Publications by authors named "Jun-Suh Lee"
Hepatocellular carcinoma (HCC) is the most common primary liver cancer, the incidence of which is rising globally. Despite recent advancements in immunotherapeutic and surgical treatment modalities, the prognosis for HCC remains poor. The surgical treatment strategy for HCC comprises a multimodal effort that ranges from ablative therapy and surgical resection to liver transplantation.
View Article and Find Full Text PDFBackground: Laparoscopic cholecystectomy, being a prevalent abdominal surgical procedure, has transitioned through various innovative stages aimed at reducing the procedure's invasiveness. These stages encompass Single-Incision Laparoscopic Cholecystectomy (SILC), Mini Laparoscopic Cholecystectomy (MLC), Natural Orifice Transluminal Endoscopic Surgery (NOTES), and Robotic-Assisted Laparoscopic Cholecystectomy (RALC). The purpose of this review is to trace the evolution of minimally invasive cholecystectomy techniques, assess their status, and identify emerging trends and challenges in the field.
View Article and Find Full Text PDFArticle Synopsis
- Minimally invasive pancreatoduodenectomy (MIPD) techniques, like robot-assisted (RAPD) and totally laparoscopic (TLPD) surgeries, are becoming more popular for treating pancreatic diseases.
- A study comparing RAPD and TLPD found similar complication rates and survival outcomes, although RAPD was associated with shorter operation times and hospital stays.
- The overall results suggest both methods are safe and effective, allowing surgeons to choose based on factors like technique preference, cost, and experience.
Article Synopsis
- The study evaluates the impact of circumferential resection margin (CRM) and circumferential surface (CS) involvement on survival outcomes in pancreatic head cancer patients after surgery.
- Analysis of 102 pancreatic ductal adenocarcinoma (PDAC) specimens revealed that R1 CRM status is linked to significantly poorer overall survival and disease-free survival compared to R0, while R0 CS showed notably better outcomes than R1.
- The findings indicate that CRM involvement (using the 0 mm rule) is a strong predictor of survival outcomes, whereas CS involvement does not significantly influence prognosis.
Background: Laparoscopic pancreatic resection is comparable to open pancreatic resection; however, cost-effectiveness analyses of laparoscopic pancreatic resection are scarce. The authors performed a population-based study investigating the cost-effectiveness of laparoscopic pancreatic resection versus open pancreatic resection.
Methods: Data from 9,256 patients who received pancreaticoduodenectomy (66.
(1) Background: The aim of this study was to compare the survival benefit of radical antegrade modular pancreatosplenectomy (RAMPS) with conventional distal pancreatosplenectomy (cDPS) in left-sided pancreatic cancer. (2) Methods: A retrospective propensity score matching (PSM) analysis was conducted on 333 patients who underwent RAMPS or cDPS for left-sided pancreatic cancer at four tertiary cancer centers. The study assessed prognostic factors and compared survival and operative outcomes.
View Article and Find Full Text PDFAssociation between hypotension during pancreatectomy and development of postoperative diabetes.
J Clin Endocrinol Metab
April 2024
Context: With advancements in long-term survival after pancreatectomy, post-pancreatectomy diabetes has become a concern, and the risk factors are not established yet. Pancreatic islets are susceptible to ischemic damage, though there is a lack of clinical evidence regarding glycemic deterioration.
Objective: To investigate association between hypotension during pancreatectomy and development of post-pancreatectomy diabetes.
Background/aims: : Recently, patients with pancreatic cancer (PC) who underwent resection have exhibited improved survival outcomes, but comprehensive analysis is limited. We analyzed the trends of contributing factors.
Methods: : Data of patients with resected PC were retrospectively collected from the Korean Health Insurance Review and Assessment Service (HIRA) database and separately at our institution.
Background: Hepatic artery obstruction is a critical consideration in graft outcomes after living donor liver transplantation. We report a case of diffuse arterial vasospasm that developed immediately after anastomosis and was managed with an intra-arterial infusion of lipo-prostaglandin E1 (PGE1).
Case Summary: A 57-year-old male with hepatitis B virus-related liver cirrhosis and hepatocellular carcinoma underwent ABO-incompatible living donor liver transplant.
Article Synopsis
- A study comparing laparoscopic anatomical resection (LAR) and laparoscopic non-anatomical resection (LNAR) for hepatocellular carcinoma (HCC) in the posterosuperior segments of the liver found that LNAR generally provided better short-term outcomes, including shorter operation times and lower blood loss.
- Despite LNAR showing a higher intrahepatic recurrence rate compared to LAR, both procedures demonstrated similar long-term survival rates, indicating that LNAR can be a safe alternative when LAR is not viable.
- The study suggests that LNAR is a feasible option for managing HCC in challenging liver locations, with acceptable oncologic results that clinicians can consider based on individual patient
Background And Aims: Laparoscopic liver resection (LLR) has evolved to become the standard surgical approach in many referral centers worldwide. The aim of this study was to analyze how LLR evolved at a single high-volume referral center since its introduction, more than two decades ago.
