Joshua Clements

Surgery & golf ⛳️

[EndoCollab™ | GI Endoscopy Community @EndoCollabcom]

Advanced Guide to Gastrointestinal Endoscopy: Mastering Vascular Anatomy

[Society of Surgical Oncology @SocSurgOnc]

In this @AnnSurgOncol #FeaturedArticle, authors review the American College of Surgeons Commission on Cancer Standard 5.6, which pertains to the curative intent colon resections performed for cancer.

📃: https://t.co/G0JlU1hGyT

[EndoCollab™ | GI Endoscopy Community @EndoCollabcom]

🔍 Fun fact:

The caudate lobe drains into the left hepatic duct

Understanding hilar anatomy is crucial for tackling bile duct strictures and complex stones

[Higher FRCS - Higher Vasc - Higher VIVA @HFrcs]

Critical appraisal

https://t.co/WthrHTJq7m

[Giovanni Marchegiani @Gio_Marchegiani]

Neoadjuvant FOLFIRINOX 🤜🤛upfront surgery for resectable pancreatic cancer

NORPACT-1 out 🔥 now @LancetGastroHep

📈 Median OS 25 vs. 38 months and resection rate did not differ

💉 60% neoadjuvant group had severe adverse event 🚨

🫵Comments?🧐

👉 https://t.co/zhikhG8XQN

[theRadiologist @radiologistpage]

BILIARY DUCT ANATOMY
👨🏽‍💻The anatomy of the biliary ducts always confused me prior to qualifying as a doctor but it needn’t be so confusing - let’s start at the top and work down...

👨🏽‍💻The intrahepatic biliary ducts drain bile from the liver (each segment of the liver is represented by Roman numerals on the diagram) into the right and left main hepatic which converge to form the common hepatic duct

👨🏽‍💻This is then joined by the cystic duct which connects the gallbladder. Sometimes stones in the cystic duct can compress the common hepatic duct or common bile duct resulting in obstruction - called Mirzizzi syndrome

👨🏽‍💻Once the cystic duct has joined the common hepatic duct it is now termed as the common bile duct which in normal variant anatomy joins up with the main pancreatic duct at the ampulla of Vater and drains into the major papilla

👨🏽‍💻The ampulla is surrounded by a circular layer of muscle known as the Sphincter of Oddi

👨🏽‍💻The accessory duct of Santorini drains into the minor papilla and the main pancreatic duct drains into the major papilla - there can be variant anatomy! In pancreatic divisum the ducts are separate and most of the pancreas is drained through the minor papilla - this puts the patient at risk of recurrent pancreatitis

[Giovanni Marchegiani @Gio_Marchegiani]

Postoperative complications 🐳 after a Whipple for malignancy: analysis of 1.3k cases

🔴 Major morbidity 17% - Mortality 4% 🔴

🔮 ASA and BMI predict complications

📐 Targeted prehabilitation / individualized treatment regimens are key

👉 https://t.co/mJSxsD3iLH

[EndoCollab™ | GI Endoscopy Community @EndoCollabcom]

Understanding the Couinaud Classification of Liver Anatomy

Introduction to Liver Segmentation

The liver is intricately divided into eight distinct segments. Each segment boasts its own vascular and biliary systems, ensuring efficient blood supply and bile drainage.

[Pancreas Verona @PancreasVerona]

New guidelines for IPMN management, formulated by an expert group including our @SalviaRobi. Major changes:
🟢Imaging findings and cytology obtained by EUS included into the assessment of HRS and WF
🟢Surveillance discontinuation possibile for small unchanged BD-IPMN after 5years

[Shravan Sharad Nadkarni @OncoShravan]

🚨🚨🚨🚨

Which is the best technique (Tx) for a pancreatico-enteric anastomosis ⟖ ⟖ after a #Whipple Operation (#pancreaticoduodenectomy) for #PancreaticCancer?

#Bookmark this #Thread 🧵🧵...

The Pancreatico-enteric anastomosis ready reckoner!

Winning Tx revealed at d end!

[Syed A. Ahmad @SyedAAhmad5]

Landmark Neoadjuvant Trials For Pancreas Cancer.

Nice table created by @KevinTurnerMD for a paper we are writing. @GregWilson152 @DavendraSohal @UCincySurg

[Colorectal Disease @ColorectalDis]

🎁#CodiSundays☀️

🌎 @escp_tweets & @colorectaldis look at:

🙌🤲hands teaching method🤲🙌

🏥applied to anorectal surgery anatomy🏥

🔗link🔗

https://t.co/vVCpwQHqLE

#SoMe4Surgery #colorectalsurgery

[EndoCollab™ | GI Endoscopy Community @EndoCollabcom]

🚀 Explore the Couinaud classification for liver anatomy! 🏥🧪

[Higher FRCS - Higher Vasc - Higher VIVA @HFrcs]

Are you thinking of taking the FRCS General Surgery exam?

If so you should check out the comprehensive post of resources that Higher FRCS offer

Part 1

Free Guide to part 1 - https://t.co/j79ZVxwHSV

Free access to a whole host of resources collated by previous candidates - https://t.co/5mdG2Ji1kI

Free Twitter/X qs every fortnight with latest useful information - @HFRcs

Starter course on tips and techniques with cancer protocols saving you those initial 6 weeks of revision and preparation - https://t.co/mFHW9y0GJm

Question bank of over 1200 qs with images - https://t.co/hMyLZcVG6C

Book with over 400 qs from an international facility - https://t.co/nhfnicvFCT

Part 2

Free Guide to part 2 - https://t.co/UbwvqFgAvU

Free access to a whole host of resources collated by previous candidates - https://t.co/2ND78EkDP3

Free Twitter/X qs every fortnight with latest useful information - @HFRcs

Last minute Viva course to hone in your skills - https://t.co/gjjegTRVzS

Part 2 question bank with over 100 scenarios, model audio answers, ability to record and critique your own answers, summaries of seminal papers, summaries of guidelines and integrated chat GPT api

We are here to help you succeed

https://t.co/hMyLZcVG6C

https://t.co/0FmKPPauOy

[Enrik Aguila @enrrikke]

Zargar Classification 🚨 #GITwitter #MedTwitter
⚡️ Widely used to grade endoscopic severity of corrosive injuries and provide prognostic information
🔦 Endoscopy performed preferably during the first 24-48 hours after ingestion to evaluate extent of injury

[Joshua Clements @_joshuaclements]

@DL08OMD @_JoshBurke_ @SocSARS @ASiTofficial Congratulations 👏 @_JoshBurke_

[Anuraag Jena @DrAnuraagJ]

1/15.

MUST READ : Randomized Control Trials in Acute Biliary Pancreatitis

A Thread #GITwitter #MedTwitter

[Anuraag Jena @DrAnuraagJ]

1/15

📢The recent ACG Guidelines on biliary strictures

👉Focus on DRAINAGE principles

🔥A Tweetorial #GITwitter @AmJGastro

[Chris Nahm @chris_nahm]

Simple things surg regs should practice #1. One-handed suturing. This has come in super handy for me in tricky situations when one hand is either retracting something, plugging a hole in a blood vx or just holding the thread. 1/5

[EndoCollab™ | GI Endoscopy Community @EndoCollabcom]

Algorithm for Diagnosis and Management of Esophageal Dysmotility Disorders