Early-stage pancreatic cancer outcomes hinge on lymph node counts, affecting surgical decisions. Optimal examined lymph nodes for best survival in stage I and II is ≥10. Stage II patients benefit most with ≥12 examined lymph nodes; ≥7 for T3N0M0 cases. An examined lymph node to regional node positive ratio of ≥9 leads to optimal survival […]

Three-dimensional imaging technology may enhance surgical selection for neoadjuvant-treated pancreatic cancer patients. The 3D-PANC study compares 3D-MSP imaging accuracy to conventional CT in assessing vascular involvement. CT has significantly low accuracy in predicting which patients benefit from surgical resection. This could lead to improved patient outcomes by better identifying surgical candidates. The study will use […]

Triple therapy regimens significantly improve surgical candidacy for patients with unresectable hepatocellular carcinoma. Conversion to surgery rates (CSR) rise from 6% with conventional therapy to 41% with a combination of drug-eluting beads TACE, HAIC, TKI, and immune checkpoint inhibitor. Dual therapies yield lower CSRs (up to 15%) compared to triple therapies, emphasizing the need for […]

Dynamic changes in main pancreatic duct (MPD) diameter are key in predicting malignancy risk for patients with MPD-involved IPMN. In a study of 168 patients, 17.8% developed malignancy over a median of 4 years, with an annual incidence of 4.5%. An MPD growth rate of ≥ 2 mm/year emerged as the strongest predictor, with a […]

Surgeons can leverage a simple scoring system to predict new-onset diabetes after distal pancreatectomy, enhancing patient management. 26.9% of non-diabetic patients developed diabetes within 10 months post-surgery. Five key predictors include prediabetes, age ≥65, BMI ≥25, neck/proximal tumor, and concomitant splenectomy. The scoring system stratifies patients into risk categories with 5-year cumulative incidences of 4.4% […]

Switching to piperacillin-tazobactam for prophylaxis significantly lowers surgical site infections and pancreatic fistula rates in open pancreatoduodenectomy. Patients on piperacillin-tazobactam had 30% fewer surgical site infections and pancreatic fistulas compared to those on cefoxitin. The switch is backed by data from over 4,000 patients, with a clear trend toward piperacillin-tazobactam usage increasing. Consider adopting piperacillin-tazobactam […]

Surgical interventions for mucinous cystic neoplasms (MCN) should be more selective based on updated risk factors. The pooled rate of high-grade dysplasia (HGD) or invasive carcinoma (IC) in resected MCNs is just 17%. Cyst size is crucial: a threshold of 65 mm best differentiates high-risk from low-risk lesions. Key risk factors linked to HGD/IC include […]

Early-onset pancreatic cancer is surging, demanding attention from surgeons. In 2021, there were 31,531 new cases and 26,996 deaths worldwide. Asia, particularly East Asia, accounts for the highest burden, with developing nations like China and India leading. Risk factors differ; high fasting plasma glucose is not a primary risk for early-onset cases. Surgeons should prioritize […]

Surgeons need to adapt to evolving strategies for hepatocellular carcinoma (HCC) that prioritize biological insights and dynamic eligibility criteria. Curative treatments offer optimal long-term outcomes, yet 5-year recurrence rates remain at about 70%. New methods in immunogenomic profiling and liquid biopsy enhance patient selection beyond traditional staging. These advances enable personalized surgical strategies and improve […]

A new intraoperative classification system enhances pancreatic surgery for benign and low-grade tumors. 122 patients underwent robotic resections with IPDECT; type I defects had a 10.6% overall complication rate including 8.5% for postoperative pancreatic fistula. Type IV defects had longer operations (mean 127.6 min) yet only 5.9% complications. Standardizing decision-making may enhance patient outcomes and […]