Surgeons can now better identify patients who may not benefit from surgery for gallbladder cancer.

• 11.1% of patients experienced ‘futile surgery’ with a median survival of only 8.9 months.
• Those who received successful surgical intervention had a median survival of 88.7 months (p < 0.001).

Incorporating this nomogram into preoperative decision-making may significantly reduce unnecessary procedures.

• Key predictors include elevated CA 19-9 levels, borderline resectable status, and the need for extended resections.

A new meta-analysis shows the Albumin-Bilirubin (ALBI) score is crucial for predicting survival and liver function in hepatocellular carcinoma patients treated with transhepatic arterial chemoembolization (TACE).

• Higher ALBI grades significantly correlate with shorter overall survival: 2nd vs. 1st grade (1.52 times higher risk); 3rd vs. 1st (2.67 times); and 3rd vs. 2nd (1.94 times).
• The risk of acute-on-chronic liver failure (ACLF) increases with higher ALBI scores (4.57 times higher risk for patients with worse scores).

Surgeons should consider the ALBI classification to refine patient selection for TACE and anticipate potential complications from repeated treatments.

Preoperative and postoperative multidrug-resistant bacteria significantly impair recovery after pancreatic surgery.

• 20.75% of patients tested positive for multidrug-resistant bacteria, linked to higher complications like pancreatic fistula (37.84% vs. 3.92% in MDR-negative).
• Key outcomes such as major complication rates, ICU stay, and overall hospitalization increased for MDR-positive patients (all p < 0.0001).

Consider preoperative decolonization and broad-spectrum antibiotics for at-risk patients to improve surgical outcomes.

Optimal lymphadenectomy and adjuvant capecitabine boost survival for gallbladder cancer patients.

• Patients with ≥6 lymph nodes resected had a 68% lower risk of death compared to those with inadequate lymphadenectomy.
• Adjuvant capecitabine led to a 48% increase in disease-free survival and a 67% improvement in overall survival.

Use these findings to prioritize thorough lymphadenectomy and consider capecitabine for eligible patients to enhance surgical outcomes.

• Hepatic disease, T stage, and resection status significantly impacted survival, underscoring the need for careful patient selection.

Pancreatic cancer in sub-Saharan Africa is largely diagnosed in advanced stages, severely affecting surgical outcomes.

• Over 80% of patients present with advanced or metastatic disease, limiting curative interventions.
• Surgical resections occur in less than 10% of cases, with palliative bypass as the primary procedure.

Improving outcomes hinges on addressing healthcare disparities and investing in infrastructure and training.

• Diagnostic imaging is often not available, and opioid access remains below 50% in many centers.