In patients undergoing pancreaticoduodenectomy with severe hyperbilirubinemia (≥14.6 mg/dl), preoperative biliary drainage significantly reduces 90-day mortality from 13.3% to lower rates seen in other groups (2.9-5.7%). While biliary drainage increases the risk of surgical site infections (21.2-26.4%), it decreases overall morbidity compared to non-drained patients who face higher rates of acute respiratory distress syndrome (6.0%) […]
Category: HPB & Spleen
Braun Enteroenterostomy Reduces Severe Delayed Gastric Emptying After Pancreaticoduodenectomy
Implementing Braun enteroenterostomy (BEE) in pancreaticoduodenectomy significantly lowers the incidence of severe delayed gastric emptying (DGE) and major complications, enhancing patient outcomes. In a study of 214 patients, those receiving BEE experienced a drastic reduction in severe DGE (2.6% vs. 15.9%) and shorter hospital stays (14.7 days vs. 21.4 days). With a 56% reduction in […]
Rapid embolization significantly boosts splenic preservation outcomes in trauma patients
Splenic artery embolization (SAE) demonstrates high efficacy in preserving the spleen during treatment of grade III-V splenic injuries. Notably, timing is crucial; earlier embolization correlates with better outcomes. In a study of 400 patients, both SAE (98.2% preservation) and nonoperative observation (97.7%) achieved significant success. Factors influencing embolization effectiveness include cranial AIS scores and the […]
Laparoscopic Repeat Liver Resection Outperforms Open Surgery in Key Metrics
Laparoscopic repeat liver resection (LRLR) significantly reduces intraoperative blood loss, complications, and hospital stays compared to open repeat liver resection (ORLR) for recurrent liver cancer. LRLR boasts a higher R0 resection rate, making it a safer, more effective option for patients. While operative time, transfusion rates, mortality, and three-year survival show no significant differences between […]
Radical Resection Outperforms Preservation in Congenital Bile Duct Surgery
In a comprehensive multicenter trial involving 355 patients with type I congenital bile duct dilation, radical extrahepatic cyst excision, compared to subtotal excision, markedly improved long-term outcomes. The radical approach significantly reduced rates of recurrent cholangitis, pancreatitis, and readmission, leading to better quality of life metrics and lower carcinogenesis risk. Both techniques showed similar perioperative […]
Fully Covered Metal Stents Top Choice for Preoperative Biliary Drainage
In a comprehensive analysis of over 26,000 patients, fully covered self-expandable metal stents (FCSEMS) with endoscopic retrograde cholangiopancreatography (ERCP) emerged as the safest preoperative biliary drainage method, boasting fewer adverse events than plastic stents. However, they showed a higher incidence of pancreatitis. Plastic stents are linked to more complications, while internal stents are optimal for […]
GNAS Droplet Digital PCR Boosts Pancreatic Cyst Diagnosis Accuracy by 62%
GNAS droplet digital PCR effectively enhances the diagnosis of mucinous pancreatic cystic neoplasms (MPCNs) in fine-needle aspiration samples. In a cohort of 140 patients, this method achieved a 62% detection rate for MPCNs and identified 33% of inconclusive lesions as MPCNs, all with 100% specificity. Compared to traditional diagnostic methods, GNAS ddPCR markedly reduced diagnostic […]
Anti-PD-1 Therapy Boosts Survival in High-Risk HCC Patients
Postoperative anti-PD-1 therapy significantly enhances overall survival and recurrence-free survival in hepatocellular carcinoma (HCC) patients, particularly those with vessels encapsulating tumor clusters (VETC), a marker of aggressive disease. Among 388 patients studied, those receiving the therapy showed improved outcomes compared to untreated counterparts, while VETC status emerged as a crucial prognostic biomarker. This study underscores […]
Robot-Assisted Hemihepatectomy Reduces Blood Loss, Conversion Rates
Robot-assisted hemihepatectomy outperforms laparoscopic techniques by significantly lowering intraoperative blood loss and reducing conversion to open surgery. An analysis of 1,113 patients revealed that while both approaches yielded similar operation times and complication rates, the robotic method exhibited distinct advantages. This comprehensive review consolidates findings from eight studies, bolstering the case for the robotic approach […]
New Amylase Metric Predicts Pancreatic Fistulas Better
The “real amylase value” (RAV) significantly outperforms traditional drain amylase concentration in predicting postoperative pancreatic fistula (POPF) risk. An analysis of 198 patients revealed RAV’s area under the ROC curve reached 0.85 on postoperative day 1 and 0.89 on day 3, compared to 0.79 for classic measurement. Enhanced prediction lets surgeons optimize clinical management, refine […]