Annals of hepato-biliary-pancreatic surgery最新文献

{"title":"\"Liver-loop\": a case report of an alternative modified liver hanging maneuver.","authors":"Rodrigo Antonio Gasque, José Gabriel Cervantes, Magalí Chahdi Beltrame, Marcelo Enrique Lenz Virreira, Francisco Juan Mattera, Emilio Gastón Quiñonez","doi":"10.14701/ahbps.24-217","DOIUrl":"https://doi.org/10.14701/ahbps.24-217","url":null,"abstract":"<p><p>The liver hanging maneuver (LHM), introduced by Belghiti et al. in 2001, has been widely adapted to various hepatectomy techniques to reduce blood loss and facilitate parenchymal transection. However, its primary limitation is the risk of vascular injury, particularly near the inferior vena cava (IVC). In this report, we describe a modified \"Loop-Hanging\" maneuver designed as an alternative to enhance exposure during parenchymal transection and improve the control of Glissonean pedicles. In this case, we employed the technique during an open right hemihepatectomy on a 47-year-old male patient with a complex bile duct injury following two unsuccessful Roux-en-Y hepaticojejunostomies (RYHJ). The patient was referred to our institution due to an RYHJ stricture. Imaging identified a right hepatic artery pseudoaneurysm and a fistula to the biliary limb. After two failed attempts at endovascular embolization, a surgical approach was determined through multidisciplinary discussions. During the surgery, the liver was looped with a nasogastric tube positioned anterior to the IVC, allowing gentle upward traction that facilitated the transection, minimized bleeding, and enhanced pedicle control. The LHM is known to reduce blood loss but carries risks for patients with anatomical variations, scarring, or cirrhosis. Our \"Loop-Hanging\" technique retains the core advantages of LHM, simplifies the process, and diminishes the risk of vascular injury. Further research is required to assess its safety and broader applicability.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parenchymal-sparing non-anatomic resection vs. classic anatomic resection in colorectal cancer liver metastases.","authors":"Sungwon Jung","doi":"10.14701/ahbps.24-151","DOIUrl":"https://doi.org/10.14701/ahbps.24-151","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Although anatomical liver resection is considered more effective in preventing complications and recurrence in hepatocellular carcinoma, its efficacy has yet to be clearly defined in colorectal cancer liver metastasis (CLM).</p><p><strong>Methods: </strong>From January 2000 to December 2023, 145 patients underwent liver resections for CLM, divided into anatomic and non-anatomic resection cohorts. The dataset included demographic details, tumor size, number and distribution of metastases, neoadjuvant chemotherapy, primary tumor location and stage, type of liver surgery, transfusion rates, duration of hospital stay, postoperative complications, and completeness of resection.</p><p><strong>Results: </strong>Of the 145 patients who underwent liver resections for metastases from colorectal cancer, 62 were in the anatomic group and 83 were in the non-anatomic group. The anatomic group had larger tumors (6.71 cm vs. 3.18 cm). Intraoperative transfusion rates were higher in the anatomic group (56.5% vs. 12.0%). Hospital stays, positive resection margin rates, and postoperative complication rates showed no significant differences. One surgery-related death occurred in the anatomic group. Disease-free and overall survival rates were comparable between groups.</p><p><strong>Conclusions: </strong>Anatomic liver resection did not demonstrate a reduction in recurrence or an improvement in survival rates compared to non-anatomic resection. As such, anatomical resection does not offer a <i>survival</i> advantage over non-anatomical resection. Consequently, surgical method selection should prioritize patient safety, preservation of residual liver parenchyma, and tumor-specific factors.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comprehensive study on postoperative complications and postoperative pancreatic fistula in sporadic non-functional pancreatic neuroendocrine tumors: A retrospective cohort study.","authors":"Juwan Kim, Seung Soo Hong, Sung Hyun Kim, Ho Kyoung Hwang, Chang Moo Kang","doi":"10.14701/ahbps.24-215","DOIUrl":"https://doi.org/10.14701/ahbps.24-215","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Balancing surgical risks and benefits is crucial for managing non-functional pancreatic neuroendocrine tumors (NF-PNETs). Despite high postoperative pancreatic fistula (POPF) rates, studies on postoperative complications of sporadic NFPNETs are scarce. Thus, this study aimed to investigate postoperative complications and identify risk factors for POPF.</p><p><strong>Methods: </strong>A retrospective review of 166 NF-PNET surgeries performed at Severance Hospital between February 2000 and August 2023 was conducted.