A novel pancreatic head clockwise devascularization approach during robotic pancreaticoduodenectomy significantly reduced operation time and blood loss compared to the traditional superior mesenteric artery-first method. Surgery duration dropped to 616 minutes with only 50 ml of blood loss, while the conventional method saw 772 minutes and 330 ml. Both groups had similar postoperative complications, with […]
Category: HPB & Spleen
Perinephric Vein Identified as Key Landmark for Pancreatectomy
A new anatomical landmark, the perinephric vein, enhances access to the left renal vein during minimally invasive distal pancreatectomy (MIDP) for pancreatic cancer. In a cohort of 114 patients, 63.2% with pancreatic ductal adenocarcinoma showed the vein could help secure the posterior surgical margin, improving overall surgical precision. Of those, 92% had visible perinephric veins, […]
Advanced dynamic models improve survival predictions in colorectal cancer liver metastases
Dynamic prognostic models for colorectal cancer with liver metastases significantly enhance survival predictions by integrating longitudinal laboratory markers. In a cohort of 976 patients, the most effective model outperformed static approaches, achieving area under the curve (AUC) values of 0.850 for five-year progression-free survival and 0.849 for overall survival. A web-based tool has been developed […]
Prehabilitation Program Cuts Postoperative Complications for Sarcopenic Liver Surgery Patients
A 6-week multimodal prehabilitation program significantly slashed postoperative morbidity in patients with sarcopenia undergoing major hepatectomy. The prehabilitation group experienced a mere 13.3% complication rate compared to 50% in the standard care arm, translating to a 36.7% absolute risk reduction. All major complications occurred in the control group. Beyond lowering complications, the program also enhanced […]
Conversion therapy extends survival for locally advanced intrahepatic cholangiocarcinoma patients
Conversion therapy (CT) significantly improves overall and progression-free survival in patients with locally advanced intrahepatic cholangiocarcinoma (LA-ICCA). In a retrospective analysis of 115 patients, median overall survival reached 45.53 months and progression-free survival was 18.23 months post-propensity score matching, both superior to systemic therapy (ST) outcomes. CT emerged as an independent factor linked to better […]
Liver Cancer Rates Surge Across Europe Amid Rising Health Disparities
The burden of liver cancer in Europe has escalated significantly from 1990 to 2021, with age-standardized incidence rising from 3.04 to 4.20 per 100,000. Males experienced disproportionately higher rates, particularly in older populations. Key risk factors include hepatitis C, alcohol consumption, and nonalcoholic steatohepatitis, with Andorra recording the highest rates and Ukraine the lowest. The […]
Innovative surgical technique offers new hope for pancreatic cancer
A modified Appleby procedure successfully treated a pancreatic body tumor encasing the celiac axis, previously deemed inoperable. Utilizing a replaced left hepatic artery, surgeons safeguarded gastric and hepatic perfusion during the distal pancreatectomy and en bloc celiac axis resection. This rare vascular variant opened new avenues for safe surgical intervention, demonstrating that careful mapping and […]
New Perineural Invasion Score Predicts Survival in Pancreatic Cancer
A novel perineural invasion (PNI) severity score effectively predicts disease recurrence and survival in resected pancreatic ductal adenocarcinoma. Among 300 patients, PNI severity correlated with worse pathological outcomes: shorter recurrence times (24 months for PNI 0 vs. 15 months for PNI 2) and reduced survival (57 months for PNI 0 vs. 32 months for PNI […]
Deceased Donor Pancreas Model Enhances Surgical Training in Pancreaticojejunostomy
A novel training model utilizing deceased donor pancreata significantly boosts surgical residents’ skills in pancreaticojejunostomy. Nearly 87% of participants reported increased confidence, while over 82% noted enhancements in anastomotic technique and execution. Faculty assert that inadequate exposure hinders residents’ participation, but access to this training lab could bridge that gap, leading to improved tissue handling […]
Surgeons Back Preoperative Chemotherapy for Intrahepatic Cholangiocarcinoma Management
An international survey reveals that 91.6% of surgeons advocate for preoperative chemotherapy in initially unresectable intrahepatic cholangiocarcinoma (ICCA). Most cite tumor downstaging and selecting favorable cases for R0 resection as major benefits. Key concerns defining unresectability include insufficient future liver remnant volume and inability to achieve negative margins. As multidisciplinary discussions dominate decisions, establishing expert […]