A study focused on the efficacy of laparoscopic left hemihepatectomy combined with choledochoscopic lithotomy showed a significantly higher total effective rate (98.04%) compared to laparoscopic surgery alone (82.61%). While operation times were longer for the combined approach, recovery times for various postoperative metrics were notably shorter, alongside reduced complications (5.88% vs. 19.57%). Additionally, liver function […]
Category: HPB & Spleen
Validation of ISGPS Definition for Post-Pancreatectomy Acute Pancreatitis
An international study involving 2,902 patients undergoing pancreatoduodenectomy found that 7.5% developed post-pancreatectomy acute pancreatitis (PPAP), predominantly grades B (6.3%) and C (1.2%). The study revealed significant differences in hospital stays and costs linked to PPAP severity, with grade C patients hospitalized for an average of 43 days, incurring costs 11 times greater than those […]
Adjusting chemotherapy improves survival in pancreatic cancer patients
Adjustments in neoadjuvant chemotherapy regimens based on carbohydrate antigen 19-9 (CA19-9) levels significantly enhanced overall survival in patients with resectable or borderline resectable pancreatic ductal adenocarcinoma (PDAC). In a study of 283 patients, those who changed their chemotherapy when CA19-9 levels remained elevated achieved better survival rates (35.9 months) compared to those who did not […]
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 […]
Pathological response correlates with improved survival in UHCC patients
In a study of 76 patients with unresectable hepatocellular carcinoma (UHCC) undergoing conversion surgery after triple therapy, major pathological response (MPR) and pathological complete response (PCR) were observed in 69.7% and 32.9% of cases, respectively. Those achieving MPR had significantly higher overall survival rates at one and two years compared to non-MPR patients (100.0% and […]
Improved methods reveal high liver margin cancer rates in surgery
A multicenter study on perihilar cholangiocarcinoma revealed a significant discrepancy in liver margin (lm) resection rates. The discovery cohort showed a lm R1 resection rate of 38.6%, compared to 5.6% in the control cohort, indicating that whole-mount digital large sections (WDLS) identify more R1 cases. Additionally, carcinoma was predominantly within 20 mm of the proximal […]
Laparoscopic central hepatectomy shows promise for liver tumors
Laparoscopic central hepatectomy (CH) demonstrates comparable perioperative outcomes to hemihepatectomy (HH) for patients with centrally located hepatocellular carcinoma (HCC). A review of 70 CH cases revealed shorter postoperative hospital stays (median 6 days vs. 9 days) and fewer ICU transfers (19% vs. 44%) compared to HH. Additionally, the 90-day mortality rate was notably lower in […]
Machine learning predicts early recurrence after liver surgery.
A new machine learning model successfully predicted early extrahepatic recurrence (EEHR) following curative resection of colorectal liver metastases (CRLM). Among 1,410 patients, 131 (9.3%) experienced EEHR, with median overall survival significantly lower for affected patients (35.4 months) versus those without (120.5 months, p < 0.001). The model achieved a c-index of 0.77, highlighting primary tumor […]
Decreased HVPG Post-Surgery Linked to Improved Outcomes
Laparoscopic splenectomy plus esophagogastric devascularization significantly reduced hepatic venous pressure gradient (HVPG) in patients with portal hypertension, with 66% showing a decrease. Notably, those exhibiting a postoperative HVPG reduction greater than 20% demonstrated improved recurrent hemorrhage-free survival rates compared to others. Baseline HVPG and preoperative Child-Turcotte-Pugh class B were found to correlate with decreased HVPG […]
Combined radiomics and body analysis enhance predictive accuracy for pancreatic surgery complications
A new model integrating radiomics, pancreatic duct diameter, and body composition analysis effectively predicts clinically relevant postoperative pancreatic fistula in patients undergoing pancreaticoduodenectomy. This combined approach achieved an area under the ROC curve of 0.839, outperforming existing models. Internal validation through 1,000 bootstrap resamples demonstrated the model’s reliability, culminating in the development of a web-based […]