Publications by authors named "Dionisios Vrochides"

Article Synopsis
  • The study investigates how the length of time taken during liver surgeries affects the likelihood of postoperative complications in patients undergoing different types of liver resections.
  • A total of 5,424 patients were analyzed from multiple centers between 2000 and 2022, focusing on procedures like right hemihepatectomy, technically major resection, and left lateral sectionectomy.
  • Results show that patients in the longest operative time group had a significantly higher risk of complications, particularly in various surgical approaches like open, laparoscopic, and robotic surgeries.
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Purpose: Pancreatic ductal adenocarcinoma (PDAC) has been shown to have a lower incidence in patients with blood group O. It is currently uncertain if patients with group O have a better prognosis after pancreatectomy. This study assessed the overall survival (OS) and disease-free survival (DFS) of PDAC patients who underwent upfront pancreatoduodenectomy based on ABO blood groups.

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Background: Although minimally invasive distal pancreatectomy (MIDP) is considered a standard approach it still presents a non-negligible rate of conversion to open that is mainly related to some difficulty factors, as obesity. The aim of this study is to analyze the preoperative factors associated with conversion in obese patients with MIDP.

Methods: In this multicenter study, all obese patients who underwent MIDP at 18 international expert centers were included.

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Background And Objectives: Deep learning models (DLMs) are applied across domains of health sciences to generate meaningful predictions. DLMs make use of neural networks to generate predictions from discrete data inputs. This study employs DLM on prechemotherapy cross-sectional imaging to predict patients' response to neoadjuvant chemotherapy.

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Article Synopsis
  • A study was conducted to compare the perioperative outcomes of robotic liver surgery (RLS) and laparoscopic liver surgery (LLS) across various healthcare settings from 2009 to 2021.
  • The results showed that RLS had better outcomes in terms of "textbook outcomes," lower blood loss, fewer complications, and shorter operative times compared to LLS after matching patient groups for bias.
  • Despite the higher costs generally associated with robotic surgery, this study suggests that RLS may offer specific clinical advantages over LLS in minimally invasive liver procedures.
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Article Synopsis
  • - This study examines how compliance with the Enhanced Recovery after Surgery (ERAS) protocol affects surgical recovery outcomes in four different surgery types across two major healthcare systems in the US.
  • - Key findings show that specific ERAS practices, such as early Foley catheter removal and limited use of NG tubes, led to shorter hospital stays and fewer complications for liver, pancreas, and head and neck surgeries.
  • - The research highlights the importance of individual ERAS recommendations and suggests that future studies should explore how these recommendations can be better applied in real-world surgical settings.
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This review discusses long-term complications from immunosuppressants after liver transplantation and the management of these complications. Common complications of calcineurin inhibitors include nephrotoxicity and metabolic diseases. Nephrotoxicity can be managed by targeting a lower drug level and/or adding an immunosuppressant of a different class.

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Background: This meta-analysis investigated the effects of enhanced recovery after surgery (ERAS) protocols compared to conventional care on postoperative outcomes in patients aged 70 years or older undergoing pancreatoduodenectomy (PD).

Methods: Five databases were systematically searched. Comparative studies with available individual patient data (IPD) were included.

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Introduction: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality and often arises in the setting of cirrhosis. The present series reviews outcomes following 791 operations.

Methods: Retrospective review surgical MWA for HCC from March 2007 through December 2022 at a high-volume institution was performed using a prospective database.

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Background: Robotic distal pancreatectomy (RDP) is associated with a lower conversion rate and less blood loss than laparoscopic distal pancreatectomy (LDP). LDP has similar oncological outcomes as open surgery in PDAC. The aim of this study was to compare perioperative and oncological outcomes in obese patients with RDP versus LDP for PDAC.

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There has been steady growth in the adoption of robotic HPB procedures world-wide over the past 20 years, but most of this increase has occurred only recently. Not surprisingly, the vast majority of robotics has been in the United States, with very few, select centers of adoption in Italy, South Korea, and Brazil, to name a few. We began our robotic HPB program in 2008, well before almost all other centers in the world, with the most notable exception of Giullianotti and colleagues.

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Introduction: Adoption of robotic liver resections has been gradually increasing throughout the HPB surgical community over the past decade. Currently there is limited literature which demonstrates a significant benefit of robotic surgery for major hepatectomies over open or laparoscopic. As one of the first centers to develop a robotic HPB program, we have experienced improved outcomes over time with increasing utilization of robotics.

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Background: Robotic pancreaticoduodenectomy (RPD) is an emerging alternative to open pancreaticoduodenectomy (OPD). Although RPD offers various theoretical advantages, it is used in less than 10% of all pancreaticoduodenectomies. The aim of this study was to report our 10-year experience and compare RPD outcomes with international benchmarks for OPD.

