A comprehensive analysis revealed that opioid reduction strategies initially aimed at pancreatectomy markedly influenced posthepatectomy prescribing. With a cohort of 2,005 patients, researchers documented over a 50% reduction in intraoperative and total inpatient opioid use, coupled with a 73% decline in discharge opioids. Importantly, patient pain scores remained stable, and the percentage of opioid-free discharges […]
Category: HPB & Spleen
EUS-PD shows high success rates and manageable adverse events
A systematic review and meta-analysis of endoscopic ultrasound-guided pancreatic duct drainage (EUS-PD) revealed significant effectiveness, with technical success at 89% and clinical success at 88%. Examining 27 trials involving 902 patients, the study also noted a 17% rate of adverse events, primarily post-EUS-PD acute pancreatitis at 3%. Other complications like bleeding, perforation, pancreatic leak, and […]
Iwate scoring system effectively stratifies laparoscopic liver resections
An international multicenter study validated the Iwate difficulty scoring system (DSS) for laparoscopic liver resections (LLR) across both its four difficulty levels and 12-point difficulty index. Analyzing 14,759 patients, researchers found that intraoperative and postoperative outcomes—such as operation time, blood loss, and complications—worsened significantly with higher difficulty levels (p < 0.001). These findings, derived from […]
Lactated Ringer’s solution improves outcomes in acute pancreatitis
A meta-analysis of 1500 patients found that lactated Ringer’s (LR) solution significantly reduces the risk of progressing to moderate-to-severe acute pancreatitis compared to normal saline (NS), with an odds ratio of 0.48. Patients receiving LR also experienced shorter hospital stays and lower ICU admission rates. Additionally, the incidence of local complications was reduced in the […]
New model predicts treatment response in liver cancer therapy
A deep learning-based clinical-radiomics model has shown strong predictive capability for durable clinical benefit (dcb) in patients with potentially convertible hepatocellular carcinoma receiving immune checkpoint inhibitors (ICIs). The model achieved an area under the curve (AUC) of 0.96 in training and 0.88 in testing, accurately stratifying survival risk and revealing significant disparities in overall survival. […]
New fluorescent probes enhance surgical navigation for liver cancer
Recent advancements in fluorescence-guided surgery provide significant improvements in identifying hepatocellular carcinoma (HCC) lesions. Indocyanine green has been essential for delineating tumor boundaries yet lacks the ability to differentiate between benign and malignant tumors. This review discusses clinical applications and emerging alternatives, such as aggregation-induced emission probes, which demonstrate enhanced fluorescence and stability. These innovative […]
Detection of mutant KRAS ctDNA predicts metastatic risk in pancreatic cancer.
In a cohort study of 785 patients with pancreatic ductal adenocarcinoma, the presence of mutant KRAS circulating tumor DNA (ctDNA) was linked to higher metastatic risk and poorer survival outcomes. Out of those tested, 104 showed plasma MKRAS positivity, correlating with increased likelihood of metastatic disease. Furthermore, among 419 patients tested for peritoneal MKRAS, 123 […]
Thermal ablation shows comparable efficacy with better safety for colorectal liver metastases.
A multi-center study of 303 patients with colorectal liver metastases revealed no significant difference in early recurrence patterns after resection versus thermal ablation. Both treatments showed similar 6-month recurrence-free survival rates; however, thermal ablation demonstrated a lower incidence of serious complications and shorter hospitalization. Key risk factors for early recurrence were identified, including the diameter […]
Improved surgical performance lowers risk of delayed gastric emptying
A study analyzing 192 robotic gastro-enterostomy procedures found that enhanced surgical performance, assessed via objective structured assessment of technical skills (OSATS), correlates with a reduced incidence of delayed gastric emptying (DGE). DGE occurred in 21.9% of patients, with an OSATS score above 25 associated with a 59.9% reduced risk of grade B/C DGE. Additionally, a […]
Machine learning effectively predicts postpancreatectomy acute pancreatitis
A novel machine learning model successfully predicts postpancreatectomy acute pancreatitis (PPAP) in patients following pancreaticoduodenectomy. In a cohort of 381 patients, 88 (23.09%) developed PPAP, which was notably associated with a higher occurrence of postoperative pancreatic fistulas (55.68%). Various algorithms, including logistic regression and gradient boosting, were tested, with recursive feature elimination optimizing variable selection. […]