Sam Douglas, MD FACS

FACS AHPBA/Board Certified HPB/General Surgeon with interests in: Liver, Pancreas, Biliary, GI Oncology, and Robotics. Proud husband, dad, and Christian.

[Sam Douglas, MD FACS @SurgOnc_Sam]

Robotic Segment 5/6 partial resection for 7cm metastatic sbNET +chole + SBRsxn. Looping a sponge around transection line gives nice control.

[Sam Douglas, MD FACS @SurgOnc_Sam]

@aabutaka Yeah my preferred method is to advance this through the ampulla (dilates to 13Fr) then fragment the stones up with EHL. Put wire through the scope through the ampulla then flush and push all the fragments into duo.

[Sam Douglas, MD FACS @SurgOnc_Sam]

Robotic chole with common bile duct exploration with spyglass and intraop ultrasound (as sensitive as IOC and more specific). Single strange duct clearance with chole saves patients LOS and extra procedures.

[Sam Douglas, MD FACS @SurgOnc_Sam]

@rajibaji1983 Transcystic 99% of the time (unless have other reason to go transductal). With glide wire and uropass sheath and EHL lithotripsy machine can almost always clear stones.

[Sam Douglas, MD FACS @SurgOnc_Sam]

@aabutaka This is by far the best sheath I've used. Soft to, very flexible and has reinforcement rings in it so it doesn't kink or crimp when grabbing it with the prograsp. Use With 035 glidewire. Can advance all the way through ampulla at times to dilate up to 13Fr.

[Sam Douglas, MD FACS @SurgOnc_Sam]

Completion cholangiogram with robot and C-Arm bothin place - feasible, but a bit annoying.

[Sam Douglas, MD FACS @SurgOnc_Sam]

Doppler Ultrasound view of the SMA and celiac before test clamp of celiac.

[Sam Douglas, MD FACS @SurgOnc_Sam]

Robotic distal pancreatectomy with en-bloc celiac resection. Ultrasound flow and ICG perfusion are indispensable.

[ECOG-ACRIN Cancer Research Group @eaonc]

#ClinicalTrial EA2222/PUMP, led by @michael_lidsky, is a randomized phase 3 study of #SystemicTherapy with or without hepatic arterial infusion for unresectable #Colorectal liver metastases. More here: https://t.co/xBChV6GALe cc: @MichaelDAngeli2, @skmaithel, @AndreaCercek

[Annals of Hepato-Biliary-Pancreatic Surgery @Journal_AHBPS]

Transcystic management of choledocholithiasis: Outcomes, factors associated with bile duct injury and implications for surgical practice
🌷https://t.co/y4mAOuWFLp
Ann Hepatobiliary Pancreat Surg 2025;29(4). Víctor Nieto Barros
#Choledocholithiasis #CholecystectomyLaparoscopic

[Morning Brew ☕️ @MorningBrew]

Top U.S. cities for recent college grads (ADP):

1. Birmingham, AL
2. Tampa, FL
3. San Jose, CA
4. Columbus, OH
5. Raleigh, NC
6. Tulsa, OK
7. San Francisco, CA
8. Nashville, TN
9. Charlotte, NC
10. New York, NY

[Sam Douglas, MD FACS @SurgOnc_Sam]

@grok @elonmusk I guess not ...

[Sam Douglas, MD FACS @SurgOnc_Sam]

https://t.co/oWPFO6yBuv

[NEJM @NEJM]

The authors of a new Perspective argue that CMS billing rules create a wide gap between the services trainees provide and the revenue hospitals can capture for those services. Competency-based billing could help close this gap. Read the Perspective by @AbbasHassanMD, PhD, and Jennifer F. Waljee, MD, MPH: https://t.co/n4deZzYDMc

[Sam Douglas, MD FACS @SurgOnc_Sam]

@TheNotoriousHPB Of course I didn't! I don't even know the number for 9-1-1...

[Sam Douglas, MD FACS @SurgOnc_Sam]

Sometimes I really wonder what my kids' thoughts of my ability to survive actually are...

My 7-year-old just explained very seriously how to make a peanut butter banana honey sandwich. I'm not sure if He thought I even knew the ingredients actually.

[Sam Douglas, MD FACS @SurgOnc_Sam]

Robotic assisted hepatic/celiac /Portal lymphadenectomy during DPS for mid body PDAC.
Single firing slow closed(5:01, Nirvana smells like teen Spirit) stapled pancreatic transection. No drain.

[Sam Douglas, MD FACS @SurgOnc_Sam]

We tried....🤷‍♂️

[Sam Douglas, MD FACS @SurgOnc_Sam]

https://t.co/OmgzJkGFMg

[Sam Douglas, MD FACS @SurgOnc_Sam]

Name the abnormality?