Robotic liver surgery proves effective for complex resections of benign liver tumors like focal nodular hyperplasia.

• A 24-year-old woman underwent robotic partial hepatectomy for a growing 7 cm FNH with critical hilar involvement.
• The procedure lasted 3 hours with minimal blood loss (100 cc) and no complications.

She was discharged on postoperative day 3, and follow-up showed no recurrence after one year.

• Enhanced visualization and fluorescence guidance were key to preserving vital structures during surgery.

Surgeons need to balance level 1 evidence and experiential insight in mitigating pancreatic fistulas after pancreatoduodenectomy.

• Analysis of 37 randomized controlled trials reveals low patient inclusion rates (39.6%) and significant discord in findings for 6 of 7 mitigation techniques.
• Meta-analyses provided more consistent conclusions than individual trials, yet rates of clinically relevant fistulas differed notably between trial participants and experiential data cohorts.

Understanding these discrepancies can help tailor strategies for risk stratification, improving patient outcomes and surgical decision-making.

• Experiences with stents, drains, and early drain removal align with level 1 data, while approaches like pancreatogastrostomy require further scrutiny.

Surgeons treating locally advanced pancreatic cancer (LAPC) can improve patient survival by using radical resection combined with intestinal autotransplantation after systemic treatment.

• Patients who underwent radical resection and autotransplantation had a median overall survival of 25.8 months, compared to 14.2 months for those who did not have surgery.
• Median progression-free survival was also better at 13.3 months versus 7.0 months for surgical non-recipients.

Select patients based on at least 8 cycles of systemic treatment and carbohydrate antigen 19-9 normalization for optimal outcomes.

• Adjuvant therapy after radical resection was associated with improved survival rates.

Assessing neoadjuvant therapy response in pancreatic cancer is crucial for improving surgical outcomes.

• A 50% decrease in CA19-9 levels correlated with better overall survival (32 months vs 24 months, p = 0.0028).
• Combining CA19-9 response with major pathologic response was linked to the best survival (40 months, p = 0.0086), though this occurred in only 9% of patients.

Surgeons should prioritize dual response indicators for optimal patient selection and prognostication.

• Neoadjuvant radiation therapy improved occurrence of this dual response (45% vs 11%, p < 0.001).