IF 2.7 3区医学

Hpb Pub Date : 2024-12-01 DOI: 10.1016/j.hpb.2024.09.002

James M. Halle-Smith , Prudence Leung , Lewis Hall , Merve Aksin , Stijn van Laarhoven , James Skipworth , Nikolaos Chatzizacharias , Rachel M. Brown , Keith J. Roberts

{"title":"Factors associated with favourable pathological tumour response after neoadjuvant chemotherapy in patients with pancreatic ductal adenocarcinoma","authors":"James M. Halle-Smith , Prudence Leung , Lewis Hall , Merve Aksin , Stijn van Laarhoven , James Skipworth , Nikolaos Chatzizacharias , Rachel M. Brown , Keith J. Roberts","doi":"10.1016/j.hpb.2024.09.002","DOIUrl":"10.1016/j.hpb.2024.09.002","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Methods</h3><div>Patients who received NAT before undergoing PDAC resection at two institutions were reviewed. Tumour regression grading (TRG) was scored according to the College of American Pathologists (CAP) system. Interactions between chemotherapy, tumour and surgical factors with TRG were explored.</div></div><div><h3>Results</h3><div>54 patients were identified, with 12 (22%) displaying a favourable response to NAT. The type of chemotherapy agent received, the number of cycles or a dose reduction during NAT course was not significantly different between the groups<strong><em>.</em></strong> The time from diagnosis to chemotherapy and time from end of chemotherapy to surgery were also similar between the groups. A favourable TRG was associated with greater disease-free survival median 33.2 months vs. 10.3 months; p = 0.0) but not overall survival (median 43.8 months vs. 32.3 months; p = 0.200), which may be due to small sample size.</div></div><div><h3>Conclusions</h3><div>Chemotherapy factors were not significantly related to a favourable response to NAT. Future studies should seek to identify modifiable factors associated with a favourable TRG.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"26 12","pages":"Pages 1536-1543"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142264587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Percutaneous hepatic artery infusion chemotherapy with oxaliplatin and fluoropyrimidines in treatment-resistant colorectal cancer patients with unresectable liver metastases: a retrospective cohort study. 经皮肝动脉输注奥沙利铂和氟嘧啶类药物化疗不可切除肝转移的耐药结直肠癌患者：一项回顾性队列研究。

IF 2.7 3区医学

Hpb Pub Date : 2024-11-29 DOI: 10.1016/j.hpb.2024.11.008

William Pat Fong, Zi-Jing Li, Chao Ren, Wen-Long Guan, Meng-Xuan Zuo, Tian-Qi Zhang, Bin-Kui Li, Yun Zheng, Xiao-Jun Wu, Pei-Rong Ding, Gong Chen, Zhi-Zhong Pan, Yun-Fei Yuan, Qiong Tan, Zhi-Qiang Wang, Yu-Hong Li, De-Shen Wang

{"title":"Percutaneous hepatic artery infusion chemotherapy with oxaliplatin and fluoropyrimidines in treatment-resistant colorectal cancer patients with unresectable liver metastases: a retrospective cohort study.","authors":"William Pat Fong, Zi-Jing Li, Chao Ren, Wen-Long Guan, Meng-Xuan Zuo, Tian-Qi Zhang, Bin-Kui Li, Yun Zheng, Xiao-Jun Wu, Pei-Rong Ding, Gong Chen, Zhi-Zhong Pan, Yun-Fei Yuan, Qiong Tan, Zhi-Qiang Wang, Yu-Hong Li, De-Shen Wang","doi":"10.1016/j.hpb.2024.11.008","DOIUrl":"https://doi.org/10.1016/j.hpb.2024.11.008","url":null,"abstract":"<p><strong>Background: </strong>Subsequent lines of therapy for chemotherapy-resistant metastatic colorectal cancer (CRC) have shown limited efficacy. Herein, we retrospectively investigated the efficacy and safety of hepatic artery infusion chemotherapy (HAIC) using oxaliplatin plus 5-FU/FUDR in patients with unresectable colorectal liver metastases (CRLM) who progressed following standard chemotherapy regimens.</p><p><strong>Methods: </strong>From March 2017 to April 2023, CRC patients with unresectable CRLM who progressed following standard chemotherapy and subsequently received HAIC oxaliplatin plus 5-FU/FUDR were evaluated. Objective response rate (ORR), disease control rate (DCR), median depth of tumor response (DpR), no evidence of disease (NED) rate, progression-free survival (PFS), overall survival (OS), and safety were assessed.</p><p><strong>Results: </strong>A total of 21 patients who progressed after a median of two (range: 1-4) lines of standard systemic chemotherapy were included. The ORR and DCR were 28.6 % and 95.2 %, respectively, with six patients reaching partial response. Additionally, the median DpR was 10.6 %, and seven patients underwent successful conversion surgery. Stratification revealed significantly better PFS in patients with liver-limited metastases compared to those with concurrent hepatic and extrahepatic metastases (P = 0.0003).</p><p><strong>Conclusion: </strong>HAIC oxaliplatin plus 5-FU/FUDR is a robust regimen for treatment-resistant CRC patients with unresectable CRLM, particularly those with liver-limited disease.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Utility of endoscopic ultrasound-guided fine needle aspiration for genetic analysis in pancreatic ductal adenocarcinoma.

