Gianluca Pellino

• MD, PhD
• Professor (Associate) at University of Campania "Luigi Vanvitelli"

Purpose Acute Pancreatitis (AP) is a prevalent clinical pancreatic disorder characterized by acute inflammation of the pancreas, frequently associated with biliary or alcoholic events. If not treated with cholecystectomy after the first episode, patients may experience a recurrence of AP, with consequent need for emergency surgery and increased ris...

Surgical site infections (SSI) are the most common complication after stoma closure. Circular skin closure (CSC) has been proposed to reduce SSI with comparable or even better outcomes than conventional primary sutures (PS). The aim of this meta-analysis is to compare circular with primary skin closure in stoma closure. A systematic review of the l...

Treating complex anal fistulae (CAF) remains a clinical challenge. Regenerative fistula treatment (RFT) with a bioactive matrix enriched with autologous platelet concentrate (Obsidian RFT®) has shown potential in healing CAF while preserving continence, but its long-term efficacy is still debated. This study aims to report the outcomes of RFT in pa...

Background Mild acute biliary pancreatitis (MABP) presents significant clinical and economic challenges due to its potential for relapse. Current guidelines advocate for early cholecystectomy (EC) during the same hospital admission to prevent recurrent acute pancreatitis (RAP). Despite these recommendations, implementation in clinical practice vari...

Crohn’s disease (CD) is an immune-mediated, multisystem inflammatory disorder characterised by discontinuous transmural, sometimes granulomatous, inflammation of the gastrointestinal tract. Although it can occur anywhere in the gastrointestinal tract, it has a 70% predilection for the terminal ileum. Ileocolonoscopy with biopsy remains the gold sta...

Purpose Time to closure and morbidity are significant issues associated with ileostomy reversal after rectal cancer resection. This study aimed to investigate the rate, time, and morbidity associated with ileostomy closure procedure. Methods Between February and December 2022, patients who underwent protective ileostomy after rectal cancer surgery...

Purpose Acute appendicitis (AA) is the leading cause of acute abdomen worldwide, with an incidence of 90–100 cases per 100,000 individuals annually and a lifetime risk of 7–12%. Despite its prevalence, historical accounts of AA are limited, particularly when compared to conditions like haemorrhoids, likely due to the appendix’s internal location. T...

Introduction: Chatbots have been increasingly used as a source of patient education. This study aimed to compare the answers of ChatGPT-4 and Google Gemini to common questions on benign anal conditions in terms of appropriateness, comprehensiveness, and language level. Methods: Each chatbot was asked a set of 30 questions on hemorrhoidal disease,...

Background Inflammatory bowel disease (IBD) affects more than 10 million people worldwide. Men and women are equally affected by Crohn's disease (CD). It has been shown that patients with CD are at an increased risk of a colorectal cancer (CRC) diagnosis and CRC‐related mortality. During the last two decades, biological therapies have revolutionize...

Background The current standard of care for mild acute biliary pancreatitis (MABP) involves early laparoscopic cholecystectomy (ELC) to reduce the risk of recurrence. The MANCTRA-1 project revealed a knowledge-to-action gap and higher recurrence rates in patients admitted to medical wards, attributable to fewer ELCs being performed. The project est...

There are many options for the surgical management of complicated diverticulitis, and standards vary widely despite international practice recommendations. We conducted a survey to capture the variation in practice across Europe. An online questionnaire was distributed to fellow and surgeon members of the European Association of Endoscopic Surgery...

Introduction Rectal cancer is a prevalent disease that requires multidisciplinary management. Results of treatment of patients suffering from this malignancy in Latin America have been scarcely reported before. Methods A retrospective, multicenter study was conducted to report preoperative and operative characteristics of patients intervened for r...

Diverting ileostomy is a common procedure in rectal cancer surgery, but it is sometimes associated with a nonnegligible rate of complications. The primary aim of this study was to analyze the incidence and types of stoma-related complications for ileostomy creation after rectal cancer resection. The secondary aims were to report the indications, th...

