The 2024 IHPBA Legacy Initiative targets hepatocellular carcinoma (HCC) in sub-Saharan Africa, addressing significant healthcare challenges due to high incidence rates and inadequate infrastructure. It focuses on enhancing management pathways and access to care through a multidisciplinary approach, including prevention, early diagnosis, and treatment strategies. Key efforts involve expanding healthcare resources, implementing screening programs, and […]
Author: STITCHES Newsletter
Robotic pancreaticoduodenectomy shows benefits over laparoscopic approach
In a systematic review of eight studies involving 6,648 patients, robotic pancreaticoduodenectomy (RPD) demonstrated significant advantages over laparoscopic pancreaticoduodenectomy (LPD) for malignant lesions. Key findings included a reduced length of hospitalization (mean difference of -0.94 days), lower conversion rates (odds ratio of 0.20), and a higher number of harvested lymph nodes (mean difference of 1.02). […]
Discovery of key players in lymph node metastasis of ICCA
Single-cell analyses reveal significant insights into lymph node metastasis in intrahepatic cholangiocarcinoma (ICCA). A complex heterogeneity was identified within the lymph node microenvironment, with an increase in stromal and mature immune cells, particularly diverse T cell subtypes. Notably, CD36+ macrophages and SAA1+ tumor cells were implicated as critical components in the metastatic process. These findings […]
High risk of surgery in complicated chronic diverticular disease
A nationwide study covering Denmark from 1996 to 2020 evaluated 33,951 patients with chronic diverticular disease and found a 5-year cumulative incidence of surgical intervention at 13.9%—9.8% elective and 4.2% emergency. Complicated cases presented a three- to six-fold increased likelihood of surgery compared to uncomplicated cases. Younger patients and those with more emergency admissions faced […]
Improved prediction model for 5-year postoperative HCC recurrence
A new predictive model significantly enhances the accuracy of forecasting 5-year recurrence rates in hepatocellular carcinoma (HCC) patients post-surgery. Integrating LASSO regression and random forest techniques, the model identified six key factors, achieving an area under the curve (AUC) of 0.733, compared to the initial model’s AUC of 0.678. Importantly, this model demonstrates better predictive […]
Weekend Surgery Increases Risk of Complications and Mortality
Patients undergoing surgeries immediately before the weekend face higher risks of death, readmission, and complications compared to those treated afterwards. An analysis of over 429,000 patients in Ontario revealed a consistent increase in adverse outcomes at 30 days, 90 days, and one year post-surgery for those in the preweekend group, with adjusted odds ratios indicating […]
Pembrolizumab shows promise for rare microsatellite-high intrahepatic cholangiocarcinoma
A 65-year-old man with unresectable, microsatellite-high intrahepatic cholangiocarcinoma experienced significant tumor shrinkage after receiving pembrolizumab, following a failed combination therapy. The comprehensive cancer genomic profiling identified an mlh1 pathogenic mutation, suggesting the microsatellite instability was somatic rather than inherited. Remarkably, the response was maintained for over 30 months, indicating pembrolizumab’s potential effectiveness in treating this […]
Erector spinae plane block reduces opioid use after surgery
In a study evaluating ultrasound-guided erector spinae plane block (ESPB) for post-operative analgesia in laparoscopic cholecystectomy, researchers found that the ESPB group required significantly less tramadol within the first 24 hours compared to controls (p=0.005). Additionally, pain scores measured by visual analogue scale (VAS) were lower in the ESPB group at various intervals. The time […]
Improved visualization of surgical needle tips enhances accuracy
A novel model was developed to visualize hidden surgical needle tips within organs, addressing challenges in laparoscopic procedures that could lead to complications like anastomotic leakage. Testing revealed real-time image inference at 33.4 frames per second and a mean needle misalignment of just 1.03 mm, well below the 1.8 mm threshold. These findings suggest that […]
Radiation-emitting metallic stents improve survival in cholangiocarcinoma
A multicenter trial demonstrated that radiation-emitting metallic stents (REMS) combined with hepatic arterial infusion chemotherapy (HAIC) significantly outperformed self-expandable metallic stents (SEMS) in patients with unresectable Bismuth type III or IV perihilar cholangiocarcinoma. The median overall survival was 10.2 months for REMS compared to 6.7 months for SEMS (p=0.002). Additionally, median time to symptomatic progression […]