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Functional liver remnant measured by preoperative gadoxetate disodium-enhanced MRI predicts post-hepatectomy liver failure

Gadoxetate disodium-enhanced MRI can predict post-hepatectomy liver failure. Low signal intensity of the remnant liver compared to the spleen post-contrast is associated with higher odds of liver failure. Functional liver remnant determined by this imaging can accurately predict post-hepatectomy liver failure, with a specific cut-off value and high sensitivity and specificity. This predictive tool may aid in identifying patients at risk, guiding surgical decisions, and ultimately reducing morbidity and mortality.

Journal Article by Lauscher JC, Dixon MEB (…) Karanicolas PJ et 9 al. in HPB (Oxford)

Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.

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Monitoring Hepatocellular Carcinoma Burden with Methylated ctDNA Quantification

Quantifying methylated circulating tumor DNA effectively monitors HCC burden without the need for biopsy. Tumor methylation scores rapidly decline postoperatively in surgical HCC patients. Preoperative tms moderately correlates with tumor burden on pathology. Δtms is better associated with tumor progression than Δalpha-fetoprotein, and a composite score improves tumor progression detection. These findings show that ctdna methylation scores can accurately assess changes in HCC burden.

Journal Article by Angeli-Pahim I, Chambers A (…) Zarrinpar A et 5 al. in J Am Coll Surg

Copyright © 2023 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Effective Infection of Pancreatic Tumors with Oncolytic Virus Expressing CD19 Antigen Triggers Enhanced Tumor Regression with CD19-CAR T Cells

Intravenous administration of an oncolytic virus (cf33) engineered to express a nonsignaling CD19 antigen (CD19t) effectively infected and expressed CD19t in pancreatic tumors, triggering cell killing and increased immunogenic response by CD19-CAR T cells. Combination therapy of virus+CAR T cells led to significant tumor regression in pancreatic cancer models.

Journal Article by Chen C, Park AK (…) Fong Y et 5 al. in J Am Coll Surg

Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Early Cholecystectomy in SCD with Cholelithiasis Reduces Complications

Cholecystectomy for uncomplicated cholelithiasis in sickle cell disease (SCD) patients leads to lower postoperative vaso-occlusive crises compared to those with acute cholecystitis, chronic cholecystitis, or gallstone pancreatitis. Advanced clinical presentations are strong predictors of complications, with 73% of SCD patients showing advanced clinical presentation at the time of cholecystectomy. These findings suggest that early cholecystectomy after screening with abdominal ultrasounds can improve outcomes in SCD patients with cholelithiasis.

Journal Article by Zeineddin A, Cornwell EE (…) Williams M et 5 al. in J Am Coll Surg

Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Continuous Preventable Mortality Review: Driving Reduction in Trauma Mortality

By using continuous preventable mortality review to guide provider education, the Arkansas Trauma System saw a progressive reduction in preventable or potentially preventable deaths from 2015 to 2022. A total of 1,979 trauma deaths were analyzed, with a 43% decrease in preventable or potentially preventable deaths. Education focusing on improving trauma care, particularly in reducing delays in treatment, played a key role in achieving these results.

Journal Article by Mabry CD, Davis B (…) Kalkwarf K et 6 al. in J Am Coll Surg

Copyright © 2023 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Home Call Negatively Impacts Sleep and Surgeon Burnout

Home call for acute care surgeons results in decreased sleep and increased burnout, with even non-active home calls contributing to sleep loss and burnout. Each additional call or return to the hospital during home call further exacerbates these negative effects. This study highlights the importance of considering the frequency of calls and returns to the hospital in creating call schedules to prevent cumulative sleep debt and adverse effects on health and well-being.

Journal Article by Coleman JJ, Robinson CK (…) Cohen MJ et 3 al. in J Am Coll Surg

Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Capsule-Based pH Testing Shows Limited Association with GERD Symptom Scores in Bariatric Surgery Patients

Researchers compared capsule-based pH testing and GERD symptom scoring in bariatric surgery patients. They found no significant difference in GERD symptom scores between patients with and without a diagnosis based on pH testing. Objective pH testing may aid in procedure selection and informed consent, potentially reducing risks for future GERD-related complications.

Journal Article by Scott J, Blackhurst D (…) Kothari SN et 5 al. in J Am Coll Surg

Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Key Role of Molecular Profiling in Intrahepatic Cholangiocarcinoma Treatment

Analysis of 125 patients with molecular profiling for intrahepatic cholangiocarcinoma revealed actionable molecular alterations in 45%, leading to targeted therapies in 21 patients. Patients with such alterations had significantly improved overall survival, with mean survival of 34.1 vs 23.6 months in those with actionable alterations. This highlights the importance of molecular profiling in guiding personalized treatment strategies for intrahepatic cholangiocarcinoma patients.

Journal Article by Purchla J, Ghabi EM (…) He J et 7 al. in J Am Coll Surg

Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Left-sided liver resection leads to lower mortality and better survival in perihilar cholangiocarcinoma

Left-sided liver resection for perihilar cholangiocarcinoma is associated with lower 90-day mortality and superior overall survival compared to right-sided resection. In a study of 1701 patients, 90-day mortality rates were 9% for left-sided and 18% for right-sided resection, with median overall survival of 30 months for left and 23 months for right. Left-sided resection was identified as an independent favorable prognostic factor for both outcomes.

Journal Article by Olthof PB, Erdmann JI (…) Groot Koerkamp B et 24 al. in Ann Surg Oncol

© 2024. The Author(s).

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High Accuracy Classification of Pancreatic Neoplasms Based on DNA Methylation Signatures.

DNA methylation profiling accurately classifies nonductal primary pancreatic neoplasms, with a random forest model achieving 96.9% accuracy and near perfect precision in identifying nonpancreatic neoplasms. Methylation signatures offer a valuable diagnostic tool with minimal misdiagnosis risk, even in preoperative settings.

Journal Article by Verschuur AVD, Hackeng WM (…) Brosens LAA et 13 al. in Clin Gastroenterol Hepatol

Copyright © 2024. Published by Elsevier Inc.

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