Category: HPB & Spleen

Laparoscopic vs. Open Hemihepatectomy: A Side-by-Side Analysis

Laparoscopic right hemihepatectomy offers benefits that may improve patient recovery despite its complexity. Laparoscopic patients had a shorter time to functional recovery (5 vs. 6 days) and shorter hospital stays (5 vs. 6 days). Operating times were longer for laparoscopic procedures (332 vs. 263 min), but other outcomes showed no significant differences. Surgeons should consider […]

Minimally invasive surgery cuts costs in liver and pancreatic procedures

Minimally invasive approaches in liver and pancreatic surgery show significant cost advantages. Laparoscopic ($77,657) and robotic ($89,713) surgeries have lower median hospital charges compared to open surgery ($111,051) (p < .001). In liver resections, laparoscopic surgery results in adjusted charge reductions of $23,564 overall, and $14,140 for early discharges. Surgeons should consider minimally invasive techniques […]

Endoscopic Necrosectomy: No Major Differences Found

Upfront endoscopic necrosectomy (UEN) and step-up endoscopic necrosectomy (SUEN) show similar outcomes for walled-off pancreatic necrosis, impacting how you approach patient management. No significant difference in clinical success (RR: 1.04) or technical success (RR: 1.27) between UEN and SUEN. Patient safety outcomes, including post-procedural bleeding (RR: 0.66) and recurrence (RR: 0.71), were comparable. Individualized treatment […]

Biliary Stents for Bile Leaks After Fenestrated Cholecystectomy Show No Difference

This study examines the effectiveness of different biliary stents for treating bile leaks post-fenestrated cholecystectomy, revealing significant implications for patient management. PCBL resolution rates were similar across stent types: 93.8% for 10 fr stents, 92.3% for 7 fr stents, and 88.9% for fully covered self-expanding metal stents. Plastic stents, including single and double pigtail options, […]

Neoadjuvant GOLP Improves Outcomes in High-Risk Cholangiocarcinoma

Neoadjuvant GOLP therapy significantly enhances event-free survival in patients with resectable high-risk intrahepatic cholangiocarcinoma. Median event-free survival was 18.0 months with GOLP, compared to 8.7 months in the control group (p<0.001). Overall survival at 24 months was 79% for the neoadjuvant group vs. 61% for controls (hazard ratio 0.43). Expect lower-grade adverse events overall, with […]

Medicaid Expansion Linked to Better Outcomes in Pancreatic Cancer

Medicaid expansion improves survival and surgical access for pancreatic cancer patients. Residents in states with early, on-time, and late Medicaid expansion had 2-year mortality reductions (hazard ratios ranging from 0.91 to 0.94). There was a 19% increase in the odds of surgical resection with Medicaid expansion (odds ratio 1.19). Outcomes improved primarily after three years […]

Liver Transplant After Immunotherapy Shows Strong Outcomes

Transplanting liver patients who respond to atezolizumab-bevacizumab is promising for those with intermediate and advanced hepatocellular carcinoma. Recurrence-free survival is 90% and overall survival is 94% at two years post-transplant. Acute rejection rates are 25%, but remain manageable; 62.5% had complications within 90 days of transplant. Surgical teams should consider immunotherapy response when selecting candidates […]

Enhanced Radiomics Predicts Pathological Response in HCC

Dynamic radiomic features from MRI can predict complete response in hepatocellular carcinoma (HCC) post-immune therapy, critical for surgical planning. A delta radiomic model achieved an AUC of 0.835 in predicting lesion-level complete response compared to 0.483 for baseline models. Combining radiomics with serum AFP response boosted predictive accuracy, yielding AUCs of 0.920 in the test […]

Long-term Atezolizumab-Bevacizumab Outcomes in HCC

Atezolizumab-bevacizumab shows promising long-term survival for patients with unresectable hepatocellular carcinoma. Median overall survival is 19.7 months with a 36-month survival rate of 30%. 36.8% experienced grade ≥3 adverse events; 14.1% had liver decompensation not related to tumor progression. Surgeons should consider multidisciplinary approaches, as 14.9% of patients underwent additional surgical or locoregional procedures post-treatment. […]

Optimal Management of Severe Splenic Injuries in Trauma Patients

Salvaging the spleen shows lower mortality and complications than splenectomy in severe blunt splenic injuries for trauma patients. Mortality risk for splenic angioembolization (0.62) and observation (0.61) is significantly lower than for open splenectomy. Both angioembolization and observation have fewer complications compared to splenectomy, with odds ratios of 0.74 and 0.75, respectively. Spleen preservation should […]