Category: HPB & Spleen

Same-day discharge after hepatectomy is safe for low-risk patients

Analysis of 7,279 patients undergoing laparoscopic or robotic hepatectomy revealed that same-day discharge is feasible for low-risk individuals. Among 361 patients discharged on the same day, there were no significant differences in 30-day mortality, readmissions, or postoperative complications compared to admitted patients. Younger age and fewer comorbidities characterized the same-day discharge cohort, suggesting careful patient […]

A standardized approach for hepatobiliary anastomotic leakage is needed.

A narrative review highlights the absence of a universally accepted definition and grading system for anastomotic leaks (AL) in hepato-pancreato-biliary procedures. Variability in reported incidence complicates understanding and managing complications such as postoperative pancreatic fistula and bile leaks. The review emphasizes the substantial human and economic costs associated with AL, including increased morbidity, mortality, and […]

Primary tumor resection significantly enhances survival in liver metastases

Analyzing data from 21,928 patients, researchers determined that primary tumor resection (PTR) improves overall and cancer-specific survival rates for patients with colorectal, pancreatic, and breast cancer liver metastases. Significant factors influencing survival benefits from PTR included age and tumor characteristics for colorectal patients, while chemotherapy affected pancreatic cancer outcomes. Additionally, a predictive model was developed […]

Spontaneous portosystemic shunts predict post-hepatectomy liver failure

Analysis of pre-operative CT scans indicated that spontaneous portosystemic shunts (SPSs) were present in 17.4% of patients undergoing liver resection for hepatocellular carcinoma. Among 425 patients, post-hepatectomy liver failure (PHLF) occurred in 6.4%, with 4% experiencing grades B/C. Multivariable analysis revealed SPS as an independent risk factor for all-grades PHLF (OR 6.83) and clinically significant […]

Inadequate surgical management of gallbladder cancer impacts survival.

Gallbladder cancer patients who received oncological resection demonstrated significantly better overall survival rates compared to those undergoing cholecystectomy alone. Among 1,129 patients analyzed, 299 had complete resection, with survival rates at one, three, and five years markedly higher for these patients. Factors influencing inadequate surgical intervention included female gender, advanced age, frailty, treatment by general […]

Combined prognostic model outperforms individual models for PDAC survival

A combined prognostic model integrating deep learning-derived digital pathology features and clinical indicators demonstrated enhanced predictive accuracy for pancreatic ductal adenocarcinoma (PDAC) survival. In a study involving 142 postoperative cases, the combined model achieved a Harrell concordance index (c-index) of 0.86 in the training set and 0.77 in the testing set, surpassing the individual clinical […]

Machine Learning Model Accurately Predicts Early Recurrence in PCCA Patients

A multicenter study developed a machine learning model to predict early recurrence in patients with perihilar cholangiocarcinoma (PCCA) after curative surgery. The model, leveraging five key factors, including carbohydrate antigen 19-9 and tumor size, achieved superior predictive performance, particularly with the random forest algorithm (AUC: 0.983) compared to others. High-risk patients showed significantly different recurrence-free […]

Postoperative survival in cholangiocarcinoma has significantly improved.

Surgical strategies implemented after the launch of the cholangiocarcinoma screening and care program led to a significant increase in postoperative survival rates. Median survival time more than doubled from 14 months (2002-2013) to 40 months (2014-2021). Enhanced early-stage detection rose to 29.1%, with surgical margins improving notably (40% vs. 53.7%). These findings underscore the effectiveness […]

Discontinuing Surveillance for Stable IPMNs Can Save Costs

In a study analyzing intraductal pancreatic mucinous neoplasms (IPMNs), findings suggest that patients with stable IPMNs have a comparable risk of pancreatic cancer to the general population. Of 746 patients studied, only 3 (0.4%) developed pancreatic cancer after a median surveillance period of 48 months. The researchers advocate for possibly discontinuing surveillance after 5 years […]

New tool predicts liver metastasis risks in neuroendocrine tumors

A novel Liver Metastasis Score (LMS) effectively predicts liver metastasis risk for patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs) post-surgery. Among 724 patients studied, 9.1% developed liver metastasis, significantly impacting survival rates (63.6% vs. 95.8% for no metastasis). Key risk factors identified include Ki-67 index, vascular invasion, lymph node metastases, and absence of adjuvant therapy. The […]