IF 2.7 3区医学

Hpb Pub Date : 2024-11-28 DOI: 10.1016/j.hpb.2024.11.009

Irene Ligato, Ana Garcia Garcia de Paredes, Sergio Lopez Duran, Irene Gonzalez Garcia, Amparo Benito Berlinches, Estefania Romio de Las Heras, Alejandra Caminoa Lizarralde, Almudena Santon Roldan, Mercedes Rodriguez Garrote, Carmen-Guillen Ponce, Victor Defarges, Jose Ramon Foruny Olcina, Agustin Albillos, Enrique Vazquez Sequeiros

引用次数: 0

Lymphadenectomy for perihilar cholangiocarcinoma: therapeutic benefit of lymph node number and station.

IF 2.7 3区医学

Hpb Pub Date : 2024-11-27 DOI: 10.1016/j.hpb.2024.11.007

Jun Kawashima, Abdullah Altaf, Yutaka Endo, Selamawit Woldesenbet, Diamantis I Tsilimigras, Zayed Rashid, Alfredo Guglielmi, Hugo P Marques, Shishir K Maithel, Bas Groot Koerkamp, Carlo Pulitano, Federico Aucejo, Itaru Endo, Timothy M Pawlik

{"title":"Lymphadenectomy for perihilar cholangiocarcinoma: therapeutic benefit of lymph node number and station.","authors":"Jun Kawashima, Abdullah Altaf, Yutaka Endo, Selamawit Woldesenbet, Diamantis I Tsilimigras, Zayed Rashid, Alfredo Guglielmi, Hugo P Marques, Shishir K Maithel, Bas Groot Koerkamp, Carlo Pulitano, Federico Aucejo, Itaru Endo, Timothy M Pawlik","doi":"10.1016/j.hpb.2024.11.007","DOIUrl":"https://doi.org/10.1016/j.hpb.2024.11.007","url":null,"abstract":"<p><strong>Background: </strong>We sought to characterize the benefit of lymphadenectomy among patients undergoing curative-intent surgery for perihilar cholangiocarcinoma (pCCA) utilizing the therapeutic index.</p><p><strong>Methods: </strong>Data on patients who underwent curative-intent resection for pCCA were obtained from 8 high-volume international hepatobiliary centers. Multivariable Cox regression analysis was used to assess clinicopathological factors associated with overall survival (OS). The therapeutic index was determined to assess the therapeutic benefit of lymphadenectomy.</p><p><strong>Results: </strong>Among 341 patients, median number of lymph nodes (LNs) evaluated was 7 (IQR: 4-11). A total of 127 (37.2 %) patients underwent lymphadenectomy of station 12 only, while 146 (42.8 %) patients had LNs from stations 12 plus 8 ± 13 harvested. On multivariable analysis, lymphadenectomy of stations 12 plus 8 ± 13 was associated with improved OS (referent, station 12 only: HR 0.51, 95%CI 0.32-0.80). The therapeutic index was highest among patients who underwent LN evaluation of stations 12 plus 8 ± 13 (33.1) and had ≥6 LNs harvested (26.3).</p><p><strong>Conclusion: </strong>At the time of surgery of pCCA, lymphadenectomy should include station 12, as well as stations 8 and 13, with the goal to evaluate ≥6 LNs to ensure optimal staging and maximize the therapeutic benefit for patients.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reoperation for pancreatic fistula: a systematic review of completion pancreatectomy vs. pancreas-preserving-procedures and outcomes.

