Managing perioperative opioid risks, improving detection of peripheral artery disease and surgical management of hard-to-treat gastrointestinal cancers, were among the topics UCSF surgeons, clinicians, and researchers discussed at the American College of Surgeon’s 2025 Clinical Congress in Chicago, Oct. 4 to Oct. 7. This year’s meeting featured distinguished experts, groundbreaking procedures, and researchers at all career stages showcasing original scientific and surgical work.
This year’s program featured innovative research and discussions by experts from UCSF Department of Surgery.
Julie Ann Sosa, MD, MA, FACS, the Leon Goldman, MD, Distinguished Professor of Surgery and chair of the Department of Surgery at UCSF, presented “Management of Low-Risk Thyroid Cancer” during the panel session “Updated American Thyroid Association Guidelines for Thyroid Nodules – What’s New?” (PS120). The American Thyroid Association (ATA) released the new guidelines for the management of adult patients with differentiated thyroid cancer (DTC) in August 2025. Sosa served as co-chair of the ATA guidelines task force, leading a diverse complement of stakeholders in developing revised clinical practice guidelines. During her presentation, Dr. Sosa highlighted the guidelines as an evidence-based resource for physicians. The guidelines include initial cancer diagnosis and continue with recommendations for staging and risk assessment; initial treatment decisions; assessment of treatment responses; monitoring approaches; diagnostic testing; and subsequent therapies based on the strength of evidence for response and consideration of side-effects and outcomes. Patient-reported outcomes, thyroid cancer survivorship, and identified areas of need for additional high-quality research were discussed as well.
Fernanda Romero Hernandez, MD, general surgery resident, was first author of “Use of Fluorescent Visualization for Dissection for a Robotic Assisted Completion Cholecystectomy” presented by Carlos Corvera, MD, chief of the Hepatobiliary & Pancreatic Surgery Program, during the video education session “Gallbladder and Common Bile Duct for the General Surgeon” (VE102). This session covered a complex case of a morbidly obese 42-year-old woman who underwent a robotic-assisted completion cholecystectomy with common bile duct exploration after recurrent cholangitis from a retained cystic duct stone. The procedure required extensive adhesiolysis, use of fluorescent cholangiography for enhanced visualization, and choledochotomy with stone extraction and primary closure. The patient had an uncomplicated recovery and was discharged on postoperative day one.
Shraddha Pandey, BA, UCSF medical student, presented “Piloting a Patient-Centered Clinical Decision Support Tool in the Electronic Health Record for Post-Surgical Opioid Prescription at Discharge” during the quick shot scientific session “Health Services Research I” (SF103). Surgical opioid prescriptions remain a significant risk factor for opioid use disorder. Prior studies have shown that current prescribing practices lead to both over- and under-prescribing, resulting in increased refill requests during follow-up. To address this, the researchers developed a clinical decision support tool that recommends personalized discharge doses based on patients' actual hospital opioid use during their final 24 hours of admission. However, a 7-month pilot of the CDS revealed that over-prescription rates remained high. Through follow-up interviews with clinicians, the research team uncovered critical implementation barriers. Successful adoption of a CDS tool for prescribing opioids will require seamless electronic health record integration, hands-on training, clear patient communication for taking opioids at home, and buy-in from attending physicians to overcome entrenched prescribing habits.
Andrea M. Gochi, MD, MS, surgery resident at UCSF East Bay General Surgery, presented “MRI for Trauma-Associated Neck Pain: Think Again” during the quick shot scientific session “Neurosurgery” (SF110). This research challenges the routine use of MRI for trauma patients with persistent neck pain but no neurological deficits and a negative CT scan. The researchers found that MRI rarely uncovers any clinically significant injuries requiring surgery, suggesting that many patients can be safely managed without emergent MRI. These findings support a more selective approach, which could reduce unnecessary imaging, shorten hospital stays, and lower costs without compromising patient safety.
