Harms 😈 and benefits 👼 of Pancreatic Cyst Surveillance Guidelines - 3 guidelines compared
@amergastroassn.bsky.social @gastroenterology.bsky.social
👉 Overall Harm-to-benefit ratio disappointing 👈
✋ STOP surveillance in stable cysts not harm
www.sciencedirect.com/science/arti...
Amazing international team at the #Wirsung2026 Pancreas Conference in @hpdsurgery.bsky.social Padova
Great minds - great connections - true friendship
🇮🇹🇳🇱🇯🇵🇰🇷
@marcbesselink.bsky.social
🔵 Post pancreatectomy mortality: the new seminal paper from
ISGPS
👉 occurring within 90 days from pancreatectomy linked to it through root-cause analysis
3️⃣ categories ✂️ vascular complexity 💦 pancreas specific 🫀 C/P sudden
journals.lww.com/annalsofsurg...
@marcbesselink.bsky.social
Celiac axis stenosis 🕵️♀️ the unknown risk factors for additional morbidity after a pancreatoduodenectomy
🌵 CAS incidence 16% in 1.7k cases published in Annals of Surgery
🚨 Grade B/C associated bile leak, liver perfusion failure, gastric ischemia
journals.lww.com/annalsofsurg...
New paper!
Long Term Metabolic Outcomes Following Pancreatectomy and Autologous Islet Transplantation: Systematic Review and Meta-Analysis
⤵️⤵️⤵️
onlinelibrary.wiley.com/doi/10.1002/...
✂️ Does venous resection affect the delivery of adjuvant chemoterapy?
🇮🇹 🇨🇳 280 resected veins / 68% ISGPS type 3
💉 70% received adjuvant chemo prolonging survival
✋ Disclaimer: authors favors neoadj chemo, conceptually always!
link.springer.com/article/10.1...
Minimally Invasive 🤜 🤛 Open Pancreatoduodenectomy for Resectable Neoplasms @nejm.org @marcbesselink.bsky.social 🔴🔴
🏥 RCT 288 pts / 14 centers
🤖 Conversion 8% but ⤵️ time to functional recovery, POPF, SSI
🤝 MI not inferior (in expert hands - in both cases…)
evidence.nejm.org/doi/full/10....
💦 Use and management of drains in pancreas surgery remains controversial
🔎 MA of 17 RCT - 4k patients out now in @bjsopen.bsky.social
🏆 Whipple level 1a: selective early drain removal
🏆 Left panc: no drain policy
🎖️ Do you stick to highest level of evidence?! 🫵
academic.oup.com/bjsopen/arti...
A great honor to serve as faculty for the course in advanced pancreas surgery at @umeauniversitet.bsky.social 🇸🇪 led by @asifhalimi.bsky.social 🫶
An amazing experience to learn and exchange knowledge on an evolving / crucial issue!
What is your anticoagulation practice 💉 after portal vein resection in pancreas surgery ?!
🧑🧑🧒🧒 1k pts / 90 days thrombosis 7% in Annals of Surgery
🔮 Predictors resection type / graft material
🩸 Therapeutic anticoagulation 📉 early thrombosis but 👎 at 90 days
journals.lww.com/annalsofsurg...
It’s out!!! 🔥🔥🔥 The PREOPANC-2 is in @thelancet.com
Neoadjuvant FOLFIRINOX 🤜🤛 Gemcitabine based chemoradiotherapy in resecatble / BR
⚖️ No difference in overall survival
😰 Serious adverse events 40%
👍 Both regimens may be considered
www.thelancet.com/pdfs/journal...
Pancreas2000 is the official postgraduate course of the EPC @myueg.bsky.social
Aimed at fostering the new generation of pancreatologists… almost 2 years with 5 in person meetings! #science #passion #education and #pancreas
🫵 Join us! Applications open in October
Amazing #Yellowstone National Park 🏞️
⏰ Early onset of GI cancers ⛑️ a window for prompt diagnosis / therapy @bjsurgery.bsky.social
☝️Incidence in <50 y/o rising particularly in 🚺
🧬 Germline mutations but most sporadic
🚬 Modifiable factors smoke/alcohol/diet
🔬 Multidisciplinarity + research needed
academic.oup.com/bjs/article/...
