IVC reconstruction during oncologic resections is safe, with robust mid-term outcomes. 80 patients treated; 94%+ primary patency at 2 years. 30-day survival rate was 96.3%, with 2- and 3-year survival at 76.8%. Most thrombosis occurrences tied to tumor recurrence or technical issues. Consider this technique in high-volume centers for complex oncologic cases. Journal Article by […]
Category: HPB & Spleen
Liver-First Approach Improves Outcomes in Colorectal Cancer
A liver-first surgical approach in stage IV colorectal cancer with isolated liver metastases leads to better survival and fewer complications. Liver resection before colon/rectal resection increased from 5.37% in 2010 to 15.43% in 2020. Patients receiving the liver-first approach had a lower 90-day mortality (1.11% vs 4.47%) and fewer 30-day readmissions (3.69% vs 5.81%). Select […]
Hepatic Artery Infusion Pump Shows Promise in Colorectal Liver Metastases
A small fraction of unresectable colorectal liver metastasis patients qualify for liver transplant, but HAIP chemotherapy can improve outcomes. Only 4.8% of patients in the study were liver transplant-eligible. After HAIP, the median overall survival was 61 months, with a 5-year survival rate of 53%. This suggests that HAIP may aid in patient selection for […]
EUS-Guided Biopsy for Pancreatic Cysts: Key Outcomes and Risks
EUS-guided through-the-needle biopsy (EUS-TTNB) offers valuable diagnostic insights for pancreatic cysts but carries significant risks that surgeons must navigate. Diagnostic adequacy is high at 80.3%, with changes in management seen in 16.3% of cases. Adverse events (AEs) occurred in 20.9% of procedures, predominantly acute pancreatitis (15%). Intraductal papillary mucinous neoplasm (IPMN) significantly raises AE risk […]
Robotic Pancreatoduodenectomy Implementation Shows Promise
A new robotic pancreatoduodenectomy program demonstrates safe implementation with improved outcomes. 79.5% of post-implementation surgeries were robotic with a conversion rate of 19.4%. Median length of stay decreased from 8 days to 5 days (p < .0001), while maintaining similar complication and mortality rates. Surgeons can consider a liberal patient selection approach without sacrificing patient […]
Surgeons Gain Ground in Choledocholithiasis Management
Surgeons can now effectively manage choledocholithiasis using a streamlined laparoscopic common bile duct exploration (LCBDE) pathway. Overall duct clearance improved from 70.6% to 87.0% after full implementation (p=0.042). Median hospital stay dropped significantly from 72.1 hours to 40 hours (p=0.01) without increasing operative time. This surgeon-led approach supports a more efficient, one-stop surgical solution for […]
Adenosquamous Carcinoma’s Grim Prognosis for Surgical Patients
Adenosquamous carcinoma of the pancreas has a dismal prognosis, demanding careful patient selection and management strategies. 1-year overall survival is 56.2%, dropping to just 9.8% at 5 years. Disease-free survival is equally concerning at 6.7% after 5 years. Avoid resection of T4 tumors in high-comorbidity patients. Providing adjuvant chemotherapy is crucial but often hampered by […]
Simultaneous Resection Improves Outcomes in Synchronous Rectal Cancer Metastases
Simultaneous resection of rectal and liver metastases is safe and linked to longer survival in high-risk patients. 92 patients showed no deaths; complications were seen in 15% with major issues like drainage (9%) and anastomotic dehiscence (3%). Median overall survival was 70 months, with recurrence-free survival at 10 months. Choose simultaneous resection judiciously; it can […]
New Immune Signatures in MEN1-Related Tumors
Identifying immune signatures could refine patient selection and surgical outcomes for those with MEN1-related neuroendocrine tumors. Analyzed 42 MEN1 patients with duodenopancreatic neuroendocrine tumors (DPNETs); 14 had liver metastasis. Identified 1,117 immunoglobulin-bound proteins; 435 antigens enriched in DPNET patients, with 130 higher in those with liver metastasis. Surgeons may consider these findings for better risk […]
Navigating Hepatectomy: New Standards for Liver Remnant Volume
A study identifies critical thresholds for future liver remnant volume (FLRV) to reduce post-hepatectomy liver failure in cancer patients. FLRV of ≥30% in normal livers and ≥50% in impaired livers reduces the risk of severe morbidity. For every 10% increase in FLRV, the odds of severe liver failure-related complications decrease by nearly 40%. Focus on […]