Among 107 patients with initially unresectable colorectal liver metastases undergoing conversion surgery, posthepatectomy liver failure (PHLF) occurred in 14% of cases. Multivariate analysis indicated that preoperative splenomegaly (greater than 135%) was an independent risk factor for PHLF, with an odds ratio of 14.30. Other contributing factors included lower platelet counts, increased blood loss, and extensive […]
Category: HPB & Spleen
Fibrinogen to pre-albumin ratio predicts prognosis in PDAC
A study of 563 patients with pancreatic ductal adenocarcinoma revealed that the preoperative fibrinogen to pre-albumin ratio (FPR) serves as an independent prognostic indicator for recurrence-free survival (RFS) and overall survival (OS) following radical resection. With an optimal threshold of 14.77, patients were stratified into low and high FPR groups. High FPR levels were associated […]
Deep learning accurately classifies colorectal liver metastasis growth patterns
A new deep learning algorithm successfully distinguishes between desmoplastic and non-desmoplastic histopathological growth patterns in colorectal liver metastases, achieving high discriminatory power with area under the curve values of 0.93 and 0.95 during development and external validation, respectively. This automated classification parallels manual scoring regarding overall survival outcomes, ensuring its potential utility in routine histopathological […]
Eosinophil counts are causally linked to pancreatic cancer.
A comprehensive study using MR-PheWAS and mendelian randomization demonstrated a causal association between pancreatic cancer and eosinophil counts, highlighting a notable correlation. Among 776 phenotypes analyzed, 41 showed significance, with specially validated results indicating that genetically predicted pancreatic cancer was linked to elevated eosinophils. This suggests a self-reinforcing relationship between the two. The findings call […]
Standardized Trocar Technique Improves Outcomes in Robotic Surgery
Implementation of a standardized trocar placement method using a 5-cm umbilicus incision combined with two robotic ports resulted in successful outcomes for robotic liver resection (RLR) and robotic pancreaticoduodenectomy (RPD) across a cohort of 60 patients. The approach achieved 82.8% uptake for RLR and 100% for RPD, with no serious postoperative complications, including hepatic insufficiency […]
Liver resection improves survival in colorectal metastases with extrahepatic disease
A population-based analysis of 170,978 patients revealed that liver resection significantly enhances overall survival for those with colorectal liver metastases and concurrent extrahepatic disease. Among 62,003 patients with this dual condition, only 6% underwent liver resection, yet they experienced markedly better median overall survival (52 months) compared to those without resection (27 months). Factors influencing […]
Combination of hepaticogastrostomy and stenting enhances outcomes
A systematic review assessed the effectiveness of hepaticogastrostomy with antegrade stenting (hgas) compared to hepaticogastrostomy alone (hgs) for malignant biliary obstruction. Findings revealed pooled clinical success rates of 94% for hgas versus 88% for hgs, while re-intervention needs were significantly lower with hgas (OR=0.37). Although overall adverse events were similar, hgas led to reduced bile […]
Recognition of Borderline Resectable Colorectal Liver Metastases as a Distinct Entity
The review delineates ‘borderline resectable colorectal liver metastases’ (BR-CRLM) as a distinct category, integrating both surgical and oncological criteria for optimal decision-making. Current treatments highlight the necessity of pre-operative chemotherapy and advanced surgical interventions, which now offer substantial long-term survival benefits. By emphasizing this classification, clinicians can better tailor therapeutic strategies, involving locoregional therapies and […]
Compliance with Quality Performance Indicators in Acute Pancreatitis
The PANORAMA study aims to assess how well New Zealand hospitals adhere to quality performance indicators (QPIs) for acute pancreatitis management. Researchers will gather data from adult patients diagnosed over a three-month period to evaluate compliance levels. In addition, the study will explore the connection between QPI compliance and early clinical outcomes, such as complications […]
ctDNA provides a reliable alternative to tissue genomic profiling
In a study involving 102 advanced biliary tract cancer patients, circulating tumor DNA (ctDNA) demonstrated an 84.8% sensitivity and a 79.4% positive predictive value compared to tissue genomic profiling. Targetable alterations were identified in 34.3% of patients, including mutations such as FGFR2 fusion and BRCA1/2 mutations. Notably, a novel FGFR2-TNS1 fusion was detected via ctDNA […]