An expert panel from the Japan Liver Cancer Association and Japanese Society of Hepato-Biliary-Pancreatic Surgery has established clear criteria for assessing the oncological resectability of hepatocellular carcinoma (HCC). Three classifications were introduced—resectable, borderline resectable 1, and borderline resectable 2—distinguishing treatment strategies and anticipated survival outcomes. This consensus aims to facilitate discussions on “conversion therapy” and […]
Category: HPB & Spleen
Normal ca19-9 levels correlate with improved survival in pancreatic cancer
In a study involving 1,558 pancreatic cancer patients, 13.9% exhibited normal carbohydrate antigen 19-9 (ca19-9) levels, linked to significantly longer median survival rates (18.1 vs. 9.7 months). Those with stage IV ca19-9-normal cancer had a 5-year survival chance of 22.4%, compared to 6.8% in the ca19-9-high group. Findings suggest that glucose control, influenced by insulin […]
Trans-cystic stenting reduces hospital stay and improves ERCP efficiency
Implementing trans-cystic biliary stenting during acute cholecystectomy significantly reduced the median total hospital stay from six to five days for patients needing both endoscopic retrograde cholangiopancreatography (ERCP) and cholecystectomy. The stenting process was efficient, with 22 out of 23 attempts successful and a median insertion time of 14 minutes. Post-stenting, outpatient ERCP cases increased dramatically, […]
Endoscopic ultrasonography-guided ethanol injections demonstrate efficacy for small pancreatic tumors
A prospective multicenter study evaluated endoscopic ultrasonography-guided ethanol injections (EUS-EI) for treating small pancreatic neuroendocrine neoplasms (PNENs). Of the 25 patients treated, 76% achieved the primary endpoint compared to surgical outcomes, and 88% attained complete ablation at 1 and 6 months. Safety results were promising, with 96% experiencing no severe adverse events within one month. […]
Clinical indicators can predict complications post-thermal ablation.
A study involving 218 patients undergoing thermal ablation for hepatocellular carcinoma found that 52.8% experienced complications. Key independent predictors included tumor size, area, and abnormal aspartate aminotransferase levels. Specific complications such as postoperative pain and fever were noted, with 6.9% of patients facing major issues. The research emphasizes the importance of assessing liver background using […]
Improved survival observed in colorectal liver metastasis patients
Data from 5,085 patients newly diagnosed with colorectal liver metastasis (CRLM) between 2013 and 2017 showed a significant increase in survival rates compared to 3,820 patients diagnosed from 2005 to 2007. The five-year overall survival rate after hepatectomy improved from 56.7% to 62.4%. Despite a greater prevalence of advanced-stage CRLM in the later cohort, prognostic […]
Structured mentorship improves laparoscopic bile duct exploration outcomes
A structured mentorship program significantly expedited the learning curve for laparoscopic common bile duct exploration (LCBDE). The mentee’s initial 100 cases showed a lower median postoperative hospital stay of 2 days versus 5 days for the mentor’s initial 100 cases, alongside a higher transcystic approach rate. Importantly, outcomes in mentees were comparable to those of […]
Predictive model identifies risk factors for delayed gastric emptying after pancreatectomy
A novel predictive model was successfully developed to assess the risk of clinically relevant delayed gastric emptying (DGE) in patients undergoing total pancreatectomy (TP). Key risk factors include end-to-side gastrointestinal anastomosis, intraoperative blood transfusion, and venous reconstruction. The model demonstrated robust prediction accuracy with ROC values of 0.853 in the training set and 0.789 in […]
Extended wait times for CVP measurements increase mortality risk
Delays in obtaining central venous pressure (CVP) measurements significantly raise the risk of 28-day mortality in critically ill patients with acute pancreatitis. An analysis of data from 233 patients revealed that those who experienced longer wait times for CVP assessments had more than double the risk of early death compared to those monitored within 12 […]
Surgical Resection Improves Outcomes for Selected HCC Patients
Findings indicate that surgical resection significantly enhances overall survival (OS) and cancer-specific survival (CSS) in selected patients with hepatocellular carcinoma (HCC) and portal vein invasion (PVI) who maintain preserved liver function and performance status. In a study of 998 patients undergoing treatment, those in the resection group (151 patients) demonstrated notable survival advantages compared to […]