Category: HPB & Spleen

Novel Technique for LGA Reconstruction in Distal Pancreatectomy

Surgeons can now consider a new arterial reconstruction method for the left gastric artery (LGA) during distal pancreatectomy with celiac axis resection (DP-CAR). The common hepatic artery (CHA) can successfully supply the replaced left hepatic artery (RLHA), ensuring adequate blood flow. The procedure had an operative time of 215 minutes and only 35 ml of […]

New technique enhances Pringle maneuver success in liver surgery

This study reveals a liver surface-guided method that significantly improves success rates for the Pringle maneuver in minimally invasive repeat liver resections. Pringle taping success jumped from 33% to 91.4% with the new technique. Median operative time was 331.5 minutes with only 70 ml blood loss and a short 8-day hospital stay. This approach is […]

High-Volume Centers Improve Pancreatic Cancer Survival

Waiting for surgery at high-volume centers yields better outcomes for pancreatic cancer patients than early surgery at low-volume centers. Patients at high-volume centers with longer waits (over 28 days) had a 5-year survival rate of 23%, compared to 19% at low-volume centers. Adjusted analysis shows a mortality hazard ratio of 0.81 for high-volume centers, indicating […]

New TNM Staging for Intrahepatic Cholangiocarcinoma Enhances Prognosis

A novel TNM staging system offers improved prognostic insight for intrahepatic cholangiocarcinoma, impacting surgical decision-making and patient outcomes. In a study of 496 patients, five-year survival rates surpassed 80% for specific tumor types (≤50 mm intraductal, ≤20 mm mass-forming without vascular invasion). The new system classified survival more accurately than the AJCC, especially for tumors […]

Postoperative Adjuvant Therapies for High-Risk HCC Patients

Adjuvant therapies significantly reduce recurrence risk in hepatocellular carcinoma patients after hepatectomy. Radiotherapy (RT) shows the best results for disease-free survival (HR 0.31) and overall survival (HR 0.31). Tyrosine kinase inhibitors (TKI) also improve outcomes but are less effective than RT (HR 0.48 for DFS, HR 0.50 for OS). Surgeons should consider RT as the […]

Minimally Invasive Pancreatic Surgery Reduces Metabolic Risks

Minimally invasive parenchyma-sparing pancreatectomy (mi-psp) lowers the risk of new-onset diabetes and pancreatic exocrine insufficiency in patients with benign and low-grade pancreatic tumors. Postoperative diabetes occurred in 9.8% of mi-psp patients compared to 23% in the standard approach (p=0.008). The five-year cumulative risk of diabetes was 26.7% for mi-psp versus 38.9% for the traditional method. […]

Laparoscopic bile duct exploration proves safe and effective for stones

Laparoscopic common bile duct exploration (LCBDE) offers surgeons a reliable way to manage bile duct stones with promising outcomes. In a study of 1,689 patients, the overall conversion rate to open surgery was just 5%. Success rates were high: 77.6% for trans-cystic LCBDE and 93.4% for trans-choledochal LCBDE. Bile leak rates were notably lower for […]

Patient Factors Impact Robotic Hepatectomy Outcomes

Patient selection is critical in robotic hepatectomy for optimizing surgical outcomes. Major hepatectomy complications increase with cirrhosis, obesity, and tumor size ≥ 10 cm, leading to longer operative times (up to 310 min) and higher estimated blood loss (up to 242 ml). Minor hepatectomy faces similar trends, with cirrhosis and obesity extending operative times to […]

Surgery improves outcomes for gastroenteropancreatic neuroendocrine tumors with liver metastasis.

Patients undergoing primary resection and metastasectomy for small-bowel neuroendocrine tumors (sbnets) had a mean disease-specific survival of 97 months, compared to 71.6 months for pancreatic neuroendocrine tumors (pnets). Surgical candidates who refused surgery had notably worse outcomes, with mean survivals of 73.5 months for sbnets and 56.5 months for pnets. Surgeons should prioritize surgical intervention […]

Enhanced Biliary Brush Cytology Boosts Detection of Cholangiocarcinoma

Updated protocols for biliary brush cytology significantly improve sensitivity in diagnosing perihilar and intrahepatic cholangiocarcinoma. Sensitivity jumped from 50.5% to 88.3% after protocol changes, with first sample sensitivity reaching 78%. Specificity remained high at 100% across both prospective and historical cohorts. These results suggest that adopting optimized protocols can enhance diagnostic accuracy, potentially improving patient […]