Comparison of robotic liver resection in obese vs. non-obese patients: a multicentric propensity score-matched analysis of perioperative outcomes.

Obesity poses unique challenges in liver surgery, potentially affecting perioperative outcomes. While laparoscopic liver resection (LLR) has demonstrated clear benefits over open surgery, evidence regarding the impact of body mass index (BMI) on robotic liver resection (RLR) outcomes remains limited. This study aims to evaluate the influence of BMI on perioperative outcomes following RLR.

Patterns of Site and Timing of Recurrence After Curative Resection in Single and Multiple Large Hepatocellular Carcinoma: A Multicenter International Comprehensive Analysis.

Background: Curative options for large hepatocellular carcinoma (LHCC) are limited because of the high risk of early and extrahepatic recurrence. However, only a few studies report data on long-term outcomes in large cohorts of resected LHCC. We therefore investigated timing and site of recurrence of LHCC and assessed factors strictly associated with adverse patterns.

Laparoscopic versus open liver resection for large (≥ 5 cm) hepatocellular carcinoma in elderly patients: a multicenter propensity score-matched study.

The outcomes of laparoscopic liver resection (LLR) for large (≥ 5 cm) hepatocellular carcinoma (HCC) in elderly (≥ 70 years old) patients have not been deeply investigated so far. The aim of the study was to compare short- and long-term results of LLR vs. open liver resection (OLR) in this setting.

MAMBA (Moisture Assisted Multiple BipolAr) technique vs Robo-lap approach in robotic liver resection. Is it possible a full robotic approach for parenchymal transection? A propensity score matching analysis.

Background: Robotic surgery is becoming more and more widespread. Despite its diffusion, parenchymal transection still remains a matter of debate. Up to now, in minimally invasive surgery, most of liver resection were performed laparoscopically with the support of ultrasonic dissector.

Safety and feasibility of robotic approach to choledochal cysts in adults: a multicenter European experience.

Choledochal cysts (CCs) are rare congenital anomalies of the bile ducts associated with an increased risk of biliary malignancy. Surgical management typically involves cyst excision, cholecystectomy, and Roux-en-Y hepaticojejunostomy. While minimally invasive techniques are gaining popularity, their application for CCs management in adults remains underreported and limited to isolated cases.

Conversion during Minimally Invasive Left Pancreatectomy: A Nationwide Study of Causes and Consequences.

Objectives: To identify risk factors for conversion, develop a predictive Conversion Risk Score (CRS), and assess the association between conversion and severe postoperative complications.

Background: Conversion occurs in 15-30% of minimally invasive left pancreatectomies (MILP). Risk factors and potential negative impacts on postoperative outcomes are poorly described.

Robotic Liver Resection for Hepatocellular Carcinoma: A Multicenter Case Series.

Background: Liver resection is the standard treatment for resectable hepatocellular carcinoma (HCC). The advent of robotic surgery has extended its application in liver surgery, reducing post-operative complications without compromising oncological safety. This study is a retrospective series with the aim of analyzing the preoperative patient's and tumor's characteristics and evaluating intraoperative and post-operative data in terms of hospital stay, complications, and oncological radicality.

Association between pancreatic adenocarcinoma risk and concentration of organochlorine pesticides in adipose tissue and urine: A targeted-screening analysis case-control study (PESTIPAC).

Background: Knowledge about environmental pancreatic adenocarcinoma (PA) risk factors, including pesticide exposure, remains limited. Organochlorine (OC) accumulates in adipose tissue and can help reflect long-term exposure.

Patients And Methods: Age and body mass index (BMI) of patients with PA were matched with those undergoing a surgery for a benign disease on age and BMI (1:1).

How to do pancreatic transection during robotic pancreaticoduodenectomy. Is hanging manoeuvre always necessary?

Since its first description in 1898, pancreaticoduodenectomy has constantly been improved, allowing increasingly more complex operations to be performed even with a minimally invasive approach: laparoscopic and, in recent years, robotic approach. In most cases, similarly to open surgery, parenchymal transection is performed after the creation of a retropancreatic tunnel to ensure adequate control of the mesenteric vessels before sectioning the parenchyma. Sometimes tunnelling can be very difficult even dangerous to achieve, due to conditions such as: vascular involvement by the neoplasm of superior mesenteric vein (SMV) or portal vein (PV); fibrosis secondary to acute pancreatitis (AP) or radiotherapy.

Metaverse and Telementoring: From Surgery to Workshop.

