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Emergency General Surgery

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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.

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

Citations - 1 (as of January 2018)

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.

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. 

Citations - 0 (as of January 2018)

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.

Citations - 2 (as of January 2018)

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.

Citations - 0 (as of January 2018)

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.

Citations - 1 (as of January 2018)

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%).

Citations - 1 (as of January 2018)

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.

Citations - 1 (as of July 2017)

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.

Citations - 3 (as of July 2017)

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.

Citations - 5 (as of July 2017)

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.

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

Citations - 6 (as of January 2018)

Missed Opportunity: Laparoscopic Colorectal Resection Is Associated With Lower Incidence of Small Bowel Obstruction Compared to an Open Approach.
Aquina, C.; Probst, CP; Becerra, AZ; Iannuzzi, JC.; Hensley, BJ.; Noyes, K; Monson, JT.; Fleming, FJ.
Ann Surg. 2016 Jul;264(1):127-34.

Rationale for inclusion: This large study confirms that the incidence of SBO is lower after laparoscopic vs. open surgery.

Citations - 16 (as of July 2017)

ACG Clinical Guideline: Management of Patients with Acute Lower Gastrointestinal Bleeding.
Strate LL, Gralnek IM.
Am J Gastroenterol. 2016 May;111(5):755.

Rationale for inclusion: This article provides a nice summary of management of lower GI bleeding.

Citations - 37 (as of July 2017)

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.

Citations - 5 (as of January 2018)

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. 

Citations - 5 (as of July 2017)

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.

Citations - 10 (as of July 2017)

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.

Citations - 22 (as of July 2017)

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.

Citations - 11 (as of July 2017)

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.

Citations - 2 (as of July 2017)

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.

Citations - 17 (as of January 2018)

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.

Citations - 15 (as of July 2017)

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.

Citations - 3 (as of July 2017)

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.

Citations - 7 (as of July 2017)

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. 

Citations - 70 (as of July 2017)

Endovascular therapy as a primary revascularization modality in acute mesenteric ischemia.
Kärkkäinen JM, Lehtimäki TT, Saari P, Hartikainen J, Rantanen T, Paajanen H, Manninen H.
Cardiovasc Intervent Radiol. 2015 Oct;38(5):1119-29.

Rationale for inclusion: This retrospective review looking at an endovascular approach to acute mesenteric ischemia (AMI) found that endovascular therapy can be attempted in most cases with favorable outcomes and no increased risk of complications.

Citations -17 (as of July 2017)

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.

Citations - 1 (as of July 2017)

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).

Citations - 57 (as of July 2017)

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

Citations - 75 (as of January 2018)

An updated meta-analysis of laparoscopic versus open repair for perforated peptic ulcer.
Zhou, C; Wang, W; Wang, J; Zhang, X; Zhang, Q; Li, B; Xu, Z.
Sci Rep. 2015 Sep 9;5:13976.

Rationale for inclusion: Unlike previous reviews that have found little difference between laparoscopic and open repair, this more recent meta-analysis found high quality evidence that laparoscopic repair is associated with fewer postoperative complications compared to an open approach.

Citations - 5 (as of July 2017)

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.

Citations - 6 (as of July 2017)

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.

Citations - 10 (as of January 2018)

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.

Citations - 9 (as of July 2017)

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.

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.

Citations - 61 (as of July 2017)

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.

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.

Citations - 8 (as of July 2017)

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. 

Citations - 12 (as of July 2017)

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.

Citations - 10 (as of July 2017)

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.

Citations - 14 (as of July 2017)

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.

Citations - 138 (as of July 2017)

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.

Citations - 130 (as of July 2017)

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.

Citations - 115 (as of July 2017)

Risk of upper and lower gastrointestinal bleeding in patients taking nonsteroidal anti-inflammatory drugs, antiplatelet agents, or anticoagulants.
Lanas Á, Carrera-Lasfuentes P, Arguedas Y, García S, Bujanda L, Calvet X, Ponce J, Perez-Aísa Á, Castro M, Muñoz M, Sostres C, García-Rodríguez LA.
Clin Gastroenterol Hepatol. 2015 May;13(5):906-12.e2.

Rationale for inclusion: The common use of NSAIDS and oral anticoagulants necessitate an understanding of the risks associated with their use. This study confirms that GI bleeds are increased when these agents are used.

