Machine learning effectively predicts recurrent extrahepatic bile duct stones after common bile duct exploration, enhancing surgical decision-making. Random forest model achieved AUCs of 97.99% in training and 83.1% externally, outperforming other methods. Key risk factors include maximum stone diameter, common bile duct diameter, and direct bilirubin, with larger stones (>15 mm) significantly increasing recurrence risk. […]
Category: HPB & Spleen
Gallbladder Cancer Risk Factors Uncovered for Cholecystectomy Patients
Incidental gallbladder cancer (IGBC) is often diagnosed post-cholecystectomy, making pre-op risk assessment crucial. Key predictors: advancing age (OR 1.09), female gender, elevated alkaline phosphatase, and larger gallbladder polyps increase IGBC risk. 788,214 patients analyzed from 18 studies reveal significant patterns for targeted evaluations. Surgeons should integrate these factors into decision-making for better surveillance and patient […]
Outcomes of Robotic Liver Surgery Standardized by IWATE Criteria
Robotic liver resections show promising outcomes when evaluated with the IWATE criteria, aiding in surgical decision-making. Operative times increased with complexity: 148 to 350 minutes; blood loss ranged from 75 to 400 ml (p<0.001). Conversion rate was 9.6%, significantly higher in advanced groups (p<0.001). Median hospital stay varied by complexity, from 3 to 7 days […]
New treatment option enhances survival in advanced HCC
Hepatic arterial infusion chemotherapy (HAIC) significantly improves survival outcomes in advanced hepatocellular carcinoma vs. transarterial chemoembolization (TACE). HAIC improves overall survival (OS) by 49% and progression-free survival (PFS) by 45%. Key prognostic factors for better outcomes with HAIC include male gender, AFP <400 ng/ml, vascular invasion, and HBV positivity. Consider HAIC especially for patients with […]
Robotic Right Hepatectomy Sets New Benchmarks for Surgeons
New benchmarks for robotic right hepatectomy (RRH) show it may outperform traditional laparoscopic and open techniques. 357 patients analyzed; 172 were low-risk benchmark patients. Key reference values for surgical performance: operative time ≤476 min, conversion rate ≤8.2%, major complications ≤23.1%. Robotic RRH shows lower conversion and complication rates compared to laparoscopic and open approaches, suggesting […]
Endoscopic ultrasound enhances gallbladder tumor diagnosis
Endoscopic ultrasound (EUS) effectively distinguishes between malignant and benign gallbladder wall thickening, improving surgical decision-making. EUS achieved a sensitivity of 79.31% and specificity of 92.86% for diagnosing gallbladder tumors. Key indicators of malignancy included wall thickness greater than 14 mm and disrupted wall layers; both are highly significant (p < 0.001). Surgeons should consider EUS […]
Augmented Reality Enhances Liver Resection Outcomes
Augmented reality in liver surgery reduces intraoperative bleeding and complications. Blood loss decreased by 75.9 ml (p < 0.001) with AR guidance. Transfusion rates dropped to nearly half (RR: 0.47; p = 0.01); fewer complications (RR: 0.64; p = 0.009). AR-assisted techniques could improve surgical precision and patient outcomes, particularly in tumor cases. Tumor recurrence […]
Effective Suturing for Bile Leaks in Laparoscopic Hepatectomy
A new suturing technique using LapraTy® suture clips shows promise for managing intraoperative bile leaks during laparoscopic surgery. Rapid closure of bile leaks without excessive tension is possible, reducing risk of tissue damage. Omental coverage may help prevent postoperative bile leakage and improve outcomes. This technique is particularly valuable in challenging surgical situations and enhances […]
Minimally Invasive Surgery Gains Ground in Pancreatic Cancer
Minimally invasive surgery (MIS) is being validated for pancreatic cancer, impacting how surgeons approach patient selection and procedures. 22 out of 28 statements on MIS received over 90% expert agreement, enhancing surgical guidance. The consensus includes recommendations for left pancreatectomy, pancreatoduodenectomy, and total pancreatectomy tailored for cancer. Surgeons can adopt these evidence-based practices to improve […]
Elra Improves Survival in Hepatic Echinococcosis with CTPV
Elra, or ex vivo liver resection and autotransplantation, offers a promising solution for patients with hepatic alveolar echinococcosis facing cavernous transformation of the portal vein. No intraoperative mortality in both treatment groups; 90-day mortality was 16.7%. Long-term survival for CTPV patients undergoing elra was 72.9%, compared to 29.6% for those treated conservatively. The data supports […]