Julie Hallet, MD MSc
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halletjulie.bsky.social
Julie Hallet, MD MSc
@halletjulie.bsky.social
🎓MD MSc FRCSC FACS FSSO
😷HPB Cancer Surgeon & #NETologist
👩🏻‍💻Associate Professor at UofT
⚜️Québec City Girl
She/Her/Elle

#NETsSky #HPBSky #Surgsky
Reposted by Julie Hallet, MD MSc
🆕Team design as innovation in perioperative care: the case of HPB anesthesiology
➡️https://buff.ly/U5wd2VX

"Change takes time – in all fields, including surgery... But not all improvements require new technology."

@halletjulie.bsky.social #surgery #team #HPB #medsky #surgsky
September 23, 2025 at 5:09 PM
💥Bone mets in SI-NETs – more common than you think!

🦴25% on PET-CT
😌14% pain, 4% fracture
⏳Stage IV pts with 🦴 mets ⬇️ median survival vs without
📊>5 lesions has ⬇️ survival

What's the best strategy for bone treatments in #NETs? 💭

ow.ly/GB2N50WCokB

#NETSky #OncSky #MedSky #SurgSky
August 10, 2025 at 3:16 AM
💭Guess what day it is? #NETs OR 🦓 with Dr Meloche-Dumas

She’s focusing on NETs during surg onc fellowship. The NETs field needs more dedicated surgeons like her - watch out for what’s to come!

So fun to create tailored multidisciplinary NETs rotations with UofT SurgOnc
#NETsky #SurgSky #MedSky
August 8, 2025 at 6:16 PM
Mesoappendix invasion not a criteria for right hemi in appendix NETs

👥4800 pts
🔬meso invasion not associated with LN+ on its own
📏size main risk factor

No difference in OS appendectomy vs right hemi👌

Timely for @nanets.bsky.social guidelines!

link.springer.com/article/10.1...
#NETSky #SurgSky
Appendiceal Neuroendocrine Tumors: Prognostic Role of Mesoappendiceal Invasion and Implications for Recommending Right Hemicolectomy versus Simple Appendectomy - Annals of Surgical Oncology
Background Current guidelines are conflicting as to whether mesoappendiceal invasion (MAI) among patients with appendiceal neuroendocrine tumors (aNETs) warrants right hemicolectomy (RHC), especially ...
link.springer.com
August 7, 2025 at 3:12 PM
Reposted by Julie Hallet, MD MSc
#HPBSky Also check out the great ergonomics in surgery primer from last year 📑 🔑 at @bjsacademy.bsky.social 👏🏻 @halletjulie.bsky.social
August 6, 2025 at 7:52 PM
Reposted by Julie Hallet, MD MSc
🆕 Ergonomics in the OR is a safety imperative
The OR looks choreographed—yet beneath it lie serious ergonomic hazards for the surgical team.

Read more on BJS Academy ⬇️
buff.ly/7QuQvlA

@halletjulie.bsky.social @bjsurgery.bsky.social #surgsky #medsky #surgery
August 6, 2025 at 3:17 PM
OR under pressure⚡️

Live observations 👀 👉🏻multiple ergonomic hazards across types of surgeries
‼️poor layouts
🤸awkward postures
🏃trip risks
📟tech fails
Involving all team members😷

Time to make OR safe for workers!

📝🔗 academic.oup.com/bjs/article-...
#SurgSky #MedSky
Under pressure: live observation of ergonomic challenges in the operating room
Ergonomics is the study of how people interact with their environment to improve efficiency and well-being. In the operating room (OR), poor ergonomic prac
academic.oup.com
August 6, 2025 at 7:16 PM
Defining high-risk pancreas #NETs

496 resections 🇮🇹🇫🇷🇨🇦

Early recurrence
71% if venous thrombosis
41% if Ki 67>5% + tumor >3cm + ⬆️LN

⚠️Signs of biologically borderline-resectable NETs
🛑 before resection ➡️ start with systemic💊

🔗 journals.lww.com/annalsofsurg...

