsieh P, Chen YW, Yang MD, Wang YC, Cheng HT, Tzeng CW, Hsu CH, Muo CH.

PLoS One. 2019 Jul 3;14(7):e0219258.

Rationale for Inclusion: Retrospective study of 136 critically ill PPU disease patients showing non-inferiority of NGT feeds.

CAVEAT: Not RCT

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Hartmann's procedure versus sigmoidectomy with primary anastomosis for perforated diverticulitis with purulent or faecal peritonitis (LADIES): a multicenter, parallel-group, randomized, open-label, superiority trial

Lambrichts DPV, Vennix S, Musters GD, et al.

Lancet Gastroenterol Hepatol. 2019 Aug;4(8):599-610.

Rationale for Inclusion: Multicenter trial comparing Hartmann's vs sigmoidectomy and primary anastomosis in patients with Hinchey III and IV diverticulitis. It favors primary anastomosis in the appropriate patient.

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Rebleeding and mortality after lower gastrointestinal bleeding in patients taking antiplatelets or anticoagulants

Oakland K, Desborough MJ, Murphy MF, Schachter M, Jairath V.

Clin Gastroenterol Hepatol. 2019 Jun;17(7):1276-1284.

Rationale for Inclusion: Large, retrospective review delineating the effects of various antiplatelet and anticoagulant medications on lower GI rebleeding.

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Review of the EAST Practice Management Guideline: Evaluation and Management of Traumatic Diaphragmatic Injuries

Diaz JJ.

JAMA Surg. 2019;154(7):666–667

Rationale for Inclusion: This is a review of the literature conducted by EAST on this subject.

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Association of Race With Bariatric Surgery Outcomes

Wood MH, Carlin AM, Ghaferi AA, Varban OA, Hawasli A, Bonham AJ, Birkmeyer NJ, Finks JF.

JAMA Surg. 2019 May 1;154(5):e190029

Rationale for Inclusion: This study is an analysis of the Michigan Bariatric Surgery Collaborative consortium identifying racial disparities among bariatric surgical patient outcomes.

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Outcomes of Open Abdomen versus Primary Closure following Emergent Laparotomy for Suspected Secondary Peritonitis: A Propensity-Matched Analysis.

Kao AM, Cetrulo LN, Baimas-George M, Prasad T, Heniford BT, Davis BR, Kasten KR.

J Trauma Acute Care Surg. 2019 Apr 25

Rationale for inclusion: Open abdomen approach may not provide the benefit as perceived of a planned relook laparotomy and instead a selective approach of PC with " on demand" re laparotomy may be the method with lower complication rates, better mortality rates and lower health care costs.

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The impact of standardized protocol implementation for surgical damage control and temporary abdominal closure after emergent laparotomy.

Loftus TJ, Efron PA, Bala TM, Rosenthal MD, Croft CA, Walters MS, Smith RS, Moore FA, Mohr AM, Brakenridge SC.

J Trauma Acute Care Surg. 2019 Apr;86(4):670-678.

Rationale for inclusion: Protocol addressing patient selection, operative technique, resuscitation strategies, and critical care provisions decreases time to and rate of abdominal closure.

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Factors Affecting Mortality Following Necrotizing Soft-Tissue Infections: Randomized Prospective Study

Barupal SR, Soni ML, Barupal R.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6557049/J Emerg Trauma Shock. 2019 Apr-Jun; 12(2): 108–116.

Rationale for Inclusion: This is a randomized prospective comparative study that found APACHE II to be a significant predictor of mortality among patients with NSTI.

CAVEAT: Single center study; Small number of patients included

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Hartmann's Procedure vs Primary Anastomosis with Diverting Loop Ileostomy for Acute Diverticulitis: Nationwide Analysis of 2,729 Emergency Surgery Patients

Lee JM, Chang JBP, El Hechi M, Kongkaewpaisan N, Bonde A, Mendoza AE, Saillant NN, Fagenholz PJ, Velmahos G, Kaafarani HM.

J Am Coll Surg. 2019 Jul;229(1):48-55.

Rationale for Inclusion: NSQIP data analysis showing PADLI just as safe as Hartmann's for acute diverticulitis

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Is mesh always necessary in every small umbilical hernia repair? Comparison of standardized primary sutured versus patch repair: retrospective cohort study

Mitura K, Skolimowska-Rzewuska M, Rzewuska A, Wyrzykowska D.

Hernia. 2020 Mar 19.

Rationale for Inclusion: This retrospective analysis compares patch repair using ready-made synthetic mesh versus sutured repair of umbilical hernias and showed that the use of dense fascia suturing (short-stitch technique) may be an effective alternative to patch repair in patients with no significant risk factors for recurrence to avoid the higher risk of postoperative pain with mesh repair.

CAVEAT: Selection bias is the main weakness of this retrospective analysis.

Watch the EAST Minute

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Long-term follow-up of a multicenter cohort study on laparoscopic peritoneal lavage for perforated diverticulitis

Sneiders D, Lambrichts DPV, Swank HA, Blanken-Peeters CFJM, Nienhuijs SW, Govaert MJPM, Gerhards MF, Hoofwijk AGM, Bosker RJI, van der Bilt JDW, Heijnen BHM, Ten Cate Hoedemaker HO, Kleinrensink GJ, Lange JF, Bemelman WA.

Colorectal Dis. 2019 Jun;21(6):705-714.

Rationale for Inclusion: Long term follow up for patients who underwent laparoscopic peritoneal lavage for purulent diverticulitis showing increase risk of recurrence, reintervention and complications

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A comparison of cholecystitis grading scales.

Madni TD, Nakonezny PA, Imran JB, Taveras L, Cunningham HB, Vela R, Clark AT, Minshall CT, Eastman AL, Luk S, Phelan HA, Cripps MW.

J Trauma Acute Care Surg. 2019 Mar;86(3):471-478.

Rationale for inclusion: This is a prospective single institution compared the intraoperative Parkland Grading System to the AAST acute cholecystitis scale. Notably, the Parkland score was superior predictor of conversion and complication rates.

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Superiority of Step-up Approach vs Open Necrosectomy in Long-term Follow-up of Patients With Necrotizing Pancreatitis.

Hollemans RA, Bakker OJ, Boermeester MA, Bollen TL, Bosscha K, Bruno MJ, Buskens E, Dejong CH, van Duijvendijk P, van Eijck CH, Fockens P, van Goor H, van Grevenstein WM, van der Harst E, Heisterkamp J, Hesselink EJ, Hofker S, Houdijk AP, Karsten T, Kruyt PM, van Laarhoven CJ, Laméris JS, van Leeuwen MS, Manusama ER, Molenaar IQ, Nieuwenhuijs VB, van Ramshorst B, Roos D, Rosman C, Schaapherder AF, van der Schelling GP, Timmer R, Verdonk RC, de Wit RJ, Gooszen HG, Besselink MG, van Santvoort HC; Dutch Pancreatitis Study Group.

Gastroenterology. 2019 Mar;156(4):1016-1026.

Rationale for inclusion: This represents long term follow up of patients in the origical PANTER trial published in 2018. The results originially identified in that trial of decreased mortality and major morbidity appear to be both consistent and durable at long term follow up.

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Higher LRINEC Scores and Escalation of Anesthesia Care in Necrotizing Soft Tissue Infection

Tessler RA, Vanhoy S, Bergus K, Fong C, Bulger EM, Rivara FP, Vavilala MS.

J Surg Res. 2019;238:119-126.

Rationale for Inclusion: Larger study looking at association between LRINEC score and use of vasopressors, invasive monitoring and operative time. Authors found that preoperative LRINEC score is associated with escalations in intraoperative care, and a lower score may predict patients unlikely to require vasopressors or blood transfusions.

CAVEAT: Retrospective study design

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Acute cholecystitis in very elderly patients: disease management, outcomes, and risk factors for complications.

Escartin A, Gonzalez M, Cuello E, Pinillos A, Muriel P, Merichal M, Palacios V, Escoll, J, Gas C, Olsina J.

Surg Res Pract. 2019;2019.

Rationale for Inclusion: As the aging population is increasing, this retrospective analysis sought to evaluate the characteristics, management and outcomes of acute cholecystitis (AC) in those age 80 and older. Grade I -II (Tokyo Guidelines) AC can be safely managed with laparoscopic cholecystectomy. Grade III AC is associated with higher morbidity and mortality and treatment should be individualized to cholecystostomy, laparoscopic cholecystectomy, or conservative treatment. ASA IV patients should avoid cholecystectomy using antibiotic treatment and/or cholecystostomy.

CAVEAT: This study weakness include lack of randomization and retrospective character.

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Enhanced Recovery in Mild Acute Pancreatitis: A Randomized Controlled Trial.

Dong E, Chang JI, Verma D, Butler RK, Villarin CK, Kwok KK, Chen W, Wu BU.

Pancreas. 2019 Feb;48(2):176-181.

Rationale for inclusion: This double-blind, randomized controlled trial compared the use of a protocolized enhanced recovery bundle on time to oral feeding and pancreatitis activity score. There was no difference in length of stay or readmission.

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Validation of Tokyo guideline 2013 as treatment of acute cholecystitis by real world data.

Harai S, Mochizuki H, Kojima Y, Nakagomi K, Yoshimura D, Takaoka S, Hosoda K, Suzuki Y, Omata M.

Dig Dis. 2019;37(4):303-308.

Rationale for Inclusion: This retrospective review aimed to evaluate the TG 2013 recommendations that support early cholecystectomy and determined that surgical intervention is not always indicated in patients with advanced age. Percutaneous transhepatic gallbladder aspiration (PTGBA) and percutaneous transhepatic gallbladder drainage (PTGBD), and the administration of antibiotics were compared and showed that PTGBA and PTGBD are simple procedures with good short- and long-term safety and should be recommended for elderly patients with acute cholecystitis.

CAVEAT: No patients in this study underwent cholecystectomy as a comparison. Necrotic, gangrenous cholecystitis were excluded pathologies.

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Bariatric Surgery and the Risk of Cancer in a Large Multisite Cohort

Schauer DP, Feigelson HS, Koebnick C, Caan B, Weinmann S, Leonard AC, Powers JD, Yenumula PR, Arterburn DE.

Ann Surg. 2019 Jan;269(1):95-101.

Rationale for Inclusion: This is a large, multisite cohort analysis of the incidence of cancer in bariatric surgery patients identifying lower rates.

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Surgical repair of perforated peptic ulcers: laparoscopic versus open approach.

Vakayil V, Bauman B, Joppru K, Mallick R, Tignanelli C, Connett J, Ikramuddin S, Harmon JV.

Surg Endosc. 2019 Jan;33(1):281-292.

Rationale for inclusion: this 12 yrs NSQIP retrospective review evidenced that while laparoscopic approach is used less often, it is associated with shorter LOS, SSI, wound dehiscence and mortality.

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No survival advantage exists for patients undergoing loop ileostomy for clostridium difficile colitis.

Hall BR, Leinicke JA, Armijo PR, Smith LM, Langenfeld SJ, Oleynikov D.

Am J Surg. 2019 Jan;217(1):34-39.

Rationale for inclusion: Found no survival benefit for patients who undergo loop ileostomy for C difficile infection compared to those who undergo total colectomy; however, patients who undergo loop ileostomy are likely to retain their colon with low risk of requiring subsequent colectomy.

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Pantoprazole in Patients at Risk for Gastrointestinal Bleeding in the ICU

Krag M, Marker S, Perner A, et al.

N Engl J Med . 2018 Dec 6;379(23):2199-2208.

Rationale for Inclusion: Blinded randomized trial. Impacts both GI bleeding and critical care domains.

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Trauma and emergency general surgery patients should be extubated with an open abdomen.

Taveras LR, Imran JB, Cunningham HB, Madni TD, Taarea R, Tompeck A, Clark AT, Provenzale N, Adeyemi FM, Minshall CT, Eastman AL, Cripps MW.

J Trauma Acute Care Surg. 2018 Dec;85(6):1043-1047.

Rationale for inclusion: Demonstrates that trauma and EGS patient with open abdomen can be extubated safely with less risk of pneumonia.

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Risk of Appendiceal Neoplasm in Periappendicular Abscess in Patients Treated With Interval Appendectomy vs Follow-up With Magnetic Resonance Imaging: 1-year Outcomes of the Peri-Appendicitis Acuta Randomized Clinical Trial.

Mällinen J, Rautio T, Grönroos J, Rantanen T, Nordström P, Savolainen H, Ohtonen P, Hurme S, Salminen P.

JAMA Surg. 2018 Nov 28.

Rationale for inclusion: Informs decision with respect to interval appendectomy for patients with complicated appendicitis underging non-operative management.

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Shorter duration of antibiotic treatment for acute bacteraemic cholangitis with successful biliary drainage: a retrospective cohort study.

Doi A, Morimoto T, Iwata K.

Clin Microbiol Infect. 2018 Nov;24(11):1184-1189.

Rationale for inclusion: This single institution retrospective cohort study demostrates that a shorter course of antibiotics, 6 days, had no worse outcomes than a longer course of 12 days for patients with bacteremia and cholangitis. Antibiotics must be paired with biliary decompression.

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Outcomes Associated With Timing of ERCP in Acute Cholangitis Secondary to Choledocholithiasis.

Parikh MP, Wadhwa V, Thota PN, Lopez R, Sanaka MR.

J Clin Gastroenterol. 2018 Nov/Dec;52(10):e97-e102.

Rationale for inclusion: This retrospective review from the National Inpatient Survery demonstrates that, in inpatients with cholangitis ERCP should not be delayed beyond 48 hours.

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Efficacy of Wound Coverage Techniques in Extremity Necrotizing Soft Tissue Infections.

Lauerman MH, Scalea TM, Eglseder WA, Pensy R, Stein DM, Henry S.

Am Surg. 2018 Nov 1;84(11):1790-1795.

Rationale for inclusion: Comparing effect of different wound coverage techniques on rate and time to complete closure of wound after debridement.

CAVEAT: Small study.

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Laparoscopic cholecystectomy versus percutaneous catheter drainage for acute cholecystitis in high risk patients (CHOCOLATE): multicentre randomised clinical trial.

Loozen CS, van Santvoort HC, van Duijvendijk P, Besselink MG, Gouma DJ, Nieuwenhuijzen GA, Kelder JC, Donkervoort SC, van Geloven AA, Kruyt PM, Roos D, Kortram K, Kornmann VN, Pronk A, van der Peet DL, Crolla RM, van Ramshorst B, Bollen TL, Boerma D.

BMJ. 2018 Oct 8;363:k3965.

Rationale for inclusion: This multicenter, randomized-contgrolled trial compared percutaneous cholecystotostomy to laparoscopic cholecystectomy in patients with acute cholecystitis due to calculous in patients with an APACHE II score of 7 or more. Laparoscopic cholecystectomy in critically ill patients reduced complications, healthcare utilization and costs.

CAVEAT: Trial concluded early after interim analysis.

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Perforated Diverticulitis with Generalized Peritonitis: Low Stoma Rate Using a "Damage Control Strategy".

Sohn M, Iesalnieks I, Agha A, Steiner P, Hochrein A, Pratschke J, Ritschl P, Aigner F.

World J Surg. 2018 Oct;42(10):3189-3195.

Rationale for inclusion: Lowering stoma rate with damage control laparotomy in Hinchey II and IV diverticulitis.

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Surgical management of obstructive right-sided colon cancer at a national level results of a multicenter study of the French Surgical Association in 776 patients

Mege D, Manceau G, Beyer-Berjot L, Bridoux V, Lakkis Z, Venara A, Voron T, Brunetti F, Sielezneff I, Karoui M; AFC (French Surgical Association) Working Group.

Eur J Surg Oncol. 2018 Oct;44(10):1522-1531.

Rationale for inclusion: This retrospective cohort study found that a majority of patients with obstructing right-sided colon cancer can be managed with resection and primary anastomosis but high-risk patients may benefit from a staged surgical approach.

CAVEAT: Retrospective national cohort study.

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Five-Year Follow-up of Antibiotic Therapy for Uncomplicated Acute Appendicitis in the APPAC Randomized Clinical Trial

Salminen P, Tuominen R, Paajanen H, Rautio T, Nordström P, Aarnio M, Rantanen T, Hurme S, Mecklin JP, Sand J, Virtanen J, Jartti A, Grönroos JM.

JAMA. 2018;320(12):1259-1265.

Rationale for inclusion: Long follow up of one of the most prominent studies comparing appendectomy and antibiotics for acute appendicitis.

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Meta-Analysis of Early Enteral Nutrition Provided Within 24 Hours of Admission on Clinical Outcomes in Acute Pancreatitis.

Qi D, Yu B, Huang J, Peng M.

JPEN J Parenter Enteral Nutr. 2018 Sep;42(7):1139-1147.

Rationale for inclusion: In this metaanalysis, 8 studies were analyzed and early entereal nutrition initiated within 24 hours. This study identified no benfits in the mild or moderate pancreatitis groups. However in the predicted severe or severe groups (APACHE score of at least 6) there was a lower rate of mortality and multiple organ failure.

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Transcatheter Arterial Embolization in Lower Gastrointestinal Bleeding: Ischemia Remains a Concern Even with a Superselective Approach.

Nykänen T, Peltola E, Kylänpää L, Udd M.

J Gastrointest Surg. 2018 Aug;22(8):1394-1403.

Rationale for inclusion: This single Finnish center study demonstrated the elevated success rate of TAE (96%) with 17% post TAE ischemia rate requiring resection, supporting the TAE as second option of treatment of GIB after colonoscopy and before surgery.

