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Our top priority is providing value to members. Your Member Services team is here to ensure you maximize your ACS member benefits, participate in College activities, and engage with your ACS colleagues. It's all here.
Become a member and receive career-enhancing benefits
Our top priority is providing value to members. Your Member Services team is here to ensure you maximize your ACS member benefits, participate in College activities, and engage with your ACS colleagues. It's all here.
The authors provided a clear and easily readable review of the ethical challenges faced by surgeons and their patients when the patient’s preoperative assessment indicates that a surgical procedure will cause harm rather than an improved level of health.
They noted that the evolution of the surgeon-patient relationship away from one of paternalism toward a relationship where patient autonomy is paramount has made these situations more difficult to manage. Surgeons must now provide understandable and relevant information to the patient, family, and other caregivers without imposing their own values on the decision-making process. Using clear communication to reach a decision on the best course of action is of paramount importance.
Data cited in the article showed that 50% of surgeons followed patient and family wishes even though they felt the chosen course was not in the best interests of the patient; this decision often caused distress for the surgeon.
A pathway for management of these challenges is remembering that surgery, as a profession, requires dedication to the best interests of the patient, including declining to operate when there is no benefit for the patient, even when this decision strains the relationship with the patient. Surgeons are encouraged to review the full content of this helpful article.
Study Examines Best Management of Peripancreatic Fluid Collection after Distal Pancreatectomy with Splenectomy
Distal pancreatectomy with splenectomy is the preferred procedure for management of benign or malignant lesions of the body and tail of the pancreas. Although operative mortality is reported to be less than 1%, complications such as pancreatic fistula, peripancreatic fluid collections, hematoma, and abscess occur in up to 46% of patients. Routine postoperative imaging is used to identify complications.
Determining the best management of peripancreatic fluid collections found on imaging can be difficult. The authors reviewed outcomes in 182 patients from a single institution who underwent postoperative imaging following distal pancreatectomy with splenectomy.
Peripancreatic fluid collection was diagnosed in 83 patients; symptoms were present in 55% of these patients. Symptomatic patients had higher rates of postoperative morbidity (mainly pancreatic fistula). Symptomatic patients managed with drainage resolved collections faster compared with patients treated with antibiotics or observation (3.5 months vs. 13.2 months). Asymptomatic patients had resolution of the fluid collections within one year.
The authors concluded that symptomatic patients should have prompt drainage while observation is safe in asymptomatic patients.
Public Continues to Value Physician Expertise in Era of Health Misinformation
False claims about health increased during and after the COVID-19 pandemic. A national survey cited in this News and Analysis article showed that 74% of respondents felt that false health information is a major problem. The data also showed that up to 35% of respondents who encountered false information believed the information to be true. Of note was the finding that most respondents were skeptical of information presented on social media sources.
A specific objective of the survey was to determine resources respondents trusted to provide opinions on the quality and value of medical information. Only 60% of respondents trusted TV news sources. An encouraging finding was that over 90% of respondents indicated that they would trust their personal physician’s interpretation of medical information, while more than 80% indicated that they would trust information from the Centers for Disease Control and Prevention.
The authors concluded that exposure to false health information remains high, but respondents regularly express uncertainty regarding truthfulness and quality of the information. Most individuals rely on physicians and government health agencies to assist in interpreting the information.