Background: The Coronavirus 2019 (COVID-19) pandemic has favored the growth of telemedicine systems and in this context the idea of Metaverse was born and developed. A 3D reality in which people can interact with each other through digital reproductions of themselves. Metaverse has already been tested in numerous medical fields due to its ability to combine visual and auditory information with tactile sensations.

Peri-operative score for elderly patients with resectable hepatocellular carcinoma.

Background: Liver resection is the mainstay for a curative treatment for patients with resectable hepatocellular carcinoma (HCC), also in elderly population. Despite this, the evaluation of patient condition, liver function and extent of disease remains a demanding process with the aim to reduce postoperative morbidity and mortality.

Aim: To identify new perioperative risk factors that could be associated with higher 90- and 180-d mortality in elderly patients eligible for liver resection for HCC considering traditional perioperative risk scores and to develop a risk score.

Factors affecting overall survival and disease-free survival after surgery for hepatocellular carcinoma: a nomogram-based prognostic model-a Western European multicenter study.

Few studies have assessed the clinical implications of the combination of different prognostic indicators for overall survival (OS) and disease-free survival (DFS) of resected hepatocellular carcinoma (HCC). This study aimed to evaluate the prognostic factors in HCC patients for OS and DFS outcomes and establish a nomogram-based prognostic model to predict the DFS of HCC. A multicenter, retrospective European study was conducted through the collection of data on 413 consecutive treated patients with a first diagnosis of HCC between January 2010 and December 2020.

Multi-visceral resection for left-sided pancreatic ductal adenocarcinoma: a multicenter retrospective analysis from European countries.

Background: Due to delayed diagnosis and a lower surgical indication rate, left-sided pancreatic ductal adenocarcinoma (PDAC) is often associated with a poor prognosis in comparison to pancreatic head tumors. Multi-visceral resections (MVR) associated with distal pancreatectomy could be proposed for patients presenting with locally infiltrating disease.

Methods: We retrospectively analyzed a multi-centric cohort of left-sided PDAC patients operated on from 2009 to 2020.

The Brescia Internationally Validated European Guidelines on Minimally Invasive Pancreatic Surgery (EGUMIPS).

Objective: To develop and update evidence-based and consensus-based guidelines on laparoscopic and robotic pancreatic surgery.

Summary Background Data: Minimally invasive pancreatic surgery (MIPS), including laparoscopic and robotic surgery, is complex and technically demanding. Minimizing the risk for patients requires stringent, evidence-based guidelines.

Anterior Versus Classical Approach During Right Hepatectomy for Hepatocellular Carcinoma: Inverse Propensity Score Weighted Analysis.

Background: Eastern data highlight the oncological benefits of the anterior approach (AA) during right hepatectomy (RH) for hepatocellular carcinoma (HCC). However, to our knowledge, previous western data on this topic are scarce. In this study, the oncological outcomes of AA and classical approach (CA) during RH for HCC were compared.

Impact of body mass index in elderly patients treated with laparoscopic liver resection for hepatocellular carcinoma.

Background: The impact of obesity on surgical outcomes in elderly patients candidate for liver surgery is still debated.

Aim: To evaluate the impact of high body mass index (BMI) on perioperative and oncological outcome in elderly patients (> 70 years old) treated with laparoscopic liver resection for hepatocellular carcinoma (HCC).

Methods: Retrospective multicenter study including 224 elderly patients (> 70 years old) operated by laparoscopy for HCC (196 with a BMI < 30 and 28 with BMI ≥ 30), observed from January 2009 to January 2019.

Liver resection versus radiofrequency ablation in octogenarian patients for hepatocellular carcinoma: a propensity score multicenter analysis.

Background: Liver resection (LR) and radiofrequency ablation (RFA) are considered curative options for hepatocellular carcinoma (HCC). The aim of this study was to compare outcomes after LR and RFA in octogenarian patients with HCC.

Materials And Methods: This multicenter retrospective study included 102 elderly patients (> 80 years old) treated between January 2009 and January 2019, who underwent LR or RFA for HCC (65 and 37 with, respectively).

Neoadjuvant chemotherapy for borderline resectable and upfront resectable pancreatic cancer increasing overall survival and disease-free survival?

Background: Pancreatic ductal adenocarcinoma (PDAC) is the most common pancreatic neoplasm. Surgery is the factual curative option, but most patients present with advanced disease. In order to increase resectability, results of neoadjuvant chemotherapy (NAC) on metastatic disease were extrapolated to the neoadjuvant setting by many centers.