CAVEAT: Finnish study.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Long-Term Effects of Omitting Antibiotics in Uncomplicated Acute Diverticulitis.

van Dijk ST, Daniels L, Ünlü Ç, de Korte N, van Dieren S, Stockmann HB, Vrouenraets BC, Consten EC, van der Hoeven JA, Eijsbouts QA, Faneyte IF, Bemelman WA, Dijkgraaf MG, Boermeester MA; Dutch Diverticular Disease (3D) Collaborative Study Group.

Am J Gastroenterol. 2018 Jul;113(7):1045-1052.

Rationale for inclusion: A follow up of the DIABOLO trial, this multicenter Dutch study, shows that omiting antibiotics for uncomplicated diverticultis did not result in more complicated attacks, or resections at 12 and 24 months follow up.

CAVEAT: Dutch study.

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Evaluating the Relevance of the 2013 Tokyo Guidelines for the Diagnosis and Management of Cholecystitis.

Joseph B, Jehan F, Dacey M, Kulvatunyou N, Khan M, Zeeshan M, Gries L, O'Keeffe T, Riall TS.

J Am Coll Surg. 2018 Jul;227(1):38-43.e1.

Rationale for inclusion: This prospecctive application of the Tokyo Guidelines demonstrates that these criteria lack sensitivity and may miss over 50% of cases of acute cholecystitis.

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The effect of damage control laparotomy on major abdominal complications: A matched analysis.

George MJ, Adams SD, McNutt MK, Love JD, Albarado R, Moore LJ, Wade CE, Cotton BA, Holcomb JB, Harvin J.

Am J Surg. 2018 Jul;216(1):56-59.

Rationale for inclusion: Comparing damage control laparotomy vs primary closure on major abdominal complications.

CAVEAT: 2 studies with similar name. Looking on different outcomes.

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Bile Spillage as a Risk Factor for Surgical Site Infection after Laparoscopic Cholecystectomy: A Prospective Study of 1,001 Patients.

Peponis T, Eskesen TG, Mesar T, Saillant N, Kaafarani HMA, Yeh DD, Fagenholz PJ, de Moya MA, King DR, Velmahos GC.

J Am Coll Surg. 2018 Jun;226(6):1030-1035.

Rationale for inclusion: This study evaluated the consequence of bile spillage during a laparoscopic cholecystectomy. With over 80% follow up, the study identified an increase in surgical site infection and legnth of stay.

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Meta-analysis of surgical strategies in perforated left colonic diverticulitis with generalized peritonitis.

Schmidt S, Ismail T, Puhan MA, Soll C, Breitenstein S.

Langenbecks Arch Surg. 2018 Jun;403(4):425-433.

Rationale for inclusion: This meta-analysis suports the results of the DIVERTI trial. Results show that laparoscopic lavage are not superior to primary resection.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Durability and Long-term Clinical Outcomes of Fecal Microbiota Transplant Treatment in Patients With Recurrent Clostridium difficile Infection.

Mamo Y, Woodworth MH, Wang T, Dhere T, Kraft CS.

Clin Infect Dis. 2018 May 17;66(11):1705-1711.

Rationale for inclusion: This study addresses durability of long term outcome after fecal transplant.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

The GroinPain Trial: A Randomized Controlled Trial of Injection Therapy Versus Neurectomy for Postherniorraphy Inguinal Neuralgia.

Verhagen T, Loos MJA, Scheltinga MRM, Roumen RMH.

Ann Surg. 2018 May;267(5):841-845.

Rationale for Inclusion: Randomized trial of surgical vs. medical management of chronic groin pain.

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Efficacy of Over-the-Scope Clips in Management of High-Risk Gastrointestinal Bleeding.

Brandler J, Baruah A, Zeb M, Mehfooz A, Pophali P, Wong Kee Song L, AbuDayyeh B, Gostout C, Mara K, Dierkhising R, Buttar N.

Clin Gastroenterol Hepatol. 2018 May;16(5):690-696.e1.

Rationale for Inclusion: Describes the changing epidemiology of gastroitestinal bleed in the United States.

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What are the influencing factors for chronic pain following TAPP inguinal hernia repair: an analysis of 20,004 patients from the Herniamed Registry.

Niebuhr H, Wegner F, Hukauf M, Lechner M, Fortelny R, Bittner R, Schug-Pass C, Köckerling F.

Surg Endosc. 2018 Apr;32(4):1971-1983.

Rationale for Inclusion: Risk stratification for grain pain after TAPP.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Damage control surgery for non-traumatic abdominal emergencies.

Girard E, Abba J, Boussat B, Trilling B, Mancini A, Bouzat P, Létoublon C, Chirica M, Arvieux C.

World J Surg. 2018 Apr;42(4):965-973

Rationale for inclusion: Damage control surgery (DCS) was a major paradigm change in the management of critically ill trauma patients and has gradually expanded in the general surgery arena, but data in this setting are still scarce. The study aim was to evaluate outcomes of DCS in patients with general surgery emergencies. DCS can be lifesaving in critically ill patients with general surgery emergencies. Patients with peritonitis and acute pancreatitis are those who benefit most of the DCS approach.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Validation of the AAST EGS acute cholecystitis grade and comparison with the Tokyo guidelines

Hernandez M, Murphy B, Aho JM, Haddad NN, Saleem H, Zeb M, Morris DS, Jenkins DH, Zielinski M.

Surgery. 2018 Apr;163(4):739-746.

Rationale for inclusion: Direct comparison of two validated models for cholecystitis severity, AAST grading system outperformed the Tokyo Guidelines in predicting mortality and complications.

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Endoscopic retrograde cholangiopancreatography decreases all-cause and pancreatitis readmissions in patients with acute gallstone pancreatitis who do not undergo cholecystectomy: a nationwide 5-year analysis

Qayed E, Shah R, Haddad YK.

Pancreas. 2018 Apr;47(4):425-435.

Rationale for Inclusion: Although cholecystectomty is performed as definitive managmenet of gallstone pancreatitis this study utilizing the 2010-2014 National Readmissions database of more than 150,000 admissions for gallstone pancreaitis demonstrated that ERCP was associated with reduced readmissions and support performing ERCP in patients unfit for surgery.

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Extended antibiotic therapy versus placebo after laparoscopic cholecystectomy for mild and moderate acute calculous cholecystitis: A randomized double-blind clinical trial.

de Santibañes M, Glinka J, Pelegrini P, Alvarez FA, Elizondo C, Giunta D, Barcan L, Simoncini L, Dominguez NC, Ardiles V, Mazza O, Claria RS, de Santibañes E, Pekolj J.

Surgery. 2018 Mar 2. pii: S0039-6060(18)30030-8.

Rationale for inclusion: This single center, prospective, double blind, randomized trial failed to demonstrate that the addition of 5 days of postopertive amoxiciliin/clavulanic acid was non-inferior to placebo.

CAVEAT: Trial underpowered to show noninferiority within a margin of 5%.

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Inpatient Choledocholithiasis Requiring ERCP and Cholecystectomy: Outcomes of a Combined Single Inpatient Procedure Versus Separate-Session Procedures.

Passi M, Inamdar S, Hersch D, Dowling O, Sejpal DV, Trindade AJ.

J Gastrointest Surg. 2018 Mar;22(3):451-459

Rationale for inclusion: This study demonstrates that a single operative session is safe, efficacious, and has a decrease in cost compared to separate session and hospitalizations.

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Laparoscopic mesh removal for otherwise intractable inguinal pain following endoscopic hernia repair is feasible, safe and may be effective in selected patients.

Slooter GD, Zwaans WAR, Perquin CW, Roumen RMH, Scheltinga MRM.

Surg Endosc. 2018 Mar;32(3):1613-1619.

Rationale for Inclusion: An unique option for management of chronic groin pain.

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American Gastroenterological Association Institute Guideline on Initial Management of Acute Pancreatitis

Crockett SD, Wani S, Gardner TB, Falck-Ytter Y, Barkun AN.

Gastroenterology. 2018 Mar;154(4):1096-1101.

Rationale for inclusion: Using GRADE methodology, this paper makes recommendations for the diagnosis and management of pancreatitis.

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Optimal timing of initial debridement for necrotizing soft tissue infection: a practice management guideline from the eastern association for the surgery of trauma.

Gelbard RB, Ferrada P, Yeh DD, Williams BH, Loor M, Yon J, Mentzer C, Khwaja K, Khan MA, Kohli A, Bulger EM, Robinson BRH.

J Trauma Acute Care Surg. 2018 Jul;85(1):208-214.

Rationale for Inclusion: Practice management guideline recommending early operative debridement within 12 hours of suspected diagnosis. Institutional and regional systems should be optimized to facilitate prompt surgical evaluation and debridement.

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Early Fecal Microbiota Transplantation Improves Survival in Severe Clostridium difficile Infections.

Hocquart M, Lagier JC, Cassir N, Saidani N, Eldin C, Kerbaj J, Delord M, Valles C, Brouqui P, Raoult D, Million M.

Clin Infect Dis. 2018 Feb 10;66(5):645-650.

Rationale for inclusion: One of the few articles that demonstrate effect of Early fecal transplantation on mortality for severe C diff.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Tokyo guidelines 2018: antimicrobial therapy for acute cholangitis and cholecystitis

Gomi H, Solomkin JS, Schlossberg D, Okamoto K, Takada T, Strasberg SM, Ukai T, Endo I, Iwashita Y, Hibi T, Pitt HA, Matsunaga N, Takamori Y, Umezawa A, Asai K, Suzuki K, Han HS, Hwang TL, Mori Y, Yoon YS, Huang WS, Belli G, Dervenis C, Yokoe M, Kiriyama S, Itoi T, Jagannath P, Garden OJ, Miura F, de Santibañes E, Shikata S, Noguchi Y, Wada K, Honda G, Supe AN, Yoshida M, Mayumi T, Gouma DJ, Deziel DJ, Liau KH, Chen MF, Liu KH, Su CH, Chan ACW, Yoon DS, Choi IS, Jonas E, Chen XP, Fan ST, Ker CG, Giménez ME, Kitano S, Inomata M, Mukai S, Higuchi R, Hirata K, Inui K, Sumiyama Y, Yamamoto M.

J Hepatobiliary Pancreat Sci. 2018 Jan;25(1):3-16.

Rationale for inclusion: Systematic review of literature from January 2010 to 2016 to guide antibiotic management of acute cholecystitis & cholangitis.

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Tokyo guidelines 2018: surgical management of acute cholecystitis: safe steps in laparoscopic cholecystectomy for acute cholecystitis

Wakabayashi G, Iwashita Y, Hibi T, Takada T, Strasberg SM, Asbun HJ, Endo I, Umezawa A, Asai K, Suzuki K, Mori Y, Okamoto K, Pitt HA, Han HS, Hwang TL, Yoon YS, Yoon DS, Choi IS, Huang WS, Giménez ME, Garden OJ, Gouma DJ, Belli G, Dervenis C, Jagannath P, Chan ACW, Lau WY, Liu KH, Su CH, Misawa T, Nakamura M, Horiguchi A, Tagaya N, Fujioka S, Higuchi R, Shikata S, Noguchi Y, Ukai T, Yokoe M, Cherqui D, Honda G, Sugioka A, de Santibañes E, Supe AN, Tokumura H, Kimura T, Yoshida M, Mayumi T, Kitano S, Inomata M, Hirata K, Sumiyama Y, Inui K, Yamamoto M.

J Hepatobiliary Pancreat Sci. 2018 Jan;25(1):73-86.

Rationale for inclusion: Expert consensus review of safe techniques and bail-out procedures in complex laparoscopic cases for acute cholecystitis.

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Tokyo Guidelines 2018: initial management of acute biliary infection and flowchart for acute cholangitis.

Miura F, Okamoto K, Takada T, Strasberg SM, Asbun HJ, Pitt HA, Gomi H, Solomkin JS, Schlossberg D, Han HS, Kim MH, Hwang TL, Chen MF, Huang WS, Kiriyama S, Itoi T, Garden OJ, Liau KH, Horiguchi A, Liu KH, Su CH, Gouma DJ, Belli G, Dervenis C, Jagannath P, Chan ACW, Lau WY, Endo I, Suzuki K, Yoon YS, de Santibañes E, Giménez ME, Jonas E, Singh H, Honda G, Asai K, Mori Y, Wada K, Higuchi R, Watanabe M, Rikiyama T, Sata N, Kano N, Umezawa A, Mukai S, Tokumura H, Hata J, Kozaka K, Iwashita Y, Hibi T, Yokoe M, Kimura T, Kitano S, Inomata M, Hirata K, Sumiyama Y, Inui K, Yamamoto M.

J Hepatobiliary Pancreat Sci. 2018 Jan;25(1):31-40

Rationale for inclusion: Updates TG13 on flowchart for treatment startified by disease severity.

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Tokyo Guidelines 2018: antimicrobial therapy for acute cholangitis and cholecystitis.

Gomi H, Solomkin JS, Schlossberg D, Okamoto K, Takada T, Strasberg SM, Ukai T, Endo I, Iwashita Y, Hibi T, Pitt H, Matsunaga N, Takamori Y, Umezawa A, Asai K, Suzuki K, Han HS, Hwang TL, Mori Y, Yoon YS, Huang WS, Belli G, Dervenis C, Yokoe M, Kiriyama S, Itoi T, Jagannath P, Garden OJ, Miura F, de Santibañes E, Shikata S, Noguchi Y, Wada K, Honda G, Supe AN, Yoshida M31, Mayumi T, Gouma DJ, Deziel DJ, Liau KH, Chen MF, Liu KH, Su CH, Chan ACW, Yoon DS, Choi IS, Jonas E, Chen XP, Fan ST, Ker CG, Giménez ME, Kitano S, Inomata M, Mukai S, Higuchi R, Hirata K, Inui K, Sumiyama Y, Yamamoto M.

J Hepatobiliary Pancreat Sci. 2018 Jan;25(1):3-16

Rationale for inclusion: Updates TG13 on antibiotic therapy

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Association between early ERCP and mortality in patients with acute cholangitis.

Tan M, Schaffalitzky de Muckadell OB, Laursen SB.

Gastrointest Endosc. 2018 Jan;87(1):185-192.

Rationale for inclusion: This retrospective review (over 7 yrs & over 400 patients) of a single Danish center provides the first association between early ERCP (within 24hrs) and lower mortality.

CAVEAT: The majority of the patients had malignancy.

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Endoscopic or surgical step-up approach for infected necrotising pancreatitis: a multicentre randomised trial

van Brunschot S, van Grinsven J, van Santvoort HC, Bakker OJ, Besselink MG, Boermeester MA, Bollen TL, Bosscha K, Bouwense SA, Bruno MJ, Cappendijk VC, Consten EC, Dejong CH, van Eijck CH, Erkelens WG, van Goor H, van Grevenstein WMU, Haveman JW, Hofker SH, Jansen JM, Laméris JS, van Lienden KP, Meijssen MA, Mulder CJ, Nieuwenhuijs VB, Poley JW, Quispel R, de Ridder RJ, Römkens TE, Scheepers JJ, Schepers NJ, Schwartz MP, Seerden T, Spanier BWM, Straathof JWA, Strijker M, Timmer R, Venneman NG, Vleggaar FP, Voermans RP, Witteman BJ, Gooszen HG, Dijkgraaf MG, Fockens P.

Lancet. 2018 Jan 6;391(10115):51-58.

Rationale for Inclusion: This randomized controlled trial comparing the endoscopic step-up approach to the surgical step-up approach demonstrated that the endoscopic approach is not superior in reducing major complications or death.

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Watchful Waiting Versus Surgery of Mildly Symptomatic or Asymptomatic Inguinal Hernia in Men Aged 50 Years and Older: A Randomized Controlled Trial.

de Goede B, Wijsmuller AR, van Ramshorst GH, van Kempen BJ, Hop WCJ, Klitsie PJ, Scheltinga MR, de Haan J, Mastboom WJB, van der Harst E, Simons MP, Kleinrensink GJ, Jeekel J, Lange JF; INCA Trialists Collaboration.

Ann Surg. 2018 Jan;267(1):42-49.

Watch the EAST Minute Video

Rationale for inclusion: recent look at males >50 years of age with mildly symptomatic inguinal hernia versus surgery.

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Risky business? Investigating outcomes of patients undergoing urgent laparoscopic appendectomy on antithrombotic therapy.

Pearcy C, Almahmoud K, Jackson T, Hartline C, Cahill A, Spence L, Kim D, Olatubosun O, Todd SR, Campion EM, Burlew CC, Regner J, Frazee R, Michaels D, Dissanaike S, Stewart C, Foley N, Nelson P, Agrawal V, Truitt MS.

Am J Surg. 2017 Dec;214(6):1012-1015

Rationale for inclusion: large retrospective study within a multi-center trial suggests that irreversible antithrombotic therapy (aspirin and Plavix) is not associated with worse outcomes in urgent or emergent laparoscopic appendectomy.

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Hartmann's Procedure or Primary Anastomosis for Generalized Peritonitis due to Perforated Diverticulitis: A Prospective Multicenter Randomized Trial (DIVERTI).

Bridoux V, Regimbeau JM, Ouaissi M, Mathonnet M, Mauvais F, Houivet E, Schwarz L, Mege D, Sielezneff I, Sabbagh C, Tuech JJ.

J Am Coll Surg. 2017 Dec;225(6):798-805.

Watch the EAST Minute Video

Rationale for inclusion: a well-designed prospective, multicenter, randomized controlled study comparing mortality between patients with diverticular peritonitis (Hinchey stage III and IV) who had a primary anastomosis with a protective diverting stoma versus patients who had a Hartmann’s procedure. No significant difference found in mortality, but primary anastomosis patients were > 30% more likely to have stoma reversal by 18 months.

