Publications by authors named "Jan Philipp Jonas"
Objective: The aim of this study was to evaluate the different phases of the learning curve for robotic distal pancreatectomy (RDP) in international expert centers.
Summary Background Data: RDP is an emerging minimally invasive approach; however, only limited, mostly single center data are available on its safe implementation, including the learning curve.
Methods: Consecutive patients undergoing elective RDP from 16 expert centers across three continents were included to assess the learning curve.
: The aim of this study was to investigate the association between intraoperative blood transfusion (BT) and the short-term outcomes of pancreatoduodenectomy (PD) for patients with periampullary malignancies. : In a retrospective two-center cohort analysis, we utilized a logistic and mixed-effects ordinal regression, nonparametric partial correlation, and mediation analysis, complemented by propensity score matching (PSM) and weighting. : A total of 491 patients were included.
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- The Barcelona Clinic Liver Cancer (BCLC) staging system is crucial for treating hepatocellular carcinoma (HCC); recent updates allow for BCLC stage B patients to consider liver transplantation, while hepatectomy is now discouraged.
- A systematic review analyzed 31 studies involving 3163 patients to compare survival rates, postoperative complications, and patient selection for liver resection versus transplantation in BCLC stage B patients.
- Results showed that while resection had a 50-month survival and a 15-month recurrence-free period, data on transplantation was limited, with only one study reporting on it, indicating the need for more research in this area.
Article Synopsis
- The study investigates the use of von Willebrand factor antigen (vWF-Ag) as a non-invasive biomarker to assess complications related to portal hypertension and predict patient outcomes in hepatocellular carcinoma (HCC) after liver resection.
- The research found that vWF-Ag levels were strongly linked to time to recurrence and overall survival, with specific cutoff values indicating significant risk for posthepatectomy liver failure (PHLF) and clinically significant portal hypertension (CSPH).
- Results suggest that measuring vWF-Ag could enhance preoperative risk assessment for patients with resectable HCC, potentially guiding treatment decisions based on identified risk levels.
Background: In primarily unresectable liver tumors, ALPPS (Associating Liver Partition and Portal Vein Ligation for Staged hepatectomy) may offer curative two-stage hepatectomy trough a fast and extensive hypertrophy. However, concerns have been raised about the invasiveness of the procedure. Full robotic ALPPS has the potential to reduce the postoperative morbidity trough a less invasive access.
View Article and Find Full Text PDF(1) Background: The pathological tumor response of the primary tumor to induction chemotherapy in synchronously metastasized colorectal cancer (mCRC) patients has not been investigated. The aim of this study was to compare patients treated with induction chemotherapy combined with vascular endothelial growth factor (VEGF) or with epidermal growth factor receptor (EGFR) antibodies. (2) Methods: We present a retrospective analysis, where we included 60 consecutive patients with potentially resectable synchronous mCRC who received induction chemotherapy combined with either VEGF or EGFR antibodies.
View Article and Find Full Text PDFIn patients with extensive colorectal liver metastases (CRLM) and insufficient future liver remnant (FLR) a faster and more effective FLR augmentation than portal vein embolization is the associating liver partition and portal vein ligation in staged hepatectomy (ALPPS). Before ALPPS, the presence of arterial blood supply to the subsequently resected hemiliver must be ensured. We present a case with neoadjuvant-treated CRLM and insufficient FLR who developed a large intrahepatic hematoma after liver biopsy.
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- Activin A plays a crucial role in liver regeneration, but its effects on humans after liver surgery are not well studied, prompting this research on its predictive value for posthepatectomy liver failure (PHLF).
- The study tested levels of activin A and its antagonist FSTL-3 in 59 patients undergoing liver surgery and found significant changes in their individual levels post-surgery, but not in their ratio.
- The activin A/FSTL-3 ratio was a strong predictor for PHLF and related complications, suggesting its use in preoperative evaluations, although further research is needed for confirmation.
Background And Objective: Robotic distal pancreatectomy (DP) is an emerging attractive approach, but its role compared with laparoscopic or open surgery remains unclear. Benchmark values are novel and objective tools for such comparisons. The aim of this study was to identify benchmark cutoffs for many outcome parameters for DP with or without splenectomy beyond the learning curve.
View Article and Find Full Text PDFThe concept of a centre approach to the treatment of patients with complex disorders, such as those with hepato-pancreato-biliary (HPB) diseases, is widely applied, although what is needed for an HPB centre to achieve high-quality outcomes remains unclear. We therefore conducted a literature review, which highlighted the paucity of information linking centre structure or process to outcome data outside of caseloads, specialisation, and quality of training. We then conducted an international survey among the largest 107 HPB centres with experts in HPB surgery and found that most responders work in 'virtual' HPB centres without dedicated space, assigned beds, nor personal.
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- Cholangiocarcinoma (CCA) is a rare type of biliary cancer that has increasing incidence and mortality, varying by subtype: intrahepatic (iCCA), perihilar (pCCA), and distal (dCCA), with different risk factors and clinical courses.
- In a study with 2,234 patients from the ENSCCA Registry, results showed that iCCA is often linked to obesity and chronic liver issues, while pCCA involves primary sclerosing cholangitis, and dCCA relates to choledocholithiasis; most patients are diagnosed with advanced disease, complicating treatment outcomes.
- Surgical resection provided the best survival rates, especially with clear margins, while patients with