Non-pancreatic neoplasms in and around the 🪷 ampulla of Vater: International Guidelines
🔬 Optimal pathology assessment 🤝 Multidisciplinary pathways leading to best treatment
🔜 Future research line have been defined in @myueg.bsky.social journal!
onlinelibrary.wiley.com/doi/10.1002/ue…
🟣🟣 Liver Transplantation For Colorectal Cancer Liver Metastases: does sex matter?!
♐️ Post LT recurrence liver > F; 🫁 only in M
🔮 Survival predicted by CEA, 👉 sided CRC, tumor size, 🧬 KRAS mutation
🔑 Selection criteria key factor
www.jhep-reports.eu/article/S258...
@jhepatology.bsky.social
What to do when recurrent acute pancreatitis 🤕 is the only worrisome feature of a BD-IPMN 🍇?!
Even more tricky in case of comorbidities like liver fibrosis … ⚖️ where do you set your threshold for surgery?! 🧐
What is "Conversion surgery" 🐛➡️🦋 for upfront unresectable upper GI and HPB cancers ⁉️
💉 Triggered by improvements in non surgical therapies 🧰 Many techniques included
🏆 Able to improve survival!
💡 All u need to know ⬇ comprehensive review in @bjsopen.bsky.social
academic.oup.com/bjsopen/arti...
Is it possible to attend 4️⃣ LAPC cases simultaneously?! 🙈 only at University Hospital Heidelberg (UKHD) 🇩🇪!!!
A unique team led by Christoph Michalski paving the way to treat pancreas cancer in a modern fashion, taking into account biology 🧬 and “extreme” surgery 🪡
Out now in @sages.org journal!
POPF 🐳 after distal pancreatectomy still a poorly understood complication 🙃
🌍 International validation of the fistula risk score 800 pts
🧯POPF predicted by BMI, NAT, robot approach 🤔
FRS insufficient discrimination 🧐 !!!
link.springer.com/article/10.1...
So honored to be part of this!!!
👇🎓💪
I see #pancreas everywhere - Japan 🇯🇵 edition
#HPBSky
With @hannesjsson.bsky.social @asifhalimi.bsky.social and many more!
🇯🇵 My keynote lecture at the 37th Japanese Society of HPB Surgery
From 🔮 prediction to 🧯prevention of complications in pancreas surgery… a risk based approach to 🐳 POPF assessing POH 🧪 and PPAP!
Thank you for having me, HPB conferences in Japan are simply impossible to beat 🤯
My invited talk at @EAHPBA 2025 🇮🇪 was about IPMN 🍇 and related carcinoma
A very slippery 🧽 topic!!!
Indeed 2️⃣ different entities in 1️⃣…
IPMN derived cancer follow distinct 🧬 pathways 🆚 conventional PDAC but are way less explored (NOT a single RCT) 👉 knowledge gap!
Super excited to meet this fantastic Pancreas star ⭐️ at the EAHPBA congress right from the @myueg.bsky.social presidency!!!
Thank you @maloehr.bsky.social
United for the pancreas, always!
🔵 The European-African Hepato-Pancreato-Biliary Association (E-AHPBA) mentorship program is ready to take off 🛫 again!
So excited to serve as a mentor also for the second edition after a previous successful journey
IPMN 🍇 without HRS and long term risk of cancer development @bmj.com
🇯🇵 2.5k pts > 5 years surveillance
🫧 IPMN size and growth predict cancer within 5 years
🤏 MPD diameter at 5 years predicts cancer after 5 years
gut.bmj.com/content/74/6...
🚨 From @ascocancer.bsky.social 2025
👉 Preop chemo with PAXG 🆚 mFOLFIRINOX for extending event-free survival (EFS) in resectable or BR PDAC (phase 3 CASSANDRA trial)
🆙 PAXG 3-year EFS 31% vs. 13% P = .003
🫸 Immature analysis for survival but.. future practice changing?! 🧐
@ascopost.bsky.social
Postop ⬆️ amylasemia and acute pancreatitis 🧪 systematic review and meta analysis
🐳 POH predicts POPF
⚡️ PPAP causes POPF, DGE, PPH and mortality
👉 Check amylase early and get ready to mitigate 🧯postop complications!
#HPBSky #SurgSky
www.sciencedirect.com/science/arti...
