Robotic Versus Laparoscopic Liver Resection: A Nationwide Propensity Score Matched Analysis.

Objective: To compare nationwide outcomes of robotic liver resection (RLR) with laparoscopic liver resection (LLR).

Background: Minimally invasive liver resection is increasingly performed using the robotic approach as this could help overcome inherent technical limitations of laparoscopy. It is unknown if this translates to improved patient outcomes.

A European expert consensus surgical technique description for robotic hepatectomy.

The robotic platform enables surgeons to operate with a similar level of freedom and control as in open surgery, while still providing the patient with the benefits of a minimally invasive approach. More centres continue to adopt robotic liver surgery however standardized training materials and consensus on the surgical technique are currently lacking. The availability of a standardized surgical protocol could benefit the further dissemination of the robotic approach while promoting safe and effective operating techniques.

Gemcitabine-cisplatin induction treatment in patients with locally advanced perihilar cholangiocarcinoma (IMPACCA): A prospective registration study.

Background: Induction treatment may be beneficial in patients with unresectable locally advanced perihilar cholangiocarcinoma (LAPCCA). Prospective studies are currently lacking. This study aimed to assess the feasibility and efficacy of gemcitabine and cisplatin as induction treatment in patients with unresectable LAPCCA.

Development and external evaluation of a self-learning auto-segmentation model for Colorectal Cancer Liver Metastases Assessment (COALA).

Objectives: Total tumor volume (TTV) is associated with overall and recurrence-free survival in patients with colorectal cancer liver metastases (CRLM). However, the labor-intensive nature of such manual assessments has hampered the clinical adoption of TTV as an imaging biomarker. This study aimed to develop and externally evaluate a CRLM auto-segmentation model on CT scans, to facilitate the clinical adoption of TTV.

Outcome of a 'step-up approach' for recurrent cholangitis in patients with a non-stenotic hepaticojejunostomy after hepato-pancreato-biliary surgery: single center series.

Background: Recurrent non-stenotic cholangitis (NSC) is a challenging and poorly understood complication of a surgical hepaticojejunostomy (HJ). Optimal treatment remains unclear.

Methods: A retrospective single center series including patients with recurrent cholangitis with a non-stenotic HJ after hepato-pancreato-biliary surgery was conducted (2015-2022).

Prostate-specific membrane antigen as target for vasculature-directed therapeutic strategies in solid tumors.

Prostate-specific membrane antigen (PSMA) is one of the few biomarkers which has been successfully translated to the clinic as theranostic biomarker for patients with prostate cancer. In the context of prostate cancer, PSMA is overexpressed on the cell membrane of tumor cells, making it a viable target for interventions with urea-based small molecule inhibitors or antibodies conjugated to radioactive isotopes. Interestingly, in several non-prostatic cancers, expression of PSMA appears to be associated with the tumor neovasculature.

MicroRNAs as Bile-based biomarkers in pancreaticobiliary cancers (MIRABILE): a cohort study.

Background: Biliary obstruction can be due to both malignant and benign pancreaticobiliary disease. Currently, there are no biomarkers that can accurately help make this distinction. MicroRNAs (miRNAs) are stable molecules in tissue and biofluids that are commonly deregulated in cancer.

Indocyanine green fluorescence perfusion testing in robot-assisted hepatic arterial infusion pump placement.

Background: Hepatic arterial infusion pump (HAIP) treatment is a technique used to treat liver localized malignancy with intra-arterial chemotherapy. Methylene blue is generally administered to verify hepatic perfusion and exclude inadvertent extrahepatic perfusion. The use of indocyanine green dye (ICG) combined with near-infrared (NIR) fluorescence imaging during robot-assisted HAIP placement may be an attractive alternative by providing high contrast without blue discoloration of the operative field.

Unlocking the diagnostic power of plasma extracellular vesicle miR-200 family in pancreatic ductal adenocarcinoma.

Background: Distinguishing benign from malignant pancreaticobiliary disease is challenging because of the absence of reliable biomarkers. Circulating extracellular vesicles (EVs) have emerged as functional mediators between cells. Their cargos, including microRNAs (miRNAs), are increasingly acknowledged as an important source of potential biomarkers.

Robotic liver parenchymal transection using the SynchroSeal.

Background: There is much heterogeneity in the instrumentation used for parenchymal transection in minimally invasive liver surgery. Instruments specifically designed for robotic parenchymal transection of the liver are lacking. We aim to gain insight into the safety and effectiveness of the SynchroSeal (Intuitive Surgical, Inc.

Surgery for Locally Advanced Pancreatic Cancer Following Induction Chemotherapy: A Single-Center Experience.

Background: The use of surgery in patients with locally advanced pancreatic cancer (LAPC) following induction chemotherapy is increasing. However, most series do not report on the total cohort of patients undergoing surgical exploration; therefore, this single-center study investigates outcomes among all consecutive patients with LAPC who underwent surgical exploration.

