Multivisceral transplantation as a rescue treatment for intestinal failure following pancreaticoduodenectomy: A case report.

Background: Post-pancreaticoduodenectomy (PD) intestinal failure (IF) is rare and associated with poor outcomes. To our knowledge, the role of intestinal transplantation (ITx) as a rescue treatment for this complication has never been reported.

Case Summary: A 42-year-old female with a benign neurilemmoma of the duodenum underwent PD.

Comparison of Pancreatic Fistula Between Robotic-Assisted and Open Pancreatoduodenectomy: A Comprehensive Evaluation Using an Alternative Fistula Risk Score.

Background: Robotic-assisted pancreatoduodenectomy (RPD) offers ergonomic advantages, yet its effect on pancreatic fistula risk remains unclear. This study evaluated RPD safety using the alternative fistula risk score (aFRS).

Methods: We retrospectively reviewed the pancreatoduodenectomy database at Seoul National University Hospital (2014-2023), comparing RPD with open pancreatoduodenectomy (OPD) in a 1:1 aFRS probability-matched analysis.

Unraveling the Long-term Natural History of Branch Duct Intraductal Papillary Mucinous Neoplasm: Beyond 10 years.

Objective: To describe the long-term natural history of branch duct intraductal papillary mucinous neoplasm (BD-IPMN).

Background: The BD-IPMN is a known precursor of pancreatic cancer, yet its long-term natural history is largely unknown.

Methods: We retrospectively reviewed patients with BD-IPMN who were followed at the Massachusetts General Hospital for at least 10 years without surgical intervention.

Robotic subtotal left pancreatectomy with preservation of the bile duct and spleen for multifocal pancreatic metastases: a video vignette of organ-sparing pancreatectomy for tumors that do not require regional lymphadenectomy.

Pancreatectomy for pancreatic metastases (PM) yields acceptable survival outcomes in selected renal cell carcinoma (RCC) patients. We describe a technique for robotic subtotal left pancreatectomy with preservation of the common bile duct (CBD) and spleen in a patient with multifocal RCC-PM. The patient, who had RCC and underwent nephrectomy 20 years ago, presented with a pancreatic mass.

Absence of a pancreatic microbiome in intraductal papillary mucinous neoplasm.

Objective: This study aims to validate the existence of a microbiome within intraductal papillary mucinous neoplasm (IPMN) that can be differentiated from the taxonomically diverse DNA background of next-generation sequencing procedures.

Design: We generated 16S rRNA amplicon sequencing data to analyse 338 cyst fluid samples from 190 patients and 19 negative controls, the latter collected directly from sterile syringes in the operating room. A subset of samples (n=20) and blanks (n=5) were spiked with known concentrations of bacterial cells alien to the human microbiome to infer absolute abundances of microbial traces.

Incidence and Risk Factors Associated With Chronic Kidney Disease After Liver Transplantation: A Review of a 20-Year Experience at a Single Center.

Background: Chronic kidney disease (CKD) is one of the major complications after liver transplantation (LT), with a significant impact on patient outcomes. This study aims to investigate the incidence and risk factors of CKD in LT recipients at Siriraj Hospital over the past 20 years.

Methods: There were 366 adult patients undergoing LT at Siriraj Hospital between January 2002 and December 2021.

Pancreatic Serous Cystadenoma: A Continuing Diagnostic Challenge.

Objective: To understand the natural history of serous cystadenoma (SCA), and the diagnostic accuracy of SCA and identify possible factors that lead to the correct diagnosis.

Background: SCA is a benign cystic pancreatic neoplasm of the pancreas, accounting for ~15% of resected pancreatic cysts. Current recommendations are to proceed with surgical resection in symptomatic patients or when there is uncertainty regarding diagnosis.

The Revised R Status is an Independent Predictor of Postresection Survival in Pancreatic Cancer After Neoadjuvant Treatment.

Objective: To investigate the oncological outcomes of patients with pancreatic ductal adenocarcinoma (PDAC) who had an R 0 or R 1 resection based on the revised R status (1 mm) after neoadjuvant therapy (NAT).

Background: The revised R status is an independent prognostic factor in upfront-resected PDAC; however, the significance of 1 mm margin clearance after NAT remains controversial.

Methods: Patients undergoing pancreatectomy after NAT for PDAC were identified from 2 prospectively maintained databases.

Delayed Calcineurin Inhibitor Introduction Without Antibody Induction in Liver Transplantation Is Safe and Helps Preserve Kidney Function.

Introduction: Acute kidney injury (AKI) is common after liver transplantation and affects outcome after liver transplantation. Antibody induction is commonly used to reduce dose and/or to delay introduction of calcineurin inhibitor (CNI) but is very expensive. We propose a modified immunosuppressive protocol that delays administration of CNI for 48 to 72 hours without antibody induction.