A novel ultrasound-guided technique to compress the middle hepatic vein allows for better detection of left-sided communicating veins, improving surgical options.

• Left-sided communicating veins were detected in 71% of patients using this method.
• Surgical strategies were modified in 57% of patients, enabling more parenchyma-sparing resections.

This technique could expand the criteria for liver resections and improve patient outcomes in cases involving the caval confluence.

• Major complications occurred in only 5%, with no perioperative mortality.

Surgical resection without multimodal treatment for early-stage pancreatic cancer can lead to better survival outcomes.

• Upfront surgery showed a median overall survival of 14.09 months compared to 6.34 months for those who refused surgery.
• One-year survival rates were 56% with surgery versus 26% without.
• R0 resection patients had a median survival of 17.87 months, significantly outpacing the 7.56 months in non-R0 cases.

Surgeons should consider early resection even in patients unable to tolerate multimodal therapies, particularly aiming for R0 margins for optimal outcomes.

A new preoperative scoring system enhances risk stratification for clinically relevant postoperative pancreatic fistula (cr-popf) after pancreatoduodenectomy, potentially improving surgical outcomes.

• The 6-point score boasts an area under the ROC curve of 0.89, with 81.8% sensitivity and 91.7% specificity.
• cr-popf incidence is 4.6% in low-risk patients versus 82.5% in very-high-risk patients.

Implementing this tool allows for tailored surgical plans and preventive measures, potentially reducing complications.

• Key factors include pancreatic attenuation ≤30 Hounsfield units, duct-to-parenchyma ratio ≤0.2, main pancreatic duct diameter <3 mm, and BMI ≥25 kg/m².