HORACIO ASBUN, MD

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This study focused on creating and testing a machine learning tool that predicts the best outcomes for patients undergoing liver surgery. Researchers analyzed data from over 2,000 patients, finding that 62.8% achieved a "textbook outcome," which means they experienced a successful recovery without major complications. Notably, patients who reached this outcome had a 18% better chance of survival long-term. Who this helps: This helps patients undergoing liver surgery by providing better predictions about their recovery outcomes.

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This paper corrects previous information about a study that created and tested a computer-based model to predict successful outcomes for liver surgery. The model was built using data from multiple hospitals around the world and aims to help doctors determine which patients are most likely to have a good recovery after surgery. This is important because it can improve patient care and surgical planning. Who this helps: Patients undergoing liver surgery.

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The study focused on improving how doctors diagnose and classify tumors around the ampulla of Vater, an area where the bile duct and pancreas meet. A team of 43 experts reviewed over 37,000 research articles and came up with 51 recommendations. They aimed to reduce confusion and ensure accurate patient care by providing clearer definitions and guidelines for these tumors. This is important because it will lead to better diagnosis and treatment options for patients with these specific types of cancers. Who this helps: Patients with ampullary tumors and their healthcare teams.

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This study looked at the use of minimally invasive surgery for liver donation around the world. Researchers found that in 2022, 32.6% of liver donor surgeries (1,551 out of 4,774) were done using minimally invasive techniques, with more than half of the left lateral procedures performed this way. This trend matters because it shows that minimally invasive methods are becoming more common, leading to likely better recovery for donors. Who this helps: This benefits patients who are potential living liver donors, as they may experience less pain and a quicker recovery.

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Researchers studied a rare bile duct disease called intraductal papillary neoplasm (IPNB) in patients from Europe and Nagoya, Japan. They found that European patients had more tumors and less aggressive forms of the disease compared to those in Japan, but experienced a higher rate of death within 90 days after surgery (7% vs. 0%). This research highlights the differences in tumor characteristics and surgical outcomes between the two regions, which can help improve treatment strategies. Who this helps: This helps patients and doctors by providing insights into how geographical differences affect the management of a rare disease.

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This study explored how surgeons experience joy in their work and what factors contribute to their well-being. Out of 307 surveyed surgeons, 85.7% reported finding joy in their surgical skills and patient relationships, but many felt overwhelmed by their workloads, working an average of 51-70 hours a week, and expressed dissatisfaction with their compensation. Improving support, reducing administrative tasks, and fostering teamwork could enhance surgeons' satisfaction and ultimately patient care. Who this helps: This helps surgeons and, in turn, their patients by improving the surgical environment and care delivery.

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This study looked at how to safely implement minimally invasive hepato-pancreato-biliary (MIS HPB) surgery, which is a type of surgery for liver and pancreatic conditions. Researchers found that 91% of surgeons agreed that hospitals should perform a certain number of these complex surgeries each year to ensure safety, and 100% said that surgeons should define and enforce guidelines for this surgery. This matters because having clear guidelines and requirements can help improve the safety and effectiveness of MIS HPB surgeries for patients. Who this helps: This helps patients undergoing liver and pancreas surgeries.

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Researchers from a surgery group studied how gender affects the happiness and well-being of surgeons. They surveyed 223 surgeons and found that while both men and women wanted more time with family and friends, women felt less supported at work and less respected by their colleagues—only 52% of women felt respected compared to 68.3% of men. The study highlights the need for better support for female surgeons to improve their job satisfaction and well-being. Who this helps: This helps surgeons, particularly female surgeons, by highlighting the need for more support in their work environment.

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This study looked at the challenges that prevent the widespread use of robotic-assisted surgery for liver and pancreas operations. Researchers found that while many surgeons see benefits to using robots, they face significant hurdles like high costs and a lack of hospital support; 23 surgeons involved pointed to access to robotic systems as the biggest issue. Improving access to these technologies is crucial because it could lead to better surgery outcomes for patients. Who this helps: Patients needing liver or pancreas surgery.

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This study looked at how doctors from around the world manage patients with acute pancreatitis, a serious condition affecting the pancreas. Out of 1,054 medical professionals surveyed, 73.4% recommended not allowing patients to eat when they could, and only 15.5% gave antibiotics to severely ill patients when current guidelines suggest more should be done. This matters because the way doctors handle this condition can greatly affect patients' recovery and health outcomes, showing a need for better adherence to guidelines, especially regarding nutrition and antibiotic use. Who this helps: This helps patients with acute pancreatitis and their healthcare providers.