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Laparoscopic appendectomy vs antibiotic therapy for acute appendicitis: a propensity score-matched analysis from a multicenter cohort study.

Poillucci G, Mortola L, Podda M, Di Saverio S, Casula L, Gerardi C, Cillara N, Presenti L.

Updates Surg. 2017 Dec;69(4):531-540.

Rationale for inclusion: A propensity score-matched analysis was performed in a multi-center European study aiming to assess safety and feasibility of both nonoperative management with antibiotics and appendectomy for patients with acute appendicitis. Patients treated with antibiotics had both an initial treatment failure and recurrence rate at 1-year followup of 20%. Due to low complication rates and the high efficacy of surgical therapy, laparoscopic appendectomy still represents the most effective treatment for patients with appendicitis.

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Meta-analysis on the impact of the acute care surgery model of disease and patient-specific outcomes in appendicitis and biliary disease

Murphy PB, DeGirolamo K, Van Zyl TJ, Allen L, Haut E, Leeper WR, Leslie K, Parry N, Hameed M, Vogt KN.

J Am Coll Surg. 2017 Dec;225(6):763-777.e13.

Rationale for inclusion: Meta-analysis looking at the acute care surgery model's impact on cholecystitis; decreased length of stay and complication rates.

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Laparoscopic common bile duct exploration versus endoscopic retrograde cholangiopancreatography for choledocholithiasis found at time of laparoscopic cholecystectomy: Analysis of a large integrated health care system database.

Al-Temimi MH, Kim EG, Chandrasekaran B, Franz V, Trujillo CN, Mousa A, Tessier DJ, Johna SD, Santos DA.

Am J Surg. 2017 Dec;214(6):1075-1079

Rationale for inclusion: This multicenter, community hospital-based retrospective study provides the current trend to favor ERCP vs laparoscopic /open common bile duct exploration in the removal of choledolithiasis. ERCP in this study has a higher clearance rate with an associated higher number of interventions per patient.

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Randomized clinical trial of antibiotic therapy for uncomplicated appendicitis.

Park HC, Kim MJ, Lee BH.

Br J Surg. 2017 Dec;104(13):1785-1790.

Rationale for inclusion: Largest trial of antibiotics versus placebo for uncomplicated appendicitis.

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Effect of antibiotic stewardship on the incidence of infection and colonisation with antibiotic-resistant bacteria and Clostridium difficile infection: a systematic review and meta-analysis

Baur D, Gladstone BP, Burkert F, Carrara E, Foschi F, Döbele S, Tacconelli E.

Lancet Infect Dis. 2017 Sep;17(9):990-1001

Rationale for inclusion: Important for the all aspects of acute care surgeons and intensvists. Demonstrates the benefits of antibiotic stewardship programs.

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Severe elevation of liver test in choledocholithiasis. An uncommon occurrence with important clinical implications.

Bangaru S, Thiele D, Sreenarasimhaiah J, Agrawal D.

J Clin Gastroenterol. 2017 Sep;51(8):728-733.

Rationale for inclusion: Awareness of this low prevalence condition can decrease unnecessary laboratory and images, thereby reducing healthcare cost.

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Value of oral proton pump inhibitors in acute, nonvariceal upper gastrointestinal bleeding a network meta-analysis.

Rodriguez EA, Donath E, Waljee AK, Sussman DA.

J Clin Gastroenterol. 2017 Sep;51(8):707-719.

Rationale for Inclusion: Meta-analysis revealing scheduled PO proton pump inhibitors were as effective as IV proton pump inhibitors for most outcomes.

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Derivation and validation of a novel risk score for safe discharge after acute lower gastrointestinal bleeding: a modelling study.

Oakland K, Jairath V, Uberoi R, Guy R, Ayaru L, Mortensen N, Murphy MF, Collins GS.

Lancet Gastroenterol Hepatol. 2017 Sep;2(9):635-643.

Rationale for Inclusion: Large prospective study used to develop and validate a novel clinical prediction model with good discriminative performance in identifying patients with lower gastrointestinal bleeding who are candidates for safe outpatient management, yielding important resource and economic implications..

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Colonic stenting as a bridge to surgery versus emergency surgery for malignant colonic obstruction: results of a multicentre randomised controlled trial (ESCO trial).

Arezzo A, Balague C, Targarona E, Borghi F, Giraudo G, Ghezzo L, Arroyo A, Sola-Vera J, De Paolis P, Bossotti M, Bannone E, Forcignanò E, Bonino MA, Passera R, Morino M.

Surg Endosc. 2017 Aug;31(8):3297-3305.

Rationale for inclusion: Multicenter study comparing self-expandable metallic stents as a bridge to surgery versus emergency surgery found no difference in morbidity and oncologic outcome at 36 months but there was a lower stoma rate in the stent group. A “non-inferiority” RCT with survival as primary end point would be the appropriate method to correctly investigate long-term outcomes after SEMS as BTS versus ES.

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2017 update of the WSES guidelines for emergency repair of complicated abdominal wall hernias.

Birindelli A, Sartelli M, Di Saverio S, Coccolini F, Ansaloni L, van Ramshorst GH, Campanelli G, Khokha V, Moore EE, Peitzman A, Velmahos G, Moore FA, Leppaniemi A, Burlew CC, Biffl WL, Koike K, Kluger Y, Fraga GP, Ordonez CA, Novello M, Agresta F, Sakakushev B, Gerych I, Wani I, Kelly MD, Gomes CA, Faro MP Jr, Tarasconi A, Demetrashvili Z, Lee JG, Vettoretto N, Guercioni G, Persiani R, Tranà C, Cui Y, Kok KYY, Ghnnam WM, Abbas AE, Sato N, Marwah S, Rangarajan M, Ben-Ishay O, Adesunkanmi ARK, Lohse HAS, Kenig J, Mandalà S, Coimbra R, Bhangu A, Suggett N, Biondi A, Portolani N, Baiocchi G, Kirkpatrick AW, Scibé R, Sugrue M, Chiara O, Catena F.

World J Emerg Surg. 2017 Aug 7;12:37.

Rationale for inclusion: evidence-based approach for emergency management of complicated abdominal wall hernias.

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Diagnosis of lower gastrointestinal bleeding by multi-slice CT angiography: a meta-analysis.

He B, Yang J, Xiao J, Gu J, Chen F, Wang L, Zhao C, Qian J, Gong S.

Eur J Radiol. 2017 Aug;93:40-45.

Rationale for Inclusion: A total of 14 articles with 549 patients were included in the meta-analysis. The study showed multi-slice spiral CTA has high value (sensitivity 90% and specificity 92%) in the diagnosis of lower gastrointestinal bleeding and should be considered an adjunct in the clinical treatment of lower GI bleeds.

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Decreasing the use of damage control laparotomy in trauma: A quality improvement project.

Harvin JA, Kao LS, Liang MK, Adams SD, McNutt MK, Love JD, Moore LJ, Wade CE, Cotton BA, Holcomb JB.

J Am Coll Surg. 2017 Aug;225(2):200-209

Rationale for inclusion: Damage control laparotomy rates of 30% are documented and there is substantial morbidity associated with the open abdomen. The purpose of this quality improvement (QI) project was to decrease the rate of DCL at a busy, Level I trauma center in the US. A QI initiative rapidly changed the use of DCL and improved quality of care by decreasing resource use without an increase morbidity or mortality. This decrease was sustained during the QI period and further improved upon after its completion.

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Mortality after emergent trauma laparotomy: A multicenter, retrospective study.

Harvin JA, Maxim T, Inaba K, Martinez-Aguilar MA, King DR, Choudhry AJ, Zielinski MD, Akinyeye S, Todd SR, Griffin RL, Kerby JD, Bailey JA, Livingston DH, Cunningham K, Stein DM, Cattin L, Bulger EM, Wilson A, Undurraga Perl VJ, Schreiber MA, Cherry-Bukowiec JR, Alam HB, Holcomb JB.

J Trauma Acute Care Surg. 2017 Sep;83(3):464-468

Rationale for inclusion: Hypotensive trauma patients requiring emergent laparotomy had a 40% mortality. In the interim, multiple interventions to decrease hemorrhage-related mortality have been implemented but few have any documented evidence of change in outcomes for patients requiring emergent laparotomy. The mortality rate for hypotensive patients (46%) appears unchanged over the last two decades and is even more concerning, with almost half of patients presenting with an SBP of 90 mm Hg or less dying.

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One-year results of the SCANDIV randomized clinical trial of laparoscopic lavage versus primary resection for acute perforated diverticulitis.

Schultz JK, Wallon C, Blecic L, Forsmo HM, Folkesson J, Buchwald P, Kørner H, Dahl F, Øresland T, Yaqub S.

Br J Surg. 2017 Sep;104(10):1382-1392.

Rationale for inclusion: Longer follow up on previously reported RCT showing similar rates of a second operation after the index operation, mortality, and complications. Lower incidence of stoma at one year in the laparoscopic lavage group.

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Failure of conservative treatment of acute diverticulitis with extradigestive air.

Colas PA, Duchalais E, Duplay Q, Serra-Maudet V, Kanane S, Ridereau-Zins C, Lermite E, Aubé C, Hamy A, Venara A.

World J Surg. 2017 Jul;41(7):1890-1895

Rationale for inclusion: Multicenter review of diverticulitis patients treated medically to identify clinical and CT findings associated with failure of medical management.

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Multi-institutional, prospective, observational study comparing the Gastrografin challenge versus standard treatment in adhesive small bowel obstruction.

Zielinski MD, Haddad NN, Cullinane DC, Inaba K, Yeh DD, Wydo S, Turay D, Pakula A, Duane TM, Watras J, Widom KA, Cull J, Rodriguez CJ, Toschlog EA, Sams VG, Hazelton JP, Graybill JC, Skinner R, Yune JM; EAST SBO Workgroup: Martin D. Zielinski, MD; Nadeem N. Haddad, MD; Asad J. Choudhry, MBBS; Daniel C. Cullinane, MD; Kenji Inaba, MD; Agustin Escalante; D. Dante Yeh, MD; Salina Wydo, MD; David Turay, MD; Andrea Pakula, MD; Therese M. Duane, MD; Jill Watras, MD; Kenneth A. Widom, MD; John Cull, MD; Carlos J. Rodriguez, DO; Eric A. Toschlog, MD; Valerie G. Sams, MD; Joshua P. Hazelton, DO; John Christopher Graybill, MD, Ruby Skinner, MD, Ji-Ming Yune, MD.

J Trauma Acute Care Surg. 2017 Jul;83(1):47-54.

Rationale for inclusion: EAST sponsored multi-institutional, prospective, observational study performed on patients appropriate for Gastrografin with adhesive SBO. Patients receiving Gastrografin for adhesive SBO had lower rates of exploration and shorter hospital length of stay compared to patients who did not receive Gastrografin.

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Loop ileostomy versus total colectomy as surgical treatment for Clostridium difficile-associated disease: An Eastern Association for the Surgery of Trauma multicenter trial.

Ferrada P, Callcut R, Zielinski MD, Bruns B, Yeh DD, Zakrison TL, Meizoso JP, Sarani B, Catalano RD, Kim P, Plant V, Pasley A, Dultz LA, Choudhry AJ, Haut ER; EAST Multi-Institutional Trials Committee.

J Trauma Acute Care Surg. 2017 Jul;83(1):36-40.

Rationale for inclusion: the first multicenter study comparing total abdominal colectomy (TC) with loop ileostomy (LI) in the treatment of Clostridium difficile (CDAD). In this study, LI carried less mortality than TC. In patients without contraindications, LI should be considered for the surgical treatment of CDAD.

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Optimal Timing of Endoscopic Retrograde Cholangiopancreatography in Acute Cholangitis

Hou LA, Laine L, Motamedi N, Sahakian A, Lane C, Buxbaum J.

J Clin Gastroenterol. 2017 Jul;51(6):534-538.

Rationale for inclusion: This large prospective series demostrates that delays more than 48 hrs in ERCP have an increase in length LOS.

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Gastrointestinal safety of celecoxib versus naproxen in patients with cardiothrombotic diseases and arthritis after upper gastrointestinal bleeding (CONCERN): an industry-independent, double-blind, double-dummy, randomised trial.

Chan FKL, Ching JYL, Tse YK, Lam K, Wong GLH, Ng SC, Lee V, Au KWL, Cheong PK, Suen BY, Chan H, Kee KM, Lo A, Wong VWS, Wu JCY, Kyaw MH.

Lancet. 2017 Jun 17;389(10087):2375-2382.

Rationale for Inclusion: Large industry independent study that determines best discharge strategy in patients with GI bleed.

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Procalcitonin is a useful biomarker to predict severe acute cholangitis: a single-center prospective study

Umefune G, Kogure H, Hamada T, Isayama H, Ishigaki K, Takagi K, Akiyama D, Watanabe T, Takahara N, Mizuno S, Matsubara S, Yamamoto N, Nakai Y, Tada M, Koike K.

J Gastroenterol. 2017 Jun;52(6):734-745

Rationale for inclusion: This study shows that procalcitonin levels could be used to stratify the severity of cholangitis and predicts the need for early decompression.

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Open abdomen with vacuum-assisted wound closure and mesh-mediated fascial traction in patients with complicated diffuse secondary peritonitis: A single-center 8-year experience.

Tolonen M, Mentula P, Sallinen V, Rasilainen S, Bäcklund M, Leppäniemi A.

J Trauma Acute Care Surg. 2017 Jun;82(6):1100-1105

Rationale for inclusion: This is a retrospective, single center study of patients with diffuse secondary peritonitis treated with open abdomen and vaccuum assisted closure and mesh mediated traction. They had 92% fascial closure rates with their technique and a low rate (7%) of enteroatmospheric fistula.

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Operation versus antibiotics--The "appendicitis conundrum" continues: A meta-analysis.

Sakran JV, Mylonas KS, Gryparis A, Stawicki SP, Burns CJ, Matar MM, Economopoulos KP.

J Trauma Acute Care Surg. 2017 Jun;82(6):1129-1137.

Rationale for inclusion: recent metaanalysis synthesizes evidence from five RCTs comparing nonoperative versus surgical management of uncomplicated acute appendicitis in 1,430 adult patients. Treatment efficacy at 1-year follow-up was significantly lower (63.8%) for antibiotics compared with the surgery group (93%).

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Impact of hospital volume on outcomes for laparoscopic adhesiolysis for small bowel obstruction.

Jean RA, O'Neill KM, Pei KY, Davis KA.

J Surg Res. 2017 Jun 15;214:23-31.

Rationale for Inclusion: Using the National Inpatient Sample, this study looked at outcomes for laparoscopic lysis of adhesions in the setting of an adhesive small bowel obstruction. They showed that high volume centers produce better outcomes.

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Neural network prediction of severe lower intestinal bleeding and the need for surgical intervention.

Loftus TJ, Brakenridge SC, Croft CA, Smith RS, Efron PA, Moore FA, Mohr AM, Jordan JR.

J Surg Res. 2017 May 15;212:42-47.

Rationale for Inclusion: Artificial neural network (ANN) models have outperformed scoring systems based on regression models in predicting severe bleeding. This study compared ANNs to the Strate model in predicting acute lower intestinal bleed (ALIB). The Strate model was less accurate than an ANN featuring six variables present on admission: hemoglobin, systolic blood pressure, outpatient prescription for Aspirin 325 mg daily, Charlson comorbidity index, base deficit, and international normalized ratio. A similar ANN predicted the need for surgery by integrating two additional parameters: hemoglobin nadir and the occurrence of a 20% decrease in hematocrit. The optimal approach to clinical prognostication may incorporate the efficiency and pragmatism regression-based risk calculators and the accuracy of ANNs.

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History of the innovation of damage control for management of trauma patients: 1902-2016.

Roberts DJ, Ball CG, Feliciano DV, Moore EE, Ivatury RR, Lucas CE, Fabian TC, Zygun DA, Kirkpatrick AW, Stelfox HT.

Ann Surg. 2017 May;265(5):1034-1044

Rationale for inclusion: This article provides an excellent review of the history of the use of damage control laparotomy. Newer studies question whether damage control laparotomy should be used more selectively, especially in the context of changing resuscitation strategies.

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Laparoscopic or open appendicectomy for suspected appendicitis in pregnancy and evaluation of foetal outcome in Australia.

Winter NN, Guest GD, Bozin M, Thomson BN, Mann GB, Tan SBM, Clark DA, Daruwalla J, Muralidharan V, Najan N, Pitcher ME, Vilhelm K, Cox MR, Lane SE, Watters DA.

ANZ J Surg. 2017 May;87(5):334-338.

Rationale for inclusion: Largest study comparing laparoscopic and open appendectomy in pregnancy.

CAVEAT: Used statistical methods to account for differnences in gestational age.

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The role of endovascular therapy in acute mesenteric ischemia.

Ierardi AM, Tsetis D, Sbaraini S, Angileri SA, Galanakis N, Petrillo M, Patella F, Panella S, Balestra F, Lucchina N, Carrafiello G.

Ann Gastroenterol. 2017; 30(5): 526–533

Rationale for inclusion: This is an online review using PubMed that identified 18 articles from 2005 to 2016. Patients with arterial mesenteric ischemia treated with endovascular approach, the technical success rate was high (up to 100%). Technical success rate and clinical success of patients with acute venous mesenteric ischemia approached with endovascular treatment was 74-100% and 87.5-100%, respectively.

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The introduction of adult appendicitis score reduced negative appendectomy rate.

Sammalkorpi HE, Mentula P, Savolainen H, Leppäniemi A.