</p><p><strong>Results: </strong>Age > 65 years and higher American Society of Anesthesiology (ASA) grade were not significantly correlated with severe complications (odds ratio [OR]: 1.10, <i>p</i> = 0.871 and OR: 1.47, <i>p</i> = 0.491, respectively). Surgical procedures included enucleation (13.9%), distal pancreatectomy (50.0%), central pancreatectomy (4.8%), pancreaticoduodenectomy (PD) (26.5%), and total pancreatectomy (4.8%). Severe complications occurred in 12.05% of surgeries. The overall incidence of all POPFs including biochemical leaks was 53%, while clinically relevant POPF (grade B or C) occurred in 7.8% of patients. Logistic regression showed that PD (OR: 3.94, <i>p</i> = 0.092) tended to be risk factor for POPF and that diameter of the main pancreatic duct (MPD) ≤ 3 mm was a significant risk factor for POPF (OR: 0.22, <i>p</i> = 0.008). A pancreas thickness (PT)/MPD ratio > 4.47 on preoperative computed tomography predicted all POPFs in PD patients (OR: 11.70, <i>p</i> = 0.001).</p><p><strong>Conclusions: </strong>Age and comorbidities had no significant impact on surgical outcomes. PD was associated with higher serious complications and POPF rates. The PT/MPD ratio is a valuable preoperative tool for predicting POPF risk in PD patients.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of postoperative outcomes of single-incision cholecystectomy: Propensity score matching of robotic surgery using the da Vinci SP system and da Vinci Xi system vs. laparoscopic surgery.","authors":"Jeong-Ik Park, Yong-Kyu Chung, Young Min Lee, Chang Woo Nam, Yang Won Nah","doi":"10.14701/ahbps.24-198","DOIUrl":"https://doi.org/10.14701/ahbps.24-198","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>We compared the postoperative outcomes of single-incision laparoscopic cholecystectomy (SILC) with those of single-incision robotic cholecystectomy (SIRC) using the da Vinci Xi and SP systems.</p><p><strong>Methods: </strong>We retrospectively analyzed data from 206 patients who underwent these procedures by a single surgeon between August 2020 and April 2022. Propensity score matching was used to adjust for confounders and evaluate outcomes.</p><p><strong>Results: </strong>SILC exhibited shorter operation times compared to SIRC with Xi and SP (44.9 ± 14.5 min vs. 55.3 ± 12.2 min vs. 55.2 ± 16.2 min, <i>p</i> < 0.001). SIRC with Xi had shorter docking times (6.2 ± 2.8 min vs. 10.3 ± 2.3 min, <i>p</i> < 0.001), while SIRC with SP demonstrated reduced console times (11.2 ± 2.4 min vs. 18.6 ± 8.0 min, <i>p</i> < 0.001). Pain scores and complications did not significantly differ between the groups.</p><p><strong>Conclusions: </strong>Both SILC and SIRC showed comparable outcomes, with the SP system providing advantages such as reduced console time and fully articulated arms, likely reducing surgeon stress.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heterotopic pancreas of the gallbladder: A case report of a rare and commonly incidental finding.","authors":"Nelson Chen, Jessica Gu","doi":"10.14701/ahbps.24-190","DOIUrl":"https://doi.org/10.14701/ahbps.24-190","url":null,"abstract":"<p><p>Heterotopic pancreas (HP) refers to the presence of ectopic pancreatic tissue located outside of the normal pancreatic location without anatomical or vascular continuity with the pancreas. HP within the gallbladder (HPGB) was first described by Otschkin in 1916. It remains an exceedingly rare pathology with few reported cases. Here we describe a case of HPGB in a 42-year-old female following laparoscopic cholecystectomy for symptoms of biliary colic. She presented with epigastric pain, elevated levels in liver function tests, and gallbladder sludge on ultrasound. Her lipase and bilirubin levels were within normal limits. Histopathological assessment of the gallbladder identified mild chronic cholecystitis and pancreatic heterotopia adjacent to the cystic duct of the gallbladder with all three elements (ducts, acini, and endocrine islets) of the pancreas, consistent with type 1 based on the classification of Gaspar Fuentes et al. HPGB is often diagnosed incidentally during histopathological examination after cholecystectomy. Preoperative diagnosis is challenging due to its rarity. It is thought to be asymptomatic. Although the clinical significance of HPGB remains uncertain, it has been hypothesized that HPGB can cause acalculous cholecystitis and also have the potential for malignant transformation. Our case supports the theory that the exocrine function of an ectopic pancreatic tissue may contribute to chronic inflammation in the gallbladder. In conclusion, although HPGB is a rare finding with unclear clinical relevance, its potential for malignancy and association with cholecystitis warrant further investigation. Given its scarcity, most knowledge about HPGB comes from case reports and case series. This report adds to the existing literature.