A study evaluated whether local therapy benefits patients who experience early recurrence after hepatectomy for colorectal liver metastases (CLM). Clinicopathologic data of 671 patients were analyzed, with 81% experiencing recurrence. Local therapy, including ablation, resection, or radiation, resulted in improved survival for patients with early, intermediate, or later recurrence. Treatment with local therapy, liver and […]
Category: HPB & Spleen
Guidelines Favor Single-Operator Cholangioscopy for Biliary Strictures and Stones
Researchers conducted a systematic review to develop clinical practice guidelines on the use of single-operator cholangioscopy (SOC) as a diagnostic and therapeutic alternative for indeterminate biliary strictures and difficult biliary stones. The guidelines recommend SOC with stricture pattern characterization for adult patients with indeterminate biliary strictures, and SOC over endoscopic retrograde cholangiopancreatography with large-balloon dilation […]
Laparoscopic Transverse Abdominis Plane Block Reduces Operation Time and Cost in Pancreatectomy and Gastrectomy
The study compared the efficacy and efficiency of laparoscopic transverse abdominis plane block (lap-tap) versus ultrasound-guided tap (us-tap) in patients undergoing pancreatoduodenectomy and gastrectomy. The lap-tap group showed a significantly shorter median time to skin incision and a reduction in operation cost by $602 compared to the us-tap group. Pain control and opioid use were […]
Variations in pancreatic surgeons’ practice patterns for pancreatic adenocarcinoma
Surveying HPB surgeons, this study found significant variations in the decision-making and surgical practices for pancreatic adenocarcinoma. Most respondents performed staging laparoscopy selectively and would abort the procedure in the presence of a pathological aorto-caval node. However, they would continue surgery with a positive hepatic artery node. Surgeons in Europe were more likely to resect […]
Islet Autotransplantation into the Liver Shows Superior Insulin Function in Total Pancreatectomy Patients
A European single-center study evaluated the outcomes of total pancreatectomy with islet autotransplantation (tp-iat) in patients with chronic pancreatitis. The study found that tp-iat is a safe procedure with a low risk of complications. Islet autotransplantation into the liver resulted in higher levels of fasting c-peptide and significantly lower insulin doses compared to skeletal muscle […]
Survival and Treatment Differences Between Cirrhotic and Non-cirrhotic Liver in Hepatocellular Carcinoma
A nationwide cohort study in Sweden compared the treatment and survival outcomes of hepatocellular carcinoma (HCC) in cirrhotic versus non-cirrhotic livers. Out of the 4259 identified patients, 34% had HCC in a non-cirrhotic liver. Cirrhotic patients presented at a younger age, had poorer performance status, and a higher prevalence of underlying liver disease. Tumors in […]
Surgical Resection Alone Improves Long-Term Survival in Localized Biliary Tract Cancers
Patients with localized biliary tract cancers (BTCs) who underwent surgical resection had higher long-term survival rates compared to those treated with multiagent chemotherapy alone, according to a study. The research analyzed data from 5,988 patients with localized BTCs and found that surgical resection led to a decline in overall survival within the first 30 days […]
Feasibility and Challenges of Pancreaticoduodenectomies with Concurrent Colectomies
Pancreaticoduodenectomies with concurrent colectomies for pancreatic and colon cancer are feasible, but their morbidity and oncological benefits are controversial. This review examines the outcomes of this combined procedure and finds that it is a viable option for select patients with anticipated negative resection margins. However, caution must be exercised due to increased complication rates, including […]
Risk-stratified Pathways Improve Post-Hepatectomy Outcomes
Risk-stratified post-hepatectomy pathways (rsphps) were analyzed in a study of 1,354 patients. The pathways effectively stratified hepatectomy patients based on their risk of early postoperative events. The results showed that post-pathway implementation led to shorter hospital stays and decreased the need for readmission and interventional radiology procedures. rsphps can reliably predict the most frequent time […]
Incidentally detected T2 gallbladder cancer associated with poorer outcomes compared to upfront surgery
Incidentally detected T2 gallbladder cancer (pt2 GBC) has been found to have significantly worse outcomes compared to similarly staged patients who undergo upfront radical cholecystectomy. A retrospective analysis of 425 cases revealed that patients with incidentally detected tumors had higher rates of locoregional, liver, and abdominal wall recurrences. The five-year disease-free survival rate was lower […]