Scand J Surg. 2017 Sep;106(3):196-201.

Rationale for inclusion: Prospective study validating the adult appendicitis score (AAS) as a fast, accurate, and easily applicable method for straifying patients according to risk of appendiciits. Additionally, AAS can be used to help reduce negative appendectomy rates without mandatory imaging in those patients suspected of having acute appendicitis.

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Risk factors for surgical site infection after cholecystectomy

Warren DK, Nickel KB, Wallace AE, Mines D, Tian F, Symons WJ, Fraser VJ, Olsen MA.

Open Forum Infect Dis. 2017 Feb 22;4(2):ofx036.

Rationale for inclusion: Expansive study of > 66,000 patients identifying SSI risk factors such as male gender, chronic anemia, DM, drug abuse, malnutrition, obesity, previous infection, acute cholecystitis, and open surgery.

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A Prospective Study of the Conservative Management of Asymptomatic Preoperative and Postoperative Gallbladder Disease in Bariatric Surgery.

Pineda O, Maydón HG, Amado M, Sepúlveda EM, Guilbert L, Espinosa O, Zerrweck C.

Obes Surg. 2017 Jan;27(1):148-153.

Rationale for inclusion: A Prospective study for the management of cholelithiasis in bariatric patients. Cholelithiasis one of the most common complications after bariatric surgery, commonly seen by EGS surgeons. Low percentage actually require surgery so if diagnosed conservative management appropriate.

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Recurrence of choledocholithiasis following endoscopic bile duct clearance: Long term results and factors associated with recurrent bile duct stones.

Konstantakis C, Triantos C, Theopistos V, Theocharis G, Maroulis I, Diamantopoulou G, Thomopoulos K.

World J Gastrointest Endosc. 2017 Jan 16;9(1):26-33.

Rationale for inclusion: This study describes some risk factors for recurrence of biliary obstruction even after ERCP.

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Non-Elective Paraesophageal Hernia Repair Portends Worse Outcomes in Comparable Patients: a Propensity-Adjusted Analysis.

Tam V, Luketich JD, Winger DG, Sarkaria IS, Levy RM, Christie NA, Awais O, Shende MR, Nason KS.

J Gastrointest Surg . 2017 Jan;21(1):137-145.

Rationale for inclusion: Retrospective review of prospectively collected data including 980 patients who underwent paraesophageal hernia repair, attempting to determine whether non-elective repair is associated with different postoperative outcomes using propensity-score weighting. This was largely driven by the fact most non-elective repairs are performed in the elderly, who have more adverse prognostic factors and increased risk of major complication. After adjusting propensity-weighted data for age and comorbidity score, odds of major morbidity (OR 1.67) and mortality (OR 2.74) were significantly higher in non-elective repair, suggesting all symptomatic patients should be referred for discussion of elective repair.

CAVEAT: Single institution.

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Nationwide Assessment of Trends in Choledocholithiasis Management in the United States From 1998 to 2013.

Wandling MW, Hungness ES, Pavey ES, Stulberg JJ, Schwab B, Yang AD, Shapiro MB, Bilimoria KY, Ko CY, Nathens AB.

JAMA Surg. 2016 Dec 1;151(12):1125-1130.

Rationale for inclusion: This longitudinal analysis of the National Inpatient Sample from 1998 to 2013 confirms the decreasing role of common bile duct exploration (particularly via the open approach) concomitant with the increasing utilization of ERCP for CBD clearance. While a shorter median hospital LOS was seen with laparoscopic CBE compared to ERCP, the difference was small (0.5 days) and of questionable clinical significance.

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Patients With Adhesive Small Bowel Obstruction Should Be Primarily Managed by a Surgical Team

Aquina CT, Becerra AZ, Probst CP, Xu Z, Hensley BJ, Iannuzzi JC, Noyes K, Monson JR, Fleming FJ.

Ann Surg. 2016 Sep;264(3):437-47.

Rationale for inclusion: This large study confirms that patients with SBO managed by a surgical team have superior outcomes compared to those managed by a medical team.

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Umbilical hernia in patients with liver cirrhosis: A surgical challenge.

Coelho JC, Claus CM, Campos AC, Costa MA, Blum C.

World J Gastrointest Surg. 2016 Jul 27; 8(7): 476–482.

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Rationale for inclusion: recent review of available literature on cirrhotic umbilical hernia.

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Traumatic abdominal wall hernias: Location matters.

Coleman JJ, Fitz EK, Zarzaur BL, Steenburg SD, Brewer BL, Reed RL, Feliciano DV.

J Trauma Acute Care Surg. 2016 Mar;80(3):390-6;

Rationale for inclusion: largest series to date.

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Multicenter validation of American Association for the Surgery of Trauma grading system for acute colonic diverticulitis and its use for emergency general surgery quality improvement program.

Shafi S, Priest EL, Crandall ML, Klekar CS, Nazim A, Aboutanos M, Agarwal S, Bhattacharya B, Byrge N, Dhillon TS, Eboli DJ, Fielder D, Guillamondegui O, Gunter O, Inaba K, Mowery NT, Nirula R, Ross SE, Savage SA, Schuster KM, Schmoker RK, Siboni S, Siparsky N, Trust MD, Utter GH, Whelan J, Feliciano DV, Rozycki G; American Association for the Surgery of Trauma Patient Assessment Committee.

J Trauma Acute Care Surg. 2016 Mar;80(3):405-10; discussion 410-1.

Rationale for inclusion: This retrospective study found that the newly developed AAST grades for acute colonic diverticulitis were independently associated with clinical outcomes and resource use. This has important implications for EGS quality improvement program methodology.

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Evidence for an antibiotics-first strategy for uncomplicated appendicitis in adults: a systematic review and gap analysis.

Ehlers AP, Talan DA, Moran GJ, Flum DR, Davidson GH.

J Am Coll Surg. 2016 Mar;222(3):309-14.

Rationale for inclusion: This is an excellent review paper which discusses the limitations and methodological flaws (selection bias, diagnostic criteria, treatment strategy, outcome selection) of recently published randomized trials.

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Reoperative Surgery for Management of Early Complications After Gastric Bypass.

Augustin T, Aminian A, Romero-Talamás H, Rogula T, Schauer PR, Brethauer SA.

Obes Surg. 2016 Feb;26(2):345-9.

Rationale for inclusion: Recent study evaluating early 30 day reoperations due to complications after LRYGB. Included bleeding, obstruction or leak. These complications may present to the acute care surgeon on call requiring intervention.

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Subtotal cholecystectomy-"fenestrating" vs "reconstituting" subtypes and the prevention of bile duct injury: definition of the optimal procedure in difficult operative conditions.

Strasberg SM, Pucci MJ, Brunt LM, Deziel DJ.

J Am Coll Surg. 2016 Jan;222(1):89-96.

Rationale for inclusion: this review article describes the history, rationale, and methods of performing subtotal cholecystectomy, an important part of the armamentarium of any surgeon treating acute cholecystitis.

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The impact of elective colon resection on rates of emergency surgery for diverticulitis.

Simianu VV, Strate LL, Billingham RP, Fichera A, Steele SR, Thirlby RC, Flum DR.

Ann Surg. 2016 Jan;263(1):123-9.

Rationale for inclusion: This retrospective cohort study found that although the rate of elective colectomy for diverticulitis has more than doubled since 1987, the rate of emergent surgical intervention has not declined. Perhaps this reinforces the notion that elective colectomy does not help reduce the need for emergency surgery and should not be done routinely.

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Role of urgent contrast-enhanced multidetector computed tomography for acute lower gastrointestinal bleeding in patients undergoing early colonoscopy.

Nagata N, Niikura R, Aoki T, Moriyasu S, Sakurai T, Shimbo T, Shinozaki M, Sekine K, Okubo H, Watanabe K, Yokoi C, Yanase M, Akiyama J, Uemura N.

J Gastroenterol. 2015 Dec;50(12):1162-72.

Rationale for inclusion: This is a small study but addresses one of the dilemmas with LGIB; to scan or to perform endoscopy. In a small cohort of patients, the authors demonstrate some benefit with contrast-enhanced multidetector computed tomography for acute LGIB in localizing the lesion.

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An analysis of omitting biliary tract imaging in 668 subjects admitted to an acute care surgery service with biochemical evidence of choledocholithiasis.

Riggle AJ, Cripps MW, Liu L, Subramanian M, Nakonezny PA, Wolf SE, Phelan HA.

Am J Surg. 2015 Dec;210(6):1140-4; discussion 1144-6.

Rationale for inclusion: This large study contradicts the traditional teaching that patients presenting with biochemical evidence of choledocholithiasis require preoperative or intraoperative biliary imaging. The findings are encouraging because they report a low rate of adverse outcomes. Additional studies are required to confirm these findings.

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Results of prosthetic mesh repair in the emergency management of the acutely incarcerated and/or strangulated groin hernias: a 10-year study.

Bessa SS, Abdel-fattah MR, Al-Sayes IA, Korayem IT.

Hernia. 2015 Dec;19(6):909-14.

Rationale for inclusion: Results of prosthetic mesh repair in the emergency management of the acutely incarcerated and/or strangulated groin hernias: a 10-year study.

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Gangrenous cholecystitis: deceiving ultrasounds, significant delay in surgical consult, and increased postoperative morbidity!

Yeh DD, Cropano C, Fagenholz P, King DR, Chang Y, Klein EN, DeMoya M, Kaafarani H, Velmahos G.

J Trauma Acute Care Surg. 2015 Nov;79(5):812-6.

Rationale for inclusion: this study warns of false negative ultrasounds and delay in surgical consultation for gangrenous cholecystitis.

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Implementation of an acute care surgery service facilitates modern clinical practice guidelines for gallstone pancreatitis.

Murphy PB, Paskar D, Parry NG, Racz J, Vogt KN, Symonette C, Leslie K, Mele TS.

J Am Coll Surg. 2015 Nov;221(5):975-81.

Rationale for inclusion: This paper uniquely supports the creation of an ACS team in the treatment of gallstone pancreatitis and further supports the practice of cholecystectomy during index admission for gallstone pancreatitis.

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Internal Hernia After Laparoscopic Antecolic Roux-en-Y Gastric Bypass.

Al-Mansour MR, Mundy R, Canoy JM, Dulaimy K, Kuhn JN, Romanelli J.

Obes Surg. 2015 Nov;25(11):2106-11.

Rationale for inclusion: This is an important study looking at a complication that is common and often presents years after weight loss surgery which acute care surgeons may be faced with managing. Internal hernia is a potentially fatal complication and CT findings arent always positive. Time is critical and diagnostic laparoscopy gold standard. If no bariatric surgeon avaialble acute care surgeon needs to intervene.

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Laparoscopic Lavage vs Primary Resection for Acute Perforated Diverticulitis: The SCANDIV Randomized Clinical Trial.

Schultz JK, Yaqub S, Wallon C, Blecic L, Forsmo HM, Folkesson J, Buchwald P, Korner H, Dahl FA, Oresland T; SCANDIV Study Group.

JAMA. 2015 Oct 6;314(13):1364-75.

Rationale for inclusion: This multi-center, randomized clinical superiority trial found that the use of laparoscopic lavage did not reduce postoperative complications. There was no difference in mortality, postoperative length of stay or quality of life.

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Computed tomography is more sensitive than ultrasound for the diagnosis of acute cholecystitis.

Fagenholz PJ, Fuentes E, Kaafarani H, Cropano C, King D, de Moya M, Butler K, Velmahos G, Chang Y, Yeh DD.

Surg Infect (Larchmt). 2015 Oct;16(5):509-12.

Rationale for inclusion: this modern series supports the use of CT for the diagnosis of acute cholecystitis.

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Abdominal wall hernia and pregnancy: A systematic review.

Jensen K, Henriksen N, Jorgensen L.

Hernia. 2015 Oct;19(5):689-96.

Rationale for inclusion: Review of 31 manuscripts, reviewing outcomes of hernia repair in fertile women. While no major complications were reported following hernia repair before or during pregnancy, some patients developed significant pain related to repair (both primary suture and mesh repair) during the late stages of subsequent pregnancy. Additionally, incarcerated hernia repair during pregnancy and hernia repair at time of cesarean section appear safe.

CAVEAT: Limited largely to individual case reports and small case series.

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Same-admission versus interval cholecystectomy for mild gallstone pancreatitis (PONCHO): a multicentre randomised controlled trial.

da Costa DW, Bouwense SA, Schepers NJ, Besselink MG, van Santvoort HC, van Brunschot S, Bakker OJ, Bollen TL, Dejong CH, van Goor H, Boermeester MA, Bruno MJ, van Eijck CH, Timmer R, Weusten BL, Consten EC, Brink MA, Spanier BW, Bilgen EJ, Nieuwenhuijs VB, Hofker HS, Rosman C, Voorburg AM, Bosscha K, van Duijvendijk P, Gerritsen JJ, Heisterkamp J, de Hingh IH, Witteman BJ, Kruyt PM, Scheepers JJ, Molenaar IQ, Schaapherder AF, Manusama ER, van der Waaij LA, van Unen J, Dijkgraaf MG, van Ramshorst B, Gooszen HG, Boerma D; Dutch Pancreatitis Study Group.

Lancet. 2015 Sep 26;386(10000):1261-8.

Rationale for inclusion: This represents a multi-center RCT in patients with mild biliary pancreatitis and further supports index admission cholecystectomy in patients with mild disease (utilizing defined criteria).

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Small bites versus large bites for closure of abdominal midline incisions (STITCH): a double-blind, multicentre, randomised controlled trial.

Deerenberg EB, Harlaar JJ, Steyerberg EW, Lont HE, van Doorn HC, Heisterkamp J, Wijnhoven BP, Schouten WR, Cense HA, Stockmann H, Berends FJ, Dijkhuizen FPH, Dwarkasing RS, Jairam AP, van Ramshorst GH, Kleinrensink GJ, Jeekel J, Lange JF.

Lancet. 2015 Sep 26;386(10000):1254-1260.

Rationale for inclusion: evidence-based technique for abdominal wall closure, 4:1 SWL ratio, not necessarily applicable in obese and emergency surgery

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Surgical management of chronic pancreatitis: current utilization in the United States.

Bliss LA, Yang CJ, Eskander MF, de Geus SW, Callery MP, Kent TS, Moser AJ, Freedman SD, Tseng JF.

HPB (Oxford). 2015 Sep;17(9):804-10.

Rationale for inclusion: Although rare, surgical intervention in chronic pancreatitis may be useful in complex cases. In a study of more than 21 000 patients, the authors attempt to identify outcomes in patients who undergo surgery. The findings suggest that surgical management is a viable management strategy that can be associated with improved long-term outcomes. Earlier surgical intervention may also reduce the need for prolonged opioid pain management.

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Randomized clinical trial of Desarda versus Lichtenstein repair for treatment of primary inguinal hernia.

Youssef T, El-Alfy K, Farid M.

Int J Surg. 2015 Aug;20:28-34.

Rationale for inclusion: evaluation of tissue based repair compared to tension free mesh repair.

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Laparoscopic surgery or conservative treatment for appendiceal abscess in adults? A randomized controlled trial.

Mentula P, Sammalkorpi H, Leppäniemi A.

Ann Surg. 2015 Aug;262(2):237-42.

Rationale for inclusion: this study challenges the practice of percutaneous treatment for appendiceal abscess.

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Faecal microbiota transplantation plus selected use of vancomycin for severe-complicated Clostridium difficile infection: description of a protocol with high success rate

Fischer M, Sipe BW, Rogers NA, Cook GK, Robb BW, Vuppalanchi R, Rex DK.

Aliment Pharmacol Ther. 2015 Aug;42(4):470-6

Rationale for inclusion: The largest series of patients undergoing fecal transplant for fulminant C. diff.

CAVEAT: Will outdate quickly

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Restrictive versus liberal blood transfusion for acute upper gastrointestinal bleeding (TRIGGER): a pragmatic, open-label, cluster randomised feasibility trial.

Jairath V, Kahan BC, Gray A, Doré CJ, Mora A, James MW, Stanley AJ, Everett SM, Bailey AA, Dallal H, Greenaway J, Le Jeune I, Darwent M, Church N, Reckless I, Hodge R, Dyer C, Meredith S, Llewelyn C, Palmer KR, Logan RF, Travis SP, Walsh TS, Murphy MF.

Lancet. 2015 Jul 11;386(9989):137-44.

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Rationale for inclusion: this large cluster randomized trial confirmed the feasibility and safety of a restrictive transfusion trigger (Hgb <8 g/dL) compared to a more liberal trigger (Hgb <10 g/dL) for upper GI bleeding.

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Initial Cholecystectomy with Cholangiography Decreases Length of Stay Compared to Preoperative MRCP or ERCP in the Management of Choledocholithiasis.

Lin C, Collins JN, Britt RC, Britt LD.

Am Surg. 2015 Jul;81(7):726-31.

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Rationale for inclusion: This study demonstrates that a strategy of initial laparoscopic cholecystectomy with intraoperative cholangiogram (IOC) is associated with a shorter hospital stay compared to preoperative MRCP or ERCP.

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Delayed endoscopic retrograde cholangiopancreatography is associated with persistent organ failure in hospitalised patients with acute cholangitis.

Lee F, Ohanian E, Rheem J, Laine L, Che K, Kim JJ.

Aliment Pharmacol Ther. 2015 Jul;42(2):212-20.

Rationale for inclusion: Delay in the management of acute cholangitis can increase morbidity and mortality. The ability to decompress via ERCP improves outcome. The authors demonstrate that a delay of >48 hours in performing ERCP even with ongoing antibiotic treatment, worsened outcome thereby emphasizing the need for timely intervention with these patients.

