Annals of hepato-biliary-pancreatic surgery最新文献

{"title":"Propensity score analysis of adjuvant therapy in radically resected gallbladder cancers: A real world experience from a regional cancer center.","authors":"Sushma Agrawal, Rahul, Mohammed Naved Alam, Neeraj Rastogi, Ashish Singh, Rajneesh Kumar Singh, Anu Behari, Prabhakar Mishra","doi":"10.14701/ahbps.24-169","DOIUrl":"10.14701/ahbps.24-169","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Given the high mortality associated with gallbladder cancer (GBC), the efficacy of adjuvant therapy (AT) remains controversial. We audited our data over an 11-year period to assess the impact of AT.</p><p><strong>Methods: </strong>This study included all patients who underwent curative resection for GBC from 2007 to 2017. Analyses were conducted of clinicopathological characteristics, surgical details, and postoperative therapeutic records. The benefits of adjuvant chemotherapy (CT) or chemoradiotherapy (CTRT) were evaluated against surgery alone using SPSS version 20 for statistical analysis.</p><p><strong>Results: </strong>The median age of patients (n = 142) was 50 years. The median overall survival (OS) was 93, 34, and 30 months with CT, CTRT, and surgery alone respectively (<i>p</i> = 0.612). Multivariate analysis indicated that only disease stage and microscopically involved margins significantly impacted OS and disease-free survival (DFS). CT showed increased effectiveness across all prognostic subsets, except for stage 4 and margin-positive resections. Following propensity score matching, median DFS and OS were higher in the CT group than in the CTRT group, although the differences were not statistically significant (<i>p</i> > 0.05).</p><p><strong>Conclusions: </strong>Radically resected GBC patients appear to benefit more from adjuvant CT, while CTRT should be reserved for cases with high-risk features.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"38-47"},"PeriodicalIF":1.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904208","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":"ArtiSential^® laparoscopic cholecystectomy versus singlefulcrum laparoscopic cholecystectomy: Which minimally invasive surgery is better?","authors":"Jae Hwan Jeong, Seung Soo Hong, Munseok Choi, Seoung Yoon Rho, Pejman Radkani, Brian Kim Poh Goh, Yuichi Nagakawa, Minoru Tanabe, Daisuke Asano, Chang Moo Kang","doi":"10.14701/ahbps.24-137","DOIUrl":"10.14701/ahbps.24-137","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>In recent years, many minimally invasive techniques have been introduced to reduce the number of ports in laparoscopic cholecystectomy (LC), offering benefits such as reduced postoperative pain and improved cosmetic outcomes. ArtiSential^® is a new multi-degree-of-freedom articulating laparoscopic instrument that incorporates the ergonomic features of robotic surgery, potentially overcoming the spatial limitations of laparoscopic surgery. ArtiSential^® LC can be performed using only two ports. This study aims to compare the surgical outcomes of ArtiSential^® LC with those of single-fulcrum LC.</p><p><strong>Methods: </strong>This retrospective study compared ArtiSential^® LC and single-fulcrum LC among LCs performed for gallbladder (GB) stones at the same center, analyzing the basic characteristics of patients; intraoperative outcomes, such as operative time, estimated blood loss, and intraoperative GB rupture; and postoperative outcomes, such as length of hospital stay, incidence of postoperative complications, and postoperative pain.</p><p><strong>Results: </strong>A total of 88 and 63 patients underwent ArtiSential^® LC and single-fulcrum LC for GB stones, respectively. Analysis showed that ArtiSential^® LC resulted in significantly fewer cases of surgeries longer than 60 minutes (30 vs. 35 min, <i>p</i> = 0.009) and intraoperative GB ruptures (2 vs. 10, <i>p</i> = 0.007). In terms of postoperative outcomes, ArtiSential^® LC showed better results in the respective visual analog scale (VAS) scores immediately after surgery (2.59 vs. 3.73, <i>p</i> < 0.001), and before discharge (1.44 vs. 2.02, <i>p</i> = 0.01).</p><p><strong>Conclusions: </strong>ArtiSential^® LC showed better results in terms of surgical outcomes, especially postoperative pain. Thus, ArtiSential^® LC is considered the better option for patients, compared to single-fulcrum LC.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"48-54"},"PeriodicalIF":1.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309231","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 rare case of a large solid pseudopapillary neoplasm with extensive liver metastasis.","authors":"Jun Hyung Kim, Hyung Sun Kim, Jung Min Lee, Ji Hae Nahm, Joon Seong Park","doi":"10.14701/ahbps.24-147","DOIUrl":"10.14701/ahbps.24-147","url":null,"abstract":"<p><p>Solid pseudopapillary neoplasms (SPNs) are uncommon pancreatic tumors that primarily affect young females. We report a case of a 24-year-old female diagnosed with SPN and liver metastasis during a routine examination. Imaging revealed an 8-cm pancreatic mass with multiple liver metastases. Histopathology confirmed SPN. Subsequent next-generation sequencing revealed a <i>CTNNB1</i> mutation. The patient underwent a total pancreatectomy with splenectomy, right hemihepatectomy, and intraoperative radiofrequency ablation. Two years after the surgery, she remained complication-free. She is under regular surveillance. This case underscores the importance of early detection and comprehensive management of SPN.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"83-87"},"PeriodicalIF":1.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482198","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":"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}

