The intricate vascular anatomy of the pancreas, rife with variations, profoundly impacts surgical and interventional outcomes. Key arterial and venous structures, including the superior pancreaticoduodenal arteries and the gastrocolic trunk, require careful consideration to ensure effective surgical planning. Advances in imaging technologies now allow for precise mapping of these high-risk vascular variants, enhancing the safety […]
Category: HPB & Spleen
Accelerated Management Cuts Treatment Times for Pancreatic and Liver Cancer
A streamlined approach to pancreatic and hepatocellular cancer treatment in Scotland significantly slashed the time from diagnosis to definitive treatment. Median treatment initiation for hepatocellular carcinoma (HCC) decreased from 98 to 62 days, while for pancreatic cancer (PC) the timeline shortened from 54 to 38 days. Enhanced communication and centralized oversight under the pathway improvement […]
Innovative Ex Vivo Surgery and Autotransplantation Successfully Treats IVC Leiomyosarcoma
Surgeons successfully performed an ex vivo liver resection and autotransplantation in a patient with extensive inferior vena cava leiomyosarcoma. The operation included en bloc tumor removal, extensive vascular reconstruction, and involvement of open-heart surgery techniques. After a 13-hour procedure and significant blood loss, the patient was discharged after a month and remains disease-free 16 months […]
Minimally Invasive Surgery Cuts Complications and Mortality in Pancreatic Cancer Patients
Minimally invasive distal pancreatectomy (MIDP) markedly reduces hospital stays, infections, and 90-day mortality compared to open distal pancreatectomy (ODP) in pancreatic ductal adenocarcinoma patients. Analyzing data from 20 studies involving 9,339 patients, MIDP also leads to significantly lower blood loss and transfusions. Despite showing better clinical outcomes, further randomized clinical trials are necessary to solidify […]
Innovative Patch Technique Enhances Venous Reconstruction in Pancreatoduodenectomy
A new patch reconstruction technique for venous resection during pancreatoduodenectomy offers significant advantages. It preserves essential venous collaterals while maintaining oncologic radicality, minimizing risks of torsion or stenosis typically seen with segmental resection. This versatile approach is effective for both open and robotic surgeries, addressing various tumor infiltrations without compromising surgical outcomes. The technique emphasizes […]
Positive lymph node status predicts very early recurrence in pancreatic cancer
Positive lymph node status dramatically increases the risk of very early recurrence—defined as recurrence within three months—after neoadjuvant therapy and curative resection for pancreatic ductal adenocarcinoma. In a cohort of 305 patients, 9.1% experienced this rapid recurrence, which severely impacts overall survival (6 months vs. 40 months). This finding suggests that patients with positive lymph […]
New Surgical Score Predicts Postoperative Complications After Liver Cancer Surgery
A novel surgical burden score (SBS), factoring in adjusted blood loss and operative time, significantly forecasts postoperative complications in hepatocellular carcinoma (HCC) surgery. Among 801 patients analyzed, complications were noted in 39.1%, with severe cases at 11%. The SBS model surpassed existing models, achieving area under the curve (AUC) scores of 0.73 for training and […]
New Nomogram Accurately Predicts Survival in Hepatocellular Carcinoma with Vascular Invasion
A newly developed nomogram effectively predicts overall survival for hepatocellular carcinoma (HCC) patients with major vascular invasion. Analyzing data from 2,211 patients, key survival factors include tumor size, N stage, metastases, and treatment modalities. The model demonstrates robust predictive accuracy with c-index values around 0.72–0.73 across cohorts and high area under the curve (AUC) scores […]
Innovative EUS Techniques Transform Access for Biliary Interventions in Complex Anatomy
New endoscopic methods, EDGE and EDEE, revolutionize access to the biliary system for patients with surgically altered anatomy. These techniques facilitate minimally invasive procedures, significantly lowering morbidity rates while maintaining high success rates. By using lumen-apposing metal stents, they improve safety profiles and expand treatment options. This comprehensive review underscores the need for multicenter trials […]
Optimal strategies for necrotizing pancreatitis: Early drainage and delayed surgery show promise
Early drainage with lavage and delayed step-up surgery demonstrate significant survival benefits in necrotizing pancreatitis, decreasing mortality and complications. In contrast, delayed video-assisted surgery leads to higher mortality rates. No significant differences between early and delayed intervention approaches were found. Tailoring treatment based on individual risk profiles is crucial as current evidence remains inconclusive, highlighting […]