Open versus minimally invasive hepatic and pancreatic surgery: 1-year costs, healthcare utilization and days of work lost
Utilization of minimally invasive surgery (MIS) has become increasingly popular due to its potential benefits such as earlier recovery and reduced morbidity. We sought to characterize differences in 1-year healthcare costs and missed workdays among patients undergoing MIS and open surgery for a hepatic or pancreatic indication.
Outcome of a 'step-up approach' for recurrent cholangitis in patients with a non-stenotic hepaticojejunostomy after hepato-pancreato-biliary surgery: single center series
Recurrent non-stenotic cholangitis (NSC) is a challenging and poorly understood complication of a surgical hepaticojejunostomy (HJ). Optimal treatment remains unclear.
Nationwide analysis of one-year mortality following pancreatectomy in 17,183 patients with pancreatic cancer
The use of 1-year mortality following pancreatectomy for PDAC as a measure of surgical quality has not been evaluated. We aim to i) assess the 1-year mortality rate following pancreatectomy for PDAC, and ii) identify patient and hospital characteristics associated with 1-year mortality.
Adjunct mucin biomarkers MUC2+MUC5AC and MUC5AC+PSCA in a clinical setting identify and may improve correct selection of high-risk pancreatic lesions for surgery
Pancreatic cancer has dismal prognosis with a 5-year survival of 12 %. Cystic lesions have been identified as premalignant lesions. The challenge is to identify lesions with high risk of malignant progression, to offer patients prophylactic curative pancreatic surgery. Previous studies have identified mucin biomarker panels (MUCPs) as potential discriminators of pre- and malignant pancreatic cystic lesions. The present study assessed whether MUCPs contribute to more accurate identification of patients with high-risk pancreatic lesions and improve selection for surgery.
Advancing excellence: a national peer-coaching program for advanced laparoscopic HPB techniques
Surgical coaching is valuable for disseminating knowledge, refining skills, and fostering continuous professional development for surgeons in practice. This work aims to implement a national coaching program for Canadian HPB surgeons, emphasizing advanced laparoscopic techniques, and to assess subsequent adoption. Secondary objectives include evaluating surgeon perceptions, barriers, and experiences.
Robotic versus open pancreaticoduodenectomy in octogenarians: a comparative propensity score analysis of perioperative outcomes
Compared to open pancreaticoduodenectomies (OPD), the robotic (RPD) approach decreases the rate of complication and the length of stay (LOS). However, it remains unknown if these benefits persist in octogenarians, who are at higher risk for perioperative morbidity and mortality.
Achievement of international benchmark outcomes for robotic pancreaticoduodenectomy in a low volume country
Recently, there has been an increase in the utilisation of the robotic platform to perform minimally invasive pancreaticoduodenectomy in high volume centres, with the goal of reducing morbidity and improving patient outcomes. This study reports the successful implementation of a robotic pancreaticoduodenectomy (RPD) programme in the relatively low volume setting of Australia, measured against established, internationally accepted benchmarks for low-risk open pancreaticoduodenectomy (OPD).
Impact of patient age on outcome of minimally invasive versus open pancreatoduodenectomy: a propensity score matched study
Pancreatoduodenectomy in elderly patients may be associated with increased postoperative mortality, but studies in minimally invasive pancreatoduodenectomy (MIPD) are scarce.
Identifying an optimal cancer risk threshold for resection of pancreatic intraductal papillary mucinous neoplasms
IPMN consensus guidelines make implicit judgments on what cancer risk level should prompt surgery. We used decision modeling to estimate this cancer risk threshold (CRT) for BD-IPMN patients.
Learning curve in robotic liver surgery: easily achievable, evolving from laparoscopic background and team-based
Limited and heterogeneous literature data necessitate a focused examination of the learning curve in robotic liver resections. This study aims to assess the learning curve of two surgeons from the same team with differing laparoscopic backgrounds.
Combined division of the splenic vessels and pancreatic parenchyma during laparoscopic distal pancreatectomy is a safe alternative to separate division: a single-institution retrospective study
Limited data exists regarding the safety and outcomes of combined division of the splenic vessels with the pancreatic parenchyma during laparoscopic distal pancreatectomy (LDP). This study aims to evaluate the combined division technique.
Replacement of the main bile duct by bioprosthesis in an experimental porcine model (24-month results)
Cholecystectomy for conditions like iatrogenic injury during cholecystectomy can lead to complications such as bile duct injuries, necessitating alternative options like bioprosthesis.
Prognostic value of resection margin and lymph node status in perihilar cholangiocarcinoma
The impact of resection margin and lymph node status on survival in patients undergoing resection for perihilar cholangiocarcinoma (pCCA) is controversial. The aim of this study was to investigate the influence of nodal and resection margin status on long-term survival after resection for pCCA.
Pancreatic surgery after preoperative biliary drainage in periampullary cancers: does timing matter? A systematic review and meta-analysis
Preoperative biliary drainage (PBD) has been introduced to control the negative effects of obstructive jaundice in patients undergoing pancreaticoduodenectomy (PD). The optimal time interval between PBD and PD remains unclear. The purpose of our systematic review and meta-analysis was to evaluate the optimal period for PBD before PD.
The impact of chronic obstructive pulmonary disease on risk for complications after pancreatoduodenectomy - a single centre cohort study
The association between chronic obstructive pulmonary disease (COPD) and risk for postoperative complications after pancreatic surgery has not been clarified. The aim of this study was to investigate if COPD is associated with increased risk for postoperative complications after pancreatoduodenectomy.
The impact of lymph node ratio on survival in gallbladder cancer: a national cancer database analysis
The study aimed to investigate the impact of lymph node ratio (LNR) on survival in patients with resectable gallbladder adenocarcinoma.
Factors associated with favourable pathological tumour response after neoadjuvant chemotherapy in patients with pancreatic ductal adenocarcinoma
Pathological response of pancreatic ductal adenocarcinoma (PDAC) to neoadjuvant chemotherapy (NAT) has been associated with oncological outcome. The aim of the study was to investigate factors associated with favourable tumour regression in patients undergoing pancreatic resection for PDAC.
Is robotic liver resection feasible in patients with lesions in close proximity to major vessels? A propensity score matching analysis
Robotic surgery is widely diffused in the surgical field and is becoming increasingly prevalent, however several aspects need more detailed assessment. One of them concerns the role of robotic liver surgery for lesions in contact with major vascular (CMV) pedicles. The aim of our study is to evaluate and compare intra and post operative outcomes in patients undergoing robotic liver resections between lesions in contact or free from major vessels.
Artificial intelligence in the detection of choledocholithiasis: a systematic review
Choledocholithiasis is a potentially life-threatening manifestation of acute biliary dysfunction (ABD) often requiring magnetic resonance cholangiopancreatography (MRCP) for diagnosis when standard investigation findings are inconclusive. Machine learning models (MLMs) may offer alternatives to diagnose choledocholithiasis.
Hospital charge and resource use analysis of extended-spectrum penicillin antibiotic therapy after pancreatoduodenectomy in intermediate- and high-risk patients
We previously reported that an extended antibiotic mitigation pathway following pancreatoduodenectomy in patients with intermediate-/high-risk glands is associated with 83 % lower odds of clinically relevant postoperative pancreatic fistula (CR-POPF). We now describe associations between the pathway, resource utilization, and hospital charges.
Protocol for a national, multicentre prospective study of acute pancreatitis management and outcomes: the PANORAMA study
The primary aim of this study is to determine compliance with key quality performance indicators (QPIs) for the management of acute pancreatitis. The secondary aim is to examine the relationship between compliance to QPIs and clinical outcomes with factors that influence this.