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Purpose: Statin treatment has been shown in certain population studies and meta-analyses to improve survival of patients with pancreatic ductal adenocarcinoma (PDAC). This study assessed if patients with statin treatment had better overall survival (OS) and disease-free survival (DFS) after upfront pancreatoduodenectomy for PDAC.

Methods: Consecutive PDAC patients were retrospectively collected from three centers in Europe and USA (study period: 2000-2017).

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Article Synopsis
  • Robotic distal pancreatectomy (RDP) shows better short-term outcomes than laparoscopic distal pancreatectomy (LDP) in obese patients with a BMI of 30 or higher, including lower complication rates and less blood loss.
  • The study included 446 obese patients over a 10-year span, focusing on surgery effectiveness and treatment comparisons at 18 expert centers.
  • RDP was found to have a lower conversion rate to open surgery and achieved better spleen preservation compared to LDP, highlighting its advantages for surgical interventions in this patient group.
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Introduction: The Japanese difficulty score (JDS) categorizes laparoscopic hepatectomy into low, intermediate, and high complexity procedures, and correlates with operative and postoperative outcomes. We sought to perform a validation study to determine if the JDS correlates with operative and postoperative indicators of surgical complexity for patients undergoing robotic-assisted hepatectomy.

Methods: Retrospective review of 657 minimally invasive hepatectomy procedures was performed between January 2008 through March 2019.

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Background: The 2022 incoming fellows' expectations for their robotics training, as well as their perceptions of the utility of the surgical robot, are not well defined.

Methods: Cross-sectional survey of 24 AHPBA fellows in 2022, analyzed with descriptive statistics and Spearman's rho.

Results: Of 33 current AHPBA fellows, 22 completed the survey (66.

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Background: Enhanced recovery after surgery (ERAS®) pathways aim to improve patient outcomes by applying multimodal practices before, during, and after operative procedures. Compared with standard care before ERAS, we investigated whether compliance to ERAS guidelines for nutritional care, preoperative oral carbohydrate loading and postoperative oral nutrition, was associated with a decrease in hospital length of stay (LOS) after pancreaticoduodenectomy, distal pancreatectomy, hepatectomy, radical cystectomy, and head and neck tumor resection with reconstruction.

Methods: Compliance to ERAS nutrition recommendations was evaluated.

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Introduction: Robotic surgery has been increasingly utilized, yet its application for hepato-pancreato-biliary (HPB) procedures remains low due to technical complexity, perceived financial burden, and unproven clinical benefits. We hypothesized that the robotic approach would be associated with improved clinical outcomes following major hepatectomy compared with the laparoscopic approach among elderly patients who would benefit from the advantages of minimally invasive surgery.

Methods: A retrospective review of consecutive patients who underwent major hepatectomy between January 2010 and December 2021 at Carolinas Medical Center was performed.

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Purpose: Ex vivo hepatectomy with autotransplantation (EHAT) provides opportunity for R0 resection. As EHAT outcomes after future liver remnant (FLR) augmentation techniques are not well documented, we examine results of EHAT after augmentation for malignant tumors.

Methods: Retrospective analysis of six cases of EHAT was performed.

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Background: Pancreatic necrosectomy with concomitant internal drainage is a single-stage treatment option for walled-off pancreatic necrosis (WOPN). However, an optimal minimally invasive technique has not been established. We evaluated the safety and single-intervention success rate of robotic pancreatic necrosectomy and internal drainage.

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Background: A significant number of patients with advanced pancreatic cancer are unable to undergo resection due to vascular involvement. Irreversible electroporation (IRE) has shown promise in improving survival. This study sought to assess a novel IRE application whereby IRE was performed pre-resection to alter tissue plasticity and assist tumor removal from underlying vasculature when surgical excision was otherwise precluded.

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Synopsis of recent research by authors named "Dionisios Vrochides"

  • - Dionisios Vrochides' recent research predominantly focuses on surgical outcomes and methodologies in the context of liver and pancreatic surgeries, examining intricate factors such as operative time, blood group prognostics, and the conversion rates of minimally invasive procedures in obese patients.
  • - His studies employ large multicenter cohorts and advanced methodologies, such as deep learning models, to derive significant insights into postoperative complications, patient response to treatments, and the effectiveness of enhanced recovery protocols in both younger and elderly populations.
  • - Findings from his research highlight the complexities of surgical interventions, revealing crucial correlations between various preoperative factors and surgical outcomes, such as complications in liver resections and the prognostic implications of blood types in pancreatic surgeries.