A study involving 218 patients undergoing thermal ablation for hepatocellular carcinoma found that 52.8% experienced complications. Key independent predictors included tumor size, area, and abnormal aspartate aminotransferase levels. Specific complications such as postoperative pain and fever were noted, with 6.9% of patients facing major issues. The research emphasizes the importance of assessing liver background using […]
Category: HPB & Spleen
Improved survival observed in colorectal liver metastasis patients
Data from 5,085 patients newly diagnosed with colorectal liver metastasis (CRLM) between 2013 and 2017 showed a significant increase in survival rates compared to 3,820 patients diagnosed from 2005 to 2007. The five-year overall survival rate after hepatectomy improved from 56.7% to 62.4%. Despite a greater prevalence of advanced-stage CRLM in the later cohort, prognostic […]
Structured mentorship improves laparoscopic bile duct exploration outcomes
A structured mentorship program significantly expedited the learning curve for laparoscopic common bile duct exploration (LCBDE). The mentee’s initial 100 cases showed a lower median postoperative hospital stay of 2 days versus 5 days for the mentor’s initial 100 cases, alongside a higher transcystic approach rate. Importantly, outcomes in mentees were comparable to those of […]
Predictive model identifies risk factors for delayed gastric emptying after pancreatectomy
A novel predictive model was successfully developed to assess the risk of clinically relevant delayed gastric emptying (DGE) in patients undergoing total pancreatectomy (TP). Key risk factors include end-to-side gastrointestinal anastomosis, intraoperative blood transfusion, and venous reconstruction. The model demonstrated robust prediction accuracy with ROC values of 0.853 in the training set and 0.789 in […]
Extended wait times for CVP measurements increase mortality risk
Delays in obtaining central venous pressure (CVP) measurements significantly raise the risk of 28-day mortality in critically ill patients with acute pancreatitis. An analysis of data from 233 patients revealed that those who experienced longer wait times for CVP assessments had more than double the risk of early death compared to those monitored within 12 […]
Surgical Resection Improves Outcomes for Selected HCC Patients
Findings indicate that surgical resection significantly enhances overall survival (OS) and cancer-specific survival (CSS) in selected patients with hepatocellular carcinoma (HCC) and portal vein invasion (PVI) who maintain preserved liver function and performance status. In a study of 998 patients undergoing treatment, those in the resection group (151 patients) demonstrated notable survival advantages compared to […]
New definitions and treatments for borderline resectable liver metastases
A narrative review highlights the importance of recognizing “borderline resectable colorectal liver metastases” (br-crlm) as a distinct entity. By analyzing criteria for resectability, researchers found a significant need for chemotherapy prior to surgery. Advances in surgical techniques, locoregional therapies, and perioperative chemotherapy have improved long-term survival outcomes for patients with br-crlm undergoing treatment. The current […]
Robotic liver surgery shows manageable learning curves for surgeons
Evaluation of robotic liver resections at San Raffaele Hospital revealed effective learning curves for two surgeons with varied laparoscopic experience. The pioneer surgeon achieved proficiency in high-complexity cases after 10 cases, while the new generation surgeon required 18. Operative times improved significantly for both after completing 15 low and 10 intermediate cases, demonstrating the impact […]
Better IPMN risk stratification could optimize cancer surgery decisions.
Personalized Cancer Risk Thresholds Can Guide IPMN Surgery Decisions Clinicians found that optimal cancer risk thresholds (CRT) for surgery in patients with branch-duct intraductal papillary mucinous neoplasms (bd-IPMN) vary based on age, comorbidities, and tumor location. For a 60-year-old with mild comorbidities, surgery was favored at a 20% CRT for tumors in the pancreatic head […]
Alloplastic grafts enhance patency in pancreatic surgery
Findings reveal that alloplastic vascular grafts used in pancreatic surgeries demonstrate superior patency rates compared to other materials. For example, the 7-day patency rate reached 99%, while the 1-year patency for polytetrafluorethylene grafts was 78%. Among 201 patients, the all-cause 90-day mortality was recorded at 10%, with no incidences of graft infection. The study highlights […]