Citations - 65 (as of July 2017)

The impact of tranexamic acid on mortality in injured patients with hyperfibrinolysis.
Harvin JA, Peirce CA, Mims MM, Hudson JA, Podbielski JM, Wade CE, Holcomb JB, Cotton BA.
J Trauma Acute Care Surg. 2015 May;78(5):905-9; discussion 909-11.

Rationale for inclusion: This study failed to find a mortality benefit resulting from the use of TXA in patients with evidence of hyperfibrinolysis.

Citations - 35 (as of July 2017)

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).

Citations – 32 (as of July 2017)

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.

Citations - 21 (as of July 2017)

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.

Citations - 4 (as of July 2017)

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.

Citations - 15 (as of July 2017)

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.

Citations - 40 (as of July 2017)

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.

Citations - 45 (as of July 2017)

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.

Citations -9 (as of July 2017)

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.

Citations -  28 (as of July 2017)

Oral, capsulized, frozen fecal microbiota transplantation for relapsing clostridium difficile infection.
Youngster I, Russell GH, Pindar C, Ziv-Baran T, Sauk J, Hohmann EL.
JAMA. 2014 Nov 5;312(17):1772-8.

Rationale for inclusion: this is one of the first studies showing the safety of taking poop by frozen pill, rather than nasogastric tube infusion. 

Citations - 305 (as of July 2017)

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.

Citations - 90 (as of July 2017)

Effect of postoperative antibiotic administration on postoperative infection following cholecystectomy for acute calculous cholecystitis: a randomized clinical trial.
Regimbeau JM, Fuks D, Pautrat K, Mauvais F, Haccart V, Msika S, Mathonnet M, Scotté M, Paquet JC, Vons C, Sielezneff I, Millat B, Chiche L, Dupont H, Duhaut P, Cossé C, Diouf M, Pocard M; FRENCH Study Group.
JAMA. 2014 Jul;312(2):145-54.

Rationale for inclusion: this trial demonstrates no benefit in continuing prolonged antibiotic therapy beyond the immediate perioperative period and therefore supports a more restrictive philosophy.

Citations - 50 (as of July 2017)

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.

Citations - 43 (as of July 2017)

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.

Citations - 17 (as of July 2017)

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.

Citations – 9 (as of July 2017)

Update with level 1 studies of the European Hernia Society guidelines on the treatment of inguinal hernia in adult patients.
Miserez M, Peeters E, Aufenacker T, Bouillot JL, Campanelli G, Conze J, Fortelny R, Heikkinen T, Jorgensen LN, Kukleta J, Morales-Conde S, Nordin P, Schumpelick V, Smedberg S, Smietanski M, Weber G, Simons MP.
Hernia. 2014 Apr;18(2):151-63.

Rationale for inclusion: EHS guidelines for inguinal hernia treatment based on best available pooled data.

Citations - 187 (as of January 2018)

Surgery for diverticulitis in the 21st century: a systematic review.
Regenbogen SE, Hardiman KM, Hendren S, Morris AM.
JAMA Surg. 2014 Mar;149(3):292-303.

Rationale for inclusion: This comprehensive systematic review presents the more recent data since 2000 guiding decision making, technical consideration, and surgical outcomes of sigmoid diverticulitis.

Citations - 67 (as of July 2017)

Fulminant clostridium difficile colitis: prospective development of a risk scoring system.
van der Wilden GM, Chang Y, Cropano C, Subramanian M, Schipper IB, Yeh DD, King DR, de Moya MA, Fagenholz PJ, Velmahos GC.
J Trauma Acute Care Surg. 2014 Feb;76(2):424-30.

Rationale for inclusion: this study provides a scoring system to help identify patients at risk of developing fulminant C.diff and will require total colectomy.

Citations - 27 (as of July 2017)

Modern treatment of acute mesenteric ischaemia.
Acosta S, Bjorck M.
Br J Surg. 2014 Jan;101(1):e100-8.

Rationale for inclusion: Though not a “landmark” research article, this review of acute mesenteric ischemia describes the modern approach to the condition.