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This study looked at how a training program called the Safe Cholecystectomy modules affects surgeons' skills during gallbladder surgery, specifically focusing on reducing the risk of serious injuries to bile ducts. After training, surgeons who completed the modules made significantly fewer mistakes managing bile duct injuries and were less likely to switch to open surgery when faced with challenging situations—about 41% of them made errors compared to those who did not complete the training. This is important because it shows that structured training can lead to safer surgeries and better outcomes for patients. Who this helps: Patients undergoing gallbladder surgery benefit from improved surgeon skills and reduced risks.

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In this study, researchers looked at how effective a procedure called adrenal vein sampling (AVS) is in helping decide if surgery is needed for patients with adrenal hormone imbalances that lead to high blood pressure. They reviewed 71 patients over eleven years and found that surgery significantly reduced potassium deficiency in patients with high aldosterone levels—from 68.7% needing treatment before surgery to just 10.4% afterward. This matters because it shows that proper testing can lead to better health outcomes and fewer necessary medications for patients with specific adrenal problems. Who this helps: This benefits patients with adrenal hormone disorders and their doctors.

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This study focused on patients with pancreatic cancer who couldn't initially have surgery and were treated with a new type of radiation therapy after chemotherapy. Out of 62 patients, 42 (about 68%) died, with over 45% of these deaths linked to the cancer spreading to other organs, particularly the liver and peritoneum. The findings highlight that local cancer progression and distant metastasis are major causes of death, suggesting a need for improved treatments that target these advanced disease areas. Who this helps: This research helps patients with pancreatic cancer and their doctors identify more effective treatment strategies.

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This study looked at older patients (75 and over) with a challenging form of pancreatic cancer called pancreatic ductal adenocarcinoma (PDAC) who were treated using a special type of radiation therapy called ablative stereotactic MRI-guided adaptive radiation therapy (A-SMART). Out of 49 patients, 79% lived for at least a year after treatment, and 18% were able to have surgery afterward, showing a significant improvement in their survival. This matters because it offers a promising and less invasive treatment option for elderly patients with a disease that usually has very few effective treatments. Who this helps: This helps elderly patients with inoperable pancreatic cancer.

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Researchers studied how doctors in Latin America manage acute pancreatitis, especially in the first 72 hours after patients arrive at the hospital. They found that many doctors do not follow established guidelines, for instance, 42% chose inappropriate fluid treatments, and 78% didn’t start patients on an oral diet when they could. This matters because better adherence to guidelines can improve patient outcomes. Who this helps: Patients suffering from acute pancreatitis in Latin America.

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This study focused on developing guidelines for using minimally invasive surgery (MIS) in patients with colorectal liver metastases (CRLM), which affects about half of those with colorectal cancer. The expert panel recommended using MIS for liver surgery when deemed safe and effective based on the patient's situation. These guidelines aim to help doctors make better surgical decisions and improve outcomes for patients with CRLM. Who this helps: This helps patients with colorectal cancer and their healthcare providers.

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This study examined how patients in Europe who had surgery for a rare bile duct condition called intraductal papillary neoplasm of the bile duct (IPNB) fared from 2010 to 2020. Out of 85 patients, about 54% had positive surgery outcomes, with the best results seen in patients who had liver surgeries rather than pancreatic surgeries. On average, patients lived about 5.7 years after treatment, and those who had fewer health issues before surgery tended to live longer. Who this helps: This research is beneficial for doctors treating bile duct cancer, as it provides insights into improving patient outcomes.

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This study looked at how a professional medical association called SAGES manages potential conflicts of interest (COI) when working with the medical industry. They found that their processes have effectively reduced perceived bias at their annual meetings from about 6% to as low as 2% after implementing stricter COI disclosure standards. This is important because it helps ensure that educational activities for medical professionals remain trustworthy and benefit patient care. Who this helps: This helps doctors and patients seeking high-quality medical information and education.

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This study looked into what makes surgeons happy at work and what challenges they face, interviewing 17 surgeons from the U.S. and Canada for a total of 15 hours. It found that while all surgeons experience stress from factors like administrative pressures and lack of respect, they also find joy in aspects like helping patients and having autonomy in their roles. To enhance surgeon well-being, hospitals and organizations should focus on improving teamwork, providing better leadership, and allowing more time for surgeons to build relationships with patients. Who this helps: This helps surgeons and the healthcare organizations they work for.

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This study looked at a training program called SAFE CHOLE that helps surgeons in France improve their skills in performing gallbladder surgeries. Out of 481 surgeons who participated, 80% felt they learned new information that helped them; 56% changed their surgical practices based on what they learned. Notably, 46% of those who changed now consistently use a safer technique for surgery called the critical view of safety. Who this helps: This benefits patients by promoting safer surgery practices.

