A comparative study evaluated the effectiveness of continuous local wound infiltration (LWI), four-quadrant transversus abdominis plane (4QTAP) block, and needle electrical twitching intramuscular stimulation (NETOIMS) for pain management in pancreaticoduodenectomy. The 4QTAP and NETOIMS techniques significantly reduced postoperative pain scores, opioid, and ibuprofen consumption, while promoting better functional recovery indicators like gait speed and peak […]
Category: HPB & Spleen
Liver venous deprivation is safe and promotes liver growth.
A multicentric study demonstrated the safety and efficacy of liver venous deprivation (LVD) in enhancing future liver remnant (FLR) volume prior to major hepatectomy. Out of 192 patients, LVD achieved a 100% technical success rate, with only a 2.6% rate of severe complications. FLR volume increased by an average of 61.7% within 27 days. Although […]
Surgical resection improves survival for gastric cancer liver metastases
A population-based analysis of 3,694 gastric cancer patients with liver metastases revealed that those undergoing cancer-directed surgery experienced significantly longer median overall survival, 12 months versus 6 months for non-resection patients. After adjusting for selection bias, Cox regression indicated a substantial survival benefit, with a hazard ratio of 0.562. These findings highlight the importance of […]
Early recurrence in IPMN-derived pancreatic cancer is predictable.
In an international multicenter study, early recurrence in resected intraductal papillary mucinous neoplasm (IPMN)-derived pancreatic cancer was identified at 10.5 months. Among 381 patients, 42% experienced recurrence, with 38% classified as early recurrences. Key predictors included CA19-9 levels and N2 disease staging. The study stratified patients into low, intermediate, and high-risk groups, revealing that adjuvant […]
Preoperative TACE enhances survival in intermediate-stage liver cancer
In patients with intermediate-stage hepatocellular carcinoma (HKLC stage IIB), preoperative transarterial chemoembolization (TACE) significantly improves survival outcomes compared to upfront surgery alone. A study involving 154 matched patients found that the median overall survival for the TACE group undergoing surgical resection was 90.97 months, versus 30.68 months for the surgery-only group. Additionally, disease-free survival was […]
Radical resection with autotransplantation improves survival in pancreatic cancer
A study involving 208 locally advanced pancreatic cancer (LAPC) patients found that those undergoing radical resection combined with intestinal autotransplantation (RRCIA) after systemic treatment significantly improved overall survival (OS) and progression-free survival (PFS). Specifically, the RRCIA group showed a median OS of 25.8 months compared to 14.2 months for those without surgery. Additionally, successful outcomes […]
Lymphadenectomy of specific nodes improves survival in pCCA patients
Evaluating lymph nodes during surgery for perihilar cholangiocarcinoma can significantly enhance patient outcomes. In a study of 341 patients, those undergoing lymphadenectomy of stations 12, 8, and 13 demonstrated improved overall survival compared to those receiving only station 12 (HR 0.51). The highest therapeutic index was observed in patients who had six or more lymph […]
Robotic ligament release prevents complications in pancreatic surgery
Preoperative robotic median arcuate ligament release significantly mitigates complications in pancreatoduodenectomy, particularly for patients with celiac artery stenosis. The technique demonstrates a nearly 90% success rate in resolving ischemic complications, preventing hepatic ischemia, and ensuring normal arterial flow to the gastrointestinal tract. A case involving a 49-year-old male with pancreatic adenocarcinoma highlights the effectiveness of […]
EUS-guided biliary drainage techniques show high success rates
In a study of 191 endoscopic ultrasonography (EUS)-guided biliary drainage procedures, researchers achieved a technical success rate of 97.38% and a clinical success rate of 89.01%. Among the 191 patients, 16.75% experienced complications, including six fatal cases. These advanced techniques offer effective alternatives to traditional methods like ERCP for treating benign and malignant biliary strictures, […]
A novel fluorescent probe targets pancreatic juice for surgical use
Researchers identified a pancreatic juice-specific fluorescent probe, selectively targeting ectonucleotide pyrophosphatase/phosphodiesterase (enpp) 1, from a library of 411 enzyme-activatable fluorescent probes. The probe demonstrated high reactivity with pancreatic juice, providing the potential for visualizing pancreatic juice leakage during surgery. This advancement may assist surgeons in addressing leaking sites and evaluating the need for prophylactic abdominal […]