Methods: We conducted a retrospective, single-center analysis including all consecutive patients with LAPC (Dutch Pancreatic Cancer Group criteria) who underwent surgical exploration with curative intent (January 2014-June 2023) after induction therapy.

Added Value of Liver MRI in Patients Eligible for Surgical Resection or Ablation of Colorectal Liver Metastases Based on CT: A Systematic Review and Meta-Analysis.

Background: Abdominal computed tomography (CT) is the standard imaging modality for detection and staging in patients with colorectal liver metastases (CRLM). Although liver magnetic resonance imaging (MRI) is superior to CT in detecting small lesions, guidelines are ambiguous regarding the added value of an additional liver MRI in the surgical workup of patients with CRLM. Therefore, this systematic review and meta-analysis aimed to evaluate the clinical added value of liver MRI in patients eligible for resection or ablation of CRLM based on CT.

Healthcare cost expenditure for robotic versus laparoscopic liver resection: a bottom-up economic evaluation.

Background: Minimally invasive liver surgery (MILS) is increasingly performed via the robot-assisted approach but may be associated with increased costs. This study is a post-hoc comparison of healthcare cost expenditure for robotic liver resection (RLR) and laparoscopic liver resection (LLR) in a high-volume center.

Methods: In-hospital and 30-day postoperative healthcare costs were calculated per patient in a retrospective series (October 2015-December 2022).

Outpatient and Ambulatory Extended Recovery Robotic Hepatectomy: Multinational Study of 307 Cases.

Background: For open minor hepatectomy, morbidity and recovery are dominated by the incision. The robotic approach may transform this "incision dominant procedure" into a safe outpatient procedure.

Study Design: We audited outpatient (less than 2 midnights) robotic hepatectomy at 6 hepatobiliary centers in 2 nations to test the hypothesis that the robotic approach can be a safe and effective short-stay procedure.

ICG-Fluorescence Imaging for Margin Assessment During Minimally Invasive Colorectal Liver Metastasis Resection.

Importance: Unintended tumor-positive resection margins occur frequently during minimally invasive surgery for colorectal liver metastases and potentially negatively influence oncologic outcomes.

Objective: To assess whether indocyanine green (ICG)-fluorescence-guided surgery is associated with achieving a higher radical resection rate in minimally invasive colorectal liver metastasis surgery and to assess the accuracy of ICG fluorescence for predicting the resection margin status.

Design, Setting, And Participants: The MIMIC (Minimally Invasive, Indocyanine-Guided Metastasectomy in Patients With Colorectal Liver Metastases) trial was designed as a prospective single-arm multicenter cohort study in 8 Dutch liver surgery centers.

Extrahepatic perfusion and incomplete hepatic perfusion after hepatic arterial infusion pump implantation: incidence and clinical implications.

Introduction: This study investigates the incidence of extrahepatic perfusion and incomplete hepatic perfusion at intraoperative methylene blue testing and on postoperative nuclear imaging in patients undergoing hepatic arterial infusion pump (HAIP) chemotherapy.

Methods: The first 150 consecutive patients who underwent pump implantation in the Netherlands were included. All patients underwent surgical pump implantation with the catheter in the gastroduodenal artery.

Hybrid operating room applications for precision hepatobiliary surgery: A narrative review.

This review summarizes the key applications of a hybrid operating room (HOR) in hepatobiliary surgery and explores the advantages, limitations, and future directions of its utilization. A comprehensive literature search was conducted in PubMed to identify articles reporting on the utilization of HORs in liver surgery. So far, the HOR has been limitedly applied in hepatobiliary surgery.

Local Treatment of Colorectal Liver Metastases in the Presence of Extrahepatic Disease: Survival Outcomes from the Amsterdam Colorectal Liver Met Registry (AmCORE).

Background: The simultaneous presence of colorectal liver metastases (CRLMs) and extrahepatic metastases in patients with colorectal cancer (CRC) can be considered a relative contraindication for local treatment with curative intent. This study aims to assess the survival outcomes of patients with CRLMs and extrahepatic metastases after comprehensive local treatment of all metastatic sites.

Methods: Patients with CRLMs who received local treatment of all metastatic sites were extracted from the prospective AmCORE registry database and subdivided into two groups: CRLM only vs.

Outcomes of liver surgery: A decade of mandatory nationwide auditing in the Netherlands.

Background: In 2013, the nationwide Dutch Hepato Biliary Audit (DHBA) was initiated. The aim of this study was to evaluate changes in indications for and outcomes of liver surgery in the last decade.

Methods: This nationwide study included all patients who underwent liver surgery for four indications, including colorectal liver metastases (CRLM), hepatocellular carcinoma (HCC), and intrahepatic- and perihilar cholangiocarcinoma (iCCA - pCCA) between 2014 and 2022.