April 16th Afternoon

 

Management of Unusual and Complex Cases – Similarities and Differences across the Ocean (joint with JSES)

1:30 PM - 3:00 PM

Session Chair: Manabu Yamamoto, MD
Session Co-chair: Steven Schwaitzberg, MD

Session Description

Philosophy, training, disease features and resource access all impact how certain types of problems are managed around the world. The ongoing SAGES –JSES symposium series examines how complex cases are handled by experts in Japan and North America. Our experts are presented with a challenging case and will present their views on management. The opportunity to contrast and compare disease and surgical/endoscopic management may provide new management approaches for attendees.

Session Objectives

At the conclusion of this session, participants will be able to:

  • Distinguish the differences how disease may present differently in other parts of the world
  • Implement potential new disease management schemes that are applicable to clinical problems encountered inorder to achieve improved outcomes
  • Employ alternative strategies to technical issues successfully utilized transcontinentally such as staple lineleakage

Session Outline

Time Presentation Title Faculty Name
 

Management of Unusual and Complex Cases - Similarities and Differences across the ocean (joint with JSES)

 

1:30pm

Management of Complex Foregut Disease (JSES) 

Naoki Hiki, MD

1:40pm

Management of Complex Foregut Disease (SAGES) 

Ninh Nguyen, MD
1:50pm Challenging Colorectal Resection Strategy (JSES) 

Takeshi Naito, MD

2:00pm  Challenging Colorectal Resection Strategy (SAGES)  Conor Delaney, MD PhD
2:10pm Management of Complex Hepatobiliary Disease (JSES) 

Takeyuki Misawa, MD

2:20pm

Management of Complex Hepatobiliary Disease (SAGES)

James Moser, MD
2:30pm  Management of Bariatric Surgery Complications (JSES)

Kazunori Kasama, MD

2:40pm Management of Bariatric Surgery Complications (SAGES) John Morton, MD John Morton, MD
     

Avoiding Bile Duct Injury and Other Untoward Outcomes - Optimizing Your Approach to Cholecystectomy Panel

3:00 PM - 5:00 PM

Session Chair: Robert Fanelli, MD
Session Co-chair: Horacio Asbun, MD

Session Description

Surgeons, nurses, mid-level providers, and allied health professionals caring for patients before, during, and after cholecystectomy will gain useful insight from this session that addresses complications and less than optimal outcomes related to cholecystectomy. Panelists will explore modifiable practice factors that improve clinical results, including preoperative, intraoperative, and postoperative decision-making, operative timing and specific techniques, and the avoidance of bile duct injury during cholecystectomy.

Session Objectives

At the conclusion of this session, participants will be able to:

  • Adjust their operative approach to include routine achievement of the Critical View of Safety before dividing anystructures during cholecystectomy, including an intraoperative pause to confirm identity of structures to bedivided.
  • Recognize the importance of biliary inflammatory disease in increasing the hazards of surgery, and will selectappropriate procedures to be performed at appropriate phases of the disease process based on timing and clinicalindicators.
  • Distinguish the need for cholangiography and other imaging techniques in defining anatomy from traditional useswhen common bile duct stones are suspected.

Session Outline

Time Presentation Title Faculty Name
 

Avoiding Bile Duct Injury and Other Untoward Outcomes - Optimizing Your Approach to Cholecystectomy

 

3:00pm

Session Introduction - Not Listed in Program

Robert Fanelli, MD

3:01pm

The SAGES Safe Cholecystectomy Task Force: Why Now? 

Introduce topic, discuss magnitude of issue, and introduce the Safe Chole Task Force project.

L. Michael Brunt, MD
3:07pm

Mechanisms of Bile Duct Injury


Why and how bile duct injuries happen.

Abe Fingerhut, MD

3:22pm

The Critical View of Safety: What is It, How to Achieve It, Why it Works


Explain the dissection used, the importance and value of the CVS, and review the grading scenario used to gauge the CVS. Images will be reviewed later with audience participation.

Steven Strasberg, MD
3:37pm 

Imaging Techniques in Biliary Surgery


Discussion of all imaging techniques used in cholecystectomy: IOC, ultrasound, Spy, etc.

Daniel Deziel, MD

3:49pm

 Approaching the Difficult Gallbladder: Preoperative DecisionMaking

Timing of operation based on phase of disease, status of inflammatory process, time of day/night, surgeon/staff preparedness, other concepts from Delphi.

Steven Schwaitzberg, MD
4:01pm 

Approaching the Difficult Gallbladder: Intraoperative Techniques


Discussion on subtotal, partial, top-down, drain alone, cholecystostomy tubes, etc.

Benjamin Poulose, MD MPH

4:13pm

Additional Considerations: The Community Surgeon Perspective

Are there different implications for community surgeons? Timing? Time it takes? Resources?

Kevin Wasco, MD
4:23pm   Bile Duct Injury: Now What?

Recognition intraoperatively, immediately postoperatively, or delayed; management in each scenario - practical how to diagnose and treat at each level; when to refer (timing)?

Horacio Asbun, MD 
 4:35pm Emergency Department Visits After Cholecystectomy: The NY State Experience

Present research data; LC isn’t the slam dunk you think it is.

Dana Telem, MD
4:45pm  The Critical View of Safety: Is This It?

Display doublet photos of CVS, have audience grade them; if lack of response, will ask panelists to grade them; discussion session combined with this; flexible enough to allow for either to dominate session.

Robert Fanelli, MD
All Speakers