In the realm of surgical oncology, randomized controlled trials (RCTs) often face recruitment and standardization challenges. This study dives into hepatopancreatobiliary (HPB) cancer surgery, spotlighting the pivotal role of large databases. While RCTs provide crucial evidence, big data steps in where they fall short. Beyond justifying current practices, this research maps the future of HPB […]
Category: HPB & Spleen
Cholangiocarcinoma Unveiled: Early-Onset Warriors’ Triumph
In the epic battle against cholangiocarcinoma, researchers scoured the SEER database (1975-2020) for insights. Early-onset warriors (EOC), comprising 274 out of 4037 fighters, emerged with a distinct profile—often non-white, intrahepatic warriors. Despite facing a more advanced enemy at diagnosis, EOCs defied the odds. They opted for surgery, radiotherapy, and chemotherapy, influencing their fate. Cox analysis […]
Strategic Growth: Portal Vein Boost for Liver Resection in Cholangiocarcinoma
When facing borderline resectable intrahepatic cholangiocarcinoma (ICC), inducing hypertrophy pre-resection is a game-changer. In this single-center study, researchers found that portal vein embolization (PVE) prepped the battleground without raising perioperative issues. Overall survival (OS) matched non-PVE cases, but additional risks (multifocal tumors, lymph node involvement) threw a curveball, slashing OS notably. The takeaway? PVE proves […]
Harmony in Hepatic Recovery: Gata3 and Ramp2 Balance Key to Vascular Reconstitution
Unveiling liver regeneration intricacies, this study decodes Gata3 and Ramp2’s role in hepatic-vascular revival post-surgery. These hepatocyte conductors fuel liver sinusoidal endothelial cell proliferation. Pedf and Vegfa, playing contrasting roles in endothelial migration, spice up the dance. Gata3 inhibitors emerge as potential superheroes against post-hepatectomy liver failure. Serum Pedf/Vegfa Index (SPVI) steps in as a […]
Optimal Timing for Pancreatic Cancer Adjuvant Therapy: A Survival Analysis
Delving into the ideal moment for post-pancreatic adenocarcinoma surgery chemotherapy, a simulated trial tracked 1491 patients. Noteworthy findings revealed a median survival of 29.9 months for late initiators (>4-8 weeks) versus 30.4 months for early starters (0-4 weeks). Encouragingly, delaying treatment up to 8 weeks post-surgery showed comparable safety, offering a nuanced approach that respects […]
Intraoperative Pancreatoscopy Safe and Beneficial in Managing Pancreatic Neoplasms
A systematic scoping review explored the role of intraoperative pancreatoscopy (IOP) in the surgical management of intraductal papillary mucinous neoplasms (IPMN) in the pancreas. IOP allows for the visualization of the main pancreatic duct, aiding in surgical planning. The review of five studies revealed IOP to be safe, detecting additional lesions in 34% of cases […]
Minimally Invasive Surgery Benefits Pancreatoduodenectomy Patients Post-Neoadjuvant Treatment
This study delves into the impact of surgical approach on the 30-day outcomes of pancreatic cancer patients after neoadjuvant treatment (NAT). Researchers compared minimally invasive pancreatoduodenectomy (MIPD) and open pancreatoduodenectomy (OPD) within NAT groups. Among the 5,588 patients analyzed, MIPD after neoadjuvant chemotherapy alone resulted in lower complication rates, shorter hospital stays, and fewer complications […]
Hepatic Steatosis and Fibrosis Not Linked to Postoperative Outcomes in Perihilar Cholangiocarcinoma
For those facing surgery for perihilar cholangiocarcinoma (pcca), concerns about hepatic steatosis and fibrosis were investigated. Analyzing data from 401 patients, researchers found that neither hepatic steatosis nor fibrosis were associated with postoperative outcomes, including posthepatectomy liver failure (phlf) or 90-day mortality. Instead, factors like preoperative cholangitis and liver remnant size proved to be more […]
Frailty’s Alarming Impact on Pancreatic Cancer Survival
This systematic review and meta-analysis delved into the world of pancreatic cancer, focusing on frailty. Among 35,191 patients, they discovered that 45% of pancreatic cancer patients were frail. This frailty took a toll, significantly reducing their chances of survival. While the results displayed some variation, they underscored the vital role of assessing frailty in pancreatic […]
Comparing Surgical Approaches for Incisional Hernia Repair After Pancreatic Surgery
After analyzing data from the Herniamed registry, which included patients who underwent incisional hernia repair following pancreatic surgery, researchers found that both open and minimally invasive techniques were effective and safe, with low recurrence rates. Of the patients with one-year follow-up, 95% had previously undergone open pancreatic surgeries. Notable differences included a higher rate of […]