『Behind The Knife: The Surgery Podcast』のカバーアート

Behind The Knife: The Surgery Podcast

Behind The Knife: The Surgery Podcast

著者： Behind The Knife: The Surgery Podcast
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 Behind the Knife is the world’s #1 surgery podcast. From high-yield educational topics to interviews with leaders in the field, Behind the Knife delivers the information you need to know. Tune in for timely, relevant, and engaging content designed to help you DOMINATE THE DAY!

Behind the Knife is more than a podcast. Visit www.behindtheknife.org to learn more. 科学 衛生・健康的な生活 身体的病い・疾患
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  • 2: Clinical Challenges in Hepatobiliary Surgery: Necrotizing Pancreatitis, Time to Step Up!

    2: Clinical Challenges in Hepatobiliary Surgery: Necrotizing Pancreatitis, Time to Step Up!
    2025/07/07
    In the corner of the ICU, on multiple pressors, distended, oliguric, and intubated you’ll find the necrotizing pancreatitis patient. Sounds intimidating, but with the persistence, patience, and the proper care these patients can make it! In this episode from the HPB team at Behind the Knife listen in as we discuss the Step-Up approach, when to surgically intervene, various approaches to pancreatic Necrosectomy, and additional aspects of the multidisciplinary care required for the successful treatment of necrotizing pancreatitis.

    Hosts
    Anish J. Jain MD (@anishjayjain) is a current PGY3 General Surgery Resident at Stanford University and a former T32 Research Fellow at the University of Texas MD Anderson Cancer Center.

    Jon M. Harrison is a 2nd year HPB Surgery Fellow at Stanford University. He will be joining as faculty at the Massachusetts General Hospital in Boston, MA at the conclusion of his fellowship in July 2024.

    Learning Objectives
    · Develop an understanding of the severity of necrotizing pancreatitis and the proper indications to surgical intervene on this often-tenuous patients.
    · Develop an understanding of the Step-Up approach and key aspects (reimaging, clinical status, physiologic status, etc.) that determine when to “step-up” treatment for patients with necrotizing pancreatitis.
    · Develop an understanding of long term sequalae and complications associated with necrotizing pancreatitis and operative management
    · Develop an understanding of multidisciplinary care and long-term follow-up necessary for adequate treatment of patients suffering from necrotizing pancreatitis.

    Suggested Reading

    Maurer LR, Fagenholz PJ. Contemporary Surgical Management of Pancreatic Necrosis. JAMA Surg. 2023;158(1):81–88. doi:10.1001/jamasurg.2022.5695 https://pubmed.ncbi.nlm.nih.gov/36383374/

    Harrison JM, Day H, Arnow K, Ngongoni RF, Joseph A, Aldridge T, Wheeler KJ, DeLong JC, Bergquist JR, Worth PJ, Dua MM, Friedland S, Park W, Eldika S, Hwang JH, Visser BC. What's Behind it all: A Retrospective Cohort Study of Retrogastric Pancreatic Necrosis Management. Ann Surg. 2024 Sep 3. doi: 10.1097/SLA.0000000000006521. https://pubmed.ncbi.nlm.nih.gov/39225420/

    Harrison JM, Visser BC. Not Dead Yet: Managing the Abdominal Catastrophe in Necrotizing Pancreatitis. Pancreas. 2025 May 20. doi: 10.1097/MPA.0000000000002512. https://pubmed.ncbi.nlm.nih.gov/40388698/

    Harrison JM, Li AY, Sceats LA, Bergquist JR, Dua MM, Visser BC. Two-Port Minimally Invasive Nephrolaparoscopic Retroperitoneal Debridement for Pancreatic Necrosis. J Am Coll Surg. 2024 Dec 1;239(6):e7-e12. doi: 10.1097/XCS.0000000000001152. https://pubmed.ncbi.nlm.nih.gov/39051721/

    van Santvoort HC, Besselink MG, Bakker OJ, Hofker HS, Boermeester MA, Dejong CH, van Goor H, Schaapherder AF, van Eijck CH, Bollen TL, van Ramshorst B, Nieuwenhuijs VB, Timmer R, Laméris JS, Kruyt PM, Manusama ER, van der Harst E, van der Schelling GP, Karsten T, Hesselink EJ, van Laarhoven CJ, Rosman C, Bosscha K, de Wit RJ, Houdijk AP, van Leeuwen MS, Buskens E, Gooszen HG; Dutch Pancreatitis Study Group. A step-up approach or open necrosectomy for necrotizing pancreatitis. N Engl J Med. 2010 Apr 22;362(16):1491-502. doi: 10.1056/NEJMoa0908821. https://pubmed.ncbi.nlm.nih.gov/20410514/

    Bang JY, Arnoletti JP, Holt BA, Sutton B, Hasan MK, Navaneethan U, Feranec N, Wilcox CM, Tharian B, Hawes RH, Varadarajulu S. An Endoscopic Transluminal Approach, Compared With Minimally Invasive Surgery, Reduces Complications and Costs for Patients With Necrotizing Pancreatitis. Gastroenterology. 2019 Mar;156(4):1027-1040.e3. doi: 10.1053/j.gastro.2018.11.031. https://pubmed.ncbi.nlm.nih.gov/30452918/

    Zyromski NJ, Nakeeb A, House MG, Jester AL. Transgastric Pancreatic Necrosectomy: How I Do It. J Gastrointest Surg. 2016 Feb;20(2):445-9. doi: 10.1007/s11605-015-3058-y. https://pubmed.ncbi.nlm.nih.gov/26691148/

    Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

    If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen
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    31 分
  • 1: Intern Bootcamp: Dominate Intern Year

    1: Intern Bootcamp: Dominate Intern Year
    2025/07/05
    RE-RELEASE
    This was first published in 2023 but it's so good we are running it back!

