A new standardized robotic dissection technique for the celiac axis and hepatic artery shows promise for safer, more precise pancreatic surgery. Successfully performed level 1 to level 3 dissection with no intraoperative arterial injury. Utilized advanced imaging for stable magnified visualization, improving safety during intricate dissections. This approach supports consistent oncological principles in robotic procedures. […]

Intracholecystic papillary neoplasms (ICPNs) are infrequent but significant preinvasive lesions associated with high-grade dysplasia and carcinoma. The pooled incidence of ICPNs is 1.5% in cholecystectomy cases. High-grade dysplasia occurs in 35.4% of ICPN lesions; 26.9% have concurrent adenocarcinoma. Lymph node metastases found in 18% of invasive cases, with 5-year survival rates varying from 46.7% to […]

Different types of biliary stents show no significant impact on healing bile leaks after fenestrated cholecystectomy. 93.8% of patients healed with 10F stents, similar to other types, showing no advantage for larger or covered stents. Median time to follow-up ERCP for leak resolution was 59 days across the cohort of 145 patients. Surgeons can confidently […]

Conversion surgery for unresectable pancreatic cancer with liver metastasis can significantly improve survival for select patients. In a study of 90 patients, overall survival after conversion surgery was 39.7 months, with earlier treatment yielding 53.1 months from initial diagnosis. Preoperative normalization of CA 19-9 and negative lymph node metastasis were key factors linked to better […]

MRI improves liver metastasis detection in pancreatic cancer, crucial for surgical decision-making. MRI identified additional liver metastases in 2-23% of CT-negative patients and 12-45% of those with indeterminate CT findings. The impact on time to surgery was inconsistent, with delays averaging a 5.7-day increase, but cases varied widely. Surgeons should consider integrating MRI in pre-operative […]

A promising approach using implantable microdevices allows real-time evaluation of chemotherapy responses in pancreatic ductal adenocarcinoma (PDAC). In a study with mouse models, the device enabled localized delivery of chemotherapy agents and real-time monitoring of tumor response. Significant reductions in tumor cell proliferation were observed after treatment, indicating drug-specific effects. This method could advance precision […]

Robotic pancreatoduodenectomy (rpd) can reduce pancreatic fistula risk but may increase post-pancreatectomy hemorrhage (pph) risk. Among 1,925 patients, rpd led to 4.8% ppf vs. 9.3% in open procedures (opd). rpd had an increased pph risk (odds ratio 1.63) compared to opd. Patients with a pancreatic fistula faced a 3.97 times higher chance of pph, particularly […]

Surgeons can safely enucleate multiple insulinomas near the main pancreatic duct using a novel approach that combines indocyanine green (ICG) fluorescence imaging with intraoperative ultrasound (IOUS). A 12.5 mg ICG bolus delivered intraoperatively allowed rapid tumor enhancement within 15 seconds and clear demarcation at 30 minutes. The procedure resulted in minimal blood loss (50 mL) […]