Category: HPB & Spleen

Biochemical Response Predicts Survival in FOLFIRINOX-Treated Pancreatic Cancer

Evaluating 150 non-metastatic pancreatic ductal adenocarcinoma patients undergoing neoadjuvant FOLFIRINOX chemotherapy, researchers compared biochemical (CA 19-9 normalization) and radiologic responses. Three groups were identified: biochemical responders (BR+), radiology-only responders (BR-/RR+), and non-responders (BR-/RR-). BR+ showed the highest 3-year overall survival (71.0%), significantly better than BR-/RR+ (53.6%) and BR-/RR- (33.1%). Regardless of neoadjuvant response, completing adjuvant […]

Optimal Liver Remnant Volume for Safer Hepatobiliary Resection

In right hepatic trisectionectomy with bile duct resection, this study explored the impact of Future Liver Remnant volume-to-body weight ratio (FLR/BW) and indocyanine green plasma clearance rate (ICGK-F) on posthepatectomy liver failure. Among 91 patients, a FLR/BW ≥ 0.65% significantly reduced the risk of liver failure, while ICGK-F < 0.05 did not. Age, blood loss, […]

Enhanced Precision in Robotic Hepatectomy: Inflow Control and Liver Retraction Demystified

Researchers detail an improved version of Huang’s Loop for intracorporeal inflow control during minimally invasive hepatectomy. Utilizing a modified soft urinary catheter with an adjustable loop, the team ensures atraumatic and adaptable control around the porta hepatis. Additionally, they introduce a liver sling, crafted from a soft surgical sponge, for gentle yet effective retraction, enhancing […]

Equivalency in Colorectal Metastases Management: Liver vs. Peritoneum

Examining outcomes in metastatic colorectal cancer treatment, researchers conducted a review, analyzing six selected studies. Comparing surgical interventions on the liver and peritoneum, cytoreductive surgery with heated intraperitoneal chemotherapy showed comparable safety and survival outcomes to hepatectomy. This suggests a need for early integration of cytoreduction in the management algorithm for colorectal cancer patients with […]

Prophylactic Dexamethasone in Hepatectomy with 25-Min Intermittent Pringle’s Maneuver for Hepatocellular Carcinoma: A Randomized Trial

In hepatectomy for hepatocellular carcinoma (HCC) using a 25-minute Intermittent Pringle’s Maneuver (IPM), preoperative dexamethasone administration demonstrated benefits. The study included 270 patients, with the dexamethasone group exhibiting reduced hepatocellular injury, inflammatory response, and major complications, along with shorter hospital stays compared to the control group. Notably, subgroup analyses indicated milder hepatocellular injury for cirrhotic […]

Mutation-Annotated Prognostic Score for Intrahepatic Cholangiocarcinoma: Development and Validation

Researchers developed a Mutation-Annotated Prognostic Score (MAPS) for intrahepatic cholangiocarcinoma (ICC) after resection, integrating TP53 and KRASG12 mutations with clinical parameters. The MAPS model, validated internally and externally, demonstrated superior predictive efficacy (c-indices 0.782 and 0.731, respectively) compared to existing models. It effectively identified ICC patients’ overall survival and showed promise in predicting benefits from […]

Minimally Invasive Distal Pancreatectomy Outcomes for Left-Sided Tumors: Impact of Modified Frailty Index

Examining 2,212 patients undergoing minimally invasive distal pancreatectomy (MIDP) for left-sided tumors, this study categorized participants into frail and nonfrail groups using the modified frailty index (MFI). The frail group (n=79) exhibited significantly higher clinically relevant postoperative pancreatic fistula, overall complications, and 90-day mortality (1.3%). MFI ≥0.27, extended pancreatectomy, BMI ≥30 kg/m², male sex, and […]

Short-Term Outcomes of Laparoscopic Anatomical Liver Resection of Segment 8 for Hepatocellular Carcinoma

Examining 122 patients across seven Chinese centers, researchers evaluated three laparoscopic approaches for anatomical liver resection of segment 8 (LALR-S8) in hepatocellular carcinoma. The laparoscopic ultrasonography-guided, hepatic vein-guided, and Glissonean approaches showed comparable short-term oncological outcomes. Complication rates were low (5.73%), with the hepatic vein-guided approach being the most utilized. The study affirms the safety […]

Combined Hepatocholangiocarcinoma: Worse Survival Than Hepatocellular Carcinoma, Similar to Intrahepatic Cholangiocarcinoma

In a retrospective study of 3,196 surgery-treated patients with combined hepatocholangiocarcinoma, hepatocellular carcinoma, and intrahepatic cholangiocarcinoma, survival outcomes were analyzed. Despite data limitations, overall survival for combined hepatocholangiocarcinoma was worse than hepatocellular carcinoma but similar to intrahepatic cholangiocarcinoma. Disease-free survival was comparable among the three groups. Predictors of mortality included the cancer subtype, metabolic syndrome, […]

US Hepatopancreatobiliary Surgeon Supply Surpasses Demand

Examining 1998-2019 data, this study unveils a potential surplus in the supply of hepatopancreatobiliary (HPB) surgeons in the US. In 2019, 37,335 inpatient HPB procedures occurred, with an estimated 905-1191 practicing HPB surgeons. Factoring in centralization and volume-outcome benchmarks, the study projects a possible oversupply by 2030. Without adjustments, the data suggests a risk of […]