Background: s/Aims: The critical view of safety (CVS) prevents bile duct injury, but severe inflammation hinders its achievement.This study evaluated the parkland grading scale (PGS) as a real-time intraoperative predictor of CVS attainment in a Southeast Asian population, establishing standardized clinical data for future artificial intelligence applications. Methods: This prospective observational study (January–June 2025) included 88 consecutive patients undergoing laparoscopic cholecystectomy by a single surgeon. PGS was assessed upon initial laparoscopic inspection. We analyzed correlations between PGS, CVS attainment (Strasberg’s criteria), operative time, and bail-out procedures using Spearman’s correlation and multivariate logistic regression. Results: Severe inflammation (PGS grade 4–5) was observed in 31.8% of patients. PGS exhibited a strong negative correlation with CVS score (p = −0.652; p < 0.001) and strong positive correlations with operative time and blood loss. A PGS threshold of 4 accurately predicted CVS failure (area under the curve = 0.863). Bail-out procedures were necessary in 11 cases (12.5%), all occurring in the PGS ≥ 4 group. Advanced age and diabetes mellitus were independent risk factors for CVS failure. Conclusions The PGS serves as a precise intraoperative early warning system. A score ≥ 4 indicates a significant risk of CVS failure, prompting safer bail-out strategies. Additionally, this study provides a standardized dataset vital for training future autonomous surgical risk assessment models.

Laparoscopic total pancreatectomy (LTP) is technically challenging and infrequently documented in the literature. In this paper, we present a new approach for performing fully LTP, a pancreatic tail-first approach with a counterclockwise technique, to accomplish total mesopancreas dissection and standard lymphadenectomy en bloc. Firstly, the tail and body of the pancreas without the spleen were dissected retrogradely, starting from the lower border of the body of pancreas and then from left to right. After that, a counterclockwise dissection of the tail and body of the pancreas was performed. The splenic artery and vein were divided at the terminal end of the pancreatic tail. The spleen was preserved. The entire body and tail of the pancreas were then pulled to the right side. This maneuver facilitated the isolation and dissection of arteries in the retropancreatic region more easily via laparoscopy, including the splenic artery, gastroduodenal artery, and supporting superior mesenteric artery first-approach. It also enabled total mesopancreas dissection.The inferior pancreaticoduodenal artery was resected last during this phase. The remainder of the dissection was like that of a laparoscopic pancreaticoduodenectomy with total mesopancreas dissection, involving two laparoscopic manual anastomoses. The operative time was 490 minutes and the total blood loss was 100 mL. Pathology revealed a low-grade intraductal papillary mucinous neoplasm extending from the head to the tail of the pancreas.

Laparoscopic total pancreatectomy (LTP) is technically challenging and infrequently documented in the literature. In this paper, we present a new approach for performing fully LTP, a pancreatic tail-first approach with a counterclockwise technique, to accomplish total mesopancreas dissection and standard lymphadenectomy en bloc. Firstly, the tail and body of the pancreas without the spleen were dissected retrogradely, starting from the lower border of the body of pancreas and then from left to right. After that, a counterclockwise dissection of the tail and body of the pancreas was performed. The splenic artery and vein were divided at the terminal end of the pancreatic tail. The spleen was preserved. The entire body and tail of the pancreas were then pulled to the right side. This maneuver facilitated the isolation and dissection of arteries in the retropancreatic region more easily via laparoscopy, including the splenic artery, gastroduodenal artery, and supporting superior mesenteric artery first-approach. It also enabled total mesopancreas dissection.The inferior pancreaticoduodenal artery was resected last during this phase. The remainder of the dissection was like that of a laparoscopic pancreaticoduodenectomy with total mesopancreas dissection, involving two laparoscopic manual anastomoses. The operative time was 490 minutes and the total blood loss was 100 mL. Pathology revealed a low-grade intraductal papillary mucinous neoplasm extending from the head to the tail of the pancreas.

Laparoscopic total pancreatectomy (LTP) is technically challenging and infrequently documented in the literature. In this paper, we present a new approach for performing fully LTP, a pancreatic tail-first approach with a counterclockwise technique, to accomplish total mesopancreas dissection and standard lymphadenectomy en bloc. Firstly, the tail and body of the pancreas without the spleen were dissected retrogradely, starting from the lower border of the body of pancreas and then from left to right. After that, a counterclockwise dissection of the tail and body of the pancreas was performed. The splenic artery and vein were divided at the terminal end of the pancreatic tail. The spleen was preserved. The entire body and tail of the pancreas were then pulled to the right side. This maneuver facilitated the isolation and dissection of arteries in the retropancreatic region more easily via laparoscopy, including the splenic artery, gastroduodenal artery, and supporting superior mesenteric artery first-approach. It also enabled total mesopancreas dissection.The inferior pancreaticoduodenal artery was resected last during this phase. The remainder of the dissection was like that of a laparoscopic pancreaticoduodenectomy with total mesopancreas dissection, involving two laparoscopic manual anastomoses. The operative time was 490 minutes and the total blood loss was 100 mL. Pathology revealed a low-grade intraductal papillary mucinous neoplasm extending from the head to the tail of the pancreas.

BACKGROUND: Currently, it is recognized that water polluted with toxic heavy metal ions may cause serious effects on human health. Therefore, the development of new materials for effective removal of heavy metal ions from water is still a widely important area. Melanin is being considered as a potential material for removal of heavy metal from water. METHODS: In this study, we synthesized two melanin-embedded beads from two different melanin powder sources and named IMB (Isolated Melanin Bead originated from squid ink sac) and CMB (Commercial Melanin Bead originated from sesame seeds). These beads were of globular shape and 2-3 mm in diameter. We investigated and compared the sorption abilities of these two bead materials toward hexavalent-chromium (Cr) in water. The isotherm sorption curves were established using Langmuir and Freundlich models in the optimized conditions of pH, sorption time, solid/liquid ratio, and initial concentration of Cr. The FITR analysis was also carried out to show the differences in surface properties of these two beads. RESULTS: The optimized conditions for isotherm sorption of Cr on IMB/CMB were set at pH values of 2/2, sorption times of 90/300 min, and solid-liquid ratios of 10/20 mg/mL. The maximum sorption capacities calculated based on the Langmuir model were 19.60 and 6.24 for IMB and CMB, respectively. However, the adsorption kinetic of Cr on the beads fitted the Freundlich model with R values of 0.992 for IMB and 0.989 for CMB. The deduced Freundlich constant, 1/n, in the range of 0.2-0.8 indicated that these beads are good adsorption materials. In addition, structure analysis data revealed great differences in physical and chemical properties between IMB and CMB. Interestingly, FTIR analysis results showed strong signals of -OH (3295.35 cm) and -C=O (1608.63 cm) groups harboring on the IMB but not CMB. Moreover, loading of Cr on the IMB caused a shift of broad peaks from 3295.35 cm and 1608.63 cm to 3354.21 cm and 1597.06 cm, respectively, due to -OH and -C=O stretching. CONCLUSIONS Taken together, our study suggests that IMB has great potential as a bead material for the elimination of Cr from aqueous solutions and may be highly useful for water treatment applications.
Adsorption ; Chromium ; chemistry ; Kinetics ; Melanins ; chemistry ; Waste Disposal, Fluid ; methods ; Water Pollutants, Chemical ; chemistry ; Water Pollution, Chemical ; prevention & control ; Water Purification ; methods