Neal Mukherjee, BA, BS, UCSF medical student and researcher, presented “Bladder Exstrophy Iliac Osteotomies: 3D Modeling Comparative Analysis of Current Approaches’ Impact on Intrapelvic Volume and Acetabular Version” during the scientific forum “Orthopaedic Surgery I” (SF115). Through 3D modeling of osteotomies on infant bladder exstrophy pelvis models, the researchers identified which of the three most common osteotomy approaches maximizes intrapelvic volume and acetabular anteversion for optimal urologic repair.
Mukherjee also presented “Effects of Transcatheter Aortic Valve Replacement (TAVR) Introduction on Surgical Aortic Valve Replacement (SAVR) Patient Risk Scores, Surgical Techniques, and Outcomes in a Veterans Affairs Healthcare System (VAHCS)” during the quick shot scientific session “Cardiac Surgery” (SF203). Mukherjee reported on a retrospective review of all surgical aortic valve replacements (SAVR) at the SFVA to investigate the impacts of the introduction of transcatheter aortic valve replacements. The study reviewed the risk scores of patients undergoing SAVR, the techniques used and their surgical outcomes.
Amir Ashraf Ganjouei, MD, a postdoctoral scholar in UCSF Surgery and Radiation Oncology, presented “Prolonged Length of Stay in Elective Colectomy Patients: Insights from Artificial Intelligence-Based Medical Record Review” during the scientific session “Artificial Intelligence in Surgical Science: Clinical Prediction Models, Large Language Models, and Computer Vision” (SF211). Ganjuouei described the development and validation of a machine- learning-based tool to predict optimal length of stay (≤3 days) following elective colectomy, using data from 184,286 patients in the ACS-NSQIP database. Among several models tested, XGBoost achieved the best performance (AUC 0.76), with minimally invasive surgery, bowel preparation, nutritional status, and age emerging as key predictors. This tool offers a data-driven method to support individualized perioperative care and more efficient hospital resource utilization.
Kent Garber, MD, assistant professor in the UCSF Department of Surgery, Trauma/Acute Care Surgery/Critical Care, presented “Trauma Care in South Sudan” during the panel session “Humanitarian Crisis and Armed Conflict: Ethical Obligations Surrounding Healthcare” (PS221). This session explored the ethical issues surrounding access to care and the provision of care to individuals during armed conflict, with Garber focusing specifically on South Sudan.
Mandeep Kaur, BS, BA, UCSF medical student and UCSF sALLud lab member, presented “Exploring Team Dynamics and Motivations in the Operating Room: A Qualitative Study” during the quick shot scientific session “General Surgery IV” (SF218). This study explored differences in motivation amongst team members the perioperative space and potential causes of operating room inefficiency. Kaur and her colleagues conducted semi-structured interviews with surgeons, anesthesiologists, nurses, and scrub techs. The most prominent themes were related to workload, control over scheduling, and familiarity with teams. People seem more motivated to work hard and turnover cases quickly if they have help, can go home sooner, or are able to work with people they are familiar with. This study's findings lay the groundwork for exploring next steps in improving perioperative efficiency.
Caitlin A. Hendricks, BA, UCSF medical student, presented “Patient Factors Influence Patient Reported Outcome Measurement Collection Rates but Not Clinical Benefit Following Total Joint Arthroplasty” during the quick shot scientific session “Orthopaedic Surgery II” (SF230). Hendricks and her colleagues investigated whether patient-level factors influence Patient-Reported Outcome Measure (PROM) completion rates and clinical outcomes in 2,715 hip and knee replacement patients at UCSF (2020-2023). Vulnerable populations — non-English speakers, Black patients, and those with public insurance — were significantly less likely to complete PROMs. With the Centers for Medicare and Medicaid Services now requiring 50% PROM completion for reimbursement, safety-net hospitals serving vulnerable populations may face disproportionate financial penalties, underscoring the need for interventions ensuring equitable participation.
