Category: HPB & Spleen

Arterial Resection in Pancreatic Cancer: Weighing Feasibility, Morbidity, and Necessity in High-Volume Centers

In the quest for curative pancreatectomy for pancreatic cancer, researchers delve into arterial resection’s (AR) feasibility and outcomes. Analyzing 259 patients, they find AR, despite longer operation times, rivals venous resection in morbidity. Surprisingly, arterial infiltration’s likelihood is questioned, suggesting AR might be replaceable by less invasive techniques. This study at a high-volume pancreatic surgery […]

The Acinar Score Categorizes Patients into High or Low Risk for Pancreas-Specific Complications

A cohort of 761 patients revealed that the acinar score, based on pancreatic acinar content and fibrosis, effectively dichotomized the risk spectrum into high and low risk. This new stratification tool improved predictions compared to the conventional isgps classification, leading to better-targeted mitigation strategies for pancreas-specific complications in cases with intermediate macroscopic features. Journal Article […]

Cirrhosis Severity Shapes Challenges and Outcomes in Minimally Invasive Liver Resections

Examining 2534 cases across 58 global centers, this study dissected the impact of cirrhosis on minimally invasive major hepatectomies (MIMH) for liver malignancies. Child-Pugh A cirrhosis correlated with increased morbidity and extended hospital stays. Child-Pugh B cirrhotics faced higher transfusion rates and prolonged hospitalization. However, matching cirrhotics with and without portal hypertension revealed no significant […]

Extended Antibiotics Mitigate Postoperative Pancreatic Fistula in High-Risk Patients

In patients with an elevated risk of postoperative pancreatic fistula after pancreatoduodenectomy, a 10-day course of extended antibiotics significantly reduced the occurrence of clinically relevant fistulas, as well as associated complications like infections and drain placements. Patients on extended antibiotics had a shorter hospital stay compared to those on standard perioperative antibiotics. These findings support […]

Cutting Costs and Boosting Recovery: Perioperative APPs Slash Readmissions in Hepatopancreatobiliary Surgery

Dedicated perioperative Advanced Practice Providers (APPs) substantially decrease readmissions by almost 50%, saving $900 per case. Financially self-sustaining with 113 to 139 annual cases, these APPs prove pivotal in optimizing outcomes, minimizing resource utilization, and cost savings for high-volume hepatopancreatobiliary centers. Journal Article by Smith SR, Blair CM (…) Sarmiento JM et 3 al. in […]

Decoding HCC Recurrence: LI-RADS Morphologic Type II Gets Risk Score Upgrade

Unraveling the mystery of early recurrence in hepatocellular carcinoma (HCC), researchers crafted a risk scoring system based on tumor morphology. Analyzing 124 patients, they pinpointed age, histological grade, AFP, and intratumoral hemorrhage as key factors. The scoring system accurately stratified patients into low and high-risk categories, offering clinicians a powerful tool. The high-risk group exhibited […]

New Subtypes in Intrahepatic Cholangiocarcinoma

Researchers classified intrahepatic cholangiocarcinoma (ICC) into perihilar and peripheral subtypes, revealing distinctive features and survival outcomes. Among 1264 patients, 84.3% were ICC-peripheral, while 15.7% were ICC-perihilar. The perihilar subtype exhibited aggressive characteristics and poorer survival than the peripheral subtype. Interestingly, ICC-perihilar behaved akin to bile duct carcinoma, while ICC-peripheral resembled primary liver malignancies. This novel […]

Robotic Surgery Linked to Lower Postoperative Infections and Shorter Hospital Stays in Pancreatoduodenectomy

In a retrospective study spanning 2013 to 2022, researchers delved into healthcare-associated infections (HAIs) post-pancreatoduodenectomy (PD). Among 2632 patients, HAIs decreased over time, especially in open PD (OPD). Robotic PD (RPD) exhibited significantly fewer HAIs (5.8% vs. 9.6% in OPD). RPD correlated with reduced infections, shorter hospital stays, and higher costs. Notably, attention should be […]

Gallbladder Polyps: Size Matters in Predicting Cancer Risk

In this cohort study on 438 patients with gallbladder polyps (GPs), the risk of gallbladder cancer was 0.7% for all polyps, escalating to 5.9% for those ≥10 mm. GP size emerged as the sole predictor of malignancy (p = 0.0001), with a 21 mm cutoff indicating cancer risk. Patient’s age, symptoms, number of polyps, and […]