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This study looked at how removing lymph nodes might help patients with intrahepatic cholangiocarcinoma (iCCA), a type of liver cancer. It found that only about 10% of patients get a thorough lymph node dissection (LND), which is important because examining at least six lymph nodes can improve survival and treatment choices. The research highlights the need to improve the rate of proper LND to ensure better care for these patients. Who this helps: This benefits patients with intrahepatic cholangiocarcinoma and their doctors.

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This study looked at patients with kidney cancer (renal cell carcinoma) that spread to the pancreas. Out of 16 patients, half had no symptoms, and most were diagnosed by chance, with tumors averaging about 25 mm in size. After surgery, 81.25% of the patients are still alive, and eight of them have no signs of disease, showing that successful surgery can lead to long-term survival for select patients. Who this helps: This benefits kidney cancer patients with pancreatic metastasis who may be eligible for surgery.

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This study looked at a new treatment approach for patients with inoperable pancreatic cancer, where patients first received chemotherapy and then a specialized form of radiation therapy called A-SMART. Out of 62 patients treated, the study found that after treatment, about 68.8% experienced local tumor control and the average survival was 23 months, which is promising compared to traditional treatments. These results matter because they suggest that combining chemotherapy with this advanced radiation therapy may lead to better outcomes for patients who cannot have surgery. Who this helps: This helps patients with inoperable pancreatic cancer.

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This paper examines how the COVID-19 pandemic has affected medical care, particularly regarding the limited availability of resources like hospital beds, ventilators, and personal protective equipment. It highlights that the usual ways of providing surgery and care may not be safe or possible during such crises, emphasizing the need for ethical decision-making in these situations. Understanding these ethical principles is crucial for healthcare professionals to make informed decisions, ensuring patients receive the best possible care even in challenging circumstances. Who this helps: This benefits healthcare providers, including doctors and surgeons, by guiding their decisions during emergencies.

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This study focused on identifying key research articles that are essential for surgeons in the SAGES Masters Program, which helps them improve their skills through lifelong learning. Researchers found 578 important articles related to surgical techniques, outcomes, and disease understanding, and expert committees selected the most crucial ones for each of the program’s eight clinical pathways. This is important because it gives surgeons valuable resources to enhance their knowledge and ultimately improve patient care. Who this helps: This helps surgeons and, by extension, their patients.

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This study examined updated guidelines for improving recovery after pancreatic surgery, specifically pancreatoduodenectomy (PD). It found that following enhanced recovery protocols can significantly reduce complications and shorten hospital stays. Key recommendations include avoiding hypothermia and using specific pain management strategies for patients with severe weight loss. Who this helps: These guidelines benefit patients undergoing pancreatic surgery and their healthcare providers.

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This study reviews how surgeons can safely perform minimally invasive surgeries during the COVID-19 pandemic. It found that while there is no direct evidence linking these surgeries to spreading the virus, precautions are necessary. Surgeons should treat COVID-19 as a risk and use personal protective equipment (PPE) in all surgeries, and specific methods to reduce risks, like using filtration systems, should be implemented. Who this helps: This guidance benefits surgeons and operating room staff by keeping them and their patients safer during surgeries.

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This study focused on preventing serious injuries to the bile duct during gallbladder removal surgery (cholecystectomy), which is a common complication of the procedure. Experts from multiple surgical societies developed recommendations and found strong agreement on two key points: using imaging during surgery to understand the anatomy better and referring patients with bile duct injuries to experienced surgical teams. These guidelines aim to help surgeons improve their practices, potentially leading to better outcomes for patients undergoing this surgery. Who this helps: This helps patients undergoing gallbladder surgery and the surgeons performing the procedures.

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This study focused on how to safely perform gallbladder surgery (cholecystectomy) and prevent a serious complication known as bile duct injury (BDI). The expert panel reviewed current research and agreed on 17 out of 18 recommended practices, especially emphasizing the importance of using imaging during surgery if there is any doubt about the anatomy and referring any suspected BDI cases to specialized surgeons. These guidelines aim to enhance patient safety and surgical outcomes by providing clear strategies for healthcare professionals. Who this helps: Patients undergoing gallbladder surgery.

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This study looked at how age and obesity affect the outcomes of two types of pancreatic surgery: minimally invasive surgery and traditional open surgery. Researchers analyzed 13 studies involving nearly 4,630 patients and found that older patients had less blood loss and shorter hospital stays with minimally invasive surgery compared to open surgery. In obese patients, robotic surgery had similar benefits, with less blood loss and shorter surgery times. Who this helps: This information benefits patients who are older or obese, as they may have safer surgical options.

