In a study analyzing data from 724 patients undergoing biliary anastomosis, researchers reported a 5.6% bile leak rate in distal malignant obstruction cases, while the rate increased to 14.6% in proximal malignant cases. Mortality varied significantly between anastomotic failure (26%) and no failure (2.6%). Advanced comorbidities and elevated preoperative bilirubin levels correlated with higher leak […]
Category: HPB & Spleen
Muscle mass-to-fat ratio predicts outcomes in pancreatic cancer surgery
A study evaluating the muscle mass-to-fat ratio (mmfr) in pancreatic cancer patients revealed significant prognostic implications. Among 191 patients undergoing pancreaticoduodenectomy, those in the low-mmfr group faced shorter overall survival and higher incidences of postoperative pancreatic fistula compared to their high-mmfr counterparts. The optimal mmfr cutoff values were identified at 0.688 for males and 0.382 […]
Robotic pancreaticoduodenectomy shows promising safety and feasibility
Analysis of 425 patients in Japan demonstrates that robotic pancreaticoduodenectomy (RPD) can be safely introduced, achieving a low conversion rate to open surgery (3.8%) and high minimally invasive surgery completion rate (91.1%). The median operative time was 617 minutes, with a median blood loss of 160 grams. While the complication rate was 20.5%, mortality rates […]
Deep-learning model surpasses traditional methods in predicting HCC recurrence
A novel deep-learning model, Recurr-Net, showed superior accuracy in predicting hepatocellular carcinoma (HCC) recurrence post-surgery compared to histological microvascular invasion (MVI) and conventional clinical prediction scores. In a study of 1,231 patients, Recurr-Net achieved AUROC scores between 0.770 and 0.857 for internal validation, significantly better than MVI and various clinical risk scores. The model effectively […]
Delayed gastrointestinal recovery affects 16% of hepatectomy patients
The study found that 16% of patients experienced delayed return of gastrointestinal function (DRGF) after partial hepatectomy, which was notably linked to major surgery, longer operation times, and postoperative complications like biliary leaks. Among the 82 affected patients, some required a second nasogastric tube placement, and they also experienced increased risks of pneumonia and lengthened […]
Splenectomy linked to shorter survival in pancreatic cancer patients
A nationwide analysis of pancreatic cancer patients reveals that those who underwent total pancreatectomy with a spleen-preserving approach exhibited significantly prolonged survival (17.3 months) compared to those who had splenectomy (9.6 months). The study highlighted splenectomy as an independent risk factor for shorter overall survival, corroborated by a meta-analysis linking the procedure to decreased longevity […]
Augmented Reality and Fluorescence Imaging Enhance Hepatectomy Outcomes
A study examined laparoscopic parenchyma-sparing hepatectomy for colorectal liver metastases, comparing procedures using augmented reality navigation and fluorescence imaging (ARN-FI) versus traditional methods. Findings indicated that the ARN-FI group experienced shorter transection times, reduced postoperative stays, and wider margins, although recurrence-free survival rates did not differ significantly. Notably, for deep-seated tumors, the ARN-FI approach resulted […]
Adjuvant chemotherapy improves survival outcomes in biliary tract cancers
A systematic review and network meta-analysis of eight randomized controlled trials involving 1,803 biliary tract cancer patients found that adjuvant chemotherapy significantly enhances relapse-free survival and overall survival compared to observation alone. Notably, gemcitabine-based chemotherapy outperformed fluorouracil-based treatments in reducing recurrence rates. The analysis indicates that postoperative chemotherapy should be a standard recommendation following curative […]
Cholangioscopy guided biopsy outperforms ERCP brushings in malignancy detection
A study evaluating biopsy methods for malignant biliary strictures revealed that the SpyGlass™ Discover cholangioscopy guided biopsies significantly outperformed ERCP guided brushings. SpyGlass™ Discover identified 82% of malignancies compared to just 47% for brushings. Conducted on 46 patients, with 87% undergoing both procedures, the findings suggest that cholangioscopy guided biopsies may serve as a superior […]
Low central venous pressure linked to posthepatectomy liver failure risk
A study involving 755 laparoscopic hepatectomy patients found that maintaining a lowest central venous pressure (CVP) below 2 mmHg significantly increases the incidence of posthepatectomy liver failure (PHLF). After propensity score matching, results indicated that low CVP levels correlated with higher PHLF occurrence and elevated intraoperative lactate levels, particularly among elderly patients or those with […]