Combining transarterial chemoembolization (TACE) with systemic therapy significantly enhances outcomes for hepatocellular carcinoma patients with hepatic vein or inferior vena cava tumor thrombus. Median overall survival was 20.9 months with TACE vs. 14.3 months without (HR=0.65). Progression-free survival also favored TACE, at 10.7 months compared to 7.3 months (HR=0.67). Adding TACE improves the objective response […]
Category: HPB & Spleen
Kangduo Robot Outperforms Laparoscopy in Distal Pancreatectomy
Kangduo robotic distal pancreatectomy is more effective and cost-efficient than traditional laparoscopic surgery. Kangduo patients had lower blood loss and transfusion rates. Reduced operative time and conversion to open surgery rates were noted. This technique leads to similar recovery outcomes while cutting costs. Patients on the Kangduo system also showed a significant decrease in inflammatory […]
Histotripsy Shows Promise for Liver Tumor Control
Histotripsy, a novel noninvasive ultrasound technique, demonstrated effective tumor control in liver cancer treatments. 70% of patients treated with curative intent achieved nonviable tumors at 30 and 90 days. Complications were rare, with only 1% classified as significant. Targeting accuracy remains critical; improvements are expected as surgeons gain experience. 75% of treatments aimed for complete […]
Robotic Crush and Clip Technique Reduces Complications in Pancreatectomy
The crush and clip technique for pancreatic transection in robotic distal pancreatectomy shows promise for reducing complications. Postoperative pancreatic fistula rates were 13% for crush and clip vs. 26% for stapler (p=0.280). Significant advantage in thick pancreas cases: 6% vs. 47% for crush and clip vs. stapler (p=0.013). This technique eliminates major complications, with none […]
Laparoscopic Pancreatoduodenectomy Shortens Stay in African Hospital
Hospital stay: 8.1 days (LPD) vs 10.6 days (open), p=0.049. Lower intraoperative blood loss and transfusion rates in the LPD group. These findings affirm LPD as a feasible option in resource-limited settings, enhancing patient recovery without compromising oncological safety. Comparable oncologic outcomes, including margin status and lymph node yield, suggest LPD’s effectiveness in cancer surgery. […]
New Insights on Fluid Management in Acute Pancreatitis
Dynamic fluid therapy strategies in acute pancreatitis can significantly impact patient mortality. Identified five dynamic fluid therapy trajectories within the first 72 hours: low stable (7.3%), low-moderate sustained (10.8%), moderate stable (66.0%), moderate-high fluctuating (7.4%), and high sustained (8.6%). Hazard ratios reveal increased in-hospital mortality: moderate-high fluctuating group (2.08) and high sustained group (2.91) compared […]
Low-grade blunt liver injury rarely requires intervention
Adults with isolated low-grade blunt liver injury almost never need surgery, allowing for streamlined management strategies. Only 1.33% of 4,498 patients required intervention. Key risk factors for intervention included older age, tachycardia, and hypotension. Young, stable patients may be discharged after brief observation, leading to more efficient use of resources. Patients under 51 with stable […]
Corticosteroids Harm Postoperative Outcomes in Hepatopancreatobiliary Surgery
Corticosteroids do not improve postoperative outcomes after hepatopancreatobiliary surgery and may actually worsen results. Administration linked to 116% increased odds of complications. Patients who received corticosteroids had a 56% higher chance of extended hospital stays. There’s a 26% rise in 90-day mortality among steroid recipients. Avoid routine use of corticosteroids in this surgical context, as […]
Refining Hepatocellular Carcinoma Risk: Tertiary Lymphoid Structures Matter
Integrating tertiary lymphoid structures (TLS) with microvascular invasion (MVI) improves risk stratification in hepatocellular carcinoma (HCC) patients post-surgery. Patients with TLS + and MVI – had the best outcomes, while TLS – and MVI + showed the worst, suggesting significant prognostic value. In a multi-cohort study of 923 patients, those with TLS + had a […]
Adjuvant Chemotherapy’s Benefit in Perihilar Cholangiocarcinoma
Log odds of metastatic lymph nodes is crucial for improving outcomes in patients undergoing surgery for perihilar cholangiocarcinoma. Patients with log odds of metastatic lymph nodes ≥ -2.0 saw a survival advantage from adjuvant chemotherapy (31.3 months vs 20.1 months). Those with log odds < -2.0 showed no survival benefit (69.2 months vs 51.0 months). […]