Non-benchmark patients with perihilar cholangiocarcinoma can achieve good outcomes despite higher complexity. 64% of 648 patients analyzed were classified as non-benchmark, with median overall survival at 46 months. Postoperative liver failure occurred in 16.7%, bile leakage in 22.8%, and in-hospital mortality was 2.9%, all within benchmark limits. Choose treatment strategies carefully: complexity impacts survival significantly, […]

Preoperative and postoperative circulating tumor DNA (ctDNA) are crucial for predicting outcomes in pancreatic cancer patients undergoing surgery. Preoperative ctDNA presence linked to 2.08-fold higher risk of disease-free survival (DFS) and 2.31-fold increased risk of overall survival (OS). Postoperative positivity raises the risk of DFS by 3.29 times and OS by 3.42 times. Monitoring ctDNA […]

Staging laparoscopy significantly lowers the rate of unnecessary laparotomies in pancreatic cancer patients post-neoadjuvant treatment. Non-therapeutic laparotomy rates dropped to 4.5% with staging laparoscopy, compared to 17.1% without (p=0.002; NNT 8). Occult metastases were found in 12.1% of patients, mainly leading to aborted surgeries. Tailoring staging laparoscopy for patients with tumor size ≥3 cm or […]

Broad-spectrum penicillin-based antibiotics significantly improve outcomes after pancreatoduodenectomy compared to standard care options. Surgical site infections dropped by 47% (OR 0.53), and postoperative pancreatic fistula rates decreased by 38% (OR 0.62). Patients had shorter hospital stays, averaging 2 days less (MD -2.02). Implementing broad-spectrum antibiotics could redefine surgical management and reduce complication rates, especially for […]

Liver transplantation (LT) and associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) yield comparable survival outcomes for colorectal liver metastases (CRLM). Median overall survival after ALPPS was 76 months vs. 72.7 months for LT. After adjusting for biases, ALPPS showed a higher risk of death (HR=1.40), but no significant difference in survival […]

Drainage fluid C-reactive protein levels can help predict clinically relevant pancreatic fistulas post-pancreaticoduodenectomy. 15.1% of patients developed clinically relevant pancreatic fistulas. CRP levels in drainage fluid on postoperative day 4 ≥6.5 mg/dl have an odds ratio of 4.95 for predicting fistulas, with a negative predictive value of 95.6%. Consider using drain CRP measurements to enhance […]

Surgeons can better anticipate interventions for celiac axis stenosis (CAS) during pancreatoduodenectomy by assessing key preoperative factors. Of 1,042 patients, 85 (8.2%) had CAS, but only 11 (1.1%) needed intervention. Four preoperative predictors emerged: stenosis diameter ≤2 mm, stenosis rate ≥70%, gastroduodenal-to-common hepatic artery ratio ≥1.0, collateral artery diameter ≥3 mm. Interventions were unnecessary when […]

A study found that a risk calculator had no significant impact on surgeons’ decisions regarding surveillance for low-risk pancreatic intraductal papillary mucinous neoplasms (IPMNs). Clinicians’ estimated likelihood of progression remained unchanged (88% vs. 89% for vignettes). Recommendation to continue surveillance did not significantly differ (57% vs. 41% across scenarios). Surgeons reported varying cancer risk thresholds, […]

Pancreatectomy outcomes for pancreatic neuroendocrine tumors (PNETs) are consistent, regardless of whether they arise from sporadic cases or genetic syndromes like MEN1 and VHL. In a study of 1,527 patients, 73 had MEN1, 26 had VHL, and 1,428 exhibited sporadic PNETs. Resection rates varied, with R2 resection at 9.6% for MEN1, compared to 2.6% for […]