Histopathologic response predicts better survival in pancreatic cancer patients despite imaging showing stable or progressive disease. 89% of patients completed neoadjuvant therapy; 73% underwent resection. Radiographic response was low: 27% had tumor regression, while 66% had stable disease. 83% achieved significant serum CA 19-9 reduction, and 74% showed histopathologic response after resection, including 8% with […]

Post-surgery tumor features impact recurrence patterns in intrahepatic cholangiocarcinoma, affecting long-term outcomes and follow-up strategies. Among 1,328 patients, 57.5% experienced recurrence; 23% had both intra- and extrahepatic recurrence. Three or more metastatic lymph nodes increased the chance of combined recurrence (adjusted odds ratio 3.47). Patients with combined recurrence had worse survival outcomes (hazard ratio 1.63) […]

Surgeons should consider local therapies for recurrent pancreatic ductal adenocarcinoma as they show significant survival benefits. For liver-only recurrence, local therapy leads to longer survival than chemotherapy alone (HR 0.26). Surgical resection for lung-only recurrence offers better survival compared to conventional treatment (HR 0.35). Careful patient selection and tailored approaches could enhance outcomes in recurrence […]

Symptom recovery following pancreatectomy is crucial for optimizing patient outcomes. Overall recovery rates were 68.1% at one month, 78.6% at three months, and 86.9% at six months post-surgery. Top symptoms included pain, fatigue, sleep disturbance, drowsiness, and bloating; fatigue persisted the longest. Preventing postoperative complications is vital for improving recovery, regardless of surgical technique. Journal […]

Mixed-type intraductal papillary mucinous neoplasms (IPMNs) have a lower malignancy risk than previously thought, affecting surgical decision-making. 46.5% of mixed-IPMNs showed malignancy, compared to 79.2% in main-duct and 33.9% in branch-duct IPMNs. In the absence of high-risk features, the malignancy rate for mixed-IPMNs dropped to 24.7%, similar to branch-duct IPMNs at 20.2%. Consider patient selection […]

A new machine learning model using endoscopic ultrasound can differentiate main-duct intraductal papillary mucinous neoplasm (MD-IPMN) from chronic pancreatitis (CP), which is crucial for surgical decision-making. Key features to note: intraductal nodules (2.4% CP vs 20.0% MD-IPMN, p = .003) and ductal stones (77.1% CP vs 2.5% MD-IPMN, p < .001). The model achieved a […]

Surveillance for IPMNs rose significantly, with 74% of 3,304 patients managed this way. Rates of high-grade dysplasia and invasive carcinoma increased after surveillance, with high-risk stigmata rising from 9% to 48%. Timely surgical intervention is crucial, as delayed resections may lead to worse outcomes. Overall, low-grade dysplasia decreased, but invasive cancer remains a concern, highlighting […]

Surgeons can now consider double mini upper transversal hepatectomy for colorectal liver metastases involving major veins, previously deemed unresectable. This novel approach utilizes peripheral communicating veins to achieve an R0 resection while preserving liver functionality. Patients in this study faced no major complications and were discharged by postoperative day 12. This method expands surgical options […]