IF 2.7 3区医学

Hpb Pub Date : 2024-11-27 DOI: 10.1016/j.hpb.2024.11.006

Alessio Marchetti, Gaetano Corvino, Giampaolo Perri, Giovani Marchegiani, Raffaele De Luca

{"title":"Reoperation for pancreatic fistula: a systematic review of completion pancreatectomy vs. pancreas-preserving-procedures and outcomes.","authors":"Alessio Marchetti, Gaetano Corvino, Giampaolo Perri, Giovani Marchegiani, Raffaele De Luca","doi":"10.1016/j.hpb.2024.11.006","DOIUrl":"https://doi.org/10.1016/j.hpb.2024.11.006","url":null,"abstract":"<p><strong>Background: </strong>Consensus on the nomenclature and indications for reoperation for post-operative pancreatic fistula (POPF) after pancreatoduodenectomy (PD) is lacking. This study explores the available literature to classify the different types of reoperations and report outcomes.</p><p><strong>Methods: </strong>A systematic literature search was performed, including articles from 2010 to 2024 reporting reoperations for POPF after PD. The primary outcome was 30- or 90-day-mortality. Secondary outcomes included reoperation date, additional relaparotomy, ICU-admission, hospital stay, rate of pancreatic-exocrine-insufficiency, diabetes and long-term survivors.</p><p><strong>Results: </strong>Twenty-five studies were reviewed with 766 patients reoperated for POPF after PD, 283 (37 %) undergoing completion pancreatectomy (CP) and 483 (63 %) pancreas-preserving-procedures (PPPs). Among PPPs, drainage (30 %), wirsungostomy (14 %), pancreatic anastomosis repair (6 %), \"sinking\" of pancreatic stump (6 %) and re-do pancreatic anastomosis (4 %) were identified. The main indications for reoperation were post-pancreatectomy hemorrhage, necrotizing acute pancreatitis, sepsis and peritonitis. PPPs were preferred with severe hemodynamic instability. Mortality rates after CP and PPPs ranged from 20 to 56 % and 0-67 %, respectively. Early reoperation was associated with reduced ICU-recovery after \"sinking\" (p = 0.049).</p><p><strong>Conclusion: </strong>Reoperation for POPF after PD is rarely needed. When it is, early timing seems critical for better outcomes, and PPPs seems to be the best bail out option in patients with severe hemodynamic instability.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Preoperative setting of functional liver volume enhanced by portal and hepatic vein embolization is key in preventing serious morbidity after hepatectomy with bile duct resection for biliary tract cancer.

IF 2.7 3区医学

Hpb Pub Date : 2024-11-26 DOI: 10.1016/j.hpb.2024.11.005

Kenichiro Araki, Akira Watanabe, Takamichi Igarashi, Mariko Tsukagoshi, Norihiro Ishii, Shunsuke Kawai, Kei Hagiwara, Kouki Hoshino, Takaomi Seki, Norifumi Harimoto, Ken Shirabe