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Operative delay to laparoscopic cholecystectomy: racking up the cost of health care.

Schwartz DA, Shah AA, Zogg CK, Nicholas LH, Velopulos CG, Efron DT, Schneider EB, Haider AH.

J Trauma Acute Care Surg. 2015 Jul;79(1):15-21.

Rationale for inclusion: another large NIS study, this time focusing on costs, which again favors early cholecystectomy.

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Use of magnetic resonance cholangiopancreatography in clinical practice: not as good as we once thought.

Aydelotte JD, Ali J, Huynh PT, Coopwood TB, Uecker JM, Brown CV.

J Am Coll Surg. 2015 Jul;221(1):215-9.

Rationale for inclusion: another study demonstrating the inaccuracy of MRCP.

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Effect of pregnancy on adverse outcomes after general surgery.

Moore H, Juarez-Colunga E, Bronsert M, Hammermeister K, Henderson W, Moore E, Meguid R.

JAMA Surg. 2015 Jul;150(7):637-43.

Rationale for inclusion: Retrospective cohort study comparing 30-day postoperative surgical outcomes of pregnant vs non-pregnant women undergoing nonobstetric operations by general surgeons, demonstrating no increase in morbidity or mortality. This highlights the relative safety of emergency and nonemergency general surgical procedures in pregnant women.

CAVEAT: No discussion of fetal complications, which must be considered in elective surgical situations.

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Antibiotic therapy vs appendectomy for treatment of uncomplicated acute appendicitis: the APPAC randomized clinical trial.

Salminen P, Paajanen H, Rautio T, Nordström P, Aarnio M, Rantanen T, Tuominen R, Hurme S, Virtanen J, Mecklin JP, Sand J, Jartti A, Rinta-Kiikka I, Grönroos JM.

JAMA. 2015 Jun 16;313(23):2340-8.

Rationale for inclusion: this European study concludes that antibiotic therapy is non-inferior to appendectomy for acute appendicitis.

CAVEAT: When trying to decide whether or not this study may be applicable to American practice, it is important to consider that the average hospital length of stay for the surgical group was 3 days and that only 5.5% of appendectomies were performed laparoscopically. While the overall complication rate was significantly higher in the surgical group (20.5% vs. 2.8%), this was predominantly driven by superficial surgical site infections and incisional pain; this may be related to the overwhelming use of open appendectomy technique. There was a 16% negative appendectomy rate, which seems high in the modern era. There was a 1.5% incidence to tumors in the surgical group.

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Trial of short-course antimicrobial therapy for intraabdominal infection.

Sawyer RG, Claridge JA, Nathens AB, Rotstein OD, Duane TM, Evans HL, Cook CH, O'Neill PJ, Mazuski JE, Askari R, Wilson MA, Napolitano LM, Namias N, Miller PR, Dellinger EP, Watson CM, Coimbra R, Dent DL, Lowry SF, Cocanour CS, West MA, Banton KL, Cheadle WG, Lipsett PA, Guidry CA, Popovsky K.

N Engl J Med. 2015 May 21;372(21):1996-2005.

Rationale for inclusion: this high-quality randomized trial demonstrated that for complicated intra-abdominal infections (including perforated appendicitis) with adequate surgical source control, four days of post-operative antibiotics is non-inferior to a longer (median eight days) course of antibiotics.

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Fecal microbiota transplantation for clostridium difficile infection: a systematic review.

Drekonja D, Reich J, Gezahegn S, Greer N, Shaukat A, MacDonald R, Rutks I, Wilt TJ.

Ann Intern Med. 2015 May 5;162(9):630-8.

Rationale for inclusion: This systematic review, which includes two randomized controlled trials, shows that fecal microbiota transplantation leads to a high rate of symptom resolution and may be more effective than vancomycin in recurrent CDI.

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Outcome of acute mesenteric ischemia in the intensive care unit: a retrospective, multicenter study of 780 cases.

Leone M, Bechis C, Baumstarck K, Ouattara A, Collange O, Augustin P, Annane D, Arbelot C, Asehnoune K, Baldési O, Bourcier S, Delapierre L, Demory D, Hengy B, Ichai C, Kipnis E, Brasdefer E, Lasocki S, Legrand M, Mimoz O, Rimmelé T, Aliane J, Bertrand PM, Bruder N, Klasen F, Friou E, Lévy B, Martinez O, Peytel E, Piton A, Richter E, Toufik K, Vogler MC, Wallet F, Boufi M, Allaouchiche B, Constantin JM, Martin C, Jaber S, Lefrant JY.

Intensive Care Med. 2015 Apr;41(4):667-76.

Rationale for inclusion: This study is a multi-center, retrospective study conducted in 43 French intensive care units, 38 of which were public hospitals. The authors identified 780 patients with acute mesenteric ischemia with 58% of those patients not surviving to ICU discharge. Multiple patient characteristics were more common in non-survivors (older age, presence of cancer, shock, and higher lactates; to name a few).

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Early versus delayed same-admission laparoscopic cholecystectomy for acute cholecystitis in elderly patients with comorbidities.

Haltmeier T, Benjamin E, Inaba K, Lam L, Demetriades D.

J Trauma Acute Care Surg. 2015 Apr;78(4):801-7.

Rationale for inclusion: this was a NSQIP study focusing on older (age>65) patients undergoing laparoscopic cholecystectomy for acute cholecystitis… again favoring early cholecystectomy.

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Evaluation of Antibiotic Use to Prevent Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis and Cholangitis.

Ishigaki T, Sasaki T, Serikawa M, Kobayashi K, Kamigaki M, Minami T, Okazaki A, Yukutake M, Ishii Y, Kosaka K, Mouri T, Yoshimi S, Chayama K.

Hepatogastroenterology. 2015 Mar-Apr;62(138):417-24.

Rationale for inclusion: The authors conclude that addition of prophylactic antibiotics do not reduce risk of cholangitis after ERCP.

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Role of Antibiotic Prophylaxis in Necrotizing Pancreatitis: A Meta-Analysis.

Lim CL, Lee W, Liew YX, Tang SS, Chlebicki MP, Kwa AL.

J Gastrointest Surg. 2015 Mar;19(3):480-91.

Rationale for inclusion: In a meta-analysis of 11 studies including 864 patients, the use of prophylactic antibiotics was not shown to significantly reduce the incidence of infected pancreatic necrosis but appeared to affect all-cause mortality in acute necrotizing pancreatitis.

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Optimal time for early laparoscopic cholecystectomy for acute cholecystitis.

Zafar SN, Obirieze A, Adesibikan B, Cornwell EE 3rd, Fullum TM, Tran DD.

JAMA Surg. 2015 Feb;150(2):129-36.

Rationale for inclusion: this was a very large study using the NIS which supports early cholecystectomy.

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Subtotal cholecystectomy for "difficult gallbladders": systematic review and meta-analysis.

Elshaer M, Gravante G, Thomas K, Sorge R, Al-Hamali S, Ebdewi H.

JAMA Surg. 2015 Feb;150(2):159-68.

Rationale for inclusion: this study is important because it justifies the approach of “primum non nocere” when faced with a difficult gallbladder.

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Emergency endoscopy for gastrointestinal bleeding after bariatric surgery. Therapeutic algorithm.

García-García ML, Martín-Lorenzo JG, Torralba-Martínez JA, Lirón-Ruiz R, Miguel Perelló J, Flores Pastor B, Pérez Cuadrado E, Aguayo Albasini JL.

Cir Esp. 2015 Feb;93(2):97-104.

Rationale for inclusion: This study looked specifically at postoperative GI bleeding (GIB)v in bariatric surgery. GIB is a complication seen and may need intervention. Endoscopic techniques are often adequate and necessary.

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Intestinal Microbiota Transplantation, a Simple and Effective Treatment for Severe and Refractory Clostridium Difficile Infection

Zainah H, Hassan M, Shiekh-Sroujieh L, Hassan S, Alangaden G, Ramesh M.

Dig Dis Sci. 2015 Jan;60(1):181-5.

Rationale for inclusion: One of the largest series of patients undergoing fecal transplant for fulminant C. diff.

CAVEAT: Will outdate quickly

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Early oral refeeding based on hunger in moderate and severe acute pancreatitis: A prospective controlled, randomized clinical trial.

Zhao XL, Zhu SF, Xue GJ, Li J, Liu YL, Wan MH, Huang W, Xia Q, Tang WF.

Nutrition. 2015 Jan;31(1):171-5.

Rationale for inclusion: Enteral nutrition in acute pancreatitis is well established. The timing however remains unclear. This prospective randomized study helps establish timing in the disease process.

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Acute cholecystitis: When to operate and how to do it safely.

Peitzman AB, Watson GA, Marsh JW.

J Trauma Acute Care Surg. 2015 Jan;78(1):1-12.

Rationale for inclusion: Expert acute care surgeon on approach to acute cholecystitis with data review.

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A population-based analysis of emergent versus elective paraesophageal hernia repair using the Nationwide Inpatient Sample.

Jassim H, Seligman JT, Frelich M, Goldbatt M, Kastenmeier A, Wallace J, Zhao HS, Szabo A, Gould JC.

Surg Endosc . 2014 Dec;28(12):3473-8.

Rationale for inclusion: Large outcomes analysis from the Nationwide Inpatient Sample (n=8,462), demonstrating significantly higher rate of morbidity (33.4 vs 16.5%) and mortality (3.2 vs 0.37%) comparing emergent and elective repair. Furthermore, supports the decreased morbidity and mortality associated with laparoscopic repair, regardless of circumstances of repair.

CAVEAT: Database study, potentially underestimating frequency of major morbidity and mortality. Additionally, analysis includes all repairs, regardless of indication (GERD vs type 4 PEHR.)

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The NOTA study (non operative treatment for acute appendicitis): prospective study on the efficacy and safety of antibiotics (amoxicillin and clavulanic acid) for treating patients with right lower quadrant abdominal pain and long-term follow-up of conservatively treated suspected appendicitis.

Di Saverio S, Sibilio A, Giorgini E, Biscardi A, Villani S, Coccolini F, Smerieri N, Pisano M, Ansaloni L, Sartelli M, Catena F, Tugnoli G.

Ann Surg. 2014 Jul;260(1):109-17.

Rationale for inclusion: this observational study of 159 patients treated non-operatively for suspected acute appendicitis demonstrated 83% long-term efficacy at 2 years.

CAVEAT: this study included patients suspected of having acute appendicitis by clinical exam, Alvarado and/or Appendicitis Inflammatory Response (AIR) scores, but only 73% underwent ultrasound assessment and only 17% underwent CT scan to confirm the diagnosis.

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Initial cholecystectomy vs sequential common duct endoscopic assessment and subsequent cholecystectomy for suspected gallstone migration: a randomized clinical trial.

Iranmanesh P, Frossard JL, Mugnier-Konrad B, Morel P, Majno P, Nguyen-Tang T, Berney T, Mentha G, Toso C.

JAMA. 2014 Jul;312(2):137-44.

Rationale for inclusion: this RCT favors initial cholecystectomy with IOC over initial ERCP followed by cholecystectomy for patients with intermediate (total bilirubin < 4.0) risk of choledocholithiasis.

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Intussusception after Roux-en-Y gastric bypass.

Stephenson D, Moon RC, Teixeira AF, Jawad MA.

Surg Obes Relat Dis. 2014 Jul-Aug;10(4):666-70.

Rationale for inclusion: This is a 10-year review of patients presenting with intussusception after RYGB. This is a rare but serious complication. Often presents with upper abdominal pain, can be mistaken for other surgical processes. Requires surgical intervention to avoid bowel necrosis. Acute care surgeons need to be aware in order to manage timely.

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Timing and type of surgical treatment of clostridium difficile-associated disease: a practice management guideline from the Eastern Association for the Surgery of Trauma.

Ferrada P, Velopulos CG, Sultan S, Haut ER, Johnson E, Praba-Egge A, Enniss T, Dorion H, Martin ND, Bosarge P, Rushing A, Duane TM.

J Trauma Acute Care Surg. 2014 Jun;76(6):1484-93.

Rationale for inclusion: this EAST PMG provides a summary of the evidence (poor) and attempts to provide guidance regarding timing and procedure.

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Vagotomy/drainage is superior to local oversew in patients who require emergency surgery for bleeding peptic ulcers.

Schroder VT, Pappas TN, Vaslef SN, De La Fuente SG, Scarborough JE.

Ann Surg. 2014 Jun;259(6):1111-8.

Rationale for inclusion: This study examined 3611 patients (775 bleeding ulcers and 2374 perforated ulcers) in 2005-2011 ACS NSQIP database. After controlling for patient-related factors in multivariable regression analysis, the authors found that simple repair(presumably with post-operative H. pylori eradication and medical acid suppression) had outcomes equivalent to vagotomy/drainage, but with shorter postoperative hospitalization. However, for bleeding ulcers, vagotomy/drainage had lower mortality rates than local oversew alone.

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Portomesenteric vein thrombosis after laparoscopic sleeve gastrectomy.

Salinas J, Barros D, Salgado N, Viscido G, Funke R, Pérez G, Pimentel F, Boza C.

Surg Endosc. 2014 Apr;28(4):1083-9.

Rationale for inclusion: This study is one of the few looking at the very rare but serious complication of portmesenteric venous thrombosis (PSMV) thrombosis. It often presents as abdominal pain, may require exploration for bowel necrosis/splenectomy and may need to be managed by an acute care surgeon.

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Complicated gallstones after laparoscopic sleeve gastrectomy.

Sioka E, Zacharoulis D, Zachari E, Papamargaritis D, Pinaka O, Katsogridaki G, Tzovaras G.

J Obes. 2014;2014:468203.

Rationale for inclusion: Another study demonstrating the common presentation after bariatric surgery of complicated cholelithiasis. This often requires surgery and can be technically difficult postop and may warrant early cholecystectomy. The oncall acute care surgeon will often see and need to manage these patients.

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Clostridium difficile colitis in the United States: a decade of trends, outcomes, risk factors for colectomy, and mortality after colectomy.

Halabi WJ, Nguyen VQ, Carmichael JC, Pigazzi A, Stamos MJ, Mills S.

J Am Coll Surg. 2013 Nov;217(5):802-12.

Rationale for inclusion: This large study using the NIS documents the rising incidence, risk factors for mortality after colectomy, and also poorer outcomes associated with delayed colectomy.

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Acute cholecystitis: early versus delayed cholecystectomy, a multicenter randomized trial (ACDC study, NCT00447304).

Gutt CN, Encke J, Köninger J, Harnoss JC, Weigand K, Kipfmüller K, Schunter O, Götze T, Golling MT, Menges M, Klar E, Feilhauer K, Zoller WG, Ridwelski K, Ackmann S, Baron A, Schön MR, Seitz HK, Daniel D, Stremmel W, Büchler MW.

Ann Surg. 2013 Sep;258(3):385-93.

Rationale for inclusion: this was a fairly large, recent RCT supporting early cholecystectomy.

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American College of Gastroenterology guideline: management of acute pancreatitis.

Tenner S, Baillie J, DeWitt J, Vege SS; American College of Gastroenterology.

Am J Gastroenterol. 2013 Sep;108(9):1400-15; 1416.

Rationale for inclusion: Utilizing GRADE methodology, this paper makes recommendations for the diagnosis and management of pancreatitis that may not be covered in the other recommended papers.

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Eastern Association for the Surgery of Trauma: management of the open abdomen, part III-review of abdominal wall reconstruction.

Diaz JJ Jr, Cullinane DC, Khwaja KA, Tyson GH, Ott M, Jerome R, Kerwin AJ, Collier BR, Pappas PA, Sangosanya AT, Como JJ, Bokhari F, Haut ER, Smith LM, Winston ES, Bilaniuk JW, Talley CL, Silverman R, Croce MA.

J Trauma Acute Care Surg. 2013 Sep;75(3):376-86.

Rationale for inclusion: a great 3-part series of papers from EAST.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Gallstone pancreatitis without cholecystectomy.

Hwang SS, Li BH, Haigh P.

Hwang SS, Li BH, Haigh P.

Rationale for inclusion: This is a large cohort study over a 15 year period with excellent long-term follow-up. It demonstrates that in patients presenting with acute gallstone pancreatitis who undergo ERCP with or without sphincterotomy but did NOT receive a subsequent cholecystectomy, the overall risk for recurrence at 1, 2, and 5 years were roughly 5%, 7.5%, and 10%. The rates are roughly double for those patients who did not receive ERCP during the index hospitalization. This study provides strong supporting evidence for ERCP and cholecystectomy to prevent recurrence of biliary pancreatitis.

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Long-term results of a randomized controlled trial of a nonoperative strategy (watchful waiting) for men with minimally symptomatic inguinal hernias.

Fitzgibbons R Jr, Ramanan B, Arya S, Turner SA, Li X, Gibbs JO, Reda DJ; Investigators of the Original Trial.

Ann Surg. 2013 Sep;258(3):508-15.

Rationale for inclusion: Evaluation of safety of nonoperative approach to inguinal hernia in minimally symptomatic men.

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Clear liquid diet vs soft diet as the initial meal in patients with mild acute pancreatitis: a randomized interventional trial.

Rajkumar N, Karthikeyan VS, Ali SM, Sistla SC, Kate V.

Nutr Clin Pract. 2013 Jun;28(3):365-70.

Rationale for inclusion: This study is intriguing as it evaluates patients with mild acute pancreatitis and randomizes them to soft versus clear liquid diets with the finding of significantly shorter lengths of stay in those that receive the soft diet as the initial po option.

