Anastomotic leakage is a potentially severe complication occurring after colorectal surgery and can lead to increased morbidity and mortality, permanent stoma formation, and cancer recurrence. Multiple risk factors for anastomotic leak have been identified, and these can allow for better prevention and an earlier diagnosis of this significant complication. There are nonmodifiable factors such as male gender, comorbidities and distance of tumor from anal verge, and modifiable risk factors, including smoking and alcohol consumption, obesity, preoperative radiotherapy and preoperative use of steroids or non-steroidal anti-inflammatory drugs. Perioperative blood transfusion was shown to be an important risk factor for anastomotic failure. Recent studies on the laparoscopic approach in colorectal surgery found no statistical difference in anastomotic leakage rate compared with open surgery. A diverting stoma at the time of primary surgery does not appear to reduce the leak rate but may reduce its clinical consequences and the need for additional surgery if anastomotic leakage does occur. It is still debatable if preoperative bowel preparation should be used, especially for left colon and rectal resections, but studies have shown similar incidence of postoperative leak rate.

Abdominal compartment syndrome (ACS) represents a severe complication of acute pancreatitis (AP), resulting from an acute and sustained increase in abdominal pressure >20 mmHg, in association with new organ dysfunction. The harmful effect of high intra-abdominal pressure on regional and global perfusion results in significant multiple organ failure and is associated with increased morbidity and mortality. There are several deleterious consequences of elevated intra-abdominal pressure on end-organ function, including respiratory, cardiovascular, gastrointestinal, neurologic, and renal effects. It is estimated that about 15% of patients with severe AP develop intra-abdominal hypertension or ACS, with a mortality rate around 50%. The treatment of abdominal compartment syndrome in acute pancreatitis begins with medical intervention and percutaneous drainage, where possible. Abdominal compartment syndrome unresponsive to conservatory treatment requires immediate surgical decompression, along with vacuum-assisted closure therapy techniques, followed by early abdominal fascia closure.

Acute necrotizing pancreatitis (ANP), characterized by necrosis of pancreatic and/or peripancreatic tissues, is a potentially severe and life-threatening complication of acute pancreatitis, exhibiting a considerable mortality rate, particularly in the presence of infection, with rates ascending to 20–30%. Contrast-enhanced computed tomography is the definitive diagnostic standard, although treatment is determined by illness severity and the presence of secondary infection. The management of this condition has undergone considerable evolution, transitioning from initial surgical intervention to a more progressive, minimally invasive strategy. Initial management emphasizes aggressive fluid resuscitation, nutritional support, and monitoring of organ dysfunction. Infected necrosis is a critical factor influencing prognosis and requires intervention, typically starting with percutaneous drainage or endoscopic necrosectomy prior to evaluating surgical debridement. Recent advancements, such as the implementation of endoscopic and minimally invasive techniques, have enhanced outcomes by decreasing morbidity and mortality linked to open surgery. Despite these advancements, optimal treatment strategies are patient-specific and necessitate a multidisciplinary approach. Additional research is necessary to enhance guidelines and optimize patient outcomes.

Background and Objectives: This study aimed to investigate the potential risk factors for severe postoperative complications after oncologic right colectomy. Materials and Methods: All consecutive patients with right colon cancer who underwent right colectomy in our department between 2016 and 2021 were retrospectively included in this study. The Clavien–Dindo grading system was used to evaluate postoperative complications. Univariate and multivariate logistic regression analyses were used to investigate risk factors for postoperative severe complications. Results: Of the 144 patients, there were 69 males and 75 females, with a median age of 69 (IQR 60–78). Postoperative morbidity and mortality rates were 41.7% (60 patients) and 11.1% (16 patients), respectively. The anastomotic leak rate was 5.3% (7 patients). Severe postoperative complications (Clavien–Dindo grades III–V) were present in 20 patients (13.9%). Univariate analysis showed the following as risk factors for postoperative severe complications: Charlson score, lack of mechanical bowel preparation, level of preoperative proteins, blood transfusions, and degree of urgency (elective/emergency right colectomy). In the logistic binary regression, the Charlson score (OR = 1.931, 95% CI = 1.077–3.463, p = 0.025) and preoperative protein level (OR = 0.049, 95% CI = 0.006–0.433, p = 0.007) were found to be independent risk factors for postoperative severe complications. Conclusions: Severe complications after oncologic right colectomy are associated with a low preoperative protein level and a higher Charlson comorbidity index.

Acute pancreatitis is a common inflammatory digestive disease with an unpredictable clinical course, ranging from self-limited forms to severe forms, associated with complications and increased mortality. Early identification of patients at risk of severe disease is particularly important from a surgical perspective, as it has a significant impact on subsequent management. Traditional severity scores, such as APACHE (Acute Physiology And Chronic Health Evaluation) II and BISAP (Bedside Index for Severity in Acute Pancreatitis), remain widely used, but their rigid structure and delayed applicability may limit initial risk assessment. In this review we highlight the evolving role of artificial intelligence in predicting the severity of acute pancreatitis and supporting clinical decision-making, with a focus on surgical management. Recent advances show that data-driven models could improve early risk assessment compared to traditional methods. Although their potential clinical benefits are becoming increasingly clear, real-world implementation remains limited. Initial results are encouraging, but important questions regarding reliability, safety, and integration into clinical practice still need to be addressed.