JACS Highlights November-December 2025

The following articles appear in the November and December 2025 issues of the Journal of the American College of Surgeons. A complimentary online subscription to JACS is a benefit of ACS membership. See more articles on the JACS website.

Longitudinal Trends in Efficiency and Complexity of Surgical Procedures: Analysis of 1.7 Million Operations Between 2019 and 2023

Christopher P. Childers, MD, PhD, Lauren M. Foe, MPH, Vinita Mujumdar, JD, and colleagues

Overall, for common high-volume surgical procedures, operative times and patient complexity have significantly increased over time. There does not appear to be empirical evidence of efficiency gains that would justify an efficiency adjustment as proposed in the calendar year 2026 Medicare Physician Fee Schedule. Read more.

Identifying Diagnostic Gaps and Mitigation Strategies for Older Adult Emergency General Surgery Patients: A Scoping Review

Jessica K. Liu, MD, MS, MPH, Xane D. Peters, MD, MS, Sarah L. Remer, MD, and colleagues 

Current diagnostic issues, clinical tools, and clinician feedback strategies in the older adult emergency general surgery (EGS) setting were identified in this scoping review. While challenges unique to older adults exist, variability in the use of tools to improve identification of older adult conditions in EGS and gaps in feedback to improve diagnosis remain. Read more.

Evaluating Effectiveness and Long-Term Outcomes of Roux-en-Y Gastric Bypass vs. Gastric Sleeve Bariatric Surgery in Obese and Diabetic Patients: Systematic Review

Rebekah Brown, MD

This systematic review compared long-term outcomes of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), highlighting RYGB’s superior weight loss and diabetes remission but higher complication risk, while SG offered fewer nutritional deficiencies but increased gastroesophageal reflux disease and revision rates. Surgical choice should be tailored to individual patient profiles. Read more.

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