{"title":"Preoperative setting of functional liver volume enhanced by portal and hepatic vein embolization is key in preventing serious morbidity after hepatectomy with bile duct resection for biliary tract cancer.","authors":"Kenichiro Araki, Akira Watanabe, Takamichi Igarashi, Mariko Tsukagoshi, Norihiro Ishii, Shunsuke Kawai, Kei Hagiwara, Kouki Hoshino, Takaomi Seki, Norifumi Harimoto, Ken Shirabe","doi":"10.1016/j.hpb.2024.11.005","DOIUrl":"https://doi.org/10.1016/j.hpb.2024.11.005","url":null,"abstract":"<p><strong>Background: </strong>The risk of mortality due to serious complications associated with hepatectomy for biliary tract cancer remains high. We aimed to investigate the significance of preoperative functional liver volume in predicting and preventing serious morbidity following hepatectomy with bile duct resection (BDR).</p><p><strong>Methods: </strong>Seventy-one patients who underwent hepatectomy with BDR for biliary tract cancer were included. Functional future remnant liver volume (fFRLV) was calculated using future liver remnant (FLR) volume and functional score measured using EOB-MRI. Patients with unsatisfactory fFRLV values underwent portal or sequential portal/hepatic vein embolization (PVE/HVE). We assessed relationship between variables for liver-related morbidity (LRM), including posthepatectomy liver failure, bile leakage, and persistent ascites. Additionally, we assessed Clavien-Dindo grade IV complications (CD ≥ IV) as indicators of serious morbidity.</p><p><strong>Results: </strong>LRM and CD ≥ IV occurred in 20 (28.2 %) and 6 (8.5 %) cases, respectively. Preoperative FLR volume (p = 0.021), FLR ratio (p = 0.004), fFRLV (p = 0.008), and ICGK-F (p = 0.023) were associated with LRM. fFRLV (p = 0.017) was predictive for LRM but not independent (AUC:0.704). Preoperative FLR volume (p = 0.005), FLR ratio (p = 0.008), and fFRLV (p < 0.001) were associated with CD ≥ IV. fFRLV (p = 0.017) was an independent predictive factor for CD ≥ IV(AUC:0.914), showing greater predictive power compared to other factors.</p><p><strong>Conclusion: </strong>fFRLV predicts CD ≥ IV in patients undergoing hepatectomy with BDR. A sufficient fFRLV, enhanced by PVE/HVE if necessary, may prevent serious morbidity and mortality.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Primary closure compared with T-tube drainage following laparoscopic common bile duct exploration among elderly patients with hepatolithiasis and/or choledocholithiasis: a comparative study using a propensity score matching.

IF 2.7 3区医学

Hpb Pub Date : 2024-11-20 DOI: 10.1016/j.hpb.2024.11.004

Phu V La, Hieu T Le, Thang M Tran, Quan M Tran, Phuc V La, Vu A Doan

{"title":"Primary closure compared with T-tube drainage following laparoscopic common bile duct exploration among elderly patients with hepatolithiasis and/or choledocholithiasis: a comparative study using a propensity score matching.","authors":"Phu V La, Hieu T Le, Thang M Tran, Quan M Tran, Phuc V La, Vu A Doan","doi":"10.1016/j.hpb.2024.11.004","DOIUrl":"https://doi.org/10.1016/j.hpb.2024.11.004","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic common bile duct exploration (LCBDE) is commonly used for hepatolithiasis and/or choledocholithiasis, but the ideal method for common bile duct closure remains uncertain, especially for elderly patients (≥65 years). This study compared outcomes of primary closure versus T-tube drainage following LCBDE in elderly patients.</p><p><strong>Methods: </strong>Data from elderly patients undergoing LCBDE for hepatolithiasis and/or choledocholithiasis between May 2016 and December 2020 at two Vietnamese hospitals were analyzed. Patients were divided into groups A (T-tube drainage, n = 52) and B (primary closure, n = 57). Propensity score matching (PSM) was utilized to adjust for baseline characteristics, comparing short- and long-term outcomes between groups.</p><p><strong>Results: </strong>PSM yielded 56 matched patients. Pre-PSM, group A had longer operating times and hospital stays than Group B (p = 0.001). Group A had higher postoperative complications (17.9 % vs. 7.1 %) but was not statistically significant (p = 0.422). Group A also had more complex biliary stones. Post-PSM, Group B maintained shorter operating times and hospital stays. Regarding long-term results, stone recurrence rates were similar (5.8 % vs. 3.5 %, p = 0.668).</p><p><strong>Conclusion: </strong>Primary closure following LCBDE is a safe and effective alternative to T-tube drainage for treating hepatolithiasis and/or choledocholithiasis in elderly patients.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Transfusion of irradiated autologous blood for hepatobiliary and pancreatic cancer resections: a feasibility study.