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-cholecystectomy total bile duct strictures: Cases for magnetic compression anastomosis.","authors":"Freddy Pereira Graterol, Francisco Salazar Marcano, Yajaira Venales Barrios, Yeisson Rivero-Moreno, Dong Ki Lee","doi":"10.14701/ahbps.24-186","DOIUrl":"https://doi.org/10.14701/ahbps.24-186","url":null,"abstract":"<p><p>Bile duct injuries are a serious issue, and their surgical treatment carries the risk of morbidity and mortality. In selected cases, non-surgical treatments are possible, even for total strictures. We outline the technique and results of using magnetic compression anastomosis (MCA) to treat post-cholecystectomy bile duct stricture (PCBDS), in two female patients. Initially, a bilio-cutaneous tract was established via external biliary drainage, followed by the positioning of both endoscopic and percutaneous biliary magnets. After their approximation and subsequent removal, a fully covered self-expandable metal stent (FCSEMS) was deployed across the stricture. The magnet coupling was successfully achieved within the first two weeks of placement. The FCSEMS was maintained for durations of 12 and 16 months. Follow-up durations were 28 and 15 months post-FCSEMS removal. Both patients remain asymptomatic, with normal laboratory and imaging studies, and no adverse events were reported. MCA proves to be a safe and effective method for treating selected cases of total PCBDS. However, further studies and long-term follow-up are required to fully assess the efficacy of this technique.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of longitudinal tumor location on postoperative outcomes in gallbladder cancer: Fundus and body vs. neck and cystic duct, a retrospective multicenter study.","authors":"Kil Hwan Kim, Ju Ik Moon, Jae Woo Park, Yunghun You, Hae Il Jung, Hanlim Choi, Si Eun Hwang, Sungho Jo","doi":"10.14701/ahbps.24-117","DOIUrl":"10.14701/ahbps.24-117","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Systematic investigations into the prognostic impact of the longitudinal tumor location in gallbladder cancer (GBC) remain insufficient. To address the limitations of our pilot study, we conducted a multicenter investigation to clarify the impact of the longitudinal tumor location on the oncological outcomes of GBC.</p><p><strong>Methods: </strong>A retrospective multicenter study was conducted on 372 patients undergoing radical resections for GBC from January 2010 to December 2019 across seven hospitals that belong to the Daejeon-Chungcheong branch of the Korean Association of Hepato-Biliary-Pancreatic Surgery. Patients were divided into GBC in the fundus/body (FB-GBC) and GBC in the neck/cystic duct (NC-GBC) groups, based on the longitudinal tumor location.</p><p><strong>Results: </strong>Of 372 patients, 282 had FB-GBC, while 90 had NC-GBC. NC-GBC was associated with more frequent elevation of preoperative carbohydrate antigen (CA) 19-9 levels, requirement for more extensive surgery, more advanced histologic grade and tumor stages, more frequent lymphovascular and perineural invasion, lower R0 resection rates, higher recurrence rates, and worse 5-year overall and disease-free survival rates. Propensity score matching analysis confirmed these findings, showing lower R0 resection rates, higher recurrence rates, and worse survival rates in the NC-GBC group. Multivariate analysis identified elevated preoperative CA 19-9 levels, lymph node metastasis, and non-R0 resection as independent prognostic factors, but not longitudinal tumor location.</p><p><strong>Conclusions: </strong>NC-GBC exhibits more frequent elevation of preoperative CA 19-9 levels, more advanced histologic grade and tumor stages, lower R0 resection rates, and poorer overall and disease-free survival rates, compared to FB-GBC. However, the longitudinal tumor location was not analyzed as an independent prognostic factor.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"474-482"},"PeriodicalIF":1.1,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11599822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142006015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally invasive pancreatoduodenectomy with combined venous vascular resection: A comparative analysis with open approach.","authors":"Dong Hyun Shin, Munseok Choi, Seoung Yoon Rho, Seung Soo Hong, Sung Hyun Kim, Ho Kyoung Hwang, Chang Moo Kang","doi":"10.14701/ahbps.24-082","DOIUrl":"10.14701/ahbps.24-082","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>This study aimed to compare the minimally invasive pancreatoduodenectomy with venous vascular resection (MI-PDVR) and open pancreatoduodenectomy with venous vascular resection (O-PDVR) for periampullary cancer.</p><p><strong>Methods: </strong>Data of 124 patients who underwent PDVR (45 MI-PDVR, 79 O-PDVR) between January 1, 2016, and December 31, 2023, was retrospectively reviewed.