A multi-institutional analysis of patients with locally advanced pancreatic cancer revealed that irreversible electroporation (IRE), a novel treatment, resulted in a lower rate of adverse events (25%) compared to pancreatectomy (39%) for early-stage disease. IRE patients had a greater risk of severe complications when they received high-dose neoadjuvant radiation, had electrodes close to vital blood […]
Category: HPB & Spleen
Innovative Approach for Pancreatic Cancer Surgery Yields Promising Outcomes
A novel cranial-to-caudal approach (CC approach) for minimally invasive distal pancreatectomy (MIDP) in pancreatic cancer was examined. The study included 94 patients, with 23 undergoing the CC approach. This approach aimed to identify Gerota’s fascia from the cranial side of the pancreas and ensure complete tumor removal. Results revealed similar operation times, blood loss, and […]
A Decade of Robotic Hepatectomies: Learning Curve and Outcomes
Over a 10-year span, a medical center’s experience with 100 major robotic liver resections was examined, showing the evolution of robotic surgery. The study found no significant differences in key parameters like operative time, blood loss, length of hospital stay, 90-day readmission, major complications, and mortality between early and late cases. Notably, the study revealed […]
Dilation Status Irrelevant in Bile Duct Injury Repairs: Surgical and Radiological Drainages Equally Effective
A retrospective study on 87 patients who underwent hepaticojejunostomy (HJ) for bile duct injuries (BDI) aimed to determine whether the dilation status of the bile duct before repair affected outcomes. The study found that dilation status had no impact on short- or long-term results, including anastomotic stricture rates. Patients without preoperative dilation had more severe […]
How Condition Timing Impacts Liver Surgery Outcomes
In the realm of liver surgery, understanding the “condition(s) present at time of surgery” (PATOS) from the American College of Surgeons (ACS) database is crucial. Researchers explored postoperative complications, considering PATOS, and found that when these conditions were factored in, complication rates dropped across the board. Their study, covering data from 2015 to 2019, highlights […]
Conversion to Open Surgery in Liver Resection: Risks and Consequences
Researchers delved into minimally invasive liver resections (MILR) and what happens when they switch to open procedures. Out of 1,675 patients, 6.1% required a switch due to unfavorable findings or intraoperative issues. Those needing a conversion experienced higher complications, blood loss, and mortality. Intraoperative conversions had even worse outcomes, emphasizing the need for cautious planning […]
ERCP Vital in Managing Post-COVID-19 Cholangiopathy with Dismal Prognosis
Endoscopic findings reveal that post-COVID-19 cholangiopathy resembles secondary sclerosing cholangitis, affecting critically ill patients. It emerges early during intensive care, causing significant and often irreversible damage to bile ducts. Typical cholangiographic features include a centripetal pattern of bile duct destruction, “vanishing bile ducts,” and intraductal biliary casts. This condition is associated with peribiliary liver abscesses. […]
Preoperative Weight Loss Program in Hepatocellular Carcinoma Patients with High BMI
Researchers investigated the impact of a weight-loss program (WLP) on patients with a high body mass index (BMI) before undergoing liver resection for hepatocellular carcinoma (HCC). In a study of 19 patients with a BMI of 25.0 or higher, WLP successfully led to weight loss without affecting short- or long-term surgical outcomes. The program improved […]
Embolization Reduces Failure of Nonoperative Management in Blunt Splenic Trauma
Researchers compared outcomes in patients with splenic pseudoaneurysms (PSAs) following blunt trauma, some treated with splenic artery embolization (Embo) and others without (No-Embo). Patients who underwent embolization had a significantly lower rate of failure of nonoperative management (FNOM) compared to the No-Embo group (3.1% vs. 13.3%). The study suggests that embolization may play a crucial […]
3D Reconstructions Improve Understanding of Hepato-Biliary Surgical Anatomy
A multicentric survey involving 11 patients with liver tumors and 23 experienced surgeons demonstrated that 3D reconstructions significantly enhance the comprehension of complex liver anatomy and the relationship between tumors and adjacent vascular structures. Compared to standard 2D CT scans, the 3D models provided superior accuracy in identifying vascular structures related to tumors. This advancement […]