#NETSky #HPBSky #PancSky #SurgSky
August 1, 2025 at 3:37 PM
🎙️New data for management of #HCC
What is new?
What is in the works?

Review this & more with Adam
Yopp, Amit Singhal & Katie Kelley in new #SurgOncToday podcast 🎧 from @socsurgonc.bsky.social
A real masterclass in perioperative care for HCC 🔝

#HPBsky #SurgSky #medsky #oncsky
July 24, 2025 at 4:02 PM
What will my life look like after surgery?

The STAYHOME tool can help with this question for older adults for cancer surgery:
🏡 individualized risk of staying home at 6 & 12 months
😷 uses preop info
✅ good discrimination & well calibrated

📝 in JAMASurgery lnkd.in/gTtRgj_e

#SurgSky #OncSky
June 29, 2025 at 3:57 PM
That was the last OR day with Dr Acher! Always bittersweet to see fellows go 🥹

So proud of the highly skilled, brilliant, whip-smart surgeon she is 🌟 @wiscsurgery.bsky.social, you're lucky to have her!

Now, we can always dream of getting her on social media 🙃

@uoftsurgery.bsky.social
June 29, 2025 at 3:55 PM
Should we chase margins intraop for PDAC?

✅Yes - R0 is key for cure
❌No - R1 reflects biology, not technical cure

Great summary & sharp debate on surgical cure vs disease reality from #SSO2024 in @annsurgoncology.bsky.social between Alice Wei & David Kooby

link.springer.com/article/10.1...
Great Debate: Chasing Intraoperative Neck Margins During Pancreatoduodenectomy—Beneficial or Not? - Annals of Surgical Oncology
Annals of Surgical Oncology -
link.springer.com
June 18, 2025 at 7:31 PM
Sub-typing to select NAT in #PDAC?

NeoPancONE 🇨🇦 #ASCO25 @ascocancer.bsky.social

👥84 resectable PDAC
💉mFOLFIRINOX NAT
Median OS 34 months😀
🔬Classical vs basal sub-type main predictor EFS & OS

What next 🤔: sub-type all PDAC prior to chemo? wait for more data?

ascopubs.org/doi/10.1200/...
NeoPancONE: GATA6 expression as a predictor of benefit to peri-operative modified FOLFIRINOX in resectable pancreatic adenocarcinoma (r-PDAC): A multicentre phase II study.
4011Background: Modified FOLFIRINOX (mFFX) is increasingly used in the perioperative setting in r-PDAC and patients (pts) would benefit from a biomarker approach. GATA6 expression enriches for the cla...
ascopubs.org
June 4, 2025 at 4:56 PM
Not in Chicago but getting the updates - #ASCO25 learnings today:

😀there's an option in BRAFV600 mCRC
😀Ipi+Nivo better in MSI-h unresectable mCRC
🫤ctDNA+ still not guiding care in CC
😳CRS+HIPEC no better with chemo

@oncbrothers.bsky.social
got the details 👉🏻 tinyurl.com/bd75xjw7

#OncSky #MedSky
tinyurl.com
May 31, 2025 at 1:47 AM
Stable OR teams contribute to better outcomes🤝✨

Each additional case done by same anesthesiologist-surgeon team 👉 ⬇️ major morbidity

🔓‼ Opportunity is knocking: ⬆️outcomes by re-organizing teams

How do we do it?

