Category: HPB & Spleen

Cholecystectomy effectively resolves symptoms in biliary dyskinesia patients

A study of 415 patients identified that 89 (21%) had biliary dyskinesia, primarily affecting younger women (median age 46, BMI 28). Abdominal pain was the most common symptom. Pathological evaluations showed chronic cholecystitis in 84% of cases. Importantly, all patients with biliary dyskinesia experienced symptom resolution after cholecystectomy, suggesting this procedure is a first-line treatment […]

Distinct prognostic implications observed in pancreatic neuroendocrine neoplasms

Findings indicate significant differences between insulinomas and non-functional pancreatic neuroendocrine neoplasms (nf-pnens) regarding prognosis and tumor biology. nf-pnens exhibited higher rates of lymph node involvement, perineural invasion, and more advanced tumor grades. The study’s multivariate analysis revealed that nf-pnens with lymph node metastasis and high grading correlated with reduced recurrence-free survival. Genetically, distinct somatic mutations […]

EUS-TA significantly enhances diagnostic accuracy for biliary lesions

Endoscopic ultrasound-guided tissue acquisition (EUS-TA) demonstrated high diagnostic yields in biliary lesions, achieving 96.3% sensitivity and 100% specificity. Of 71 cases, 54 were diagnosed as malignant, marking a 76.1% malignancy rate. When combined with endoscopic retrograde cholangiography (ERC), EUS-TA increased overall diagnostic accuracy from 82.5% to 94.2%, identifying 30 additional malignant cases. The procedure’s adverse […]

Radiologic-pathologic discordance significantly impacts HCC survival rates

In a nationwide cohort study, researchers found that discrepancies between radiologic findings and pathological evaluations in hepatocellular carcinoma patients undergoing resection are linked to worse survival outcomes. Specifically, discordance in more than two factors notably increased the hazard ratio to 3.251. Factors like lymph node metastasis and vascular invasion were also significant independent predictors of […]

Next-generation sequencing enhances management of pancreatic cysts

Incorporating next-generation sequencing (NGS) into the management of pancreatic cysts improved diagnostic precision and surgical decision-making. In a retrospective study of 441 patients, NGS revealed high-risk mutations in 55.3% of those with unclear cyst types, guiding management changes for 26.1% of patients. Specifically, NGS demonstrated a sensitivity of 72.7% and specificity of 97.8% in predicting […]

PGA-wrapping reduces complications in minimally invasive left pancreatectomy

A study involving 148 patients demonstrated that polyglycolic acid (PGA) mesh wrapping significantly reduces the incidence of clinically relevant postoperative pancreatic fistula (CR-POPF) after minimally invasive left pancreatectomy. The PGA group showed a 20% CR-POPF rate compared to 44% in the control group (p = 0.024). Additionally, patients with PGA wrapping experienced shorter drain removal […]

Rendezvous treatment effectively resolves external pancreatic fistulas

Long-term follow-up of 40 patients treated for external pancreatic fistulas revealed a 100% closure rate after rendezvous internalization treatment, with an average closure time of 20 days. Complication rates were modest, including post-procedural acute pancreatitis (12.5%) and minor bleeding (7.5%). During a median follow-up of 53.5 months, 7.5% experienced fistula recurrence. Notably, new-onset diabetes mellitus […]

Tumour Biology Characteristics Score Predicts Outcome in HCC Patients

A novel tumour biology characteristics score (TBCS), utilizing alpha-fetoprotein and PIVKA-II levels, significantly predicts recurrence-free survival (RFS) and overall survival (OS) in hepatocellular carcinoma (HCC) patients post-resection. Analysis of 695 patients revealed distinct survival outcomes across TBCS groups: 5-year RFS and OS were lowest in the high TBCS group (9.7% and 23.5%, respectively). TBCS serves […]

Postoperative hepatic insufficiency still occurs in 12% of patients.

Despite achieving the desired future liver remnant volume through portal vein embolization, 12% of patients still experienced postoperative hepatic insufficiency following major hepatectomy. Key risk factors identified include older age, performance status, preoperative biliary drainage, and specific diagnoses such as cholangiocarcinoma or gallbladder cancer. Notably, postoperative hepatic insufficiency significantly increased mortality rates from 3.5% to […]