A study involving 292 patients undergoing major liver surgery revealed that the hepatic uptake index (hui) derived from gadoxetic acid-enhanced MRI outperformed traditional volume-only assessments in identifying those at risk for severe post-hepatectomy liver failure (phlf). Among the cohort, 8.6% developed severe phlf, with affected individuals showing significantly lower hui scores. Combining hui with the […]
Category: HPB & Spleen
New machine learning tool enhances obstructive jaundice diagnosis
A novel machine learning-based diagnostic tool for obstructive jaundice has shown promising results. Researchers analyzed data from over 6,000 patients and identified key causes including pancreatic adenocarcinoma and biliary cholangiocarcinoma. Traditional markers performed poorly on their own. Two machine learning models were developed, achieving an area under the receiver operating characteristic of 0.862 for identifying […]
Synchronous portal vein embolization improves outcomes in liver surgery
In a cohort study of 115 patients with hepatitis B virus-related hepatocellular carcinoma, synchronous terminal branches portal vein embolization (tbpve) combined with transcatheter arterial chemoembolization (tace) resulted in significantly greater future liver remnant volume and hypertrophy compared to traditional portal vein embolization (pve). Those receiving tbpve demonstrated improved perioperative metrics and better disease-free survival rates […]
Predictive model for liver metastasis risk in AEG patients
A novel nomogram accurately predicts the risk of postoperative liver metastasis in patients with adenocarcinoma of the esophagogastric junction (AEG) based on six independent factors: type of surgery, N stage, tumor differentiation, vascular thrombus, intestinal type, and p53 status. High predictive accuracy was demonstrated with a concordance index exceeding 0.96 in both training and validation […]
Fully-covered metal stents outperform plastic for biliary drainage
A comprehensive review of 81 studies with 26,251 patients reveals that fully-covered self-expandable metal stents used during endoscopic retrograde cholangiopancreatography result in fewer adverse events compared to plastic stents, though they carry a higher risk of pancreatitis. Plastic stents resulted in more complications and shorter duration of effectiveness. Internal stents are identified as the best […]
Preoperative embolization with thermal ablation is effective
Combining preoperative trans-arterial embolization with thermal ablation shows promise in treating large hepatic hemangiomas, achieving a 100% lesion coverage rate. Among 82 patients followed for up to 48 months, minor complications occurred in 65.9% of cases, with no severe complications reported. The median operating time was approximately 79 minutes. This novel approach offers a simpler […]
A new predictive tool enhances T-staging in gallbladder cancer
A user-friendly prediction tool, combining multimodal features, achieved significant advancements in preoperative T-staging accuracy for gallbladder cancer (GBC). In a multicenter study analyzing 189 patients, the weighted GBC T-staging (wgbct) model outperformed existing methods with an AUC of 0.910 and demonstrated perfect sensitivity (1.0) in internal cohorts. The tool aids surgical planning by providing robust […]
Practical strategies enhance outcomes in robotic pancreaticoduodenectomy
Researchers outline essential techniques for robotic pancreaticoduodenectomy, emphasizing vascular protection and drainage positioning. Key strategies include utilizing 4/0 PDS stitches to control bleeding, avoiding energy during pancreas dissection to prevent ischemia, and implementing a modified Blumgart anastomosis to reduce fistula formation. These practical tips aim to significantly decrease pancreatic occlusion and postoperative bleeding incidents, ultimately […]
Scoring systems accurately predict early recurrence in pancreatic cancer
A study involving 194 patients with borderline resectable pancreatic cancer revealed significant early recurrence rates, with 69% of patients experiencing recurrence, primarily within six months post-surgery. Researchers developed a preoperative scoring system using CA19-9 and CA125 levels, achieving an AUC of 0.700, alongside a postoperative scoring system based on CA19-9 response, with an AUC of […]
New prediction score enhances risk assessment in gallbladder cancer
An international study involving 3,676 gallbladder cancer patients identified critical risk factors for node involvement. Tumor stage, lymphovascular, and perineural infiltration were significant predictors, forming the omega node positivity prediction score (omega-nopps) with robust c-statistics of 0.81 and 0.79. This score highlights that incidental gallbladder cancer with poor differentiation and infiltration risks node positivity, suggesting […]