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Background: Anastomotic leaks (AL) and surgical site infections (SSI) are serious complications after colorectal resection. Studies have shown the benefits of pre‐operative oral antibiotics (OAB) with mechanical bowel preparation (MBP) in reducing AL and SSI rates. We aim to investigate our experience with the short‐term outcomes of AL and SSI following elective colorectal resections in patients receiving OAB with MBP versus MBP only. Methods: A retrospective analysis was performed from our database for patients who underwent elective colorectal resection between January 2019 and November 2021. Prior to August 2020, OAB was not used as part of MBP. After 2020, Neomycin and Metronidazole were used in conjunction with MBP. We evaluated differences in AL and SSI between both groups. Results: Five hundred and seventeen patients were included from our database with 247 having MBP while 270 had OAB and MBP. There was a significantly lower rate of AL in patients receiving MBP and OAB as compared to MBP alone (0.4% versus 3.0%, P‐value = 0.03). The SSI rate at our institution was 4.4%. It was lower in patients with MBP and OAB as compared to MBP alone, but this was not clinically significant (3.3% versus 5.7%, P‐value = 0.19). Conclusion: The association in the reduction of AL with the addition of OAB to the MBP protocol seen here reinforces the need for future randomized controlled trials in the Australasian context. We recommend colorectal institutions in Australian and New Zealand consider OAB with MBP as part of their elective colorectal resection protocol. [ABSTRACT FROM AUTHOR]

Objectives: Right hemicolectomy is a common colorectal operation for resection of cancers of the right colon. The ileocolic anastomosis may be created using a stapled end‐to‐side, stapled side‐to‐side or handsewn technique. Anastomotic leak and post‐operative bleeding are uncommon but serious causes of morbidity and mortality, while post‐operative ileus contributes to prolonged length of stay. The aim of this study was to evaluate differences in short‐term outcomes between different anastomotic configurations following right hemicolectomy for colon cancer. Methods: We conducted a retrospective study using data from the Bowel Cancer Outcomes Registry (BCOR), including 94 hospitals across Australia and New Zealand, of all patients who underwent right hemicolectomy or extended right hemicolectomy for colon cancer with formation of a primary anastomosis between 2007 and 2021. Results: We included 8164 patients in the analysis. There was no significant difference in rates of anastomotic leak and anastomotic bleeding based on anastomotic technique. A stapled end‐to‐side anastomosis was associated with a lower rate of post‐operative ileus than stapled side‐to‐side anastomosis (6.5% vs. 7.2%; P = 0.03). Conclusion: Both handsewn and stapled anastomosis techniques may be utilized for oncologic right hemicolectomy, with comparable rates of anastomotic leak and post‐operative bleeding. Stapled end‐to‐side anastomosis resulted in lower rates of prolonged ileus compared to stapled side‐to‐side anastomoses. [ABSTRACT FROM AUTHOR]

Introduction Minimally-invasive options for the management of choledocholithiasis in patients undergoing laparoscopic cholecystectomy include laparoscopic and endoscopic approaches. This study reviews the effectiveness of both approaches in an emergency setting. Methods A retrospective chart review was performed for a cohort of patients who underwent laparoscopic cholecystectomy. Outcomes assessed were duct clearance, the number of procedures performed ( NPP), length of stay ( LOS) and complication rate. Results A total of 182 patients who underwent emergency laparoscopic cholecystectomies received intervention for choledocholithiasis. The duct clearance rate was lower in the laparoscopic group, 63% versus 86% ( P = 0.001). However, the median NPP was also lesser in the laparoscopic group, 1 (interquartile range ( IQR) 1-2) versus 2 ( IQR 2-2) ( P < 0.001), as was the median LOS, 5 days ( IQR 3-8) versus 7 days ( IQR 6-10) ( P = 0.009). Forty-eight laparoscopic endobiliary stents were attempted; stent deployment was successful in 37 patients. A larger proportion of patients with laparoscopic endobiliary stents had duct clearance by endoscopic retrograde cholangiopancreatography ( ERCP) compared with those without, although this was not statistically significant ( P = 0.208). Conclusion Laparoscopic clearance is not as effective as post-operative ERCP in an emergency cohort, but is associated with fewer procedures required and a shorter inpatient stay. Thus, laparoscopic clearance may still be an attractive option for surgeons especially where conditions are favourable during an emergency laparoscopic cholecystectomy. [ABSTRACT FROM AUTHOR]