In patients with advanced hepatocellular carcinoma who responded to systemic therapy, surgical resection significantly prolongs time to treatment failure compared to maintenance therapy. Median time to treatment failure was 20.4 months with surgery versus 11.8 months with maintenance therapy (hazard ratio 0.60; p=0.015). Adverse events were higher in the surgery group (39%) versus maintenance (21%), […]

Patients with pancreaticobiliary maljunction (PBM) have significantly worse recurrence-free survival following surgical resection for gallbladder carcinoma without hepaticojejunostomy. PBM is associated with a 2.10-fold increased risk of recurrence (95% CI 1.13-3.89, p=0.019) compared to non-PBM patients in the study population. Overall survival in palliative settings is also adversely impacted, with a hazard ratio of 3.10 […]

A counterclockwise, step-by-step approach for robotic pancreatoduodenectomy enhances surgical workflow and appears to reduce operative complications. Mean console time was 279 minutes across 150 procedures, with no conversions to open surgery. Major complications occurred in 13.3% of patients, with a postoperative pancreatic fistula rate of 6.7% and delayed gastric emptying in 23.3%. The 30- and […]

Surgeons are familiar with intraoperative cell salvage (ICS) but use it sparingly during liver resections for cancer due to concerns about tumor cell contamination, indicating a need for more robust oncological outcome data. 26 hepatopancreatobiliary surgeons reported moderate to high familiarity with ICS (23/26) and occasional use (23/26), but only 10 used it during liver […]

Utilizing an artery-first approach for distal pancreatectomy with celiac axis resection can effectively manage blood loss and maintain low mortality in pancreatic cancer surgery. In a study of 14 patients, R0 resection was achieved in all cases, with a 90-day mortality rate of 0%. The median operation time was 469 minutes, and median blood loss […]

A randomized trial reveals no significant cost benefit of robotic pancreatoduodenectomy compared to open surgery, despite higher intraoperative costs. Total hospital costs were similar: €30,956 for robotic vs. €28,271 for open (p=0.538). Robotic technique had significantly higher intraoperative costs (€11,906 vs. €6,451, p<0.001) but lower postoperative costs (€19,051 vs. €21,856). Health-related quality of life scores […]

A study comparing hepatocellular carcinoma (HCC) patients in South Africa and Sweden found stark differences in survival and access to curative treatment, underscoring the need for region-specific guidelines. South African HCC patients were younger (median age 50 vs. 71) and predominantly had hepatitis B-related HCC (60% vs. 3.6%) compared to their Swedish counterparts. Only 9.2% […]

Non-receipt of guideline-concordant treatment in pancreatic cancer is linked to worse outcomes and distinct patient patterns. 32.4% of patients in a study cohort did not receive guideline-concordant treatment. Key factors include socioeconomic status, access to care, and patient vulnerability at first contact. Addressing these factors may improve treatment access and outcomes. Areas with higher deprivation […]

Surgeons need to know that bile leaks and Klebsiella pneumoniae infections are major predictors of severe postpancreatectomy hemorrhage in patients with postoperative pancreatic fistulas. Postpancreatectomy hemorrhage occurred in 7.8% of patients, with grade b/c complications in 5.2%. The pancreaticojejunal anastomosis was the most frequent bleeding source (15.6%), followed by branches of the superior mesenteric artery […]