In periampullary cancer patients undergoing pancreatoduodenectomy, anomalies in the right hepatic artery (RHA) anatomy, including accessory or replaced RHAs, were observed in 16.3% of cases. However, when comparing outcomes with a propensity score-matched analysis, the presence of these anomalies did not significantly impact perioperative complications or histopathological findings. High-volume centers performing pancreatoduodenectomy can manage cases […]
Category: HPB & Spleen
Effect of Perioperative Dexamethasone on Postoperative Complications after Pancreaticoduodenectomy
Perioperative dexamethasone did not significantly reduce postoperative complications within 30 days after pancreaticoduodenectomy, as evidenced by similar comprehensive complication index scores, major complications, and pancreatic fistula rates between the dexamethasone and placebo groups. However, in patients with a main pancreatic duct ≤3 mm, the dexamethasone group showed a significantly lower complication index score. Journal Article […]
Prognostic Significance of CA19-9 in Resectable Pancreatic Cancer
In a nationwide study on resectable pancreatic ductal adenocarcinoma (PDAC), researchers found that elevated preoperative CA19-9 levels (≥500 U/ml) significantly reduced overall survival after upfront resection, unlike Eastern Cooperative Oncology Group performance status. This highlights the prognostic value of incorporating CA19-9 into the preoperative staging of anatomically resectable PDAC, emphasizing the importance of considering both […]
Pediatric Pancreatic Surgery: Safe, Effective, and Centralized
Pediatric pancreatic surgery, analyzed in a 73-patient study, demonstrated safety and effectiveness. Distal pancreatectomy was the most common procedure, addressing indications like chronic pancreatitis, tumors, and trauma. Postoperative morbidity occurred in 34.2%, with no 90-day mortality. The 5-year overall survival was 90.5%, emphasizing the feasibility of pediatric pancreatic surgery. Centralization in specialized pancreatic centers ensures […]
Crucial Role of EUS in LT Workup for Unresectable pCCA
EUS plays a crucial role in the liver transplantation (LT) workup for patients with unresectable perihilar cholangiocarcinoma (pCCA). In a nationwide study, EUS identified malignant nonregional lymph nodes (LNs) in 4% of patients potentially eligible for LT. Surgical staging confirmed malignancy in 14% of patients with nonregional LNs. The study emphasizes the limited but clinically […]
Antegrade stenting followed by EUS-guided hepaticogastrostomy extends time to recurrent biliary obstruction in patients with unresectable malignant distal biliary obstruction.
Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is associated with higher rates of adverse events and recurrent biliary obstruction compared to antegrade stenting followed by EUS-HGS (EUS-HGAS) in patients with malignant distal biliary obstruction. However, EUS-HGAS significantly extends the time to recurrent biliary obstruction, potentially benefiting patients with longer life expectancy. Journal Article by Ishiwatari H, Ogura T […]
Identification of Predictive Factors for Postoperative Pancreatic Fistula in Distal Pancreatectomy Using Novel Model
Researchers proposed a novel predictive model based on preoperative imaging parameters and stapler handling for postoperative pancreatic fistula (POPF) in distal pancreatectomy. Among 81 patients who underwent the procedure using a linear stapler, 38.2% developed POPF. The model identified computed tomography-measured pancreatic thickness and pancreas-to-muscle signal intensity ratio as significant risk factors. The model also […]
Preoperative pancreatic radiologic characteristics predict postoperative pancreatic complications
High acinar pancreatic content on preoperative CT scans is associated with increased risk of postpancreatectomy acute pancreatitis and pancreatic fistula formation. A simple radiological score combining pancreatic density, wirsung caliber, and pancreatic thickness predicts patients at higher risk for these complications, with male gender and obesity also contributing to the risk. Understanding these radiologic factors […]
Novel SLE Index Enhances Prognostic Evaluation in Pancreatic Cancer Post Neoadjuvant Treatment
Patients with modest radiologic response to neoadjuvant treatment (NAT) for pancreatic cancer face operative eligibility uncertainties. A novel Sialyl-Lewis Antigen-related Index (SLE Index) combining CA19-9 and Dupan-II reveals significant prognostic value. An SLE Index below 45.25 correlates with favorable disease-free survival, proving superior in predicting recurrence within 24 months compared to individual tumor markers. This […]
Incidence and Risk Factors of Marginal Ulcers Post-Pancreaticoduodenectomy
Researchers analyzed data from 190 post-pancreaticoduodenectomy patients with upper gastrointestinal symptoms and found a 10.5% incidence of marginal ulcers. Factors associated with an increased risk of marginal ulcers included advanced age, alcohol consumption, smoking, longer surgery time, and postoperative bleeding, while regular use of antacids was a protective factor. This study highlights the importance of […]