Citations - 79 (as of July 2017)

Long-term risk of acute diverticulitis among patients with incidental diverticulosis found during colonoscopy.
Shahedi K, Fuller G, Bolus R, Cohen E, Vu M, Shah R, Agarwal N, Kaneshiro M, Atia M, Sheen V, Kurzbard N, van Oijen MG, Yen L, Hodgkins P, Erder MH, Spiegel B.
Clin Gastroenterol Hepatol. 2013 Dec;11(12):1609-13.

Rationale for inclusion: This Veterans Affairs (VA) study demonstrated that a very low percentage (4%) of patients with incidentally diagnosed diverticulosis will go on to develop acute diverticulitis.

Citations - 112 (as of July 2017)

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.

Citations - 44 (as of July 2017)

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.

Citations - 743 (as of July 2017)

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 - 18 (as of July 2017)

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.

Citations - 180 (as of July 2017)

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. 

Citations - 372 (as of January 2018)

Gallstone pancreatitis without cholecystectomy.
JAMA Surg. 2013 Sep;148(9):867-72.
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.

Citations - 39 (as of July 2017)

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.

Citations - 12 (as of July 2017)

Accuracy of magnetic resonance cholangiopancreatography for diagnosing stones in the common bile duct in patients with abnormal intraoperative cholangiograms.
Richard F, Boustany M, Britt LD.
Am J Surg. 2013 Apr;205(4):371-3.

Rationale for inclusion: MRCP is not that accurate and has high rate of false negative results.

Citations - 21 (as of July 2017)

Laparoscopic repair for perforated peptic ulcer disease.
Sanabria A, Villegas MI, Morales Uribe CH.
Cochrane Database Syst Rev. 2013 Feb 28;(2):CD004778.

Rationale for inclusion: This Cochrane review summarizes three randomized controlled trials comparing laparoscopy vs. open surgery for perforated peptic ulcer. Although there was no significant difference (likely due to insufficiency sample sizes), there were trends favoring laparoscopy for septic abdominal complications, pulmonary complications, surgical site infection, postoperative ileus, and mortality. The authors conclude that “With the information provided it could be said that laparoscopic surgery results are not clinically different from those of open surgery.

Citations – 95 (as of July 2017)

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.

Citations - 1614 (as of July 2017)

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.

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.

Citations - 819 (as of July 2017)

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.

Citations - 49 (as of July 2017)

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.

Citations - 77 (as of July 2017)


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.

Citations - 133 (as of July 2017)

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.

Citations -  1753 (as of July 2017)

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.

Citations - 40 (as of July 2017)

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.

Citations - 162 (as of July 2017)

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.

Citations - 65 (as of July 2017)

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.

Citations – 7 (as of July 2017)

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.

Citations - 71 (as of July 2017)

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.

Citations - 66 (as of July 2017)

A systematic review and meta-analysis of diagnostic performance of imaging in acute cholecystitis.
Kiewiet JJ, Leeuwenburgh MM, Bipat S, Bossuyt PM, Stoker J, Boermeester MA.
Radiology. 2012 Sep;264(3):708-20.

Rationale for inclusion: this meta-analysis confirms that HIDA scan is more sensitive than US, CT, and MRI for the diagnosis of acute cholecystitis.

Citations - 96 (as of July 2017)

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.

Rationale for inclusion: This Tokyo Guidelines 2013 update provides a good evidence-based review of the diagnostic criteria and severity assessment of acute cholangitis.

Citations - 94 (as of July 2017)

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.

Citations - 405 (as of July 2017)

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.

Citations - 113 (as of July 2017)

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.

Citations - 147 (as of July 2017)

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.

Citations - 48 (as of July 2017)

A conservative and minimally invasive approach to necrotizing pancreatitis improves outcome.
van Santvoort HC, Bakker OJ, Bollen TL, Besselink MG, Ahmed Ali U, Schrijver AM, Boermeester MA, van Goor H, Dejong CH, van Eijck CH, van Ramshorst B, Schaapherder AF, van der Harst E, Hofker S, Nieuwenhuijs VB, Brink MA, Kruyt PM, Manusama ER, van der Schelling GP, Karsten T, Hesselink EJ, van Laarhoven CJ, Rosman C, Bosscha K, de Wit RJ, Houdijk AP, Cuesta MA, Wahab PJ, Gooszen HG; Dutch Pancreatitis Study Group.
Gastroenterology. 2011 Oct;141(4):1254-63.

