Category: HPB & Spleen

Robotic hepatectomy shows improved outcomes and lower costs

A recent analysis of 152 robotic hepatectomies demonstrated significant benefits compared to traditional open procedures. Key findings indicate lower overall morbidity, reduced blood loss, and shorter ICU stays, leading to substantially lower hospital costs despite higher operating room expenses. The study also revealed that robotic hepatectomy achieved a higher textbook outcome rate (85% vs. 64% […]

Tumor marker clustering predicts hepatocellular carcinoma outcomes.

A multi-institutional study involving 1,515 hepatocellular carcinoma patients revealed that combining preoperative alpha-fetoprotein and des-gamma-carboxy prothrombin levels enables effective prognostic clustering. Patients in cluster 3 exhibited the worst five-year overall survival rate of 52.8% and a high recurrence rate of 79.3%. Conversely, cluster 4 showed superior outcomes with a 71.5% survival rate. Notably, des-gamma-carboxy prothrombin […]

Robotic surgery reduces pancreatic fistula risk in high-risk patients

In a retrospective study involving 204 patients, robotic pancreatoduodenectomy (rpd) significantly lowered the incidence of clinically relevant postoperative pancreatic fistula (cr-popf) in high-risk patients compared to open pancreatoduodenectomy (opd). The cr-popf rate was 6.0% in the rpd group versus 38.2% in the opd group (p < 0.001). Moreover, multivariate analyses confirmed opd as an independent […]

Transduodenal ampullectomy proves effective for unexplained duct dilation

Transduodenal ampullectomy (TDA) effectively diagnoses and treats unexplained dilation of the cholangiopancreatic duct (UDCD), demonstrating superior diagnostic rates compared to preoperative biopsies (78.41% vs. 65.94%). A study evaluated 203 patients and reported a postoperative complication rate of 27.07% with no mortality. Five-year survival rates varied significantly: 68.31% for adenocarcinoma, 85.99% for adenomas with high-grade dysplasia, […]

Video grading predicts bile leak risk in robotic surgeries

Bile leak rates post-robotic pancreatoduodenectomy are substantially reduced when surgical performance is graded. In a multicenter study of 259 patients, an objective structured assessment of technical skills (OSATS) score greater than 21 was linked to a 59.2% relative reduction in bile leaks, with rates decreasing from 12.5% to 5.1%. Additionally, a significant learning curve was […]

Intraoperative blood loss impacts morbidity after liver surgery

Among 2,491 patients undergoing liver cancer surgery, significant associations were found between adjusted blood loss (ABL) and postoperative complications. Patients with ABL below 8.5 ml/kg experienced a lower comprehensive complication index (CCI) of 10.6 compared to 15.2 in those with higher ABL (p < 0.001). A nonlinear correlation indicated CCI increases sharply beyond 10 ml/kg, […]

A predictive nomogram effectively identifies high-risk patients for cr-popf.

A novel nomogram utilizing preoperative factors has been developed to predict clinically relevant postoperative pancreatic fistula (cr-popf) following pancreaticoduodenectomy. The nomogram, based on 262 patient data, identified key risk factors such as triglycerides and pancreatic duct size. With an area under the curve of 0.812 during validation and strong calibration, it achieved sensitivities of 60.9% […]

Venous thromboembolism poses high mortality risk post-cancer surgery

A nationwide study found that 90-day postoperative venous thromboembolism rates were 6.1% for liver and 6.7% for pancreatic surgeries. Key risk factors included major hepatectomy, left pancreatectomy, obesity, and prior thromboembolism history. By one year, pancreatic surgery patients had a significantly higher cumulative incidence (9.8%) compared to liver surgery patients (7.0%). Patients experiencing venous thromboembolism […]

Machine learning predicts early recurrence risk in cholangiocarcinoma

A novel machine learning model effectively predicts very early recurrence (VER) of perihilar cholangiocarcinoma (PCCA) post-surgery. In a study of 434 patients, 15% experienced VER, significantly reducing median overall survival to 8.4 months compared to 38.5 months for those without recurrence (p

New nanosensor assay shows promise for early pancreatic cancer detection

A novel protease-activated nanosensor assay effectively identifies pancreatic ductal adenocarcinoma (pdac) in patients with high specificity and sensitivity. The assay achieved 98% specificity and 73% sensitivity for pdac samples and demonstrated an impressive 85% sensitivity for stage I pdac combined with the CA 19-9 biomarker. By leveraging serum protease activity, this rapid and noninvasive method […]