A systematic review of 34 studies on post-hepatectomy liver failure (PHLF) models reveals a troubling risk of bias across all analyses. While most models utilized diverse predictive data types, their validation performance lagged significantly behind development metrics. The area under the curve for training models varied widely, indicating inconsistent predictive accuracy. Researchers highlight the urgent […]
Category: HPB & Spleen
New model predicts liver failure risk in surgery patients
A novel multivariable model combining aspartate aminotransferase to platelet ratio and albumin-bilirubin grade effectively predicts clinically significant posthepatectomy liver failure (PHLF) in over 12,000 patients. With an area under the curve (AUC) of 0.77 in the prediction cohort and 0.74 in validation, its performance matches more costly liver function tests. Furthermore, a smartphone app was […]
New risk score predicts mortality after major liver resection
A newly developed preoperative risk score accurately predicts 90-day mortality in patients undergoing major liver resection, identifying five key factors: age ≥ 65 years, type 2 diabetes, primary liver cancer diagnosis, an American Society of Anesthesiologists score of ≥ 3, and extended hemihepatectomy. The score categorizes patients into low, intermediate, and high risk, with respective […]
Certain patient factors suggest early abandonment in bile duct procedures
A study analyzing 952 laparoscopic common bile duct explorations found an impressive success rate of 89.2%. However, factors like older age, higher American Society of Anesthesiologists (ASA) scores, and the presence of larger or previously identified stones were linked to undesirable outcomes. Surgeons developing their skills in this procedure are advised to consider bailing early […]
Minimally invasive endoscopic interventions outperform traditional surgery for pancreatic fluid collections
A review highlights a shift toward minimally invasive endoscopic interventions for managing symptomatic pancreatic fluid collections linked to acute pancreatitis. Endoscopic transmural drainage and necrosectomy show comparable effectiveness to traditional surgery but with fewer adverse effects. Early intervention may be warranted in cases of suspected infection and organ dysfunction. Key findings support ongoing evolution and […]
Interventional EUS improves biliary drainage success in patients
In a retrospective multicenter study of 432 patients with surgically altered anatomy, endoscopic biliary drainage (BD) achieved technical and clinical success rates of 80.3% and 79.9%, respectively. Adverse events were more common in those with Billroth-II reconstruction (14.4%). Notably, the last two years showed increased use of interventional EUS, leading to significantly better clinical outcomes […]
Novel plasma proteins identified as biomarkers for pancreatic cancer
The research highlights keratin 5 (KRT5) and versican (VCAN) as effective biomarkers for early detection and clinical monitoring of pancreatic ductal adenocarcinoma (PDAC). In a multicenter validation study with over 1,000 plasma samples, a combined diagnostic model featuring KRT5, VCAN, and the existing CA 19-9 antigen achieved an impressive AUC of 0.95. Additionally, these biomarkers […]
A novel MRI-based model predicts perineural invasion in cholangiocarcinoma
An innovative MRI-based fusion model effectively predicts perineural invasion (PNI) status in intrahepatic cholangiocarcinoma (ICC) patients. The model, incorporating deep learning, radiomics, and clinical features, was developed from a study involving 192 patients. In the training phase, it achieved an AUC of 0.905 and 82.3% accuracy, while the external test set yielded an AUC of […]
Tumor volume and reduction predict colorectal liver metastases outcomes
Evaluation of total metastases volume (TMV) and relative volume reduction (RVR) reveals their superior predictive ability over established clinical risk scores (CRS) for colorectal liver metastases post-neoadjuvant chemotherapy. Patients with TMV below 29.5 ml before and 7.5 ml after therapy had significantly longer progression-free survival (PFS) and overall survival (OS). An RVR of at least […]
Indeterminate bile duct cytology carries significant malignancy risks
A systematic review revealed that among 8,458 bile duct samples with indeterminate cytology, the overall risk of malignancy was 60.1%. Specifically, atypical cytology had a malignancy risk of 50.4%, while suspicious cytology exhibited a higher risk at 80.2%. Furthermore, suspicious cytology significantly correlated with a 1.59-fold increased risk of malignancy compared to atypical results. These […]