Category: HPB & Spleen

Liver venous deprivation enhances surgery outcomes over portal vein embolization

In a meta-analysis involving 588 patients, liver venous deprivation (LVD) improved liver resection rates (OR, 1.89), accelerated liver growth rates, and shortened time to surgery compared to portal vein embolization (PVE). Notably, LVD resulted in lower post-hepatectomy liver failure (OR, 0.45) without increasing complications or mortality rates. Thus, LVD not only proves effective for liver […]

EUS and Surgery Enhance Treatment Options for Pancreatic Tumors

The review highlights the evolving role of endoscopic ultrasound (EUS) in managing pancreatic neuroendocrine tumors (PanNETs), addressing their increasing incidence and associated diagnostic and therapeutic challenges. EUS has advanced from solely a diagnostic tool to facilitating minimally invasive locoregional therapies. Surgical intervention remains paramount, especially for localized, low-grade PanNETs larger than 2 cm. Although not […]

Preoperative model predicts futile pancreatic surgery.

A preoperative risk model developed by clinicians identified criteria to predict futile up-front pancreatectomy in patients with anatomically resectable pancreatic cancer. Among 1,426 patients, the rate of futile pancreatectomy was 18.9%. Clinicians identified four specific tumor size and cancer antigen (CA 19.9) criteria that maintained futility likelihood below 20%. Patients meeting these criteria demonstrated significantly […]

No-drainage policy enhances patient outcomes after distal pancreatectomy

A systematic review covering 3,610 patients undergoing distal pancreatectomy reveals that a no-drainage approach significantly reduces complications. The odds of postoperative pancreatic fistula decreased to 0.38, while major morbidity, readmissions, and reinterventions also showed considerable reduction (odds ratios of 0.64, 0.69, and 0.70, respectively). Additionally, patients experienced a shorter hospital stay by an average of […]

Bile microRNAs can effectively distinguish between disease types.

A cohort study identified specific bile microRNAs (miRNAs) that differentiate malignant from benign pancreaticobiliary diseases. Among 111 patients, 14 differentially-expressed miRNAs were identified, with bile miR-340 and miR-182 significantly validated. The study achieved an area under the curve (AUC) of 0.79, demonstrating sensitivity of 65% and specificity of 82% in predicting malignancy. These findings underscore […]

Biodegradable prosthesis shows promise for bile duct replacement

Development of a biodegradable prosthesis utilizing electrospun poly(d,l-lactide-co-glycolide)-polycaprolactone-gelatin nanofibers successfully demonstrated mechanical strength, biocompatibility, and biodegradability in a pig model. This innovative scaffold maintained bile duct permeability and facilitated cell adhesion and growth without adversely affecting liver function over two years. Notably, immunohistochemical evaluations confirmed the presence of biliary epithelium, showcasing the scaffold’s potential for […]

A grading system improves patient selection for minimally-invasive pancreatoduodenectomy

The ISGPS developed a complexity and experience grading system for minimally-invasive pancreatoduodenectomy (MIPD), aimed at enhancing patient selection. This system categorizes patient risk factors and surgeon experience, enabling optimal decision-making for safe MIPD implementation. It assesses anatomical and conditional risks alongside surgeon experience and center volume. By employing this evidence-based approach, the grading system facilitates […]

Novel predictive model improves risk assessment for hemorrhage

A new lasso-logistic regression model was developed and validated, identifying nine independent risk factors for postpancreatectomy hemorrhage among 9,631 patients across two cohorts. The model demonstrated strong predictive accuracy, achieving an area under the receiver operating characteristic curve of 0.87 during external validation, significantly outperforming previous prediction models (p