Right (H145678) and Left (H123458) 6-segmentectomies show potential for long-term survival in select patients with malignant liver tumors. Surgical futility occurred in 15.6%, with failure-to-rescue rates at 30.3%. Achieved textbook outcomes in 30.8% of patients, with a median follow-up of 26 months. 5-year overall survival at 30.8% and disease-free survival at 18.9%. Consider targeted strategies […]
Category: HPB & Spleen
Novel Radiation Approach Elevates Outcomes in Locally Advanced Pancreatic Cancer
Hypofractionated ablative radiation therapy before surgery improves overall survival in locally advanced pancreatic cancer. 38% overall survival at 2 years; 54% for those who underwent resection. Only 11% local progression and 73% distant metastasis rates at 2 years. This strategy shows no increase in surgical morbidity, making it significant for patient selection and preoperative planning […]
Redo Hepatic Vein Reconstruction Effective for Liver Metastases
Late-onset venous stenosis after hepatic vein reconstruction may signal tumor recurrence, impacting how you monitor and treat patients. In a study of 72 reconstructed veins, 19 developed stenosis: 14 due to technical issues, and 5 linked to tumor recurrence. Technical stenoses occurred within 6 months, whereas late stenoses were associated with tumor recurrence detected years […]
New technique safely guides liver surgery in rare anatomy
Surgeons can effectively navigate complex liver anatomy using the Arantius-first approach, particularly with right-sided ligamentum teres (RSLT). RSLT occurs in about 0.43% of patients, complicating conventional techniques. The Arantius-first approach enhances visibility and control, reducing the risk of injuries during laparoscopic left hemi-hepatectomy. Effective application of this method can improve surgical outcomes in patients with […]
New Staging System Cuts Risks in Perihilar Cholangiocarcinoma
This study introduces the ABC scoring system for preoperative staging in perihilar cholangiocarcinoma, aiming to improve patient selection for curative surgery. Patients with a score of 3 had a 21% 90-day mortality rate versus 6% for score 0. Six-month recurrence rates were 18% for score 3 compared to 5% for score 0. Median overall survival […]
Long-term Outcomes of Pancreaticojejunostomy Techniques
A study comparing invagination versus duct-to-mucosa pancreaticojejunostomy shows similar long-term anastomotic patency and pancreatic function. Remnant pancreatic duct dilatation occurred in 18.6% of invagination and 9.8% of duct-to-mucosa patients, with no significant clinical impact. Cumulative incidences of benign stricture at 3 and 5 years were 9.3% and 19.9% for invagination, compared to 9.5% and 13.4% […]
Effective Techniques for Difficult Biliary Cannulation in ERCP
Advanced techniques yield 100% final success in difficult biliary cannulation, crucial for ensuring effective ERCP outcomes. Initial cannulation success: 72% (double-guidewire), 68% (trans-pancreatic sphincterotomy), 68% (precut fistulotomy). Precut technique used less contrast dye (p<0.005). Consider individualizing the technique based on patient anatomy and operator skill for optimal outcomes. Post-ERCP pancreatitis rates were 10% (dgt), 22% […]
Endoscopic techniques for ampullary tumors yield stark differences
Endoscopic submucosal dissection (ESD) outperforms endoscopic papillectomy (EP) for ampullary tumors ≥20 mm in base size. ESD achieved 100% en bloc resection and 89.5% R0 rates compared to 71.7% and 30.2% for EP. ESD showed 0% residual disease versus 42.9% with EP during over a year of follow-up. Consider ESD for better outcomes despite its […]
Endoscopic approach shows high success for pancreatic stones
EUS-guided pancreaticogastrostomy followed by pancreatoscopy is effective for managing pancreatic head duct stones. 95% technical success rate for EUS-guided pancreaticogastrostomy in 20 patients. Complete stone clearance achieved in 89% of those treated with subsequent pancreatoscopy-guided lithotripsy. This method is safe, with only mild early adverse events and a 6% recurrence rate. No late adverse events […]
Surgical approach impacts outcomes in intrahepatic cholangiocarcinoma.
Only 38.8% of patients achieved R0 resection and lymphadenectomy, with open liver resection at 51.1%, robotic at 44.4%, and laparoscopic at just 14.5% (p < 0.001). Laparoscopic liver resection showed the best overall survival rates at 95% and 89% at 1 and 3 years, respectively, compared to open (79%/30%) and robotic (90%/81%) approaches (p < […]