Surgeons must recognize cholangiocarcinoma’s three subtypes to tailor patient care. Intrahepatic, perihilar, and distal cholangiocarcinoma show unique biology affecting diagnosis and treatment. Each subtype has distinct risk factors like chronic biliary diseases, impacting surgical outcomes. Understanding these differences enhances surgical decision-making and patient selection for better outcomes. Innovations in surgical techniques and strategies, guided by […]

Postoperative adjuvant transarterial chemoembolization (pa-TACE) significantly improves survival in hepatocellular carcinoma (HCC) patients after liver resection. Patients receiving pa-TACE had 30% lower recurrence risk (HR=0.70, p=0.04) and 35% better survival rates (HR=0.65, p=0.04) compared to controls. The benefits are pronounced in microvascular invasion-positive patients, with recurrence-free survival improved by 69% (HR=0.31, p<0.001) and overall survival […]

Feeding jejunostomy (FJT) after pancreatoduodenectomy increases complications and length of stay. Delayed gastric emptying occurred in 55% of FJT patients vs. 25% in nasojejunal tube (NJT) patients (p = 0.006). FJT led to a longer hospital stay: 11 days compared to 9 days for NJT (p = 0.007). Omit FJT to reduce postoperative complications without […]

Minimally invasive and robotic-assisted surgeries enhance recovery in hepatopancreatobiliary procedures. Patients who underwent robotic-assisted gastrectomy had shorter hospital stays and less intraoperative bleeding than those who had open surgeries. Operative times differed among procedures due to technical complexity and learning curves. Surgeons should consider robotic techniques for better postoperative recovery in select patients. Overall, advances […]

Achieving a textbook outcome (TO) significantly enhances overall survival in biliary tract cancer (BTC) post-hepatectomy. Patients who achieved TO had a 31% reduced hazard of mortality (HR 0.69, 95% CI 0.58-0.82). Thirteen predictors of TO were identified, including younger age (OR 1.61), lower ASA score (OR 1.83), and smaller tumor size (OR 1.08). Laparoscopic surgery […]

Surgeons must prioritize preoperative identification of celiac artery stenosis in patients undergoing pancreaticoduodenectomy to reduce ischemic complications. Celiac artery stenosis occurs in 6.1% of patients undergoing the procedure; only 2.2% had preemptive median arcuate ligament release. Stenosis over 80% significantly increases the risk of postoperative ischemia. Identifying stenosis preoperatively results in fewer complications (5.8% vs. […]

Surgeons must prioritize preoperative identification of celiac artery stenosis in patients undergoing pancreaticoduodenectomy to reduce ischemic complications. Celiac artery stenosis occurs in 6.1% of patients undergoing the procedure; only 2.2% had preemptive median arcuate ligament release. Stenosis over 80% significantly increases the risk of postoperative ischemia. Identifying stenosis preoperatively results in fewer complications (5.8% vs. […]

Combining sequential hepatic vein embolization with portal vein embolization significantly boosts liver volume and function before major hepatectomy. Future remnant liver volume regeneration improved to 35.5% with sequential embolization, versus 26.2% with portal vein embolization alone. Both procedures had no severe complications, indicating safety in surgical applications. Surgeons should consider sequential embolization to optimize outcomes […]

A 4-day course of sulbactam/ampicillin effectively lowers perineal wound infections after abdominoperineal resection for rectal cancer. Incidence of perineal wound infection dropped significantly from 46% with cefmetazole to 14% with sulbactam/ampicillin. This multicenter trial involved 80 patients, with a focus on surgical site infections and overall complications. Consider shifting to a 4-day sulbactam/ampicillin regimen to […]