Researchers examined the concept of total neoadjuvant therapy (TNT) for pancreatic ductal adenocarcinoma (PDAC), finding that the term “total” is not consistently defined. Although it has gained popularity for its promise of comprehensive preoperative treatment, the current understanding and protocols vary widely, with inconsistent therapy durations and approaches. Among 7 studies reviewed, the length of […]
Category: General Surgery
Minimally Invasive Approach Improves Oncological Outcomes for High-Risk Ver Patients with Intrahepatic Cholangiocarcinoma
Minimally invasive surgery for intrahepatic cholangiocarcinoma in patients at high risk of early recurrence provides better disease-free and overall survival compared to open surgery. Laparoscopic approach leads to shorter surgery-adjuvant treatment interval and higher rates of adjuvant therapy initiation within 2 months post-surgery. This study highlights the oncological benefits of laparoscopy in high-risk VER patients. […]
Familial Obesity Linked to Reduced Long-Term Success After Sleeve Gastrectomy
Researchers examined the outcomes of sleeve gastrectomy (SG) in patients with familial aggregation of obesity (FAO) compared to those with sporadic obesity (SO). The study, involving 193 patients, found no significant differences in baseline characteristics or short-term postoperative weight loss between FAO and SO groups. However, by the two-year mark, patients with FAO had a […]
Root Causes of Mortality After Esophagectomy for Cancer
Root cause analysis of mortality after esophagectomy revealed that more than half of deaths were potentially preventable. Factors such as inappropriate indications, patient characteristics, unexpected intraoperative findings, and delays in diagnosing complications were associated with preventable deaths. Following national guidelines and centralizing care may reduce mortality in these cases. Journal Article by Levenson G, Coutrot […]
Smaller Gastrojejunostomy Diameters Linked to Enhanced Weight Loss in Laparoscopic Gastric Bypass
Researchers reviewed the impact of gastrojejunostomy (GJ) anastomosis diameter on weight loss outcomes after laparoscopic Roux-en-Y gastric bypass (RYGB). In the systematic review, including six studies with varying GJ diameters and follow-up durations of 1-5 years, smaller GJ diameters generally led to greater short-to-medium-term weight loss. However, complications like stenosis increased with smaller diameters beyond […]
Prognostic Value of Preoperative CALLY Index in Gastric Cancer Patients
The preoperative CALLY index is a valuable prognostic marker for gastric cancer patients, correlating with clinicopathological factors, overall and disease-free survival, and postoperative complications. A low preoperative CALLY index was significantly associated with advanced disease stages and independently predicted poorer outcomes. This index shows promise for guiding perioperative and oncological management in this patient population. […]
Feasibility and Safety of Highly Complex Liver Resections
Highly complex liver resections (HCLR) can be performed with an acceptable complication profile, similar to major non-HCLR procedures. However, HCLR is associated with increased rates of biliary complications, readmissions, and reoperations. No postoperative 90-day mortality was observed in the HCLR group. Tertiary hepato-pancreato-biliary centers should be considered for cases of questionable resectability. Journal Article by […]
Management of Infected Collections in Acute Pancreatitis: To Drain or Not Drain?
Recent literature advocates for delaying catheter drainage in acute pancreatitis, but critically ill patients with severe disease and infected peri-pancreatic collections may still benefit from drainage procedures. A retrospective review of 72 patients showed high rates of ICU admission, respiratory and renal failure, and in-hospital mortality. Until more research is done, drainage should continue to […]
Laparoscopic Liver Resection VS Radiofrequency Ablation for Small Hepatocellular Carcinoma
Patients with small hepatocellular carcinoma showed similar overall and recurrence-free survival rates whether treated with laparoscopic liver resection or radiofrequency ablation. This randomized clinical trial suggests that percutaneous radiofrequency ablation may offer comparable therapeutic effects to laparoscopic liver resection for this patient population. Journal Article by Song J, Cao L (…) Zheng S et 4 […]
Low Morbidity and High Survival with Surgical Microwave Ablation for Colorectal Liver Metastasis
Researchers conducted a retrospective review of 394 microwave ablation (MWA) procedures on 328 patients with colorectal liver metastasis. The study found a low morbidity rate, with Clavien-Dindo grade III or IV complications occurring in 3.6% of patients, all of whom had concomitant procedures. Incomplete ablation and local recurrence rates were 1.5% and 6.3% per tumor, […]