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Duodenal infusion of donor feces for recurrent clostridium difficile.

van Nood E, Vrieze A, Nieuwdorp M, Fuentes S, Zoetendal EG, de Vos WM, Visser CE, Kuijper EJ, Bartelsman JF, Tijssen JG, Speelman P, Dijkgraaf MG, Keller JJ.

N Engl J Med. 2013 Jan 31;368(5):407-15.

Rationale for inclusion: donor feces is significantly more effective than vancomycin in the treatment of recurrent C. diff infection.

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Transfusion strategies for acute upper gastrointestinal bleeding.

Villanueva C, Colomo A, Bosch A, Concepción M, Hernandez-Gea V, Aracil C, Graupera I, Poca M, Alvarez-Urturi C, Gordillo J, Guarner-Argente C, Santaló M, Muñiz E, Guarner C.

N Engl J Med. 2013 Jan 3;368(1):11-21.

Watch the EAST Minute Video

Rationale for inclusion: this single-center randomized trial demonstrated that a restrictive transfusion strategy (Hgb trigger <7 g/dL) was superior to a more liberal transfusion strategy for upper GI bleeding.

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How many sunsets? Timing of surgery in adhesive small bowel obstruction: a study of the nationwide inpatient sample.

Schraufnagel D, Rajaee S, Millham FH.

J Trauma Acute Care Surg. 2013 Jan;74(1):181-7; discussion 187-9.

Rationale for inclusion: With the advent of acute care surgery, we have an enhanced recognition that early treatment for a myriad of surgical pathologies improves outcomes. This paper, by virtue of using a secondary database, contains the largest sample of data available on this topic and reconfirms that delays in treatment represent poor management.

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A population-based analysis of the clinical course of 10,304 patients with acute cholecystitis, discharged without cholecystectomy.

de Mestral C, Rotstein OD, Laupacis A, Hoch JS, Zagorski B, Nathens AB.

J Trauma Acute Care Surg. 2013 Jan;74(1):26-30; discussion 30-1.

Rationale for inclusion: this is important “natural history” paper which informs us what will happen to the patient with acute cholecystitis treated without cholecystectomy.

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TG13 diagnostic criteria and severity grading of acute cholecystitis (with videos).

J Hepatobiliary Pancreat Sci. 2013 Jan;20(1):35-46.

Rationale for inclusion: although this is not primary literature, it is an important 2013 Tokyo Guidelines update reviewing diagnostic criteria and severity grading of acute cholecystitis.

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Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus.

Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, Tsiotos GG, Vege SS; Acute Pancreatitis Classification Working Group.

Gut. 2013 Jan;62(1):102-11.

Rationale for inclusion: This work represents a global consensus statement and updates the 1992 Atlanta Classification with better classifications of the disease, local complications, and systemic complications.

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TG13 antimicrobial therapy for acute cholangitis and cholecystitis.

Gomi H, Solomkin JS, Takada T, Strasberg SM, Pitt HA, Yoshida M, Kusachi S, Mayumi T, Miura F, Kiriyama S, Yokoe M, Kimura Y, Higuchi R, Windsor JA, Dervenis C, Liau KH, Kim MH; Tokyo Guideline Revision Committee.

J Hepatobiliary Pancreat Sci. 2013 Jan;20(1):60-70.

Rationale for inclusion: This 2013 Tokyo Guidelines update provides recommendations for antimicrobial therapy.

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TG13 flowchart for the management of acute cholangitis and cholecystitis.

Miura F, Takada T, Strasberg SM, Solomkin JS, Pitt HA, Gouma DJ, Garden OJ, Büchler MW, Yoshida M, Mayumi T, Okamoto K, Gomi H, Kusachi S, Kiriyama S, Yokoe M, Kimura Y, Higuchi R, Yamashita Y, Windsor JA, Tsuyuguchi T, Gabata T, Itoi T, Hata J, Liau KH; Tokyo Guidelines Revision Committee.

J Hepatobiliary Pancreat Sci. 2013 Jan;20(1):47-54.

Rationale for inclusion: This 2013 Tokyo Guidelines update provides a flowchart for the recommended treatment of acute cholangitis stratified by disease severity.

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Wait only to resuscitate: early surgery for acutely presenting paraesophageal hernias yields better outcomes.

Bhayani NH, Kurian AA, Sharata AM, Reavis KM, Dunst CM, Swanstorm LL.

Surg Endosc . 2013 Jan;27(1):267-71.

Rationale for inclusion: NSQIP analysis including patients undergoing surgery for obstructed paraesophgeal hernia, comparing early (first hospital day) vs delayed inpatient repair, indicating similar morbidity and mortality. Occurrence of sepsis and length of stay were significantly reduced in the early group, suggesting benefit in these specific complications if surgery can proceed safely if performed early. Mortality, however, was not statistically increased if surgery was delayed, suggesting relative safety of preoperative resuscitation and decompression with interval repair.

CAVEAT: Database study, potentially underestimating frequency of major morbidity and mortality.

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Who should we feed? Western Trauma Association multi-institutional study of enteral nutrition in the open abdomen after injury.

Burlew CC, Moore EE, Cuschieri J, Jurkovich GJ, Codner P, Nirula R, Millar D, Cohen MJ, Kutcher ME, Haan J, MacNew HG, Ochsner G, Rowell SE, Truitt MS, Moore FO, Pieracci FM, Kaups KL; WTA Study Group.

J Trauma Acute Care Surg. 2012 Dec;73(6):1380-7; discussion 1387-8.

Rationale for inclusion: support for early enteral nutrition (EN) in the open abdomen to improve fascial closure, complication rate, and mortality.

Watch the EAST Minute

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Management of the difficult duodenal stump in penetrating duodenal ulcer disease: a comparative analysis of duodenojejunostomy with "classical" stump closure (Nissen-Bsteh).

Vashist YK, Yekebas EF, Gebauer F, Tachezy M, Bachmann K, König A, Kutup A, Izbicki JR.

Langenbecks Arch Surg. 2012 Dec;397(8):1243-9.

Rationale for inclusion: In this case-control study of 124 patients with penetrating duodenal ulcer and difficult duodenal stump, the authors compared “classical” closure (distal gastric resection with direct closure of the duodenal stump and Roux-en-y gastrojejunostomy) to duodenojejunostomy (DJ) +/- gastroduodenal and biliary diversion. Selection bias notwithstanding, they report significantly decreased anastomotic leakage and mortality in the DJ group. This study provides support for DJ in the treatment of difficult duodenal stump.

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Evaluation and management of small-bowel obstruction: an Eastern Association for the Surgery of Trauma practice management guideline.

Maung AA, Johnson DC, Piper GL, Barbosa RR, Rowell SE, Bokhari F, Collins JN, Gordon JR, Ra JH, Kerwin AJ; Eastern Association for the Surgery of Trauma.

J Trauma Acute Care Surg. 2012 Nov;73(5 Suppl 4):S362-9.

Rationale for inclusion: This paper represents one of the initial Practice Management Guidelines and was developed by EAST. Using an inclusive approach to the literature search, the authors were able to answer several questions germane to SBO management based on the quality of the literature. The questions include routine use of CT, indications of strangulation obstructions which warrant early exploration, indications for laparoscopic explorations, and reasons for the use of Gastrografin.

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Outcomes in the management of appendicitis and cholecystitis in the setting of a new acute care surgery service model: impact on timing and cost.

Cubas RF, Gómez NR, Rodriguez S, Wanis M, Sivanandam A, Garberoglio CA.

J Am Coll Surg. 2012 Nov;215(5):715-21.

Rationale for inclusion: this study supports our ACS model for acute cholecystitis.

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New diagnostic criteria and severity assessment of acute cholangitis in revised Tokyo Guidelines.

Kiriyama S, Takada T, Strasberg SM, Solomkin JS, Mayumi T, Pitt HA, Gouma DJ, Garden OJ, Büchler MW, Yokoe M, Kimura Y, Tsuyuguchi T, Itoi T, Yoshida M, Miura F, Yamashita Y, Okamoto K, Gabata T, Hata J, Higuchi R, Windsor JA, Bornman PC, Fan ST, Singh H, de Santibanes E, Gomi H, Kusachi S, Murata A, Chen XP, Jagannath P, Lee S, Padbury R, Chen MF; Tokyo Guidelines Revision Committee.

J Hepatobiliary Pancreat Sci. 2012 Sep;19(5):548-56.

Watch the EAST Minute Video

Rationale for inclusion: This Tokyo Guidelines 2013 update provides a good evidence-based review of the diagnostic criteria and severity assessment of acute cholangitis.

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Fidoxamicin versus vancomycin for infection with clostridium difficile in Europe, Canada, and the USA: a double-blind, non-inferiority, randomised controlled trial.

Cornely OA, Crook DW, Esposito R, Poirier A, Somero MS, Weiss K, Sears P, Gorbach S; OPT-80-004 Clinical Study Group.

Lancet Infect Dis. 2012 Apr;12(4):281-9.

Rationale for Inclusion: Although only 68% of subjects were inpatient, 24% of all subjects had severe C.diff, so this study may be relevant to our practice. Subgroup analyses favored fidaxomicin for those receiving concomitant antibiotics and in the severe C. diff subgroup.

CAVEAT: The sponsor of the study (Optimer Pharmaceuticals) was responsible for study design, data collection, and data analysis.

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Comparison of outcomes of laparoscopic and open appendectomy in management of uncomplicated and complicated appendicitis.

Tiwari MM, Reynoso JF, Tsang AW, Oleynikov D.

Ann Surg. 2011 Dec;254(6):927-32.

Rationale for inclusion: this analysis of the University HealthSystem Consortium database concludes that laparoscopic appendectomy is superior to open appendectomy.

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Appendectomy versus antibiotic treatment for acute appendicitis.

Wilms IM, de Hoog DE, de Visser DC, Janzing HM.

Cochrane Database Syst Rev. 2011 Nov 9;(11):CD008359.

Rationale for inclusion: this Cochrane review concludes that appendectomy remains the standard treatment for acute appendicitis because of the low quality of available evidence.

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Necrotizing soft tissue infections: delayed surgical treatment is associated with increased number of surgical debridements and morbidity.

Kobayashi L, Konstantinidis A, Shackelford S, Chan LS, Talving P, Inaba K, Demetriades D.

J Trauma. 2011 Nov;71(5):1400-5.

Rationale for inclusion: This more recent study found that a delay in surgical intervention >12 hours contributes to higher mortality, septic shock an renal failure, and is associated with an increased number of debridements than patients whose initial debridement is <12 hours after admission. This confirms that early initial debridement leads to improved outcomes in NSTI.

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Diverting loop ileostomy and colonic lavage: an alternative to total abdominal colectomy for the treatment of severe, complicated clostridium difficile associated disease.

Neal MD, Alverdy JC, Hall DE, Simmons RL, Zuckerbraun BS.

Ann Surg. 2011 Sep;254(3):423-7; discussion 427-9.

Rationale for inclusion: this is the classic “Pittsburg protocol” for diverting loop ileostomy and colonic lavage. The jury is still out on whether or not it is truly beneficial…. It is only one single center, retrospective study.

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Meta-analysis: antibiotic prophylaxis for cirrhotic patients with upper gastrointestinal bleeding - an updated Cochrane review.

Chavez-Tapia NC, Barrientos-Gutierrez T, Tellez-Avila F, Soares-Weiser K, Mendez-Sanchez N, Gluud C, Uribe M.

Aliment Pharmacol Ther. 2011 Sep;34(5):509-18.

Rationale for inclusion: this meta-analysis confirms that antibiotic prophylaxis for cirrhotic upper GI bleeding is beneficial for bacterial infections, all-cause mortality, rebleeding events, and hospital length of stay.

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Eastern Association for the Surgery of Trauma: a review of the management of the open abdomen--part 2 "Management of the open abdomen."

Diaz JJ Jr, Dutton WD, Ott MM, Cullinane DC, Alouidor R, Armen SB, Bilanuik JW, Collier BR, Gunter OL, Jawa R, Jerome R, Kerwin AJ, Kirby JP, Lambert AL, Riordan WP, Wohltmann CD.

J Trauma. 2011 Aug;71(2):502-12.

Rationale for inclusion: a great 3-part series of papers from EAST.

Watch the EAST Minute

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Prospective, observational validation of a multivariate small-bowel obstruction model to predict the need for operative intervention.

Zielinski MD, Eiken PW, Heller SF, Lohse CM, Huebner M, Sarr MG, Bannon MP.

J Am Coll Surg. 2011 Jun;212(6):1068-76.

Rationale for inclusion: This paper provides validated an evidence based protocol for the management of SBO. The protocol incorporates clinical and radiographic features to predict strangulation obstructions as well as failure of non-operative management. The guideline was designed to be straightforward and easy to implement.

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Abdominal pain after gastric bypass: suspects and solutions.

Greenstein AJ, O'Rourke RW.

Am J Surg. 2011 Jun;201(6):819-27.

Rationale for inclusion: This article reviews the most common causes of abdominal pain after gastric bypass surgery as abdominal pain is one of the most common reason for surgical consult. Post RYGB often warrants surgical exploration.

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Bowel obstruction in bariatric and nonbariatric patients: major differences in management strategies and outcome.

Martin MJ, Beekley AC, Sebesta JA.

Surg Obes Relat Dis. 2011 May-Jun;7(3):263-9.

Rationale for inclusion: A very large comparison of bowel obstruction in bariatric versus nonbariatric patients was analyzed. The majority of postbaratric patients required surgery whereas the majority of nonbariatric were managed conservatively. This demonstrates that the importance of understanding the differences in this common complication between groups.

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Multicentre prospective study of fascial closure rate after open abdomen with vacuum and mesh-mediated fascial traction.

Acosta S, Bjarnason T, Petersson U, Pålsson B, Wanhainen A, Svensson M, Djavani K, Björck M.

Br J Surg. 2011 May;98(5):735-43.

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Rationale for inclusion: another great technique article.

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Colonic stenting versus emergency surgery for acute left-sided malignant colonic obstruction: a multicentre randomised trial.

van Hooft JE, Bemelman WA, Oldenburg B, Marinelli AW, Lutke Holzik MF, Grubben MJ, Sprangers MA, Dijkgraaf MG, Fockens P; collaborative Dutch Stent-In study group.

Lancet Oncol. 2011 Apr;12(4):344-52

Rationale for inclusion: One of the few multicenter randomized trials comparing stenting and emergency surgery for malignant large bowel obstruction. The authors concluded that colonic stenting has no decisive clinical advantages to emergency surgery but could be used as an alternative treatment in as yet undefined subsets of patients, although with caution because of concerns about tumor spread caused by perforation.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Randomized trial of urgent vs. elective colonoscopy in patients hospitalized with lower GI bleeding.

Laine L, Shah A.

Am J Gastroenterol. 2010 Dec;105(12):2636-41; quiz 2642.

Rationale for inclusion: this study confirmed the importance of performing upper endoscopy in patients with clinically significant lower GI bleeding with hemodynamic instability; 15% had an upper GI source of bleeding.

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Laparoscopic versus open appendectomy: an analysis of outcomes in 17,199 patients using ACS/NSQIP.

Page AJ, Pollock JD, Perez S, Davis SS, Lin E, Sweeney JF.

J Gastrointest Surg. 2010 Dec;14(12):1955-62.

Rationale for inclusion: this very large NSQIP study confirms that laparoscopic appendectomy has better outcomes compared to open appendectomy.

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Laparoscopic versus open surgery for suspected appendicitis.

Sauerland S, Jaschinski T, Neugebauer EA.

Cochrane Database Syst Rev. 2010 Oct 6;(10):CD001546.

Rationale for inclusion: this Cochrane meta-analysis concludes that laparoscopic appendectomy has advantages over open appendectomy.

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Comparison of outcomes after laparoscopic versus open appendectomy for acute appendicitis at 222 ACS NSQIP hospitals.

Ingraham AM, Cohen ME, Bilimoria KY, Pritts TA, Ko CY, Esposito TJ.

Surgery. 2010 Oct;148(4):625-35; discussion 635-7.

Rationale for inclusion: this analysis of the NSQIP database concludes that laparoscopic appendectomy (compared to open appendectomy) is associated with lower overall morbidity, but may result in higher rates of organ space infection in patients with complicated appendicitis.

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Damage control resuscitation in combination with damage control laparotomy: a survival advantage.

Duchesne JC, Kimonis K, Marr AB, Rennie KV, Wahl G, Wells JE, Islam TM, Meade P, Stuke L, Barbeau JM, Hunt JP, Baker CC, McSwain NE Jr.

J Trauma. 2010 Jul;69(1):46-52.

Rationale for inclusion: this paper emphasizes that good outcomes after DCL are dependent on anesthesia practices (DCR) as well!

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The "O" sign, a simple and helpful tool in the diagnosis of laparoscopic adjustable gastric band slippage.

Pieroni S, Sommer EA, Hito R, Burch M, Tkacz JN.

AJR Am J Roentgenol. 2010 Jul;195(1):137-41.

Rationale for inclusion: This study looks specifically at radiographic diagnosis of slipped gastric band. With increasing number of bands performed in the last decade, complications need to be recognized for early intervention.

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Eastern Association for the Surgery of Trauma: The management of the open abdomen in trauma and emergency general surgery: part 1-damage control.

Diaz JJ Jr, Cullinane DC, Dutton WD, Jerome R, Bagdonas R, Bilaniuk JW, Collier BR, Como JJ, Cumming J, Griffen M, Gunter OL, Kirby J, Lottenburg L, Mowery N, Riordan WP Jr, Martin N, Platz J, Stassen N, Winston ES.

J Trauma. 2010 Jun;68(6):1425-38.

