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 […]
Category: HPB & Spleen
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 […]
Aggressive Treatment Approach Beneficial for Elderly Pancreatic Cancer Patients
This study examined whether administering neoadjuvant therapy (nat) followed by surgical resection is safe and effective in pancreatic ductal adenocarcinoma (PDAC) patients aged 75 and older. In a comprehensive three-part analysis, the research found that this aggressive treatment approach appears to be both safe and effective for older patients. Notably, it led to improved outcomes […]
Validation of Fistula Risk Scores for Postoperative Pancreatic Fistula After Surgery
Researchers have successfully validated the accuracy of two fistula risk scores, “distal fistula risk scores” and “dispair,” in predicting postoperative pancreatic fistula (POPF) after distal pancreatectomy. These scores are based on various patient factors like body mass index, diabetes, and pancreatic characteristics. With a 19.3% incidence of clinically relevant POPF in their cohort, the study […]
Ultrasound-Guided Lithotripsy: A Game Changer for Common Bile Duct Stones
Researchers compared treatments for common bile duct (CBD) stones, and ultrasound-guided percutaneous transhepatic cholangioscopic lithotripsy (PTCSL) stood out. PTCSL outperformed laparoscopic exploration, with better perioperative outcomes and fewer complications. It also beat endoscopic treatment with fewer instances of pancreatitis, reflux esophagitis, and papillary stenosis. Additionally, the study identified gallstones and family history as independent risk […]
No Negative Impact: Aberrant Right Hepatic Artery in Pancreaticoduodenectomy
A systematic review and meta-analysis explored whether the presence of an aberrant right hepatic artery (A-RHA) influences outcomes after pancreaticoduodenectomy (PD). Results indicate that A-RHA doesn’t significantly affect critical endpoints, such as tumor margin (R1) rate, overall survival, morbidity, mortality, and biliary fistula rate. Additionally, non-critical outcomes like postoperative pancreatic fistula, delayed gastric emptying, post-pancreatectomy […]
Hepatic Arterial Infusion Pump (HAIP) Chemotherapy Improves Survival in Liver-Confined Intrahepatic Cholangiocarcinoma (ICCA)
Researchers compared the outcomes of liver-confined unresectable intrahepatic cholangiocarcinoma (ICCA) patients receiving systemic chemotherapy (gemcitabine and cisplatin) with those given hepatic arterial infusion pump (HAIP) chemotherapy. The study, involving 268 patients, revealed that HAIP chemotherapy significantly outperformed systemic treatment. Median survival for HAIP was 27.7 months compared to 11.8 months with gem-cis. Notably, HAIP resulted […]