A novel machine learning model effectively predicts perineural invasion (PNI) in intrahepatic cholangiocarcinoma (ICC) patients preoperatively, offering new insights for clinical decision-making. The XGBoost algorithm demonstrated superior predictive performance, highlighting tumor size, number, and lymph node metastasis as key factors. Significant differences were observed in postoperative outcomes, with better progression-free survival and overall survival in […]
Category: HPB & Spleen
Dynamic risk stratification improves identification of high-risk patients
A study analyzing data from 234 pancreatoduodenectomy patients established that dynamic risk stratification using serum pancreatic amylase and other biomarkers can effectively identify those at high risk for clinically relevant postoperative pancreatic fistula (POPF). The findings indicate that serum pancreatic amylase levels on postoperative days 1 and 2 are critical in risk assessment. Combining serum […]
Trans T-tube drainage outperforms traditional methods for bile leakage treatment
Trans T-tube cholangial drainage (TTCD) demonstrates superior outcomes for bile leakage management at biliary-enteric anastomosis, achieving a technical success rate of 100% compared to 88.9% with percutaneous transhepatic cholangial drainage (PTCD). Both techniques reduced bilirubin levels significantly; however, the TTCD group experienced less intraoperative bleeding, fewer complications, reduced radiation exposure, and shorter hospital stays. Additionally, […]
Routine imaging improves survival in pancreatic cancer patients post-surgery
A nationwide analysis involving 1,311 patients revealed that routine imaging after resection of pancreatic ductal adenocarcinoma significantly enhances overall survival. Patients undergoing routine imaging had a median overall survival of 43 months, compared to just 22 months for those monitored symptomatically. Additionally, routine imaging was strongly linked to the early detection of asymptomatic recurrence and […]
Proposed CGM Targets Improve Diabetes Management After Islet Autotransplantation
Clinicians have identified new continuous glucose monitoring (CGM) targets for patients post-total pancreatectomy with islet autotransplantation (TPIAT). Involving 256 CGM and hemoglobin A1c (HbA1c) pairings from 82 patients, the study suggests a time in range (TIR) of 70-140 mg/dl at 50% and TIR of 70-180 mg/dl at 75% as minimum benchmarks. These targets aim to […]
Textbook outcomes improve survival in pancreatic cancer surgery
Achieving textbook outcomes (TO) during pancreatic cancer surgery significantly enhances patient prognosis, as evidenced by a study involving 185 patients. Following the establishment of a specialized pancreatic surgery unit, TO fulfillment increased from 47% to 80.7%. One-, two-, and three-year overall survival rates improved markedly among patients meeting TO criteria, reaching 86.9%, 55.7%, and 41%, […]
Robotic glissonean approach enhances safety in liver resections.
The glissonean approach, combined with robotic surgery, significantly improves the safety and precision of liver segmental resections. This technique aids surgeons in identifying and controlling critical anatomical landmarks, promoting better outcomes. Detailed instructional videos highlight the stepwise method for managing glissonean pedicles, while tips on optimizing dissection and using advanced imaging techniques ensure effective surgical […]
Radical resection significantly improves survival in gallbladder cancer
A study found that liver resection dramatically enhances 5-year overall survival rates in T2 and T3 gallbladder cancer patients. Those undergoing this procedure had a survival rate of 43.8% versus 26.7% for non-surgical counterparts. Furthermore, achieving four or more lymph nodes increased survival to 49.9%. Radical resection notably improved survival to 52.5%. Subgroup analysis showed […]
Pancreatic guidewire-assisted fistulotomy proves more effective
In a trial involving 194 patients facing difficult biliary cannulation, the pancreatic guidewire-assisted fistulotomy method achieved a significantly higher success rate of 93.8%, compared to 81.4% for the transpancreatic biliary sphincterotomy technique (p=0.01). Both techniques exhibited similar rates of adverse events, suggesting that fistulotomy is the preferred choice after failed cannulation attempts. The transpancreatic method […]
Nomogram predicts primary liver cancer risk in liver cyst patients
A newly developed nomogram effectively predicts the risk of primary liver cancer (PLC) in patients with liver cysts, integrating CT imaging features and alpha-fetoprotein (AFP) levels. In a study involving 122 participants, higher AFP levels and specific CT characteristics were linked to PLC occurrence. The nomogram exhibited a mean absolute error of 0.020 and achieved […]