Ajay V. Maker, MD, FACS, FSSO, is the Maurice Galante Distinguished Professor of Surgery and chief of Surgical Oncology for UCSF, was the moderator for panel session “Updates in Colorectal Cancer Liver Metastases” (PS314). He also presented “Multidisciplinary Management Strategies for Colorectal Liver Metastases — Addressing the Disease Biology” during the session. The most common site of colorectal cancer metastases is the liver. Options for management can be overwhelming with systemic, liver directed, surgical, and radiation treatments all being potential modalities for treatment. All patients with colorectal liver metastasis should be evaluated by a multidisciplinary team to assess if the liver disease is amenable to surgical resection. This session updated surgeons on the management of colorectal cancer liver metastases. As the landscape for treatment of colorectal cancer evolves, so does the approach to work-up, sequencing of treatments, and role and timing for surgery.
Allison R. Chang, BA, UCSF medical student and member of the Kirkwood Lab at UCSF, presented “Distant Pancreatic Cystic Lesions (PCLs) Are Associated with Fewer Positive Lymph Nodes in Patients with Solid Pancreatic Ductal Adenocarcinoma” during the quick shot scientific session “Hepatobiliary and Pancreas IV” (SF308). As a leading cause of cancer-related mortality in the U.S., pancreatic ductal adenocarcinoma (PDAC) poses a significant challenge within the field of surgical oncology. However, it is unknown whether the presence of multifocal pancreatic cysts confers a protective benefit for patients with PDAC. In a retrospective review of resected PDAC and invasive IPMN, the presence of additional, distant pancreatic cystic lesions (PCLs) was associated with a lower likelihood of lymph node metastasis at resection. Among PDAC patients, this association was significant among those who did not receive neoadjuvant chemotherapy. These preliminary findings suggest that distant PCLs could represent a favorable prognostic marker, with the potential to inform more tailored treatment approaches and potentially reduce the burden of neoadjuvant therapy for selected patients with PDAC.
Paul Wong, BS, UCSF medical student, presented “Trends in Cyst Size of Resected Intraductal Papillary Mucinous Neoplasms over Time—has the Evolution of the International Association of Pancreatology (IAP) Guidelines Impacted Surgical Thresholds?” during the scientific forum “Hepatobiliary and Pancreas IV” (SF308). Wong and his colleagues utilized the National Cancer Database to understand whether the surgical criteria, specifically cyst size, has shifted over time for intraductal papillary mucinous neoplasms with the progression of the International Association of Pancreatology (IAP) Guidelines. Their findings conclude that non-invasive lesions have now been resected at larger sizes, whereas invasive lesions are smaller. Reasons for this may include greater adoption of the international guidelines and increased use of cyst fluid analysis to risk-stratify lesions.
Tripti Mathur, MBBS, research scholar, UCSF Department of Surgery, presented “From Prevention to Intervention: A Quality Improvement Program for Peripheral Artery Disease at a Safety Net Hospital” during the quick shot scientific session “Vascular Surgery III” (SF319). Peripheral Artery Disease (PAD) affects over 12 million Americans and disproportionately impacts patients at safety-net hospitals (SNHs), where late presentations with critical limb-threatening ischemia (CLTI) drive high amputation rates. Despite its burden, PAD remains underdiagnosed due to limited access to care. The objective of this study was to evaluate the impact of a structured vascular surgery program on early identification, intervention, and outcomes for PAD patients at an SNH.
Mathur also shared an E-Poster: Machine Learning-based Correlation of Venous Morphology with Hemorrhagic Shock Stage Using Volumetric M-mode Ultrasound in a Swine Model (SP301-2). Hemorrhagic shock remains a leading cause of preventable death, often recognized only at late stages. The researchers developed a novel ultrasound technique (volumetric M-mode or VMM ultrasound), which expands spatial coverage through lateral imaging and tilt motion, enabling detailed venous assessment. The team hypothesize that machine learning-–assisted VMM can identify stage-specific venous morphology changes to enable earlier, automated shock detection, blood loss estimation, and tailored resuscitation.
Please visit ACS Clinical Congress 2025 for complete meeting abstract and session information.