Background: There is widespread concern that treatment with biologics agents may be associated

Background Endoscopic retrograde cholangiopancreatography (ERCP) still has a relatively high complication rate, underscoring the importance of high‐quality training. Despite existing guidelines, real‐world data on training conditions remain limited. This pan‐European survey aims to systematically explore the perceptions surrounding ERCP training....

Background Anastomotic leak rates after colorectal surgery remain high. In most left-sided colon and rectal resection surgeries, a circular stapler is utilized to create the primary bowel anastomosis. However, it remains unclear whether a relationship between circular stapler technology and anastomotic leak in left-sided colorectal surgery exists....

Introduction Colon cancer presents significant surgical challenges that necessitate the development of precise strategies. Standardization with complete mesocolic excision (CME) is common, but some cases require extended resections. This study investigates the use of 3D Image Processing and Reconstruction (3D-IPR) to improve diagnostic accuracy in...

Aims The current standard of care for mild acute biliary pancreatitis (MABP) involves early laparoscopic cholecystectomy (ELC) reducing the risk of early recurrence. The MANCTRA-1 project disclosed a discrepancy in translating this evidence into clinical practice, estimating a 35 to 70% probability of narrowing this gap within 2025. This study asse...

Background Metachronous colorectal cancer refers to patients developing a second colorectal neoplasia diagnosed at least 6 months after the initial cancer diagnosis, excluding recurrence. The aim of this systematic review is to assess the incidence of metachronous colorectal cancer in early-onset colorectal cancer (defined as age at diagnosis of le...

Aim There is no universally accepted treatment consensus for haemorrhoids, and thus, management has been individualized all over the world. This study was conducted to assess a global view of how surgeons manage haemorrhoids. Methods The research panel of the International Society of University Colon and Rectal Surgeons (ISUCRS) developed a volunt...

This study presents a laparoscopic surgical protocol for right hemicolectomy and D3 lymphadenectomy (R-D3L) in right colon cancer and reports the oncological outcomes based on a prospective series. The study comprises two phases. In the first phase, a dynamic demonstration of the R-D3L surgical protocol is provided through textual explanation, illu...

Background Treating complex anal fistulae (CAF) remains a clinical challenge. Regenerative Fistula Treatment (RFT) with a bioactive matrix enriched with autologous platelet concentrate (Obsidian RFT™) has shown potential in healing of CAF while preserving continence, but its long-term efficacy is still debated. This study aimed to report the outcom...

Introduction Although several studies report that the robotic approach is more costly than laparoscopy, the cost-effectiveness of robotic distal pancreatectomy (RDP) over laparoscopic distal pancreatectomy (LDP) is still an issue. This study evaluates the cost-effectiveness of the RDP and LDP approaches across several Spanish centres. Methods This...

Acute diverticulitis (AD) is associated with relevant morbidity/mortality and is increasing worldwide, thus becoming a major issue for national health systems. AD may be challenging, as clinical relevance varies widely, ranging from asymptomatic picture to life-threatening conditions, with continuously evolving diagnostic tools, classifications, an...

The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities.

Background Mild acute biliary pancreatitis (MABP) presents significant clinical and economic challenges due to its potential for relapse. Current guidelines advocate for early cholecystectomy (EC) during the same hospital admission to prevent recurrent acute pancreatitis (RAP). Despite these recommendations, implementation in clinical practice vari...

Aim Minimally invasive surgery has been increasingly adopted for locally advanced colon cancer. However, evidence comparing robotic (RRC) versus laparoscopic right colectomy (LRC) for nonmetastatic pT4 cancers is lacking. Methods This was a multicentre propensity score‐matched (PSM) study of a cohort of consecutive patients with pT4 right colon ca...

