A proposed classification enhances understanding of bleeding complications after total pancreatectomy, impacting surgical management. 35 patients experienced bleeding complications, highlighting a significant risk. The existing ISGPS classification fails to capture all relevant bleeding sources post-total pancreatectomy. This novel classification offers a more precise framework for identifying and managing hemorrhagic events, aiding surgeons in improving patient […]

ALPPS surgery enhances liver regeneration by allowing one lobe to proliferate while another manages metabolic tasks. The fast-regenerating lobe (FRL) increases growth when the metabolic load of the non-growing lobes (LLs) is appropriately managed. Transcriptomics and metabolomics show distinct roles: FRL focuses on growth while LLs handle metabolic support. Surgeons can tailor surgical strategies based […]

A validated preoperative scoring tool enhances surgical decision-making for laparoscopic splenectomy. Age, INR, splenic thickness, and cirrhosis are key predictors of operative difficulty. The 0-23 scoring system stratifies patients into low (0-7), intermediate (8-15), and high-risk (16-23) groups, offering strong accuracy (AUC 0.78 – 0.82). High-risk patients experience increased blood loss, longer surgery times, and […]

Nonoperative treatments like splenic angioembolization show better outcomes than surgery for severe blunt splenic injuries. Morbidity is significantly lower with splenic angioembolization (odds ratio 0.61) and observation (odds ratio 0.71) compared to open splenectomy. Among hypotensive patients, there’s no mortality difference, but angioembolization and observation shorten hospital stays by about 1.4 days each. Careful patient […]

Surgeons need to tackle failure to rescue (FTR) after hepatectomy to enhance patient outcomes. FTR, linked to complications like liver failure and sepsis, remains a critical issue despite better surgical techniques. Higher surgical volumes correlate with lower FTR rates; experienced teams and quick interventions are key. Proactive strategies, including preoperative optimization and better surveillance, can […]

Next-generation sequencing identifies actionable targets in biliary tract cancer, changing treatment for fit patients. Roughly 50% of biliary tract cancer patients have actionable genomic alterations, especially in intrahepatic cholangiocarcinoma. Targeted therapies are showing clinical benefits and manageable safety profiles over standard treatments. Surgeons should consider incorporating molecular profiling into patient assessments to optimize postoperative therapy […]

Laparoscopic enucleation is a safe, efficient option for large benign or low-grade malignant pancreatic tumors. No difference in perioperative complications between large and small tumor patients undergoing laparoscopic enucleation. Laparoscopic enucleation significantly reduces operative time (160 vs. 397 minutes) compared to standard pancreatectomy procedures. Surgeons may consider laparoscopic enucleation to optimize surgical outcomes without increasing […]

ECVF from contrast-enhanced CT can predict postoperative pancreatic fistula risk. In a study of 71 patients post-pancreatic resection, ECVF correlated with pancreatic fibrosis. An ECVF of less than 36% linked to increased risk of pancreatic fistula. Understanding ECVF helps in patient selection and surgical decision-making. ECVF also indicates acinar loss and overall pancreatic histology. Journal […]

A retrospective analysis of 218 patients reveals that refined resection margin classifications significantly impact recurrence patterns in hilar cholangiocarcinoma. Adjuvant radiotherapy sharply reduces local recurrence rates, particularly in patients with narrow-clear and invasive margins. Notably, no recurrences were observed in patients with wide-clear, narrow-clear, or dysplastic margins after radiotherapy. Tailoring postoperative strategies based on margin […]