A seven-year retrospective study at Weill Cornell revealed that transitioning from laparoscopic to robotic liver surgery significantly improves perioperative outcomes in hepatectomies. Among 353 cases analyzed, robotic hepatectomies demonstrated shorter median lengths of stay by 43% and reduced complication odds by 62% compared to open surgery. The robotic approach also had an 87% lower rate […]
Category: HPB & Spleen
ERAS Protocol Enhances Recovery in Pancreatic Surgery
A systematic review and meta-analysis of seven randomized controlled trials, involving 731 patients, confirms that the Enhanced Recovery After Surgery (ERAS) protocol significantly shortens hospital stays by an average of 2.49 days compared to conventional care. Furthermore, it shows potential reductions in hospital costs, readmission rates, and infection incidence. This study marks a pivotal demonstration […]
Standardized definition of surgical success enhances outcomes in ICC
A multi-institutional study identified key predictors for a “textbook outcome” in liver surgery for intrahepatic cholangiocarcinoma (ICC). The absence of post-hepatectomy liver failure, low intraoperative blood loss, no major infectious complications, and achieving R0 resection were linked to improved overall survival of at least 12 months. Approximately 60.2% of patients achieved these outcomes, significantly enhancing […]
Predictive Models Enhance Surgical Decision-Making in Hepatic Echinococcosis
A study developed predictive models to aid surgical decision-making for hepatic cystic echinococcosis (CE). Analyzing data from 406 patients, the Cox regression model achieved a concordance index of 0.94 and AUC of 0.96. The decision tree model highlighted imaging findings, cyst stage, and symptoms as key predictors, with a mean AUC of 0.950. These validated […]
Nomograms predict outcomes for patients with large hepatocellular carcinoma.
Researchers developed three nomograms to predict short-term and long-term outcomes in patients with large hepatocellular carcinoma (HCC) post-liver resection. These models demonstrated good predictive performances with c-indices of 0.764 for surgical risk, 0.709 for overall survival (OS), and 0.695 for recurrence-free survival (RFS) in validation cohorts. Compared to six staging systems, the nomograms showed superior […]
Machine learning effectively predicts bile leaks post-hepatectomy.
A machine learning model using extreme gradient boosting (XGBoost) was developed to predict bile leaks after hepatectomy for liver cancer. The model analyzed data from over 22,000 patients, achieving areas under receiver operating characteristic curves (AUROC) of 0.748, 0.719, and 0.711 in various patient cohorts. Factors such as serum alkaline phosphatase, surgical approach, and cancer […]
Immunotherapy transforms surgical management of advanced liver cancer.
Immune checkpoint inhibitors are reshaping treatment for advanced hepatocellular carcinoma, establishing new standards and encouraging further research. A combination of atezolizumab and bevacizumab shows high response rates, prompting investigations into their roles in peri-operative settings and liver transplantation. However, there are concerns regarding immunosuppression and graft rejection, necessitating careful patient selection and management. Ongoing studies […]
Transaminase levels predict survival after liver cancer surgery
Changes in perioperative serum transaminase levels, specifically aspartate and alanine aminotransferase, were found to predict long-term survival following liver resection for hepatocellular carcinoma. A murine model demonstrated that hepatic ischemia/reperfusion injury led to increased tumor recurrence. Analyzing the ratio of aspartate to alanine aminotransferase on postoperative days one and three may help identify patients at […]
Novel surgical technique shows promise for pancreatic cancer
Laparoscopic radical antegrade modular pancreatosplenectomy, when combined with portal vein reconstruction and celiac axis resection, demonstrated safety and efficacy for treating pancreatic neck-body cancer. A 74-year-old patient underwent the procedure following neoadjuvant chemotherapy, resulting in significant tumor size reduction. The surgery lasted 300 minutes with manageable blood loss, and the patient experienced no recurrence or […]
New approach enhances laparoscopic hemihepatectomy outcomes
A dorsal approach to the middle hepatic vein from the hilar plate in laparoscopic hemihepatectomy has shown promising results. In a study involving 28 patients, the average surgery duration was 260 minutes, with median blood loss at 80 ml. Postoperative major complications occurred in only 3.6% of cases. This technique promotes better visualization and surgical […]