Rationale for inclusion: This is work from the Dutch Pancreatitis Group that illustrates that avoidance of laparotomy and delaying interventions are preferred over early and emergent interventions if at all possible.

Citations - 277 (as of July 2017)

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.

Citations - 206 (as of July 2017)

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.

Citations - 114 (as of July 2017)

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.

Citations - 56 (as of July 2017)

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.

Citations - 41 (as of July 2017)

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.

Rationale for inclusion: another great technique article.

Citations - 145 (as of July 2017)

Trends in diverticulitis management in the United States from 2002 to 2007.
Masoomi H, Buchberg BS, Magno C, Mills SD, Stamos MJ.
Arch Surg. 2011 Apr;146(4):400-6.

Rationale for inclusion: Using the NIS database, this study demonstrates an increased use of laparoscopy as well as decreased use of colostomy for urgent open operations.

Citations - 90 (as of July 2017)

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.

Citations - 103 (as of July 2017)

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.

Citations - 49 (as of July 2017)

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.

Citations - 468 (as of July 2017)

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.

Citations - 159 (as of July 2017)

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!

Citations - 178 (as of July 2017)

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.

Citations - 152 (as of July 2017)

Does an acute care surgical model improve the management and outcome of acute cholecystitis?
Lehane CW, Jootun RN, Bennett M, Wong S, Truskett P.
ANZ J Surg. 2010 Jun;80(6):438-42.

Rationale for inclusion: this study supports our ACS model for acute cholecystitis.

Citations - 43 (as of July 2017)

Proton pump inhibitors and risk for recurrent clostridium difficile infection.
Linsky A, Gupta K, Lawler EV, Fonda JR, Hermos JA.
Arch Intern Med. 2010 May 10;170(9):772-8.

Rationale for inclusion: additional correlational evidence of the connection between gastric acid suppression and C. diff recurrence.

Citations - 259 (as of July 2017)

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.

Citations - 2386 (as of July 2017)

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.

Citations - 70 (as of July 2017)

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.

Citations - 837 (as of July 2017)

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: This very large population-based cohort study demonstrates that the majority of patients with gallstones are asymptomatic and most will remain asymptomatic.  More than half of patients with mild and severe symptoms will become asymptomatic over time.

Citations - 103 (as of July 2017)

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.

Citations - 113 (as of July 2017)

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.

Citations - 34 (as of July 2017)

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. 

Citations - 18 (as of January 2018)

Meta-analysis of randomized controlled trials on the safety and effectiveness of early versus delayed laparoscopic cholecystectomy for acute cholecystitis.
Gurusamy K, Samraj K, Gluud C, Wilson E, Davidson BR.
Br J Surg. 2010 Feb;97(2):141-50.

Rationale for inclusion: yet more meta-analysis evidence supporting early cholecystectomy.

Citations - 310 (as of July 2017)

Meta-analysis of randomized trials comparing antibiotic therapy with appendectomy for acute uncomplicated (no abscess or phlegmon) appendicitis.
Mason RJ, Moazzez A, Sohn H, Katkhouda N.
Surg Infect (Larchmt). 2012 Apr;13(2):74-84.

Rationale for inclusion: this meta-analysis of randomized trials concludes that non-operative (antibiotics alone) therapy of acute, non-perforated appendicitis has higher recurrence rates compared with immediate appendectomy.

Citations - 92 (as of July 2017)

Trends and outcomes of hospitalizations for peptic ulcer disease in the United States, 1993 to 2006.
Wang YR, Richter JE, Dempsey DT.
Ann Surg. 2010 Jan;251(1):51-8.

Rationale for inclusion: This Nationwide Inpatient Sample (NIS) study demonstrates that hospitalizations for peptic ulcer disease (PUD) have decreased by 30% since the 1990s. While hemorrhage remains the most common presentation, continues to carry the highest mortality (10.6%). Endoscopic treatment to control bleeding has increased and vagotomy/gastrectomy have decreased.

Citations – 160 (as of July 2017)

Acute lower gastrointestinal bleeding in 1,112 patients admitted to an urban emergency medical center.
Gayer C, Chino A, Lucas C, Tokioka S, Yamasaki T, Edelman DA, Sugawa C.
Surgery. 2009 Oct;146(4):600-6; discussion 606-7.