🆕📝 tinyurl.com/yx44pm96

#SurgSky #MedSky #HPBSky
May 28, 2025 at 7:28 PM
PRRT before surgery in #NETs? ☢️🦓

Maybe? 💭

Think about why, how to measure success, potential risks 🤔

Some key reasons to consider the approach by Jess Maxwell @mdanderson.bsky.social 👇🏻

@nanets.bsky.social
#NETsky #HPBSky #SurgSky
@enets.bsky.social @socsurgonc.bsky.social
May 17, 2025 at 10:03 PM
#NETs in LA ⭐️🎥🌴

Reminder to debulk NETs liver metastases by Alexandra Gangi 🤩 @cedarssinai.bsky.social

➡️ mortality in NETs happens in the liver - treat it

⛔️ No to anatomic resection! 👉🏻 enucleate!

#NETsky #HPBSky #SurgSky #OncSky
@nanets.bsky.social
May 17, 2025 at 5:04 PM
Perioperative management essentials for carcinoid syndrome

🎞️👀 sneak peek of 🗺️ international expert consensus recommendations at @essonews.bsky.social #NETs webinar today
🔹Assess for 🖤disease
🔹Identify & treat crisis fast
🔹Don't rely on octreotide!

Thanks for the invite!
#NETSky #HPBSky #SurgSky
May 14, 2025 at 11:07 PM
New favourite slide from @drcnclarke.bsky.social on surgery for #PNETs 🟢🟠🔴
at AHPBA monthly fellows rounds

@nanets.bsky.social @enets.bsky.social @socsurgonc.bsky.social #NETSky #HPBSky #PancSky #SurgSky
May 14, 2025 at 10:34 PM
Symptoms & QoL are key in #NETs care

New tools🧰 from @ascocancer.bsky.social for symtpom management in well-diff GEP-NETs
☑️carcinoid syndrome, heart disease, crisis & functional PNETs
☑️surgery, liver-directed therapy & systemic

🔗📝https://ascopubs.org/doi/10.1200/OP-25-00133
#NETSky #OncSky
May 12, 2025 at 12:54 PM
Want to know more about surgery & functioning NETs?🤨

Join @essonews.bsky.social on May 14!

🔥Will include preview of international expert consensus recommendations for periop management of carcinoid crisis🦓🌎

Register 👇🏻👇🏻

#NETSky #SurgSky #OncSky #HPBSky
May 9, 2025 at 1:15 AM
Are current wait time targets optimal?

Strong work by Adom Bondzi-Simpson #AmerSurg25:
wait time & survival in #CRC
🚫 diff OS if surgery <28d (traditional target)
⬆️OS if surgery <45d (new)

Time to reconsider wait times to optimize cancer outcome vs resources? ⚖️🤔

📸cred @swexner.bsky.social
April 25, 2025 at 2:24 PM
Re-operation for SB-NETs

👥 21 pts in 🇩🇪
▪️Resected for residual disease - mostly mesenteric LN
▫️Incomplete prior surgery (48% as emergency)
▪️>80% disease-free at 52m median FU

🔑Post-resection
➡️ Get imaging
➡️ If residual disease: refer to NET expert

tinyurl.com/upc5exfw

#NETsSky #SurgSky #OncSky
Results of Surgical Reintervention After Suboptimal Initial Resection for Locoregional Neuroendocrine Tumors of the Small Intestine
Complete resection is the only chance for cure in small intestine neuroendocrine neoplasms (SI-NEN). Previous ENETS guidelines proposed standards for the surgery of SI-NEN, which should be followed t...
tinyurl.com
April 24, 2025 at 12:52 AM
The scrub cap is back for some team spirit in the OR 🏥 #StanleyCupPlayoffs

#GoHabsGo Bring back the cup where it belongs! 🔵⚪️🔴 🇨🇦
April 22, 2025 at 9:07 PM
🚨 Debulking of #NETs liver metastases 🦓

What? Why? When? How?
The 😈 is in the details

Get details in 🆕 #SurgOncToday podcast🎙️with
Jessica Maxwell & Alexandra Gangi: patient selection, preop preparation & technical approach

open.spotify.com/episode/2n7z...

#NETSky #HPBSky #SurgSky #OncSky
April 3, 2025 at 2:08 PM