Next-generation sequencing significantly alters surgical decision-making for branch-duct intraductal papillary mucinous neoplasms, providing clarity when traditional guidelines fall short. Surgical plans shifted to surveillance in 43% of distal pancreatectomy and 61% of pancreatoduodenectomy scenarios when NGS was negative. Conversely, with positive NGS results, surveillance plans shifted to surgery 90% and 72% of the time, respectively. […]

Using an externalized pancreatic stent during robotic pancreaticoduodenectomy significantly lowers the risk of postoperative pancreatic fistula. In a study of 67 patients, overall POPF rate was 17.9%, with a majority classified as intermediate risk. This novel technique showed very low rates of fistula-related complications, making it a feasible option for surgeons. Surgeons should consider this […]

Patients with unresectable, liver-confined intrahepatic cholangiocarcinoma treated with HAIP chemotherapy showed notable outcomes. Median overall survival was 26 months; 3-year survival rate was 28%, and 5-year survival rate was 15%. Partial response on imaging was achieved in 53% of patients, with a disease control rate of 96%. Consider HAIP chemotherapy for selected patients, particularly since […]

A nationwide protocol led to significantly increased resection rates for locally advanced pancreatic cancer (LAPC) in the Netherlands, improving potential long-term survival. Resection rates jumped to 86%, nearly three times the expected number. In-hospital major morbidity was 44%, while mortality was just 0.6%, both within safety benchmarks. Implementing international best practices is feasible and could […]

A study reveals stark differences in hepatocellular carcinoma outcomes between South Africa and Sweden, highlighting the need for region-specific treatment protocols. Patients in South Africa were significantly younger (median 50 vs. 71 years) and had more advanced disease. Only 9.2% received curative treatments in South Africa versus 42.5% in Sweden. Survival rates were drastically lower: […]

Robotic liver resection is safe and shows better outcomes as surgeons gain experience. Operative time decreases significantly after 62 cases, from 240 to 220 minutes. Progress to mastery increases textbook outcomes from 76% to 87%. High complexity cases still meet benchmark standards, indicating robust performance. Major complications plateau at 9% during proficiency, with low conversion […]

Histopathologic response predicts better survival in pancreatic cancer patients despite imaging showing stable or progressive disease. 89% of patients completed neoadjuvant therapy; 73% underwent resection. Radiographic response was low: 27% had tumor regression, while 66% had stable disease. 83% achieved significant serum CA 19-9 reduction, and 74% showed histopathologic response after resection, including 8% with […]

Post-surgery tumor features impact recurrence patterns in intrahepatic cholangiocarcinoma, affecting long-term outcomes and follow-up strategies. Among 1,328 patients, 57.5% experienced recurrence; 23% had both intra- and extrahepatic recurrence. Three or more metastatic lymph nodes increased the chance of combined recurrence (adjusted odds ratio 3.47). Patients with combined recurrence had worse survival outcomes (hazard ratio 1.63) […]

Surgeons should consider local therapies for recurrent pancreatic ductal adenocarcinoma as they show significant survival benefits. For liver-only recurrence, local therapy leads to longer survival than chemotherapy alone (HR 0.26). Surgical resection for lung-only recurrence offers better survival compared to conventional treatment (HR 0.35). Careful patient selection and tailored approaches could enhance outcomes in recurrence […]