A novel deep-learning model, Recurr-Net, significantly outperformed traditional methods in predicting hepatocellular carcinoma (HCC) recurrence post-curative surgery. Analyzed across 1,231 patients, Recurr-Net demonstrated an area under the receiver operating characteristic curve (AUROC) of 0.770 to 0.857 internally and 0.758 to 0.798 externally, while the historical microvascular invasion (MVI) showed much lower performance. This indicates Recurr-Net’s […]
Category: HPB & Spleen
Primary needle-knife fistulotomy is safer for biliary access.
A randomized clinical trial involving 260 patients revealed that primary needle-knife fistulotomy (PNKF) significantly outperforms standard transpapillary (STP) techniques for cannulating long-size papilla. PNKF achieved a biliary cannulation success rate of 96.2% compared to STP’s 87.7% (p = 0.01). Moreover, post-endoscopic retrograde cholangiopancreatography pancreatitis was markedly lower in the PNKF group (2.4%) versus STP (9.6%, […]
Laparoscopic liver resection proves cost-effective
Laparoscopic liver resection (LLR) demonstrated superior clinical and economic outcomes compared to open liver resection (OLR) in a study involving 920 patients. LLR resulted in significantly fewer postoperative transfusions, a shorter median length of stay, and lower rates of complications, readmissions, and reoperations. Importantly, LLR showed lower total costs across all types of hepatectomies, establishing […]
Near-infrared fluorescence imaging improves resection outcomes in liver surgery
Laparoscopic hepatectomy utilizing near-infrared fluorescence imaging significantly enhanced tumor identification, identifying over 59% of tumors on the liver surface. The technique yielded a remarkable 96.6% clear resection margins among patients with colorectal liver metastases. Furthermore, no tumor cells were found in 21.3% of cases analyzed, with a median continuous fluorescent signal distance from the tumor […]
Partial splenic embolization improves outcomes for cancer patients.
Research indicates that partial splenic embolization (PSE) significantly enhances platelet counts and reduces complications for cancer patients suffering from hypersplenism. Optimal splenic infarction volumes of 388 to 540 ml are essential for achieving these benefits. In cases of massive splenomegaly, the noninfarcted spleen volume is crucial. Additionally, combining PSE with systemic chemotherapy shows promise in […]
Asymptomatic cholecystitis requires improved surgical strategies
Asymptomatic cholecystitis is prevalent yet often overlooked, with 80% of cases lacking clinical manifestations. Surgeons frequently avoid addressing this condition, leading to inconsistencies in treatment approaches and increased risks, such as postcholecystectomy syndrome. The current literature is sparse and fragmented, lacking a unified strategy for managing asymptomatic cases. A comprehensive examination of the tactical approaches […]
Surgery combined with adjuvant therapy shows best outcomes for HCC
A systematic review and meta-analysis of 40 randomized clinical trials involving 11,576 patients reveals that locoregional therapies (LRTs) for hepatocellular carcinoma (HCC) differ significantly in efficacy. Researchers found that surgery with adjuvant therapy provides superior progression-free survival (PFS) and overall survival (OS) compared to surgery alone, radiofrequency ablation (RFA), or various embolization techniques. The analysis […]
Transpancreatic mattress suture reduces pancreatic fistula rates
A novel transpancreatic mattress suture method using a polyglycolic acid sheet significantly decreased postoperative pancreatic fistula (POPF) rates in robotic distal pancreatectomy. Among 145 cases analyzed, the TP group showed a POPF rate of 5.6%, compared to 27.3% for the hand-sewn and 14.3% for stapler methods. Notably, pancreatic thickness of ≥12 mm was an independent […]
Curative-intent resection significantly boosts survival in cholangiocarcinoma
A retrospective analysis of 720 cholangiocarcinoma patients revealed a 78.3% overall resectability rate, with the highest in perihilar cases. Median survival time was 11.6 months, varying by subtype. Patients undergoing curative-intent resection experienced markedly improved survival rates compared to those receiving palliative treatment. Notably, complete (R0) resection resulted in a five-year survival rate of 20.2%, […]
Fluorescence imaging effectively locates small pancreatic tumors.
Fluorescence imaging using indocyanine green has shown promising results for the intraoperative localization of small pancreatic neuroendocrine tumors. In a case report involving five patients, successful tumor identification and laparoscopic partial resections were achieved without serious complications. Pathological reviews confirmed four neuroendocrine tumors of G1 stage and one case of neuroendocrine cell hyperplasia. The findings […]