Surgeons can now better assess resectability in pancreatic cancer by focusing on specific vascular targets. Introducing a clear definition: “suitable target” vessels determine anatomic resectability, improving clarity in patient selection. Emphasizes the importance of 3D CT imaging and intraoperative assessment of vascular isolation for successful reconstruction. Adopting this approach enhances surgical eligibility evaluations and has […]
Category: HPB & Spleen
New Guidelines for Splanchnic Venous Thrombosis Post-Splenectomy
Splanchnic venous thrombosis is a critical yet often overlooked risk after splenectomy in hematologic patients. Incidence is 11.4%, rising to 20.7% with routine imaging and 15.1% in single-center studies. Major risk factors include splenic size and weight; age, BMI, and platelet count were not significant. Patients with myeloproliferative neoplasms, lymphoma, and thalassemia face the highest […]
Predicting Recurrence in Lymph Node-Negative Pancreatic Tumors
A new risk score for lymph node-negative pancreatic neuroendocrine tumors helps identify patients at risk for recurrence and guides postoperative surveillance. Recurrence rate for lymph node-negative patients was 10.6%, occurring at a median of 32.4 months post-surgery. Risk factors included male sex (2.2x), tumor size ≥3 cm (2.64x), grade 2 or higher (3.70x), and lymphovascular […]
Disparities Impact Pancreatic Cancer Outcomes
Multimodal treatment disparities in pancreatic cancer significantly affect patient survival and care. 8,466 patients analyzed; nonmetastatic cases had higher therapy rates than metastatic. Non-Hispanic black patients experienced longer delays to treatment compared to non-Hispanic whites. Uninsured and Medicaid patients showed the highest odds of not receiving therapy in metastatic cases. Primary resection strongly predicts improved […]
Predicting Pancreatic Fistula Risk with Elastography
Pre-operative shear wave elastography can effectively predict the risk of post-operative pancreatic fistula (POPF) after partial pancreatectomy, impacting surgical decision-making. In a study of 305 patients, lower elastography measurements correlated with a higher risk of POPF. An integrated prediction model using elastography, BMI, and pancreatic duct dilation accurately assessed POPF risk with AUC values over […]
Conversion Resection Improves Outcomes in Intermediate-Stage HCC
Preoperative conversion therapy significantly enhances surgical outcomes for intermediate-stage hepatocellular carcinoma. 23.2% of patients in the conversion resection group achieved a complete pathological response. Microvascular invasion rates were lower in the conversion group (17.9% vs. 58.6% in direct resection). Consider conversion therapy to improve pathology and survival before resection in select patients. 51.8% of the […]
Revisiting Resection Criteria for Hepatocellular Carcinoma
Tumor markers may improve patient selection for liver resection in HCC. In a study of 803 patients, 32.3% of resectable tumors had high tumor markers (AFP > 500 ng/ml or DCP > 1000 mau/ml). TM-high patients had a median survival of 120.7 months, significantly lower than non-TM-high patients at 160.8 months (p = 0.008). Incorporating […]
New Prognostic Model for Pancreatic Cancer Outcomes
A novel risk model using stress granule-related gene signatures (sgrgs) shows promise for improving prognostic accuracy in pancreatic ductal adenocarcinoma (PDAC). Four key sgrgs (lama3, itga6, col17a1, top2a) were identified as significant predictors of PDAC prognosis. A nomogram combining age, N stage, and risk score demonstrated strong predictive capacity. Understanding these markers can enhance patient […]
Predicting Post-Hepatectomy Liver Failure with Machine Learning
A new machine learning model improves prediction of liver failure after major hepatectomy, enhancing surgical decision-making. The pilot model achieved AUCs as high as 0.904, significantly outperforming traditional models (AUCs 0.502-0.644). The model integrates 55 variables, including novel biomarkers, across preoperative, intraoperative, and postoperative datasets. This innovation allows surgeons to identify high-risk patients within hours […]
Robotic Hepatectomy Surpasses Laparoscopy for Liver Cancer
Robotic hepatectomy enhances surgical options for high-risk liver cancer patients with comparable oncologic outcomes to laparoscopic methods. Robotic techniques show similar length of hospital stay and complication rates to laparoscopic approaches but may offer better precision. Patients experience shorter recovery times and can start adjuvant therapy sooner. Surgeons should consider robotic hepatectomy as a viable […]