Methods: Data from all consecutive LLR between January 2003 and September 2022 at the Seoul National University Bundang Hospital were analyzed.
Article Synopsis
- Older adults face higher risks of complications after surgery, but current tools for assessing these risks require significant effort and resources.
- The study developed a predictive model using data from two South Korean hospitals to forecast adverse outcomes in older patients undergoing general surgery, employing machine learning techniques for accuracy.
- Results showed that the logistic regression model outperformed other algorithms and demonstrated strong predictive capabilities for various postoperative complications, with promising AUC scores indicating good internal and external validation.
Hepatic artery protection using a polyglycolic acid sheet during pancreaticoduodenectomy: A multicenter study.
J Hepatobiliary Pancreat Sci
December 2023
Background: Postpancreatectomy hemorrhage (PPH) is the most feared complication after pancreaticoduodenectomy (PD). The most common cause is erosion of the gastroduodenal artery stump. Preventive measures have been previously reported, but a consensus is lacking.
View Article and Find Full Text PDFPancreatic adenocarcinoma (PDAC) is one of the most common and lethal human cancers worldwide. Surgery followed by adjuvant chemotherapy offers the best chance of a long-term survival for patients with PDAC, although only approximately 20% of the patients have resectable tumors when diagnosed. Neoadjuvant chemotherapy (NACT) is recommended for borderline resectable pancreatic cancer.
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- * Results showed that while both groups experienced a decrease in β-cell function post-surgery, the PD group improved more significantly over time compared to the DP group, leading to worse glucose control in DP patients.
- * The research concluded that patients who undergo DP are at a higher risk for new-onset diabetes and worsening glucose regulation, highlighting the need for regular monitoring of glucose levels in these patients.
Objective: This study aimed to evaluate the effect of liver resection on the prognosis of T2 gallbladder cancer (GBC).
Background: Although extended cholecystectomy [lymph node dissection (LND) + liver resection] is recommended for T2 GBC, recent studies have shown that liver resection does not improve survival outcomes relative to LND alone.
Methods: Patients with pT2 GBC who underwent extended cholecystectomy as an initial procedure and did not reoperation after cholecystectomy at 3 tertiary referral hospitals between January 2010 and December 2020 were analyzed.
Background And Objective: Guidelines are required because of the wide variability in care provided to patients with similar characteristics and similar medical conditions. Quality indicators were developed many years ago to assess the quality of care provided by hospitals. Since then, it has become evident that a composite set of factors can better characterize the patient's quality of care.
View Article and Find Full Text PDFBackground: The current definition for postoperative pancreatic fistula (POPF) is based on the drain fluid amylase (DFA), and drains must be positioned adequately. We investigated the impact of DFA level, drain position and fluid collection after distal pancreatectomy (DP).
Methods: We performed a retrospective study of 516 patients who underwent DP between June 2004 and December 2018.
Background: The International Consensus Criteria (ICC) (2017) redefined patients with borderline resectable pancreatic ductal adenocarcinoma (BR-PDAC) according to anatomical, biological, and conditional aspects. However, these new criteria have not been validated comprehensively. The aim of this retrospective cohort study was to validate the anatomical and biological definitions of BR-PDAC for oncological outcomes in patients with resectable (R) and BR-PDAC undergoing upfront surgery.
View Article and Find Full Text PDFBackground and Objectives: A difficulty scoring system was previously developed to assess the difficulty of laparoscopic liver resection (LLR) for liver tumors; however, we need another system for hepatolithiasis. Therefore, we developed a novel difficulty scoring system (nDSS) and validated its use for predicting postoperative outcomes. Materials and Methods: This was a retrospective study.
View Article and Find Full Text PDFArticle Synopsis
- The study explored the evolution of gallbladder adenocarcinoma (GBAC) using tumor samples from 11 patients, employing whole-exome sequencing to create phylogenetic trees and analyze mutations.
- A significant finding was that most gene alterations in primary tumors were present in precancerous lesions but showed subclonal diversity, with some clones shrinking in primary tumors.
- The analysis also revealed that during metastasis, many subclones underwent significant expansion and showed specific mutations associated with cancer progression, while certain mutational signatures changed, indicating evolving characteristics throughout the cancer's development.
Article Synopsis
- The study investigates whether arterial reinforcement (AR) using polyglycolic acid sheets (PAS) and fibrin sealant (FS) can prevent delayed hemorrhage (DH) after pancreatic surgery for tumors.
- It compares outcomes between two groups of patients: one that received AR and another that did not, revealing that DH occurred significantly less in the AR group.
- The findings suggest that AR is effective at reducing the risk of DH in patients with postoperative pancreatic fistula, ultimately improving patient safety after pancreatoduodenectomy.