Completion pancreatectomy during pancreatoduodenectomy significantly reduces postoperative complications and mortality rates in high-risk patients. In a study of 139 patients, total pancreatectomy (TP) resulted in shorter hospital stays, lower risks of post-pancreatectomy hemorrhage, and a significant reduction in reoperation, postoperative pancreatic fistula, hemorrhage, and mortality rates compared to pancreatoduodenectomy. Implementing a risk-tailored strategy with TP […]
Category: HPB & Spleen
Embryologically Defined Peripancreatic Compartments
Researchers identified embryologically defined peripancreatic compartments and fusion planes, demonstrating distinct pancreatic compartments with potential significance in pancreatic cancer resection. Through manual preparation of body donors, they tracked mesogastria remnants and peripancreatic spaces sealed off from surrounding units. By following avascular embryologic fusion planes, they defined pancreatic cancer fields and proposed applying the success of […]
Prognostic Nomogram for Intrahepatic Cholangiocarcinoma
Researchers developed and validated a prognostic nomogram for intrahepatic cholangiocarcinoma, incorporating hepatitis C, CA19, tumor extent, tumor size, LVI, positive lymph nodes, and TMB as predictive factors. The nomogram demonstrated high accuracy in predicting patient outcomes with a c-index of 0.78 for the training set and 0.68 for the validation set. High-risk patients identified by […]
Limited Prognostic Impact of Preoperative TACE in Large HCC
Neoadjuvant transarterial chemoembolization (TACE) in upfront resectable large hepatocellular carcinoma (HCC) did not significantly impact long-term outcomes overall, but showed improved overall survival in HCC ≥10 cm and a trend in single HCC and after portal vein embolization/ligation. TACE should not be routinely performed in all cases, but selected patients with specific characteristics such as […]
Does Initial Observation vs. Interventional Radiology Impact Management of High-Grade Liver Injuries with Extravasation?
Patients with high-grade liver injuries and contrast extravasation managed initially with observation versus interventional radiology were compared. While interventional radiology patients had a higher rate of operation, there were similar rates of liver-related complications and mortality between the two groups. The results suggest that initial observation may be a reasonable approach for appropriately selected patients […]
High Yield of Somatic Mutational Analysis in EUS-Guided Biopsy of Pancreatic Adenocarcinoma
Somatic mutational analysis from EUS-guided biopsies of pancreatic adenocarcinoma showed a high yield and comparable impact to that of surgical resection. EUS sampling had a yield of 89.5%, with over a quarter carrying actionable mutations and one in six having treatment impacted by mutational analysis. This study highlights the potential and real impact of EUS […]
Comparing Gemcitabine Plus Nab-Paclitaxel and Gemcitabine Plus S-1 as Neoadjuvant Chemotherapy in Pancreatic Cancer Patients
Patients with resectable/borderline-resectable pancreatic cancer underwent neoadjuvant chemotherapy with gemcitabine plus nab-paclitaxel or gemcitabine plus S-1. While there was no significant difference in 2-year progression-free survival rates between the two groups, the gemcitabine plus nab-paclitaxel regimen showed a longer median progression-free survival. Adverse events, completion rates, reduction in tumor marker levels, and lymph node metastasis […]
Development of a more individualized treatment approach for hepatic adenoma
Researchers reviewed the latest advancements in the diagnosis and management of hepatic adenomas. They classified it into 8 subtypes based on molecular pathology, each with unique characteristics and risks of malignant transformation. Larger adenomas over 5 cm have a higher risk of bleeding and malignancy and should generally be surgically removed. Magnetic resonance imaging is […]
Robotic liver resection is safe and feasible for huge hepatocellular carcinoma in a single-surgeon study
Robotic liver resection for huge hepatocellular carcinoma (HCC) is feasible, with comparable perioperative outcomes to regular HCC cases. A single-surgeon study of 337 patients showed no significant differences in major perioperative indicators between regular and huge HCC groups. Effective perioperative risk management suggests potential benefits for subsequent minimally invasive surgeries. Journal Article by Wu S, […]
Impact of Preoperative Anemia on Outcomes in GEP-NET Resections
Patients with preoperative anemia undergoing curative-intent resection for gastroenteropancreatic neuroendocrine tumors (GEP-NETs) had higher rates of major complications and poorer long-term outcomes. Anemia was associated with worse overall survival, while postoperative transfusions were linked to lower overall survival and recurrence-free survival rates. Preoperative anemia affected around one-third of patients and significantly increased the risk of […]