IF 2.7 3区医学

Hpb Pub Date : 2024-11-16 DOI: 10.1016/j.hpb.2024.11.003

Leyo Ruo, Pablo E Serrano, Jennifer Ramsay, James J Hankinson

引用次数: 0

Association of chemotherapy completion rates and overall survival with postoperative complications after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma. 胰腺导管腺癌胰十二指肠切除术后化疗完成率和总生存率与术后并发症的关系。

IF 2.7 3区医学

Hpb Pub Date : 2024-11-09 DOI: 10.1016/j.hpb.2024.11.002

Sophie L G Kollbeck, Carsten P Hansen, Emilie E Dencker, Paul S Krohn, Jan H Storkholm, Stefan K Burgdorf, Andreas S Millarch, Thomas B Piper, Jens G Hillingsø, Martin Sillesen

{"title":"Association of chemotherapy completion rates and overall survival with postoperative complications after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma.","authors":"Sophie L G Kollbeck, Carsten P Hansen, Emilie E Dencker, Paul S Krohn, Jan H Storkholm, Stefan K Burgdorf, Andreas S Millarch, Thomas B Piper, Jens G Hillingsø, Martin Sillesen","doi":"10.1016/j.hpb.2024.11.002","DOIUrl":"https://doi.org/10.1016/j.hpb.2024.11.002","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the benefits of surgical resection and adjuvant chemotherapy for pancreatic ductal adenocarcinoma (PDAC), over 30 % of patients fail to complete adjuvant oncological treatment. Whether postoperative complications affect chemotherapy completion rates and overall survival remains uncertain. We hypothesized that postoperative complications would be associated with chemotherapy delays, omission, and reduced overall survival (OS).</p><p><strong>Methods: </strong>This was a retrospective analysis of patients undergoing pancreaticoduodenectomy for PDAC from 2008 to 2022 to assess whether serious surgical complications, defined as Clavien Dindo Grade 3b or higher, were associated with the omission or delay of adjuvant oncologic treatment as well as OS.</p><p><strong>Results: </strong>A total of 920 patients were available for analysis. Pancreatic and bile leakage were associated with risk of chemotherapy omission (OR 1.97 [CI 95 % 1.25-3.12], p = 0.004 and OR 1.96 [CI 95 % 1.04-3.67], p = 0.032, respectively). No delay of adjuvant chemotherapy >90 days nor change in OS was found.</p><p><strong>Conclusion: </strong>Major surgical complications influence the likelihood of omitting adjuvant chemotherapy but not delaying it > 90 days. Patients with pancreatic or bile leakage were at greater risk of not completing planned chemotherapy but had the same OS.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Advancing excellence: a national peer-coaching program for advanced laparoscopic HPB techniques. 追求卓越：先进腹腔镜 HPB 技术的全国同行指导计划。

IF 2.7 3区医学

Hpb Pub Date : 2024-11-09 DOI: 10.1016/j.hpb.2024.11.001

Alice Zhu, Marisa Louridas, Sean P Cleary, Shiva Jayaraman

{"title":"Advancing excellence: a national peer-coaching program for advanced laparoscopic HPB techniques.","authors":"Alice Zhu, Marisa Louridas, Sean P Cleary, Shiva Jayaraman","doi":"10.1016/j.hpb.2024.11.001","DOIUrl":"https://doi.org/10.1016/j.hpb.2024.11.001","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>Mid-to-late career HPB surgeons across Canada joined a peer surgical coaching program for advanced laparoscopic skills. The program included didactic sessions followed by practical coaching with case observation, simulation labs, and real-time coaching in the operating room. One lead surgeon from each center was invited to participate in the exit interview.</p><p><strong>Results: </strong>Eight centers across four provinces completed the program, and one lead surgeon from each site was interviewed. Surgeons reported a 34.9 % increase in self-perceived comfort levels in laparoscopic HPB surgeries, with a 24.2 % and 56.7 % increase in laparoscopic liver and pancreas resections, respectively. Participants acknowledged challenges in implementing surgical coaching, citing barriers related to surgeon and societal factors. Overcoming these challenges required mutual respect, openness to learning, and building sustained change through team collaboration and long-term coach relationships.</p><p><strong>Discussion: </strong>This work demonstrated the practicality of a nationwide coaching program and its capacity to effect substantial, long-term change in clinical practice.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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