Rationale for inclusion: a great 3-part series of papers from EAST.

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Diagnosis of necrotizing soft tissue infections by computed tomography.

Zacharias N, Velmahos GC, Salama A, Alam HB, de Moya M, King DR, Novelline RA.

Arch Surg. 2010 May;145(5):452-5.

Rationale for inclusion: While CT scan should not delay operative intervention for NSTI, this study finds that it may be a useful adjunct for ruling out the diagnosis of a necrotizing infection.

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Clinical practice guidelines for clostridium difficile infection in adults: 2010 update by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA).

Cohen SH, Gerding DN, Johnson S, Kelly CP, Loo VG, McDonald LC, Pepin J, Wilcox MH; Society for Healthcare Epidemiology of America; Infectious Diseases Society of America.

Infect Control Hosp Epidemiol. 2010 May;31(5):431-55.

Rationale for inclusion: this is an excellent practice recommendation published by the Society for Healthcare Epidemiology of America and the Infectious Diseases Society of America.

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A step-up approach or open necrosectomy for necrotizing pancreatitis.

van Santvoort HC, Besselink MG, Bakker OJ, Hofker HS, Boermeester MA, Dejong CH, van Goor H, Schaapherder AF, van Eijck CH, Bollen TL, van Ramshorst B, Nieuwenhuijs VB, Timmer R, Laméris JS, Kruyt PM, Manusama ER, van der Harst E, van der Schelling GP, Karsten T, Hesselink EJ, van Laarhoven CJ, Rosman C, Bosscha K, de Wit RJ, Houdijk AP, van Leeuwen MS, Buskens E, Gooszen HG; Dutch Pancreatitis Study Group.

N Engl J Med. 2010 Apr 22;362(16):1491-502.

Rationale for inclusion: This RCT evaluates the step-up approach compared to open necrosectomy and shows favorable outcomes for patients that are able to be managed with percutaneous and minimally invasive therapies.

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Systematic review and meta-analysis of the diagnostic and therapeutic role of water-soluble contrast agent in adhesive small bowel obstruction.

Branco BC, Barmparas G, Schnüriger B, Inaba K, Chan LS, Demetriades D.

Br J Surg. 2010 Apr;97(4):470-8.

Rationale for inclusion: There are 14 randomized, controlled trials in the use of Gastrografin for the management of SBO. This paper is a meta-analysis of all of them. It highlights the shortcomings of the trials, which are significant. Nevertheless, it provides further data on the beneficial effects of Gastrografin for diagnostic and therapeutic utilization in SBO.

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Provocative mesenteric angiography for lower gastrointestinal hemorrhage: results from a single-institution study.

Kim CY, Suhocki PV, Miller MJ Jr, Khan M, Janus G, Smith TP.

J Vasc Interv Radiol. 2010 Apr;21(4):477-83.

Rationale for inclusion: this study that provoking bleeding by intra-arterial injection of a vasodilator and tissue plasminogen activator successfully uncovered the source of bleeding in about one-third of patients with occult lower GI bleeding. Complication rates were low and the rates of hemorrhage control (after provocation) were high.

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Natural history of gallstone disease: Expectant management or active treatment? Results from a population-based cohort study.

Festi D, Reggiani ML, Attili AF, Loria P, Pazzi P, Scaioli E, Capodicasa S, Romano F, Roda E, Colecchia A.

J Gastroenterol Hepatol. 2010 Apr;25(4):719-24.

Rationale for inclusion: knowledge of a disease’s natural history is essential for disease management. This is one of the largest population based studies of over 11,000 patients and found an overall incidence of gallstones in 7.1% of patients; of which 73.1% are asymptomatic.

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Endolaparoscopic approach vs conventional open surgery in the treatment of obstructing left-sided colon cancer: a randomized controlled trial.

Cheung HY, Chung CC, Tsang WW, Wong JC, Yau KK, Li MK.

Arch Surg. 2009 Dec;144(12):1127-32.

Rationale for inclusion: Despite being a smaller study, this RCT found that self-expanding metal stents are a safe and effective bridge to subsequent laparoscopic surgery in patients with obstructing left-sided colon cancer.

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Low recurrence rate after laparoscopic (TEP) and open (Lichtenstein) inguinal hernia repair: a randomized, multicenter trial with 5-year follow-up.

Evans MD, Williams GL, Stephenson BM.

Ann Surg. 2009 Aug;250(2):354-5.

Rationale for inclusion: RTC evaluating open versus TEP inguinal hernia repair.

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Long-term outcome of transcatheter embolotherapy for acute lower gastrointestinal hemorrhage.

Maleux G, Roeflaer F, Heye S, Vandersmissen J, Vliegen AS, Demedts I, Wilmer A.

Am J Gastroenterol. 2009 Aug;104(8):2042-6.

Rationale for inclusion: this study demonstrates high effectiveness and low complication rates associated with transcatheter angioembolism for lower GI bleeding.

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Emergency subtotal colectomy for lower gastrointestinal haemorrhage: over-utilised or under-estimated?

Plummer JM, Gibson TN, Mitchell DI, Herbert J, Henry T.

Int J Clin Pract. 2009 Jun;63(6):865-8.

Rationale for inclusion: this study reports that sub-total colectomy is the preferred treatment for unrelenting massive lower GI bleeding. Because most mortalities were secondary to sepsis from anastomotic leak, end ileostomy is recommended.

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Evaluation of acute mesenteric ischemia: accuracy of biphasic mesenteric multi-detector CT angiography.

Aschoff AJ, Stuber G, Becker BW, Hoffmann MH, Schmitz BL, Schelzig H, Jaeckle T.

Abdom Imaging. 2009 May-Jun;34(3):345-57.

Rationale for inclusion: This study examines 79 patients with acute mesenteric ischemia and essentially validates multi-detector row helical computed tomography as an accurate and rapid diagnostic tool.

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Laparoscopic sigmoid resection for diverticulitis decreases major morbidity rates: a randomized control trial: short-term results of the Sigma Trial.

Klarenbeek BR, Veenhof AA, Bergamaschi R, van der Peet DL, van den Broek WT, de Lange ES, Bemelman WA, Heres P, Lacy AM, Engel AF, Cuesta MA.

Ann Surg. 2009 Jan;249(1):39-44.

Rationale for inclusion: This is a multi-center double-blind randomized controlled trial comparing laparoscopic versus open sigmoid resection for symptomatic diverticulitis. The study found that the laparoscopic approach was associated with longer operative times but lower complication rates, less pain and shorter hospital length of stay.

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Effect of immediate enteral feeding on trauma patients with an open abdomen: protection from nosocomial infections.

Dissanaike S, Pham T, Shalhub S, Warner K, Hennessy L, Moore EE, Maier RV, O'Keefe GE, Cuschieri J.

J Am Coll Surg. 2008 Nov;207(5):690-7.

Rationale for inclusion: this article supports early EN to decrease pneumonia.

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Enteral nutrition and the risk of mortality and infectious complications in patients with severe acute pancreatitis: a meta-analysis of randomized trials.

Petrov MS, van Santvoort HC, Besselink MG, van der Heijden GJ, Windsor JA, Gooszen HG.

Arch Surg. 2008 Nov;143(11):1111-7.

Rationale for inclusion: This meta-analysis of RCTs looks specifically at patients with predicted severe acute pancreatitis and clearly shows improved outcomes in those receiving enteral versus parenteral nutrition.

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Transcatheter arterial embolization versus surgery in the treatment of upper gastrointestinal bleeding after therapeutic endoscopy failure.

Eriksson LG, Ljungdahl M, Sundbom M, Nyman R.

J Vasc Interv Radiol. 2008 Oct;19(10):1413-8.

Rationale for inclusion: this study confirms that after failed endoscopy for upper GI bleeding, arterial embolization should be attempted next before surgical intervention.

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Outcome of necrotizing skin and soft tissue infections.

Gunter OL, Guillamondegui OD, May AK, Diaz JJ.

Surg Infect (Larchmt). 2008 Aug;9(4):443-50.

Rationale for inclusion: This study identifies risk factors for mortality, including APACHE II score and lactate levels. It also focuses on the benefit of primary management by an EGS service to facilitate prompt surgical intervention.

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Effects of gastroprotectant drugs for the prevention and treatment of peptic ulcer disease and its complications: a meta-analysis of randomised trials

Scally B, Emberson JR, Spata E, Reith C, Davies K, Halls H, Holland L, Wilson K, Bhala N, Hawkey C, Hochberg M, Hunt R, Laine L, Lanas A, Patrono C, Baigent C

Lancet Gastroenterol Hepatol. 2018 Apr;3(4):231-241.

Rationale for Inclusion: Although only 68% of subjects were inpatient, 24% of all subjects had severe C.diff, so this study may be relevant to our practice. Subgroup analyses favored fidaxomicin for those receiving concomitant antibiotics and in the severe C. diff subgroup.

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Error traps and vasculo-biliary injury in laparoscopic and open cholecystectomy.

Strasberg SM.

J Hepatobiliary Pancreat Surg. 2008;15(3):284-92.

Rationale for inclusion: Expert review of anatomical variation in biliary disease that all general surgeons should be familiar with.

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Meta-analysis of enteral nutrition versus total parenteral nutrition in patients with severe acute pancreatitis.

Cao Y, Xu Y, Lu T, Gao F, Mo Z.

Ann Nutr Metab. 2008;53(3-4):268-75.

Rationale for inclusion: This study represents a meta-analysis of RCTs and further supports enteral nutrition over parenteral nutrition for severe acute pancreatitis.

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Timing of surgical intervention in necrotizing pancreatitis.

Besselink MG, Verwer TJ, Schoenmaeckers EJ, Buskens E, Ridwan BU, Visser MR, Nieuwenhuijs VB, Gooszen HG.

Arch Surg. 2007 Dec;142(12):1194-201.

Rationale for inclusion: This work includes a retrospective review and a systematic review and is yet another work supporting a delayed approach to necrosectomy.

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A comparison of vancomycin and metronidazole for the treatment of clostridium difficile-associated diarrhea, stratified by disease severity.

Zar FA, Bakkanagari SR, Moorthi KM, Davis MB.

Clin Infect Dis. 2007 Aug 1;45(3):302-7.

Rationale for inclusion: this study supports the use of vancomycin over metronidazole for severe C.diff.

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An algorithm for the management of sigmoid colon volvulus and the safety of primary resection: experience with 827 cases.

Oren D, Atamanalp SS, Aydinli B, Yildirgan MI, Basoglu M, Polat KY, Onbas O.

Dis Colon Rectum. 2007 Apr;50(4):489-97.

Rationale for inclusion: This is one of the larger retrospective reviews pertaining to the management of sigmoid volvulus. The study advocates for the surgical management of this condition.

CAVEAT: Retrospective review.

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Impact of emergency colectomy on survival of patients with fulminant clostridium difficile colitis during an epidemic caused by a hypervirulent strain.

Lamontagne F, Labbé AC, Haeck O, Lesur O, Lalancette M, Patino C, Leblanc M, Laverdière M, Pépin J.

Ann Surg. 2007 Feb;245(2):267-72.

Rationale for inclusion: emergency colectomy is beneficial in fulminant C. diff.

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An acute care surgery model improves outcomes in patients with appendicitis.

Earley AS, Pryor JP, Kim PK, Hedrick JH, Kurichi JE, Minogue AC, Sonnad SS, Reilly PM, Schwab CW.

Ann Surg. 2006 Oct;244(4):498-504.

Rationale for inclusion: this parallel-cohort study demonstrates that an acute care surgery (ACS) model, compared to the traditional home-call model, was associated with decreased time to operation, decreased complications, and shorter hospital length of stay.

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Biologic prosthesis reduces recurrence after laparoscopic paraesophageal hernia repair - A multicenter, prospective, randomized trial.

Oelschlager BK, Pellegrini CA, Hunter J, Soper N, Brunt M. Sheppard B, Jobe B, Polissar N, Mitsumori L, Nelson J, Swanstrom L.

Ann Surg . 2006 Oct;244(4):481-90.

Rationale for inclusion: Multicenter randomized trial comparing primary paraesophgeal hernia repair and primary repair with mesh buttress, demonstrating significant reduction in hernia recurrence at 6 months (9 vs 24%). Importantly, no mesh-related complications or side effects were identified, indicating safety and improved short-term outcome.

CAVEAT: Relatively small MCT without long-term outcome data.

. 2006 Oct;244(4):481-90.

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One hundred percent fascial approximation with sequential abdominal closure of the open abdomen.

Cothren CC, Moore EE, Johnson JL, Moore JB, Burch JM.

Am J Surg. 2006 Aug;192(2):238-42.

Rationale for inclusion: though it’s a small study, they describe their technique of sequential abdominal closure using NPWT for high rate of fascial closure during index hospitalization.

Watch the EAST Minute Video - https://youtu.be/FS1e9MA-q1o

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Identification of risk factors for perioperative mortality in acute mesenteric ischemia.

Acosta-Merida MA, Marchena-Gomez J, Hemmersbach-Miller M, Roque-Castellano C, Hernandez-Romero JM.

World J Surg. 2006 Aug;30(8):1579-85.

Rationale for inclusion: This is a retrospective study over a 10-year period that examines 132 patients undergoing operative therapy for acute mesenteric ischemia that identifies predictors of perioperative mortality.

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Diverticulitis: a progressive disease? Do multiple recurrences predict less favorable outcomes?

Chapman JR, Dozois EJ, Wolff BG, Gullerud RE, Larson DR.

Ann Surg. 2006 Jun;243(6):876-830; discussion 880-3.

Rationale for inclusion: Retrospective study that found that patients with multiple (>2) episodes of diverticulitis are not at increased risk for poor outcomes compared to those with fewer attacks. Therefore elective resection may not be warranted in these patients.

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Early definitive abdominal closure using serial closure technique on injured soldiers returning from Afghanistan and Iraq.

Vertrees A, Kellicut D, Ottman S, Peoples G, Shriver C.

J Am Coll Surg. 2006 May;202(5):762-72.

Rationale for inclusion: further refinement of the serial abdominal closure technique using a Gore-Tex mesh as a temporary “handle” to help sequentially draw the fascia to the midline.

Watch the EAST Minute Video - https://youtu.be/qbkGuPxuFsk

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Hyperbaric oxygen as adjuvant therapy in the management of necrotizing fasciitis.

Jallali N, Withey S, Butler PE.

Am J Surg. 2005 Apr;189(4):462-6.

Rationale for inclusion: This literature review does not find consistent evidence to support the routine use of HBO as an adjunctive therapy in the management of NSTI. These findings have since been corroborated in a recent Cochrane review that failed to locate relevant clinical evidence to support or refute the effectiveness of HBOT in the management of necrotizing fasciitis. Good quality clinical trials are needed to define the role of HBOT in the treatment of individuals with necrotizing fasciitis.

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Predictors of mortality and limb loss in necrotizing soft tissue infection.

Anaya DA, McMahon K, Nathens AB, Sullivan SR, Foy H, Bulger E.

Arch Surg. 2005 Feb;140(2):151-7; discussion 158.

Rationale for inclusion: One of the largest cohort studies to determine predictors of mortality that include leukocytosis, elevated creatinine, presence of heart disease, shock and Clostridial infection.

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Long-term prognosis after operation for adhesive small bowel obstruction.

Fevang BT, Fevang J, Lie SA, Søreide O, Svanes K, Viste A.

Ann Surg. 2004 Aug;240(2):193-201.

Rationale for inclusion: Despite the retrospective nature, this study provides long-term outcomes and risk factors for SBO occurrence and recurrence. In particular, the duration of time from index to readmission is outlined both for patients who underwent operative and non-operative management. This is critical data when providing informed consent to patients who are wondering if an operative approach is appropriate based on long-term outcomes.

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The Canadian Registry on nonvariceal upper gastrointestinal bleeding and endoscopy (RUGBE): endoscopic hemostasis and proton pump inhibition are associated with improved outcomes in a real-life setting.

Barkun A, Sabbah S, Enns R, Armstrong D, Gregor J, Fedorak RN, Rahme E, Toubouti Y, Martel M, Chiba N, Fallone CA; RUGBE Investigators.

Am J Gastroenterol. 2004 Jul;99(7):1238-46.

Rationale for inclusion: this very large registry study confirms the beneficial role of endoscopy and proton pump inhibitor therapy for nonvariceal upper GI bleeding.

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LRINEC (laboratory risk indicator for necrotizing fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections.

Wong CH, Khin LW, Heng KS, Tan KC, Low CO.

Crit Care Med. 2004 Jul;32(7):1535-41.

Rationale for inclusion: This well cited study discusses one of the most widely used scoring systems to assist with early diagnosis of NSTI. This validated scoring system is based on laboratory values found to be independent predictors of disease and can be used to guide management.

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Prospective evaluation of vacuum-assisted fascial closure after open abdomen: planned ventral hernia rate is substantially reduced.

Miller PR, Meredith JW, Johnson JC, Chang MC.

Ann Surg. 2004 May;239(5):608-14; discussion 614-6.

Rationale for inclusion: negative pressure wound therapy (NPWT) is superior to non-NPWT for fascial closure during index hospitalization.

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Laparoscopic versus open appendectomy: outcomes comparison based on a large administrative database.

Guller U, Hervey S, Purves H, Muhlbaier LH, Peterson ED, Eubanks S, Pietrobon R.

Ann Surg. 2004 Jan;239(1):43-52.

Rationale for inclusion: this analysis of the Nationwide Inpatient Sample (NIS) concludes that laparoscopic appendectomy is superior to open appendectomy with regards to hospital length of stay and post-operative in-hospital morbidity.