Rationale for inclusion: this large retrospective review demonstrates that the most common causes of acute lower GI bleeding are diverticulosis, hemorrhoids, and carcinoma, and that colonoscopy was effective in diagnosis and treatment.

Citations - 96 (as of July 2017)

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.

Citations - 37 (as of July 2017)

Low recurrence rate after laparoscopic (TEP) and open (Lichtenstein) inguinal hernia repair: a randomized, multicenter trial with 5-year follow-up.
Eklund, Arne S. MD; Montgomery, Agneta K. MD, PhD; Rasmussen, Ib C. MD, PhD; Sandbue, Rune P. MD, PhD; Bergkvist, Leif A. MD, PhD; Rudberg, Claes R. MD, PhD.
Ann Surg. 2009 Aug;250(2):354-5.

Rationale for inclusion: RTC evaluating open versus TEP inguinal hernia repair.

Citations -140 (as of January 2018)

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.

Citations - 14 (as of July 2017)

Risk of arterial thrombotic events in inflammatory bowel disease.
Ha C, Magowan S, Accortt NA, Chen J, Stone CD.
Am J Gastroenterol. 2009 Jun;104(6):1445-51.

Rationale for inclusion: This paper explores the relationship between inflammatory bowel disease and acute mesenteric ischemia by utilizing a large administrative database. The authors found a significantly higher risk of acute thrombotic intestinal events in patient with inflammatory bowel disease as compared to controls.

Citations - 132 (as of July 2017)

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.

Citations - 186 (as of July 2017)

Fulminant clostridium difficile colitis: patterns of care and predictors of mortality.
Sailhamer EA, Carson K, Chang Y, Zacharias N, Spaniolas K, Tabbara M, Alam HB, DeMoya MA, Velmahos GC.
Arch Surg. 2009 May;144(5):433-9; discussion 439-40.

Rationale for inclusion: for patients with fulminant C. diff, early operation was associated with lower mortality and those admitted to surgical services had lower mortality, possibly due to shorter delay to colectomy.

Citations - 181 (as of July 2017)

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.

Citations - 250 (as of July 2017)

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.

Citations - 207 (as of July 2017)

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.

Citations - 94 (as of July 2017)

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.

Citations - 131 (as of July 2017)

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. 

Citations - 29 (as of July 2017)

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.

Citations - 80 (as of July 2017)

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.

Citations - 84 (as of July 2017)

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.

Citations - 250 (as of July 2017)

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. Epub 2007 Jun 19.

Rationale for inclusion: this study supports the use of vancomycin over metronidazole for severe C.diff.

Citations - 987 (as of July 2017)

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.

Citations - 314 (as of July 2017)

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.

Citations - 161 (as of July 2017)

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.

Citations - 142 (as of July 2017)

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.

Citations - 121 (as of July 2017)

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. 

Citations - 222 (as of July 2017)

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.

Citations - 44 (as of July 2017)

Reduction in adhesive small-bowel obstruction by Seprafilm adhesion barrier after intestinal resection.
Fazio VW, Cohen Z, Fleshman JW, van Goor H, Bauer JJ, Wolff BG, Corman M, Beart RW Jr, Wexner SD, Becker JM, Monson JR, Kaufman HS, Beck DE, Bailey HR, Ludwig KA, Stamos MJ, Darzi A, Bleday R, Dorazio R, Madoff RD, Smith LE, Gearhart S, Lillemoe K, Göhl J.
Dis Colon Rectum. 2006 Jan;49(1):1-11.

Rationale for inclusion: Prospective, randomized trial which showed mild benefit with a commercial anti-adhesive product.

Citations - 331 (as of July 2017)

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.

Citations - 168 (as of July 2017)

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.

Citations - 231 (as of July 2017)

Elective surgery after acute diverticulitis.
Janes S, Meagher A, Frizelle FA.
Br J Surg. 2005 Feb;92(2):133-42.

Rationale for inclusion: This review of the literature on the role of elective resection after recurrent diverticulitis found no evidence to support the role of elective surgery after two attacks of diverticulitis. 

Citations - 303 (as of July 2017)

Primary anastomosis or Hartmann's procedure for patients with diverticular peritonitis? A systematic review.
Salem L, Flum DR.
Dis Colon Rectum. 2004 Nov;47(11):1953-64.