Aim The APOLLO study aimed to describe the international variation in the presentation, management and outcomes of patients presenting acutely with colorectal cancer. Method APOLLO was an international prospective, multicentre cohort study delivered through the EuroSurg student and trainee-led collaborative network. Adult patients presenting acute...

There is no international consensus on the definition of the type of oncological resection that corresponds to each of the colectomies existing in the current literature. The objective is to define for each colectomy described in the literature: embryological dissection plane, vascular pedicles in which to perform central ligation, the extent of th...

Background Identification of patients at high risk of surgical-site infections may allow surgeons to minimize associated morbidity. However, there are significant concerns regarding the methodological quality and transportability of models previously developed. The aim of this study was to develop a novel score to predict 30-day surgical-site infec...

Aim: Recent evidence challenges the current standard of offering surgery to patients with ileocaecal Crohn's disease (CD) only when they present complications of the disease. The aim of this study was to compare short-term results of patients who underwent primary ileocaecal resection for either inflammatory (luminal disease, earlier in the diseas...

Fluorescence imaging is a real-time intraoperative navigation modality to enhance surgical vision and it can guide emergency surgeons while performing difficult, high-risk surgical procedures. The aim of this study is to assess current knowledge, attitudes, and practices of emergency surgeons in the use of indocyanine green (ICG) in emergency setti...

BACKGROUND: Colorectal (CRC) cancer is becoming a disease of the elderly. Ageing is the most significant risk factor for presenting CrC. early diagnosis of CrC and management is the best way in achieving good outcomes and longer survival but patients aged ≥75 years are usually not screened for CRC. This group of patients is often required to be man...

Background Multimorbidity poses a global challenge to healthcare delivery. This study aimed to describe the prevalence of multimorbidity, common disease combinations and outcomes in a contemporary cohort of patients undergoing major abdominal surgery. Methods This was a pre-planned analysis of a prospective, multicentre, international study investi...

Fluorescence imaging is a real-time intraoperative navigation modality to enhance surgical vision and it can guide emergency surgeons while performing difficult, high-risk surgical procedures. The aim of this study is to assess current knowledge, attitudes, and practices of emergency surgeons in the use of indocyanine green (ICG) in emergency setti...

Background Timely and safe elective health care facilitates return to normal activities for patients and prevents emergency admissions. Surgery is a cornerstone of elective care and relies on complex pathways. This study aimed to take a whole-system approach to evaluating access to and quality of elective health care globally, using inguinal hernia...

Background Total mesorectal excision (TME) is the standard surgery for low/mid locally advanced rectal cancer. The aim of this study was to compare three minimally invasive surgical approaches for TME with primary anastomosis (laparoscopic TME, robotic TME, and transanal TME). Methods Records of patients undergoing laparoscopic TME, robotic TME, o...

Background Hereditary adenomatous polyposis syndromes, including familial adenomatous polyposis and other rare adenomatous polyposis syndromes, increase the lifetime risk of colorectal and other cancers. Methods A team of 38 experts convened to update the 2008 European recommendations for the clinical management of patients with adenomatous polypo...

The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities.

Aim This study aimed to evaluate the impact of the WSES-AAST guidelines in clinical practice and to investigate the knowledge, attitudes, and practices of emergency surgeons in managing the complications of ulcerative colitis (UC) and Crohn’s disease (CD). Methods The MIBODI survey is a cross-sectional study among WSES members designed as an inter...

Background This multicentre case–control study aimed to identify risk factors associated with non-operative treatment failure for patients with CT scan Hinchey Ib-IIb and WSES Ib-IIa diverticular abscesses. Methods This study included a cohort of adult patients experiencing their first episode of CT-diagnosed diverticular abscess, all of whom unde...

Background Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann’s procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing...

The COVID-19 pandemic has led to a change in healthcare models. The aim of this study was to evaluate patient acceptance of telehealth as an alternative to physical consultations, and to identify factors predicting higher satisfaction. This was an observational, cross-sectional, multi-center, international study. All consecutive patients for whom t...