</p><p><strong>Results: </strong>MI-PDVR is significantly better than O-PDVR in terms of perioperative outcomes (median operation time [452.69 minutes vs. 543.91 minutes; <i>p</i> = 0.004], estimated blood loss [410.44 mL vs. 747.59 mL; <i>p</i> < 0.01], intraoperative transfusion rate [2 cases vs. 18 cases; <i>p</i> = 0.01], and hospital stay [18.16 days vs. 23.91 days; <i>p</i> = 0.008]). The complications until the discharge day showed no significant difference between the two groups (Clavien-Dindo < 3, 84.4% vs. 82.3%; Clavien-Dindo ≥ 3, 15.6% vs. 17.7%; <i>p</i> = 0.809). In terms of long-term oncological outcomes, there was no statistical difference in overall survival (OS, 51.55 months [95% CI: 35.95-67.14] vs. median 49.92 months [95% CI: 40.97-58.87]; <i>p</i> = 0.340) and disease-free survival (DFS, median 35.06 months [95% CI: 21.47-48.65] vs. median 38.77 months [95% CI: 29.80-47.75]; <i>p</i> = 0.585), between the two groups. Long-term oncological outcomes for subgroup analysis focusing on pancreatic ductal adenocarcinoma also showed no statistical differences in OS (40.86 months [95% CI: 34.45-47.27] vs. 48.48 months [95% CI: 38.16-58.59]; <i>p</i> = 0.270) and DFS (24.42 months [95% CI: 17.03-31.85] vs. 34.35 months, [95% CI: 25.44-43.27]; <i>p</i> = 0.740).</p><p><strong>Conclusions: </strong>MI-PDVR can provide better perioperative outcomes than O-PDVR, and has similar oncological impact.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"500-507"},"PeriodicalIF":1.1,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11599825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internal and external validation of indocyanine green plasma disappearance rate to discard liver grafts before procurement.","authors":"Sergio Cortese, Katherine Plua, Alejandro J Perez-Alonso, María Savoie Hontoria, David Pacheco, Natalia Zambudio Carroll, Manuel Ángel Barrera Gómez, José María Pérez Peña, Álvaro G Morales Taboada, María Fernández Martínez, Sergio Hernández Kakauridze, Ana María Matilla, José Ángel López Baena, José Manuel Asencio","doi":"10.14701/ahbps.24-086","DOIUrl":"10.14701/ahbps.24-086","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Thirty percent of liver grafts in donors after brain death (DBD) in Spain are rejected by procurement surgeons owing to marginal graft quality. Poor donor indocyanine green (ICG) clearance has been associated with graft discard and malfunction. This study aimed to internally and externally validate the predictive value of ICG-plasma disappearance rate (ICG-PDR) to reject grafts before donation and set a cut-off to avoid missing any potential effective donors.</p><p><strong>Methods: </strong>Between March 2017 and August 2023, ICG clearance test was performed immediately before procurement in 71 DBD. The surgeon was blinded to test results. Univariate and multivariate analyses were performed to detect independent predictors of graft discard. Discrimination and calibration of predictors were assessed and a cut-off with 100% specificity was set. External validation was performed on 17 donors evaluated by three other transplantation teams.</p><p><strong>Results: </strong>In the training cohort, 30 of 71 grafts were discarded for transplantation. ICG-PDR was the only donor variable independently associated with graft discard. The area under receiver operating characteristic curve for ICG-PDR was 0.875 (95% confidence interval: 0.768-0.947) and good calibration was observed. Below a PDR of 13.5%/min, no graft was accepted for transplantation. These results were successfully validated using the external cohort of donors.</p><p><strong>Conclusions: </strong>ICG clearance test performed in DBD was internally and externally validated to predict liver graft discard. It could be used as a screening tool before donation to avoid unnecessary costs of travel and human resources.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"458-465"},"PeriodicalIF":1.1,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11599826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review of ergonomic positions to improve musculoskeletal distress in hepatobiliary pancreatic surgeons according to open, laparoscopic, and robotic surgeries.","authors":"Young Jae Cho, Jin-Young Jang","doi":"10.14701/ahbps.24-127","DOIUrl":"10.14701/ahbps.24-127","url":null,"abstract":"<p><p>Advances in surgical ergonomics are essential for the performance, health, and career longevity of surgeons. Many surgeons experience work-related musculoskeletal disorders (WMSDs) resulting from various surgical modalities, including open, laparoscopic, and robotic surgeries. To prevent WMSDs, individual differences may exist depending on the surgical method; however, the key is to maintain a neutral posture, and avoid static postures. This review aims to summarize the concepts of ergonomics and WMSDs; identify the ergonomic challenges of open, laparoscopic, and robotic surgeries; and discuss ergonomic recommendations to improve them.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"433-439"},"PeriodicalIF":1.1,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11599811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}