Minimally invasive pancreatoduodenectomy (mipd) enhances recovery compared to open pancreatoduodenectomy (opd), especially in the month post-surgery. On postoperative day 30, mipd patients averaged 659 more steps and 22 more active minutes daily than those in the opd group. Mipd patients had a 9-millisecond higher heart rate variability, indicating less physiological stress. These early recovery benefits […]

Minimally invasive robotic placement of hepatic artery infusion pumps shows promise for recurrent colorectal liver metastasis patients post-hemihepatectomy. Operative time was 150 minutes with 75 ml blood loss. Patient discharge occurred on day 3 with no complications. Surgeons can consider this technique to enhance patient recovery while maintaining safety. Postoperative scans confirmed optimal hepatic perfusion […]

Neoadjuvant chemotherapy’s benefit in early-stage pancreatic ductal adenocarcinoma is questionable due to bias in survival estimates. In a study of 13,466 patients, those receiving neoadjuvant chemotherapy showed initially longer median survival (33.4 vs. 25.7 months) but this disappeared after correcting for immortal time bias. Three robust statistical methods revealed no significant survival advantage for neoadjuvant […]

Laparoscopic anterior-approach right posterior sectionectomy is a safe option for hepatocellular carcinoma tumors over 10 cm. Four patients with median tumor size of 11.5 cm underwent the procedure; all had negative margins. Median operative time was 524 minutes with minimal blood loss (80 ml) and no transfusions. This technique allows for secure transection without the […]

Surgeons can safely perform a remnant-sparing distal pancreatectomy using fluorescence guidance for select patients with metachronous pancreatic cancer after Whipple procedure. The procedure was completed in 123 minutes with only 20 ml of blood loss. Post-op, the patient had a normal amylase level and was discharged by day 5 with no complications. This approach preserves […]

Surgeons now have a validated definition of a textbook outcome for distal pancreatectomy, which influences patient selection and post-operative management. Textbook outcomes include no readmissions or deaths within 90 days, length of stay below the 75th percentile, no major complications, and negative margins. In a study of 339 patients, only 46.3% achieved this outcome; major […]

Robotic pancreatoduodenectomy has greater postoperative complication risks than laparoscopic, especially after conversion. Major morbidity rates are 49% in robotic (rpd) versus 31% in laparoscopic (lpd) after conversion (p=0.021). Conversion required in 12% of cases, with no significant difference between robotic (12%) and laparoscopic (14%). Surgeons should assess conversion risks when choosing robotic methods, emphasizing structured […]

Patients with biological borderline resectable pancreatic cancer and CA19-9 levels ≥500 u/ml show worse outcomes and need tailored surgical approaches. Cancer-specific survival is significantly lower in patients with CA19-9 ≥500 u/ml compared to those with levels <37 u/ml (p = 0.03). Higher CA19-9 is linked to increased genomic mutations, with tumors showing ≥3 driver gene […]

Postpancreatectomy acute pancreatitis (PPAP) is a key factor increasing mortality after pancreatoduodenectomy. 24.3% of patients developed clinically relevant postoperative pancreatic fistula (CR-POP), with 90-day mortality at 9% in this group. PPAP is the strongest predictor of CR-POP (odds ratio 11.76) and 90-day mortality (odds ratio 4.88). Understanding these links can help refine patient selection and […]