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Robotic pancreaticoduodenectomy shows benefits over laparoscopic approach

In a systematic review of eight studies involving 6,648 patients, robotic pancreaticoduodenectomy (RPD) demonstrated significant advantages over laparoscopic pancreaticoduodenectomy (LPD) for malignant lesions. Key findings included a reduced length of hospitalization (mean difference of -0.94 days), lower conversion rates (odds ratio of 0.20), and a higher number of harvested lymph nodes (mean difference of 1.02). Overall morbidity was also lower in the RPD group (odds ratio of 0.50), although some outcomes showed no significant differences.

Review by Kossenas K, Kouzeiha R, Moutzouri O and Georgopoulos F in J Robot Surg

© 2025. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.

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Discovery of key players in lymph node metastasis of ICCA

Single-cell analyses reveal significant insights into lymph node metastasis in intrahepatic cholangiocarcinoma (ICCA). A complex heterogeneity was identified within the lymph node microenvironment, with an increase in stromal and mature immune cells, particularly diverse T cell subtypes. Notably, CD36+ macrophages and SAA1+ tumor cells were implicated as critical components in the metastatic process. These findings highlight new therapeutic targets and underscore the value of single-cell technologies for advancing understanding and treatment of ICCA.

Journal Article by Li Z, Ma L (…) Hang H et 3 al. in JHEP Rep

© 2024 The Author(s).

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High risk of surgery in complicated chronic diverticular disease

A nationwide study covering Denmark from 1996 to 2020 evaluated 33,951 patients with chronic diverticular disease and found a 5-year cumulative incidence of surgical intervention at 13.9%—9.8% elective and 4.2% emergency. Complicated cases presented a three- to six-fold increased likelihood of surgery compared to uncomplicated cases. Younger patients and those with more emergency admissions faced a higher risk of elective surgery. Identifying patients at risk can facilitate timely elective resections, potentially reducing disease burden.

Journal Article by Dalby HR, Erichsen R, Gotschalck KA and Emmertsen KJ in BJS Open

© The Author(s) 2025. Published by Oxford University Press on behalf of BJS Foundation Ltd.

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Improved prediction model for 5-year postoperative HCC recurrence

A new predictive model significantly enhances the accuracy of forecasting 5-year recurrence rates in hepatocellular carcinoma (HCC) patients post-surgery. Integrating LASSO regression and random forest techniques, the model identified six key factors, achieving an area under the curve (AUC) of 0.733, compared to the initial model’s AUC of 0.678. Importantly, this model demonstrates better predictive ability, improving patient management and prognosis evaluation by distinguishing low-risk from high-risk patients effectively.

Journal Article by Su BB, Zhu CJ (…) Bai DS et 7 al. in Surg Endosc

© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Weekend Surgery Increases Risk of Complications and Mortality

Patients undergoing surgeries immediately before the weekend face higher risks of death, readmission, and complications compared to those treated afterwards. An analysis of over 429,000 patients in Ontario revealed a consistent increase in adverse outcomes at 30 days, 90 days, and one year post-surgery for those in the preweekend group, with adjusted odds ratios indicating a significant concern. The need for further investigation into weekend care disparities is emphasized to enhance patient outcomes.

Journal Article by Ranganathan S, Riveros C (…) Satkunasivam R et 9 al. in JAMA Netw Open

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Pembrolizumab shows promise for rare microsatellite-high intrahepatic cholangiocarcinoma

A 65-year-old man with unresectable, microsatellite-high intrahepatic cholangiocarcinoma experienced significant tumor shrinkage after receiving pembrolizumab, following a failed combination therapy. The comprehensive cancer genomic profiling identified an mlh1 pathogenic mutation, suggesting the microsatellite instability was somatic rather than inherited. Remarkably, the response was maintained for over 30 months, indicating pembrolizumab’s potential effectiveness in treating this rare cancer type. This case highlights the importance of genomic profiling in identifying suitable treatments for difficult malignancies.

Journal Article by Horiguchi S, Kato H (…) Otsuka M et 7 al. in Clin J Gastroenterol

© 2025. The Author(s).

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Erector spinae plane block reduces opioid use after surgery

In a study evaluating ultrasound-guided erector spinae plane block (ESPB) for post-operative analgesia in laparoscopic cholecystectomy, researchers found that the ESPB group required significantly less tramadol within the first 24 hours compared to controls (p=0.005). Additionally, pain scores measured by visual analogue scale (VAS) were lower in the ESPB group at various intervals. The time to rescue analgesia was also significantly longer in the ESPB group (p=0.002), highlighting its efficacy as an analgesia technique.

Journal Article by Chauhan S, Gupta A, Harjai M and Giri MK in Turk J Surg

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Improved visualization of surgical needle tips enhances accuracy

A novel model was developed to visualize hidden surgical needle tips within organs, addressing challenges in laparoscopic procedures that could lead to complications like anastomotic leakage. Testing revealed real-time image inference at 33.4 frames per second and a mean needle misalignment of just 1.03 mm, well below the 1.8 mm threshold. These findings suggest that enhanced visibility will support surgeons in maintaining uniform suture spacing, ultimately improving surgical outcomes.

Journal Article by Memida S and Miura S in Annu Int Conf IEEE Eng Med Biol Soc

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Radiation-emitting metallic stents improve survival in cholangiocarcinoma

A multicenter trial demonstrated that radiation-emitting metallic stents (REMS) combined with hepatic arterial infusion chemotherapy (HAIC) significantly outperformed self-expandable metallic stents (SEMS) in patients with unresectable Bismuth type III or IV perihilar cholangiocarcinoma. The median overall survival was 10.2 months for REMS compared to 6.7 months for SEMS (p=0.002). Additionally, median time to symptomatic progression and stent patency were also longer with REMS, with improvements noted in physical functioning and fatigue.

Randomized Controlled Trial by Chen Q, Ge NJ (…) Lu J et 19 al. in Int J Surg

Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.

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In-hospital delays worsen outcomes in acute appendicitis cases

A meta-analysis of 28 studies involving 512,881 patients has revealed that preoperative in-hospital delays exceeding 24 hours significantly increase the risk of complicated appendicitis, postoperative complications, and mortality. Specifically, these delays are associated with a 60% higher risk of complicated appendicitis and a 51% increased likelihood of postoperative issues, alongside an 81% heightened risk of mortality. Given these findings, surgery should not be delayed beyond 24 hours for patients with acute appendicitis.

Systematic Review by Tang G, Zhang L (…) Zhou R et 3 al. in Int J Surg

Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.

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