BACKGROUND: Colorectal (CRC) cancer is becoming a disease of the elderly. Ageing is the most significant risk factor for presenting CrC. early diagnosis of CrC and management is the best way in achieving good outcomes and longer survival but patients aged ≥75 years are usually not screened for CRC. This group of patients is often required to be man...

BACKGROUND: Colorectal (CRC) cancer is becoming a disease of the elderly. Ageing is the most significant risk factor for presenting CrC. early diagnosis of CrC and management is the best way in achieving good outcomes and longer survival but patients aged ≥75 years are usually not screened for CRC. This group of patients is often required to be man...

Background Empty pelvis syndrome (EPS) is a significant source of morbidity following pelvic exenteration (PE), but is undefined. EPS outcome reporting and descriptors of radicality of PE are inconsistent; therefore, the best approaches for prevention are unknown. To facilitate future research into EPS, the aim of this study is to define a measurab...

Background The most common intestinal operation in Crohn’s disease (CD) is an ileocolic resection. Despite optimal surgical and medical management, recurrent disease after surgery is common. Different types of anastomoses with respect to configuration and construction can be made after resection for example, handsewn (end-to-end and Kono-S) and sta...

Surgical research collaboratives (SRC) include surgeon-, trainee-, and medical student-led networks aiming to develop multicentric studies, with high-quality and real-world patient data, at a regional, national, or international level. Additionally, they encourage sharing research skills as well as knowledge between peers, therefore providing a tra...

Purpose Crohn’s disease (CD) patients may require recurrent surgeries due to the chronic and relapsing nature of the disease. Despite its technical challenges, minimally invasive surgery (MIS) offers potential benefits such as early recovery and reduced morbidity. This study aims to investigate the rate and risk factors of conversion from minimally...

Abstract Cardiovascular complications after major surgery are associated with increases in morbidity and mortality. There is confusion over definitions of cardiac injury or complications, and variability in the assessment and management of patients. This international prospective cohort study aimed to define the incidence and timing of these compl...

The focus of the 2022 European Society of Coloproctology (ESCP) annual campaign was diversity, equity, and inclusion (DEI) in surgery. The ESCP “Operation Equal Access” campaign sought to interview key-opinion leaders and trainees, to raise awareness on inequalities, inform the community of the status of the topic, and to identify future areas for...

Background SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2...

Background Crohn’s disease (CD) affecting the upper gastrointestinal (GI) tract is a rare condition, leading to a scarcity of information regarding its diagnosis, surgical treatment, and adjuvant therapy. The JUICE study aimed to conduct a surgical audit of duodeno-jejuno-ileal CD across 11 European IBD Referral Centres. Methods The study included...

Background Surgical management for patients with inflammatory ileocecal Crohn’s disease (CD) could be a reasonable alternative to second-line medical treatment. Methods A retrospective analysis of patients intervened for primary ileocecal CD with uncomplicated (inflammatory) phenotype at four referral hospitals during 2012-2021 was performed. The...

Background Acute severe ulcerative colitis (ASUC) is a serious, potentially life-threatening condition. Hospital admission and prompt medical therapy with intravenous steroids is crucial, but rescue medical therapy is frequently needed, and surgery is often required. Our aim was to assess the adherence to main diagnostic and management recommendati...

Background Recent evidence challenges the current standard of offering surgery to patients with ileocecal Crohn’s disease only when they present complications of the disease. Methods A retrospective, multicenter comparative analysis was performed including patients operated for primary ileocecal CD at 12 referral centers. Patients were divided in...

Aim: We describe two options for colorectal anastomosis suitable in cases when the colon would reach the pelvis under tension. Method: Deloyers procedure and the retro-ileal colorectal anastomosis are presented, focusing on practical tips and tricks to perform them. Insights on patients who underwent the procedures are provided to demonstrate th...

