A cohort analysis of 1,130 patients with postoperative pancreatic fistulas (popf) found that those undergoing minimally invasive pancreatoduodenectomy (mipd) faced a significantly higher risk of additional complications compared to traditional open procedures (opd). Notably, 55% of mipd-popf patients encountered a secondary complication, including a higher occurrence of postpancreatic hemorrhage (21% vs 8%). Mipd also resulted […]
Category: HPB & Spleen
Consensus Established on Neoadjuvant Therapy for Pancreatic Cancer
Expert consensus has identified 82 best practices for delivering neoadjuvant therapy (NT) in localized pancreatic ductal adenocarcinoma (PDAC). Key areas include pre-NT evaluations, effective initiation and management during NT, and post-NT surgical and follow-up strategies. With 47 North American specialists involved, the findings aim to standardize care delivery, reduce variation, and potentially improve patient outcomes. […]
Area Deprivation Index affects follow-up rates in pancreas cancer patients
A study analyzing 1,001 pancreas ductal adenocarcinoma patients found that those from less marginalized backgrounds, indicated by the Area Deprivation Index (ADI), were 1.57 times more likely to attend follow-up appointments post-surgery compared to marginalized individuals. The study highlights significant disparities in patient follow-up rates, suggesting social determinants of health significantly influence care outcomes. This […]
Deep-learning model predicts hepatocellular carcinoma recurrence effectively
A novel deep-learning model, Recurr-Net, significantly outperformed traditional methods in predicting hepatocellular carcinoma (HCC) recurrence post-curative surgery. Analyzed across 1,231 patients, Recurr-Net demonstrated an area under the receiver operating characteristic curve (AUROC) of 0.770 to 0.857 internally and 0.758 to 0.798 externally, while the historical microvascular invasion (MVI) showed much lower performance. This indicates Recurr-Net’s […]
Primary needle-knife fistulotomy is safer for biliary access.
A randomized clinical trial involving 260 patients revealed that primary needle-knife fistulotomy (PNKF) significantly outperforms standard transpapillary (STP) techniques for cannulating long-size papilla. PNKF achieved a biliary cannulation success rate of 96.2% compared to STP’s 87.7% (p = 0.01). Moreover, post-endoscopic retrograde cholangiopancreatography pancreatitis was markedly lower in the PNKF group (2.4%) versus STP (9.6%, […]
Laparoscopic liver resection proves cost-effective
Laparoscopic liver resection (LLR) demonstrated superior clinical and economic outcomes compared to open liver resection (OLR) in a study involving 920 patients. LLR resulted in significantly fewer postoperative transfusions, a shorter median length of stay, and lower rates of complications, readmissions, and reoperations. Importantly, LLR showed lower total costs across all types of hepatectomies, establishing […]
Near-infrared fluorescence imaging improves resection outcomes in liver surgery
Laparoscopic hepatectomy utilizing near-infrared fluorescence imaging significantly enhanced tumor identification, identifying over 59% of tumors on the liver surface. The technique yielded a remarkable 96.6% clear resection margins among patients with colorectal liver metastases. Furthermore, no tumor cells were found in 21.3% of cases analyzed, with a median continuous fluorescent signal distance from the tumor […]
Partial splenic embolization improves outcomes for cancer patients.
Research indicates that partial splenic embolization (PSE) significantly enhances platelet counts and reduces complications for cancer patients suffering from hypersplenism. Optimal splenic infarction volumes of 388 to 540 ml are essential for achieving these benefits. In cases of massive splenomegaly, the noninfarcted spleen volume is crucial. Additionally, combining PSE with systemic chemotherapy shows promise in […]
Asymptomatic cholecystitis requires improved surgical strategies
Asymptomatic cholecystitis is prevalent yet often overlooked, with 80% of cases lacking clinical manifestations. Surgeons frequently avoid addressing this condition, leading to inconsistencies in treatment approaches and increased risks, such as postcholecystectomy syndrome. The current literature is sparse and fragmented, lacking a unified strategy for managing asymptomatic cases. A comprehensive examination of the tactical approaches […]
Surgery combined with adjuvant therapy shows best outcomes for HCC
A systematic review and meta-analysis of 40 randomized clinical trials involving 11,576 patients reveals that locoregional therapies (LRTs) for hepatocellular carcinoma (HCC) differ significantly in efficacy. Researchers found that surgery with adjuvant therapy provides superior progression-free survival (PFS) and overall survival (OS) compared to surgery alone, radiofrequency ablation (RFA), or various embolization techniques. The analysis […]