Surgeons trained in dedicated hepato-pancreato-biliary fellowships see better patient outcomes after HP cancer surgeries. Graduates of HPB fellowships achieved a 47.7% likelihood of textbook outcomes (TOS), compared to 45.2% for surgical oncology and 42.8% for transplant fellowship graduates. Patients operated by HPB fellowship graduates often had higher comorbidity scores and greater urgencies, highlighting the need […]

High-volume hospitals improve survival and reduce costs for necrotizing pancreatitis patients. Patients at high-volume centers had lower odds of mortality (odds ratio: 0.78) compared to low-volume hospitals. Even with higher overall mortality rates, high-volume hospitals had lower mortality for intervention-only patients (7.5% vs 12.0%, p < 0.001). High-volume centers also associated with shorter hospital stays […]

Patient-derived organoid testing shows promise for tailoring therapy in pancreatic ductal adenocarcinoma. 91% of organoids matched to standard-of-care regimens, with 34% of poorly matched cases potentially qualifying for more effective options. Patients receiving well-matched neoadjuvant chemotherapy showed significantly better CA 19-9 response (60% normalization) and lymph node down-staging (69% N0) compared to poorly matched cases […]

An innovative algorithm from routine data can effectively classify 30-day postoperative complications in hepatobiliary surgery, helping surgeons better understand patient outcomes. Among 959 liver resections, the algorithm achieved an impressive macro-f1-score of 0.962 and a sensitivity of 0.950. Major complications were observed in 18% of cases, with a 2.6% mortality rate. This tool outperforms machine […]

A novel vascular occlusion method improves surgical outcomes in robotic enucleation of distal pancreatic tumors, crucial for better visualization and safety. Complete segmental parenchymal vascular occlusion creates a near-bloodless field, reducing the risk of main pancreatic duct injury. Postoperative outcomes show low morbidity and no cases of parenchymal ischemic necrosis. This technique enhances safety and […]

Surveillance for intraductal papillary mucinous neoplasms (IPMNs) reveals a tenfold increased risk of pancreatic adenocarcinoma compared to the general population. Cumulative incidence of malignancy at 60 months is 0.97%. The highest risk is associated with main pancreatic duct dilation ≥5 mm (SIR: 26.5) and BMI ≥30 (SIR: 20.6). Surgeons should consider personalizing surveillance strategies based […]

Median arcuate ligament (MAL) can significantly affect outcomes in pancreaticoduodenectomy (PD) patients. MAL stenosis occurred in 1.3% (115/8676), with hemodynamically significant cases in 0.7% (59 patients). Preoperative stenting was performed in 14%, while 83% underwent intraoperative division; 14% of divisions required vascular reconstruction due to failure. MAL management doesn’t worsen overall outcomes but demands early […]

Surgeons need to be aware that robotic pancreaticoduodenectomy (RPD) initially carries higher mortality risks compared to open procedures. 30-day mortality for RPD is 2.7%, compared to 2.0% for open pancreaticoduodenectomy (adjusted relative risk 1.43, p = 0.029). Mortality risk significantly decreases with surgeon experience: 0.92% for those with 19-71 RPD cases (Q5) versus 3.9% for […]

Tracking CA19-9 levels after pancreatic cancer resection can better guide surgical prognostication and patient outcomes. Patients with normalized CA19-9 levels post-surgery had a median time-to-treatment failure of 693 days, while those with persistent elevation faced just 138 days. Neoadjuvant therapy patients presented with much higher pre-treatment CA19-9 (273 u/ml) compared to surgery-first patients (19 u/ml). […]