EAGLE is an international study bringing together surgeons, anaesthetists and theatre teams around the world to share best practice. The common goal is to reduce the global anastomotic leak rate after right colectomy and ileocaecal resection. Feel free to join ESCP Safe-anastomosis programme.

An estimated 2.5–3 million individuals (0.4%) in Europe are affected by inflammatory bowel disease (IBD). Whilst incidence rates for IBD are stabilising across Europe, the prevalence is rising and subsequently resulting in a significant cost to the healthcare system of an estimated 4.6–5.6 billion euros per year. Hospitalisation and surgical resect...

BACKGROUND Sacral neuromodulation might be effective to palliate low anterior resection syndrome after rectal cancer surgery, but robust evidence is not available. OBJECTIVE To assess the impact of sacral neuromodulation on low anterior resection syndrome symptoms, measured by validated scores and bowel diaries. DESIGN Randomized, double-blind, t...

Multidisciplinary management of patients with an ileoanal pouch requires dedicated imaging to identify structural problems of the pouch associated with dysfunction. The purpose of this study is to provide a framework for interpretation of magnetic resonance imaging (MRI) scan of the ileoanal pouch to enable surgeons and radiologists to work cohesiv...

Background: Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods: The internationally intended protocol, iteratively co-devel...

Background The association between volume, complications and pathological outcomes is still under debate regarding colorectal cancer surgery. The aim of the study was to assess the association between centre volume and severe complications, mortality, less-than-radical oncologic surgery, and indications for neoadjuvant therapy. Methods Retrospecti...

Bowel ischemia is an umbrella term encompassing a wide range of diseases, ranging from self-limiting conditions, usually responding to conservative treatment, to surgical emergencies, associated with high mortality rates. In acute setting, according to anatomy, different pathogenesis, and clinical evolution, we can classify them in two main entitie...

Background Variation exists in practice pertaining to bowel preparation before minimally invasive colorectal surgery. A survey of EAES members prioritized this topic to be addressed by a clinical practice guideline. Objective The aim of the study was to develop evidence-informed clinical practice recommendations on the use of bowel preparation bef...

Background The most common intestinal operation in Crohn’s disease (CD) is an ileocolic resection. Despite optimal surgical and medical management, recurrent disease after surgery is common. Different types of anastomoses with respect to configuration and construction can be made after resection for example, handsewn (end-to-end and Kono-S) and sta...

Objective: To develop and validate a prediction model (STOMA score) for 1-year stoma-free survival in patients with rectal cancer (RC) with anastomotic leakage (AL). Background: AL after RC resection often results in a permanent stoma. Methods: This international retrospective cohort study (TENTACLE-Rec-tum) encompassed 216 participating centres an...

Background/Aims Crohn’s disease is an inflammatory bowel disease with up to 50 per cent of patients requiring surgery within 10 years of diagnosis. Patient-reported outcome measures (PROMs) are vital to monitor and assess patient health-related quality of life (HRQoL). This systematic review aims to evaluate PROMs within studies for perioperative C...

Despite the increasing trend in liver resections for non-colorectal non-neuroendocrine liver metastases (NCNNLM), the role of surgery for these liver malignancies is still debated. Registries are an essential, reliable tool for assessing epidemiology, diagnosis, and therapeutic approach in a single hub, especially when data are dispersive and incon...

Objective: To develop and validate a prediction model (STOMA score) for 1-year stoma-free survival in patients with rectal cancer (RC) with anastomotic leakage (AL). Background: AL after RC resection often results in a permanent stoma. Methods: This international retrospective cohort study (TENTACLE-Rec-tum) encompassed 216 participating centres an...

Background The optimal treatment of anastomotic leak after rectal cancer resection is unclear. This worldwide cohort study aimed to provide an overview of four treatment strategies applied. Methods Patients from 216 centres and 45 countries with anastomotic leak after rectal cancer resection between 2014 and 2018 were included. Treatment was categ...