Category: HPB & Spleen

Preoperative Biliary Stenting and Persistent Hyperbilirubinemia: Predicting Post-Hepatectomy Complications

Following preoperative biliary stenting, patients with persistent hyperbilirubinemia (>1.2 mg/dl) are at higher risk of serious complications post-anatomic hepatectomy. Persistent hyperbilirubinemia independently predicts increased rates of serious complications and mortality, highlighting its importance in preoperative risk assessment. Failed preoperative biliary drainage serves as a crucial predictive factor for adverse post-operative outcomes in patients undergoing hepatectomy. […]

Positive outcomes of two-stage hepatectomy for colorectal liver metastasis in Japanese patients

Two-stage hepatectomy with portal vein embolization in Japanese patients with colorectal liver metastasis showed a 1-, 3-, and 5-year overall survival rate of 92.5%, 70.8%, and 34.7%. Patients with more than 10 liver nodules had a 4.2-fold increased mortality risk. Repeat hepatectomy post-tsh was more beneficial than chemotherapy. The study confirms tsh as a safe […]

Improved Efficacy in Treating Large Hepatocellular Carcinoma with Major Portal Vein Tumor Thrombosis

A study comparing lenvatinib plus drug-eluting bead transarterial chemoembolization with and without hepatic arterial infusion chemotherapy for hepatocellular carcinoma > 7.0 cm with major portal vein tumor thrombosis found that the addition of haic significantly improved objective response rate, time to progression, and overall survival, with a comparable safety profile. Journal Article by Cai M, […]

Robotic Liver Surgery Outcomes in Elderly Patients

Robotic liver surgery in elderly patients leads to less blood loss and shorter hospital stays compared to open liver surgery, especially in minor liver resections. Overall morbidity is similar between the two groups, but operative times are longer with the robotic approach. These findings highlight the safety and feasibility of robotic liver surgery for elderly […]

Reduction of Surgical Complications with Piperacillin/Tazobactam in Pancreatoduodenectomy

A meta-analysis comparing piperacillin/tazobactam and traditional antibiotics for surgical prophylaxis during pancreatoduodenectomy showed significant reductions in surgical-site infections, major complications, postoperative pancreatic fistulas, and mortality in patients receiving piperacillin/tazobactam. Subgroup analysis demonstrated reduced incidences of superficial and organ/space infections. These findings support the use of piperacillin/tazobactam to decrease postoperative complications and enhance patient outcomes following […]

Hepato-Pancreato-Biliary Surgery Capacity in West Africa

First study assessing hpb surgical capacity in West Africa reveals limited availability of specialized procedures like major hepatic resections and the whipple procedure. Most institutions lack hpb-trained surgeons, highlighting the need for regional quality improvement initiatives to enhance surgical care for hepato-pancreato-biliary malignancies in the region. Journal Article by Alatise OI, Yibrehu B (…) Kingham […]

Increased R0 resection rate with ICG-guided laparoscopic hepatectomy

ICG-guided laparoscopic hepatectomy significantly improves R0 resection rates for liver malignancies compared to non-ICG methods. A meta-analysis of seven studies totaling 598 patients showed a higher rate of complete tumor eradication with ICG guidance, indicating its efficacy in enhancing surgical outcomes without compromising safety. This systematic review highlights the potential of ICG fluorescence imaging in […]

Comparable Long-term Oncological Outcomes of Single-Port Laparoscopic Hepatectomy for Hepatocellular Carcinoma

Long-term oncological outcomes of single-port laparoscopic hepatectomy for hepatocellular carcinoma were compared with multiport laparoscopic hepatectomy. Recurrence rates were higher in the splh group, but overall and recurrence-free survival did not significantly differ between groups. Splh method and portal vein invasion were identified as independent adverse prognostic factors for recurrence-free survival. Strict patient selection is […]

Pre-operative Biliary Drainage Increases Complications in Resectable Periampullary Lesions

Pre-operative biliary drainage significantly raised complication rates in periampullary lesion patients, as shown by a meta-analysis including 35 studies and 2 randomized trials with 12,641 patients. Results revealed higher overall complication rates, increased delayed gastric emptying post-surgery, and a significant rise in wound infections post-operatively in the drainage group. These findings caution against routine pre-operative […]

Bile metabolic fingerprints distinguish biliary tract cancer from benign diseases

A novel bile-based assay, BileMet, distinguishes biliary tract cancer (BTC) from benign diseases with high accuracy (AUC 0.891). It identifies 6 metabolite biomarkers, including chenodeoxycholic acid glycine conjugate, associated with BTC. BileMet offers rapid intraoperative testing, surpassing limitations of current diagnostic methods like brush cytology, potentially reducing diagnostic costs by over 90%. Journal Article by […]