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Surg Endosc27 Oct 2023

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…

Am J Gastroenterol25 Oct 2023

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…

J Surg Res25 Oct 2023

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.…

HPB (Oxford)25 Oct 2023

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…

Ann Surg23 Oct 2023

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…

HPB & Spleen23 Oct 2023

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%…

World J Surg22 Oct 2023

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,…

World J Surg22 Oct 2023

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,…

Ann Surg Oncol21 Oct 2023

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…