High attrition during neoadjuvant therapy (NAT) complicates surgical candidacy for localized pancreatic cancer, affecting patient outcomes. Out of 427 patients receiving NAT, 57% did not proceed to pancreatectomy due to disease progression (21%) and persistent inoperability (22%). Resectable patients had an attrition rate of 23%, compared to 44% for borderline resectable and 73% for locally […]

New guidelines improve perioperative management for liver resection. Strong recommendations for prehabilitation, nutrition, and mobilization to enhance recovery. Identification of significant gaps in evidence, especially around thromboprophylaxis and post-hepatectomy liver failure management. Surgeons should standardize practices and collaborate on research to tackle these gaps and improve patient outcomes. Expert panel reached consensus through a modified […]

Robotic distal pancreatectomy shows regional disparities in outcomes for pancreatic cancer treatment. Western centers have shorter operative times (240 vs. 265 min) and lower conversion rates to open surgery (5% vs. 10%). Eastern centers boast higher R0 resection rates (85% vs. 75%) and greater lymph node yield (12 vs. 10 nodes). Despite these differences, survival […]

Upfront pancreatectomy with venous resection shows promising outcomes in select pancreatic cancer patients. 30-day mortality is low at 1.2%, while 90-day mortality is 3.7%. Median overall survival is 19.8 months, with 1-, 2-, and 3-year survival rates of 71.4%, 40.8%, and 23.2%. Key predictors of decreased survival include older age (>65 years), high preoperative CA19-9, […]

Long durations of the Valsalva maneuver during high-intensity focused ultrasound liver ablation significantly worsen brain function outcomes. Burst suppression rates soared to 66.7% with >5.2-minute Valsalva episodes, compared to 2.0% in the control group (p < 0.001). Emergence agitation was notably higher in the long Valsalva group at 64.7%, versus only 2.0% in controls (p […]

Extended cholecystectomy offers better survival for stage I gallbladder cancer patients over simple cholecystectomy. 1-year cancer-specific death rates: 6.43% (EC) vs. 11.5% (SC) 5-year cancer-specific death rates: 15.3% (EC) vs. 28.9% (SC), p=0.002 For T1b disease, extended cholecystectomy is advisable, while simple cholecystectomy may suffice for T1a. Robust survival prediction tools can help tailor patient […]

A new nomogram accurately predicts clinically relevant postoperative pancreatic fistula (cr-popf), helping surgeons identify high-risk patients. 28% of patients developed cr-popf in a study of 300 cases. Key independent risk factors include operation time, preoperative C-reactive protein levels, CT pancreas-to-CT psoas major ratio, and pancreatic thickness. The nomogram shows excellent predictive power with an AUC […]

Increasing experience results in better outcomes for robotic pancreatoduodenectomies. Operating time decreased from 420 to 369 minutes across learning phases. Conversion rate dropped from 21.7% to 7.5%. Rate of delayed gastric emptying improved from 32.3% to 15.4%. Surgeons should consider patient selection and institutional experience when planning robotic procedures to enhance recovery and minimize complications. […]

Laparoscopic splenectomy significantly improves liver function in decompensated cirrhosis patients. 73% of patients treated with splenectomy achieved recompensation versus 33% with endoscopic therapy. Recompensation contributed to a 43% reduction in mortality over 3 years, dropping to 16% by 8 years. Younger patients have better outcomes with this approach. Overall, 54% of patients in the study […]