Hepatobiliary and Pancreatic Surgery: New Trends and Solutions

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: 28 May 2024 | Viewed by 677

Special Issue Editors


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Guest Editor
Department of Surgery, Sapienza University of Rome, Rome, Italy
Interests: HPB surgery; liver surgery; liver cancer; pancreas surgery; pancreatic cancer; HPB benign diseases; liver transplant; surgical oncology; minimally invasive surgery

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Guest Editor
General and Liver Transplant Surgery, The Gemelli University Hospital, Rome, Italy
Interests: liver transplant; liver diseases; HPB surgery; pancreatic surgery; minimally invasive surgery; surgical oncology
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Guest Editor
Hepatobiliary Surgery Unit, Università del Sacro Cuore, Rome, Italy
Interests: HPB surgery; colorectal liver metastases; cholangiocarcinoma; hepatocellular carcinoma

Special Issue Information

Dear Colleagues,

Hepatobiliary and pancreatic (HPB) diseases—both benign and malignant—represent a challenge in medicine. It is estimated that liver and pancreatic diseases, both malignant and benign, will increase their incidence in the coming decades. The aggressive behavior of HPB malignancies and the often-advanced stages at diagnosis are the main causes for the high mortality rate of these patients. On the other end, benign conditions such as chronic pancreatitis or liver cirrhosis are associated with an increased risk of developing cancer and may require aggressive treatments themselves (e.g., liver transplantation). However, in recent years, several advances have been made in the management of this group of diseases. Improvements in surgical technique, targeted chemo- and radiotherapy, and radiological and endoscopic tools are at the backbone of future research endeavors in the HPB field.

We invite surgeons, oncologist, gastroenterologists, and all the physicians involved in the treatments of HPB diseases to collaborate in this Special Issue, sending us their most valuable scientific contributions.

Dr. Alessandro Coppola
Dr. Giuseppe Bianco
Dr. Elena Panettieri
Guest Editors

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Keywords

  • pancreatic surgery
  • pancreatic cancer
  • HPB surgery
  • HPB benign diseases
  • HPB cancers
  • liver surgery
  • metastases
  • cholangiocarcinoma
  • HCC
  • liver transplant
  • minimally invasive HPB surgery

Published Papers (1 paper)

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Research

14 pages, 2964 KiB  
Article
The Learning Curve for Pancreaticoduodenectomy: The Experience of a Single Surgeon
by Cristian Liviu Cioltean, Adrian Bartoș, Lidia Muntean, Sandu Brânzilă, Ioana Iancu, Cristina Pojoga, Caius Breazu and Iancu Cornel
Life 2024, 14(5), 549; https://doi.org/10.3390/life14050549 - 25 Apr 2024
Viewed by 217
Abstract
Background and Aims: Pancreaticoduodenectomy (PD) is a complex and high-skill demanding procedure often associated with significant morbidity and mortality. However, the results have improved over the past two decades. However, there is a paucity of research concerning the learning curve for PD. Our [...] Read more.
Background and Aims: Pancreaticoduodenectomy (PD) is a complex and high-skill demanding procedure often associated with significant morbidity and mortality. However, the results have improved over the past two decades. However, there is a paucity of research concerning the learning curve for PD. Our aim was to report the outcomes of 100 consecutive PDs representing a single surgeon’s learning curve and to depict the factors that influenced the learning process. Methods: We reviewed the first 121 PDs performed at our academic center (2013–2019) by a single surgeon; 110 were PDs (5 laparoscopic and 105 open) and 11 were total PDs (1 laparoscopic and 10 open). Subsequent statistics was performed on the first 100 PDs, with attention paid to the learning curve and survival rate at 5 years. The data were analyzed comparing the first 50 cases (Group 1) to the last 50 cases (Group 2). Results: The most frequent histopathological tumor type was pancreatic ductal adenocarcinoma (50%). A total of 39% of patients had preoperative biliary drainage and 45% presented with positive biliary cultures. The preferred reconstruction technique included pancreaticogastrostomy (99%), in situ hepaticojejunostomy (70%), and precolic gastro-jejunal anastomosis (88%). Postoperative complications included biliary fistula (1%), pancreatic fistula (8%), pancreatic stump bleeding (4%), and delayed gastric emptying (13%). The mean operative time decreased after the first 50 cases (p < 0.001) and blood loss after 60 cases (p = 0.046). R1 resections lowered after 25 cases (p = 0.025). Vascular resections (17%) did not influence the rate of complications (p = 0.8). The survival rate at 5 years for pancreatic adenocarcinoma was 32.93%. Conclusions: Outcomes improve as surgeon experience increases, with proper training being the most important factor for minimizing the impact of the learning curve over the postoperative complications. Analyzing the learning curve from the perspective of a single surgeon is mandatory for accurate statistical results and interpretation. Full article
(This article belongs to the Special Issue Hepatobiliary and Pancreatic Surgery: New Trends and Solutions)
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