{"title":"Robotic management of huge hepatic angiomyolipoma: A case report and literature review.","authors":"Andrew Park, Kush Savsani, Anjelica Alfonso, Ester Jo, Bryce Hatfield, Daisuke Imai, Aamir Khan, Amit Sharma, Irfan Saeed, Vinay Kumaran, Adrian Cotterell, David Bruno, Yuzuru Sambommatsu, Seung Lee","doi":"10.14701/ahbps.24-033","DOIUrl":"10.14701/ahbps.24-033","url":null,"abstract":"<p><p>Hepatic angiomyolipoma (HAML) is a rare, benign mesenchymal liver tumor encountered in Asia, primarily in females, and can be found within the right hepatic lobe, but also in other areas of the liver. Immunohistochemically, HAMLs are characteristically positive for human melanoma black-45 antigen (HMB-45) and can histochemically vary in the composition of angiomatous, lipomatous, and myomatous tissue, together with the presence of epithelioid cells. In this case report, we discuss a previously healthy patient presenting with bloating and previously documented concern of liver lesions, found to have HAML confirmed by surgical pathology. Surgery was decided, as HAMLs greater than 10 cm are at risk of rupture. This is one of the first documented cases of HAML resected through robot-assisted bisegmentectomy and cholecystectomy, and therefore, intraoperative images have been included to assist in the planning of future robotic cases.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"527-534"},"PeriodicalIF":1.1,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11599823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312377","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":"Segments 4, 7, and 8 liver resection: A case report.","authors":"Pilar Leal-Leyte, Carlos Ulises Camarillo-Sánchez, Daniel Zamora-Valdés","doi":"10.14701/ahbps.24-092","DOIUrl":"10.14701/ahbps.24-092","url":null,"abstract":"<p><p>Right superior resection (segments 7 and 8) is an uncommon resection for liver malignancies, with most of the literature limited to case reports and small series. Resection of segments 4, 7, and 8 has been reported in only a few cases. When the right hepatic vein is resected, venous reconstruction or identification of one or more right inferior hepatic veins is considered mandatory, to maintain segmentary function of segments 5 and 6. We present a case of liver resection of segments 4, 7, and 8 including the right and middle hepatic veins for symptomatic benign liver disease with no right hepatic vein reconstruction, nor a prominent right inferior hepatic vein(s). After the resection, there was no change in liver function tests, and the patient made an unremarkable recovery. Three months after the operation, partial atrophy of segments 5 and 6 with hypertrophy of the left lateral section was observed, while two and one half years after resection, the patient is asymptomatic. When right hepatic vein reconstruction would add unnecessary operative time, and there is low likelihood of the need for repeated resection, particularly when the hepatic vein is difficult to dissect, this approach can be safe and useful, while providing an adequate postoperative liver mass in the short-term to recover uneventfully from major liver resection.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"522-526"},"PeriodicalIF":1.1,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11599812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141763007","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":"Liver transplantation for organ failure following multiple locoregional treatments for breast cancer metastasis.","authors":"Giammauro Berardi, Valerio Giannelli, Marco Colasanti, Roberto Cianni, Roberto Meniconi, Nicola Guglielmo, Stefano Ferretti, Ludovica Di Cesare, Adriano Pellicelli, Guido Ventroni, Enrico Cortesi, Giuseppe Maria Ettorre","doi":"10.14701/ahbps.24-101","DOIUrl":"10.14701/ahbps.24-101","url":null,"abstract":"<p><p>Patients with nonresectable breast cancer liver metastasis (BCLM) face a dismal prognosis. Despite liver transplantation (LT) for metastatic liver tumors having recently shown good results, BCLM represents an absolute contraindication. This study aimed to investigate the potential for long-term survival after LT for BCLMs in a patient experiencing end-stage liver disease, following multiple oncologic treatments. In July 2019, we performed a deceased donor LT on a 41-year-old female with BCLM controlled with human epidermal growth factor receptor 2 targeted therapy, who developed liver failure following multiple locoregional liver-directed treatments. The primary tumor was treated with surgical resection and adjuvant chemoradiation in 2000. The procedure was performed under a protocol approved by the local ethical committee, and by the Italian National Transplant Center. A 12-month treatment with trastuzumab was performed immediately after LT. Immunosuppression following transplantation was undertaken without steroids, and with everolimus. The patient completed 12 months of follow-up without recurrence. Trastuzumab was then withdrawn. Fifteen months after LT, a liver recurrence occurred that was treated with chemotherapy. In October 2021, she developed 2 brain lesions that were treated with stereotactic radiation. The patient is still alive, with a positron emission tomography/computed tomography performed in January 2024 showing no disease. LT for this patient with BCLM of extreme selectivity showed a good clinical outcome. Perioperative systemic treatment and tumor control are necessary. A specific protocol should be discussed within a multidisciplinary team, and with local and national authorities. Even if tumor recurrence occurs, multimodal therapy can control the disease.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"516-521"},"PeriodicalIF":1.1,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11599815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891101","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}