Rationale for inclusion: One of the most well cited systematic reviews of the literature on primary anastomosis versus Hartmann's procedure for perforated diverticulitis found that primary anastomosis is a safe option without increased morbidity or mortality.

Citations - 342 (as of July 2017)

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.

Citations - 201 (as of July 2017)

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.

Citations - 376 (as of July 2017)

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.

Citations - 678 (as of July 2017)

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.

Citations -308 (as of July 2017)

Timing of cholecystectomy for acute calculous cholecystitis: a meta-analysis.
Papi C, Catarci M, D'Ambrosio L, Gili L, Koch M, Grassi GB, Capurso L.
Am J Gastroenterol. 2004 Jan;99(1):147-55.

Rationale for inclusion: meta-analysis supports early cholecystectomy (open or laparoscopic) over delayed.

Citations - 258 (as of July 2017)

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.

Citations - 508 (as of July 2017)

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.

Citations - 845 (as of July 2017)

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.  

Citations - 56 (as of January 2018)

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.

Citations - 59 (as of July 2017)

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.

Citations - 183 (as of July 2017)

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.

Citations - 143 (as of January 2018)

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.

Citations - 91 (as of July 2017)

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.

Citations - 131 (as of July 2017)

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.

Citations - 217 (as of July 2017)

Portomesenteric vein gas: pathologic mechanisms, CT findings, and prognosis.
Sebastià C, Quiroga S, Espin E, Boyé R, Alvarez-Castells A, Armengol M.
Radiographics. 2000 Sep-Oct;20(5):1213-24; discussion 1224-6.

Rationale for inclusion: This paper delves into the common imaging finding of portomesenteric gas and explores the different etiologies contributing to this finding. The paper itself has many informative figures exploring portal venous gas, pneumobilia, pneumatosis intestinalis, and pylephlebitis.

Citations - 239 (as of July 2017)

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.

Citations - 206 (as of July 2017)

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.

Citations – 254 (as of July 2017)

Vacuum pack technique of temporary abdominal closure: a 7-year experience with 112 patients.
Barker DE, Kaufman HJ, Smith LA, Ciraulo DL, Richart CL, Burns RP.
J Trauma. 2000 Feb;48(2):201-6; discussion 206-7.

Rationale for inclusion: the “Barker” technique is often cited as the “poor man’s VAC” for those who do not have ready access to commercial negative pressure wound therapy (NPWT).

Citations - 515 (as of July 2017)

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.

Citations - 204 (as of July 2017)

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.

Citations - 177 (as of July 2017)

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%).

Citations - 57 (as of July 2017)

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.

Citations – 500 (as of July 2017)

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.

Citations - 217 (as of July 2017)

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.

Citations - 244 (as of July 2017)

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.

Citations - 208 (as of July 2017)

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.

Citations - 252 (as of July 2017)

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.

Citations - 334 (as of July 2017)

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.

Citations - 446 (as of July 2017)

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.

Citations - 65 (as of July 2017)

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%.

Citations - 124 (as of July 2017)

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.

Citations - 248 (as of July 2017)

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.

Citations - 125 (as of January 2018)

Bleeding colonic diverticula. A reappraisal of natural history and management.
McGuire HH Jr.
Ann Surg. 1994 Nov;220(5):653-6.

Rationale for inclusion: this study has two main clinical pearls: 1) most (75%) bleeding stops spontaneously, and 2) “blind” colon resection is unsafe.

Citations - 327 (as of July 2017)

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.

Citations - 155 (as of July 2017)

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.

Rationale for inclusion: another study supporting EUS for the diagnosis of choledocholithiasis.

Citations - 282 (as of July 2017)

'Damage control': an approach for improved survival in exsanguinating penetrating abdominal injury.
Rotondo MF, Schwab CW, McGonigal MD, Phillips GR 3rd, 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.

Citations - 1593 (as of July 2017)

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.

Citations - 589 (as of July 2017)

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!

Citations - 155 (as of July 2017)

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.

Citations - 154 (as of July 2017)

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.

Citations – 299 (as of July 2017)

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.

Citations - 2173 (as of January 2018)

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.

Citations - 1055 (as of July 2017)

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.

Citations – 110  (as of July 2017)

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.

Citations - 881 (as of July 2017)

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.

Citations - 70 (as of January 2018)

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.

Citations – 73 (as of July 2017)

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