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The first prospective controlled trial comparing wireless capsule endoscopy with push enteroscopy in chronic gastrointestinal bleeding.

Ell C, Remke S, May A, Helou L, Henrich R, Mayer G.

Endoscopy. 2002 Sep;34(9):685-9.

Rationale for inclusion: this study demonstrates the utility of wireless capsule endoscopy in identifying occult GI bleeding and its superiority over push enteroscopy.

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How to avoid recurrence in Lichtenstein tension-free hernioplasty.

Amid, PK.

Am J Surg. 2002 Sep;184(3):259-60.

Rationale for inclusion: Amid modification to Lichtenstein, covers key technical aspects.

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Bedside diagnostic minilaparoscopy in the intensive care patient.

Gagné DJ, Malay MB, Hogle NJ, Fowler DL.

Surgery. 2002 May;131(5):491-6.

Rationale for inclusion: This paper represents one of the initial descriptions of bedside laparoscopy in the intensive care unit for the identification of intestinal and intra-abdominal pathologies in the patient with acidosis, abdominal pain, and suspected mesenteric ischemia.

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A 1-stage surgical treatment for postherniorrhaphy neuropathic pain: triple neurectomy and proximal end implantation without mobilization of the cord.

Amid, PK.

Arch Surg. 2002 Jan;137(1):100-4.

Rationale for inclusion: large experience with management of post inguinal neuralgia.

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Percutaneous transhepatic cholecystostomy and delayed laparoscopic cholecystectomy in critically ill patients with acute calculus cholecystitis.

Spira RM, Nissan A, Zamir O, Cohen T, Fields SI, Freund HR.

Am J Surg. 2002 Jan;183(1):62-6.

Rationale for inclusion: this study supports the safety and efficacy of cholecystostomy tube for acute cholecystitis in critically ill patients followed by interval cholecystectomy.

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Nonlocalized lower gastrointestinal bleeding: provocative bleeding studies with intraarterial tPA, heparin, and tolazoline.

Ryan JM, Key SM, Dumbleton SA, Smith TP.

J Vasc Interv Radiol. 2001 Nov;12(11):1273-7.

Rationale for inclusion: this is another provocative mesenteric angiography study demonstrating a similar one-third success rate.

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Laparoscopic treatment of acute small bowel obstruction: a multicentre retrospective study.

Levard H, Boudet MJ, Msika S, Molkhou JM, Hay JM, Laborde Y, Gillet M, Fingerhut A; French Association for Surgical Research.

ANZ J Surg. 2001 Nov;71(11):641-6.

Rationale for inclusion: As a multi-institutional study, this represents largest experience with the laparoscopic management of SBO contained within one paper. It provides data supporting the use of laparoscopy for SBO management as well as risk factors for conversion to open procedures.

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Arterial embolotherapy for upper gastrointestinal hemorrhage: outcome assessment.

Aina R, Oliva VL, Therasse E, Perreault P, Bui BT, Dufresne MP, Soulez G.

J Vasc Interv Radiol. 2001 Feb;12(2):195-200.

Rationale for inclusion: this study confirms the safety and efficacy of arterial embolization for upper GI bleeding.

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A simple model to help distinguish necrotizing fasciitis from nonnecrotizing soft tissue infection.

Wall DB, Klein SR, Black S, de Virgilio C.

J Am Coll Surg. 2000 Sep;191(3):227-31.

Rationale for inclusion: Although this is a smaller retrospective review to help distinguish between necrotizing and non-necrotizing infection, the model is simple and highly sensitive with a NPV of 99% for diagnosing necrotizing infection. This tool may be useful when other laboratory parameters (such as those required for the LRINEC score) are not available.

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Eradication of Helicobacter pylori prevents recurrence of ulcer after simple closure of duodenal ulcer perforation: randomized controlled trial.

Ng EK, Lam YH, Sung JJ, Yung MY, To KF, Chan AC, Lee DW, Law BK, Lau JY, Ling TK, Lau WY, Chung SC.

Ann Surg. 2000 Feb;231(2):153-8.

Rationale for inclusion: This study demonstrates that the majority of patients with perforated duodenal ulcer (81%) are infected with H. pylori. After simple repair and H. pylori eradication, the ulcer recurrence rate was only 4.8%. This study does not support definitive operation (vagotomy) in the era of H. pylori eradication.

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Acute mesenteric ischemia caused by spontaneous isolated dissection of the superior mesenteric artery: treatment by percutaneous stent placement.

Leung DA, Schneider E, Kubik-Huch R, Marincek B, Pfammatter T.

Eur Radiol. 2000;10(12):1916-9.

Rationale for inclusion: This case report is likely the first published experience of completely percutaneous stenting of the superior mesenteric artery for a flow-limiting dissection.

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Diagnostic accuracy of magnetic resonance cholangiopancreatography and ultrasound compared with direct cholangiography in the detection of choledocholithiasis.

Varghese JC, Liddell RP, Farrell MA, Murray FE, Osborne DH, Lee MJ.

Clin Radiol. 2000 Jan;55(1):25-35.

Rationale for inclusion: in contrast, this study reports high accuracy of MRCP for the diagnosis of choledocholithiasis.

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Total colectomy versus limited colonic resection for acute lower gastrointestinal bleeding.

Farner R, Lichliter W, Kuhn J, Fisher T.

Am J Surg. 1999 Dec;178(6):587-91.

Rationale for inclusion: this study supports the practice of total colectomy for the treatment of ongoing lower GI bleeding. Compared to limited colonic resection, the rebleeding rate was much lower (4% vs. 18%).

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Endoscopic retreatment compared with surgery in patients with recurrent bleeding after initial endoscopic control of bleeding ulcers.

Lau JY, Sung JJ, Lam YH, Chan AC, Ng EK, Lee DW, Chan FK, Suen RC, Chung SC.

N Engl J Med. 1999 Mar 11;340(10):751-6.

Rationale for inclusion: This study enrolled patients who had already undergone endoscopic therapy for bleeding peptic ulcers and had recurrent bleeding. Subjects were than randomized to either endoscopic retreatment or definitive surgery. The success rate of endoscopic retreatment was 73% (35/48) and mortality was not significantly different between groups (5/48 vs. 8/44), though there were significantly fewer complications in the endoscopic retreatment group. Ulcer size > 2cm and hypotension during rebleeding were independent predictors of endoscopic retreatment failure. This study supports endoscopic retreatment for recurrent bleeding.

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Early endoscopy in upper gastrointestinal hemorrhage: associations with recurrent bleeding, surgery, and length of hospital stay.

Cooper GS, Chak A, Way LE, Hammar PJ, Harper DL, Rosenthal GE.

Gastrointest Endosc. 1999 Feb;49(2):145-52.

Rationale for inclusion: this study concludes that early endoscopy for upper GI bleeding is beneficial in terms of hospital length of stay, risk of recurrent bleeding, and need for surgery.

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Diagnosis of choledocholithiasis: EUS or magnetic resonance cholangiography? A prospective controlled study.

de Lédinghen V, Lecesne R, Raymond JM, Gense V, Amouretti M, Drouillard J, Couzigou P, Silvain C.

Gastrointest Endosc. 1999 Jan;49(1):26-31.

Rationale for inclusion: this study supports the accuracy of EUS for the diagnosis of choledocholithiasis.

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Use of magnetic resonance cholangiography in the diagnosis of choledocholithiasis: prospective comparison with a reference imaging method.

Zidi SH, Prat F, Le Guen O, Rondeau Y, Rocher L, Fritsch J, Choury AD, Pelletier G.

Gut. 1999 Jan;44(1):118-22.

Rationale for inclusion: this study also suggests poor accuracy of MRCP for the diagnosis of choledocholithiasis.

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Endoscopic ultrasonography versus cholangiography for the diagnosis of choledocholithiasis.

Canto MI, Chak A, Stellato T, Sivak MV Jr.

Gastrointest Endosc. 1998 Jun;47(6):439-48.

Rationale for inclusion: this study supports the accuracy of EUS for the diagnosis of choledocholithiasis.

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Aggressive surgical management of necrotizing fasciitis serves to decrease mortality: a retrospective study.

Bilton BD, Zibari GB, McMillan RW, Aultman DF, Dunn G, McDonald JC.

Am Surg. 1998 May;64(5):397-400; discussion 400-1.

Rationale for inclusion: Although this is a smaller retrospective review, the authors found that early surgical debridement leads to a significant reduction in mortality, highlighting the importance of early recognition and expeditious initial debridement in the management of NSTI.

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Randomised trial of laparoscopic versus open cholecystectomy for acute and gangrenous cholecystitis.

Kiviluoto T, Sirén J, Luukkonen P, Kivilaakso E.

Lancet. 1998 Jan 31;351(9099):321-5.

Rationale for inclusion: this study supports the safety of laparoscopy for acute and gangrenous cholecystitis.

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Predictive factors for synchronous common bile duct stones in patients with cholelithiasis.

Alponat A, Kum CK, Rajnakova A, Koh BC, Goh PM.

Surg Endosc. 1997 Sep;11(9):928-32.

Rationale for inclusion: This study describes offers four clinical/laboratory/sonographic signs which may help predict the likelihood of having CBD stones.

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Long-term results after surgery for acute mesenteric ischemia.

Klempnauer J, Grothues F, Bektas H, Pichlmayr R.

Surgery. 1997 Mar;121(3):239-43.

Rationale for inclusion: This work is unique in its assessment of long-term outcomes after surgical intervention for acute mesenteric ischemia (AMI). Similar to other critical vascular pathologies involving tissue loss, the authors find the 5-year survival rate after surgical intervention for AMI is 50%.

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Endoscopic ultrasonography for diagnosing choledocholithiasis: a prospective comparative study with ultrasonography and computed tomography.

Sugiyama M, Atomi Y.

Gastrointest Endosc. 1997 Feb;45(2):143-6.

Rationale for inclusion: this study supports the accuracy of EUS for the diagnosis of choledocholithiasis.

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Role of the Shouldice technique in inguinal hernia repair: a systematic review of controlled trials and a meta-analysis.

Simons MP, Kleijnen J, van Geldere D, Hoitsma HF, Obertop H.

Br J Surg. 1996 Jun;83(6):734-8.

Rationale for inclusion: evaluation of Shouldice as tissue based repair based on review of literature.

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Single-stage treatment for malignant left-sided colonic obstruction: a prospective randomized clinical trial comparing subtotal colectomy with segmental resection following intraoperative irrigation.

Evans RO, Thampi KA, Mukherjee K, Stephenson BM.

Br J Surg. 1996 Apr;83(4):572.

Rationale for inclusion: First prospective RCT to compare subtotal colectomy with segmental resection and anastomosis after intraoperative irrigation for malignant left sided colonic obstruction. The authors found no differences in terms of morbidity and mortality, but significantly worse functional results after TC.

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Management of pancreatitis complicating pregnancy.

Swisher S, Hunt K, Schmit P, Hiyama D, Bennion R, Thompson J.

Am Surg. 1994 Oct;60(10):759-62.

Rationale for inclusion: Retrospective review of pancreatitis in pregnancy, identifying a significant GSP recurrence rate in patients prior to delivery, requiring additional hospitalization. No readmission or fetal or maternal morbidity occurred as a result of cholecystectomy performed during the first or second trimester, suggesting a benefit of intervention when premature labor and risk of anesthesia are lowest.

CAVEAT: 30 patient case series.

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Therapeutic effect of oral Gastrografin in adhesive, partial small-bowel obstruction: a prospective randomized trial.

Assalia A, Schein M, Kopelman D, Hirshberg A, Hashmonai M.

Surgery. 1994 Apr;115(4):433-7.

Rationale for inclusion: The first randomized, controlled trial in the use of the Gastrografin Challenge. This study demonstrated both a positive diagnostic and positive therapeutic effect for the use of Gastrografin. Most additional studies have confirmed these results.

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Diagnosis of choledocholithiasis by endoscopic ultrasonography.

Amouyal P, Amouyal G, Lévy P, Tuzet S, Palazzo L, Vilgrain V, Gayet B, Belghiti J, Fékété F, Bernades P.

Gastroenterology. 1994 Apr;106(4):1062-7.

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Rationale for inclusion: another study supporting EUS for the diagnosis of choledocholithiasis.

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'Damage control': an approach for improved survival in exsanguinating penetrating abdominal injury.

Rotondo MF, Schwab CW, McGonigal MD, Phillips GR, Fruchterman TM, Kauder DR, Latenser BA, Angood PA.

J Trauma. 1993 Sep;35(3):375-82; discussion 382-3.

Rational for inclusion: this article is often cited as the “original” modern description of damage control laparotomy.

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Endoscopic biliary drainage for severe acute cholangitis.

Lai EC, Mok FP, Tan ES, Lo CM, Fan ST, You KT, Wong J.

N Engl J Med. 1992 Jun 11;326(24):1582-6.

Rationale for inclusion: This RCT is widely cited as the evidence-base supporting initial endoscopic CBD clearance (as opposed to surgery) for patients with acute cholangitis.

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Limited value of technetium 99m-labeled red cell scintigraphy in localization of lower gastrointestinal bleeding.

Hunter JM, Pezim ME.

Am J Surg. 1990 May;159(5):504-6.

Rationale for inclusion: this study demonstrates the limited utility of nuclear imaging (technetium scintigraphy) for localizing the source of lower GI bleeding. Performing resection based on results of scintigraphy resulted in surgical error 42% of the time!

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Acute mesenteric ischemia: improved results--a retrospective analysis of ninety-two patients.

Levy PJ, Krausz MM, Manny J.

Surgery. 1990 Apr;107(4):372-80.

Rationale for inclusion: The authors of this study compare a historic cohort of patients undergoing only bowel resection and anastomosis for acute mesenteric ischemia to a more modern cohort of patients that underwent bowel resection with varying patients receiving revascularization, second-look procedures, and delayed anastomosis creation with improved survival in the latter group. The authors also propose an algorithm for the management of patients with acute mesenteric ischemia.

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A randomized trial of nonoperative treatment for perforated peptic ulcer.

Crofts TJ, Park KG, Steele RJ, Chung SS, Li AK.

N Engl J Med. 1989 Apr 13;320(15):970-3.

Rationale for inclusion: In patients with a clinical diagnosis of perforated peptic ulcer, subjects were randomized to either immediate operation or a 12-h trial of nonoperative therapy (nasogastric suction, IV broad-spectrum antibiotics, and IV ranitidine). While the majority of nonoperative patients had free air until the diaphragm on CXR (35/40), only 28% (11/40) did not improve and require rescue laparotomy. While hospital stay was longer in the nonoperative group, overall morbidity and mortality rates were similar (5%). Deaths in the nonoperative group were unrelated to delay in treatment. This small study provides support for an initial 12-h trial of nonoperative therapy of perforated peptic ulcer.

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The tension-free hernioplasty.

Lichtenstein IL, Shulman AG, Amid PK, Montllor MM.

Am J Surg. 1989 Feb;157(2):188-93.

Rationale for inclusion: original description of technique.

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A practical score for the early diagnosis of acute appendicitis.

Alvarado A.

Ann Emerg Med. 1986 May;15(5):557-64.

Rationale for inclusion: this widely cited paper describes the “Alvarado score”, a clinical scoring system which can help clinicians decide whether or not to order CT imaging for suspected acute appendicitis.

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Immediate definitive surgery for perforated duodenal ulcers: a prospective controlled trial.

Boey J, Lee NW, Koo J, Lam PH, Wong J, Ong GB.

Ann Surg. 1982 Sep;196(3):338-44.

Rationale for inclusion: Although it is dated and precedes the era of proton pump inhibition and H. pylori eradication, this study is interesting and relevant in cases of peptic ulcers refractory to medical therapy or non-compliant patients in the modern era. In this three-arm randomized trial, subjects underwent duodenal ulcer repair by simple closure, truncal vagotomy and drainage (VD), or proximal gastric vagotomy with closure (PGV). At 39 month follow-up, the cumulative rates of recurrence were 63% (closure), 12% (VD), and 4% (PGV). This study supports the use of definitive treatment (vagotomy with either closure or drainage) without resection over simple closure alone in the treatment of perforated duodenal ulcers for patients who will not receive benefit from modern postoperative medical therapy.

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Treatment of perforated diverticular disease of the colon.

Hinchey EJ, Schaal PG, Richards GK.

Adv Surg. 1978;12:85-109.

Rationale for inclusion: Although several modifications and new grading systems have been proposed that provide a more contemporary overview of the disease, this discusses Hinchey's traditional classification for perforated diverticulitis.

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Management of umbilical hernias associated with hepatic cirrhosis and ascites.

O'Hara ET, Oliai A, Patek AJ Jr, Nabseth DC.

Ann Surg. 1975 Jan;181(1):85-7.

Rationale for inclusion: one of the original series of management.

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A rapid method of treatment of perforated duodenal ulcer.

Cellan-Jones CJ.

Br Med J. 1929 Jun 15;1(3571):1076-7.

Rationale for inclusion: This historical article describes the technique of a pedicled omental plug (without primary closure), which many surgeons use as an alternative to primary closure of friable and indurated perforated anterior duodenal ulcers.

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Effect of Inclusion of Oral Antibiotics with Mechanical Bowel Preparation on the Risk of Clostridium Difficile Infection After Colectomy

Al-Mazrou, Ahmed M.; Hyde, Laura Z.; Suradkar, Kunal; Kiran, Ravi P.

J Gastrointest Surg. 2018 Nov;22(11):1968-1975.

Rationale for inclusion: Use of oral antibiotics with mechanical bowel prep before colectomy did not increase risk of postoperative C diff, and possibly decrease the risk.

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