    Buckle up, PGY-1’s! Intern year is starting whether you’re ready or not. Don’t fret, BTK has your back to make sure you dominate the first year of residency.

    In this last episode of the intern bootcamp mini-series, we’ll talk about tips & tricks as well as good habits to establish in order to dominate intern year.

    Hosts: Shanaz Hossain, Nina Clark

    Tips for New Interns:

    GENERAL TIPS FOR SUCCESS ON THE WARDS
    • Spend time with the patient!
    • Trust, but verify.
    • Be kind to everyone.
    • Stay humble.
    • Be flexible.
    • Seek and apply feedback.

    HOW TO LEARN IN THE OR
    • Double scrub as many cases as you can.
    • Write down/record everything after a case.

    MAINTAIN YOUR PERSONAL SANITY
    • Figure out your stress outlets and what brings you joy.
    • Decompress after work.
    • Maintain work/life boundaries.
    • Keep in touch with loved ones.
    • Vacations are meant for relaxation.
      • Repeat after me: NO WORK ON VACATION!
    Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

    If you liked this episode, check out our new how-to video series on suture and knot-tying skills – https://behindtheknife.org/video-playlists/btk-suture-practice-kit-knot-tying-simulator-how-to-videos/
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    13 分
  • Intern Bootcamp: Scary Pages

    Intern Bootcamp: Scary Pages
    2025/07/04
    RE-RELEASE This was first published in 2023 but it's so good we are running it back! Buckle up, PGY-1’s! Intern year is starting whether you’re ready or not. Don’t fret, BTK has your back to make sure you dominate the first year of residency. Today, we’re hitting the wards and tackling some of the scary clinical scenarios you will see as an intern. Hosts: Shanaz Hossain, Nina Clark Tips for new interns: THINGS TO REMEMBER · BREATHE. In most cases, you have a little bit of time – at least enough to take a breath and calm down outside the room before heading into an emergency. Panic doesn’t help anybody. · See the patient. Getting a bunch of pages? Worried about someone? Confused as to what’s going on? Go see the patient and chat with the bedside team. · Know your toolbox. There are a ton of people around who can help you in the hospital, and knowing the basic labs/imaging studies and when to use them can help you to triage even the sickest patients. · Load the boat. You’ve heard this one from us all week! Loop senior level residents in early. HYPOTENSION · Differential: measurement error, patient’s baseline, and don’t miss – SHOCK. - Etiologies of shock: hemorrhagic, hypovolemic, · On the phone: full set of vitals, accurate I/Os, · On the way: recent notes, PMH/PSH including from this hospital stay, and vitals/I&Os/studies from earlier in the day · In the room: ABCDs – rapidly gives you a sense of how high acuity the patient is · Get more info: labs, consider imaging, work up specific types of shock based on clinical concern. · Initial management: depends on etiology of hypotension; don’t forget to consider peripheral or central access, foley catheterization for close monitoring of urine output, and level of care HYPOXEMIA · Differential: atelectasis, baseline pulmonary disease, pneumonia, PE, hemo/pneumothorax, volume overload · On the phone: full set of vitals, amount of supplemental oxygen required and delivery device, rate of escalation in oxygen requirement · On the way: review PMH/PSH, known injuries (known hemothorax/pneumothorax? Rib fractures? Chest tubes in already?), risk factors for DVT/PE, review I/Os for evidence of volume status, vitals and labs for evidence of infection · In the room: ABCDs, pulmonary and cardiac exam, volume status exam · Get more info: basic labs, ABG if worried about oxygenation, CXR, consider bedside US of the lungs/heart, if high suspicion for PE consider CTA chest · Initial Management: supplemental O2, higher level of care, consider intubation or other supplemental oxygenation adjuncts, additional management dependent on suspected etiology · ABG Vs VBG (IBCC): https://emcrit.org/ibcc/vbg/ ALTERED MENTAL STATUS · Differential: stroke, medication effect, hypoxemia or hypercarbia, toxic or medication effect, endocrine/metabolic, stroke or MI, psychiatric illness, or infections, delirium · On the way: review PMH/PSH, recent notes for evidence of altered mentation or agitation, or signs hinting at above etiologies · In the room: ABCDs, focal neuro deficits?, alert/oriented? Be sure the patient’s mental status is adequate for airway protection! · Get more info: basic labs, blood gas/lactate, CT head noncontrast if concerned for stroke. · Initial management: rule out above; if concerned about delirium, optimize sleep/wake cycles, pain control, and lines/drains/tubes. OLIGURIA · Differential: prerenal due to hypovolemia or low effective circulating volume, intrinsic renal disease, post-renal obstruction · On the phone: clarify functional foley or bladder scan results, full set of vitals · On the way: review PMH/PSH, known injuries (known hemothorax/pneumothorax? Rib fractures? Chest tubes in already?), risk factors for DVT/PE, review I/Os for evidence of volume status, vitals and labs for evidence of infection · In the room: ABCDs, confirm functioning foley catheter · Get more info: basic labs, urine electrolytes, consider fluid challenge to evaluate responsiveness, consider adjuncts including renal US · Initial management: typically consider IVF bolus initially, but if patient not volume responsive, don't overload them -- look for other etiologies! TACHYCARDIA · Differential: sinus tachycardia (pain, hypovolemia, agitation, infection), cardiac arrhythmia, MI, PE · On the phone: full set of vitals, acuity of change in heart rate, updated I/Os · On the way: Review PMH/PSH, known cardiac history, cardiac and PE risk factors, volume resuscitation, signs concerning for infection, updated I/Os · In the room: ABCDs, cardiac/pulmonary exam, evaluate for any localizing signs for...
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    23 分

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