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This study looked at how the COVID-19 pandemic affected burnout among surgeons. During the pandemic, many surgeons found themselves shifting roles and dealing with the suspension of elective surgeries, which created opportunities for reflection and a chance to rethink their priorities. The researchers found that addressing burnout requires not just coping strategies but also focusing on finding meaning and joy in their work, which can lead to greater satisfaction and well-being among surgeons. Who this helps: This helps surgeons and healthcare leadership aiming to improve work satisfaction and reduce burnout.

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This study looked at a new method of treating patients with peritoneal carcinomatosis (cancer spread in the abdominal cavity) using a robotic-assisted surgery combined with heated chemotherapy, known as CRS-HIPEC. A 57-year-old woman with minimal cancer remaining underwent this procedure, which took about 7 hours and resulted in very little blood loss (50 cc), a hospital stay of just 4 days, and she resumed normal bowel function quickly. This approach is important because it offers a less invasive option with better short-term recovery compared to traditional open surgery. Who this helps: This benefits patients with peritoneal tumors looking for less invasive treatment options.

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This study looked at the results of a specific type of surgery called pancreatico-duodenectomy (PD) across 23 expert centers worldwide from 2012 to 2015. Researchers found that out of 6,186 patients, 38% were considered low-risk, and those had a very low in-hospital death rate of 1.6% but a high rate of complications, with 73% experiencing issues within six months. This information helps set clear standards for expected outcomes after this surgery, allowing for better comparisons across different hospitals and surgical methods. Who this helps: This helps doctors and patients make informed decisions about pancreatic surgery.

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This paper reviews updated guidelines for treating pancreatic adenocarcinoma, which is a type of cancer in the pancreas. It focuses on new recommendations for post-surgery treatments, specifically how to help patients recover after surgery. These updates aim to improve patient outcomes and ensure that doctors have the latest information to make the best treatment decisions. Who this helps: This helps patients with pancreatic cancer and their doctors.

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Researchers created guidelines for laparoscopic liver surgery after discussing and validating best practices at a European meeting. They gathered insights from 22 expert surgeons and created 67 recommendations, all of which were approved by a validation panel, achieving 95% agreement among the experts. These guidelines are important because they help ensure that laparoscopic liver surgery is performed safely and effectively, supporting the growth of this surgical technique. Who this helps: This helps patients undergoing liver surgery and the doctors performing those procedures.

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This research looked at the safety and outcomes of laparoscopic cholecystectomy (LC), a common surgery to remove the gallbladder, by reviewing 151 studies involving over 505,000 patients. The findings showed that complications from the surgery, like bile duct injury, have decreased over time—from 0.69% during 1994-1999 to 0.22% during 2010-2015—while overall complication rates remained stable at 1.6-5.3%. Understanding these trends is important for improving surgical practices and patient safety in the future. Who this helps: This benefits patients undergoing gallbladder surgery and healthcare providers performing these procedures.

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This study looked at how well patients with a specific type of pancreatic cancer that has spread (called oligometastatic pancreatic ductal adenocarcinoma) survive when they undergo a combination of treatments, including surgery. Researchers found that patients who had surgery to remove their tumors and received other treatments survived an average of 2.7 years, which is significantly longer than those who only received chemotherapy without surgery, who survived only about 0.98 years. This is important because it shows that an aggressive treatment approach can lead to better outcomes for patients with this aggressive cancer. Who this helps: This helps patients with oligometastatic pancreatic cancer and their doctors in making treatment decisions.

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This study looked at the importance of surgical and anesthesia care in global health and created a plan to improve these services worldwide. Researchers proposed a goal of providing safe surgical and anesthesia care to 80% of people globally by 2030 and identified 15 important measures to help track progress towards this goal. This is important because it aims to make surgical care accessible to more people, improving healthcare systems overall. Who this helps: Patients needing surgical care, especially in underserved areas.

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This research paper discusses the guidelines for diagnosing and treating pancreatic cancer, specifically the most common type called ductal adenocarcinoma. It highlights the importance of advanced imaging techniques to determine whether a patient can undergo surgery to remove the cancer, which is crucial for improving outcomes. The guidelines also emphasize the use of systemic therapy both before and after surgery, as well as for patients with more advanced cancer stages. Who this helps: This helps patients diagnosed with pancreatic cancer and their doctors in deciding the best treatment options.

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This study looked at different tests to see how well they can diagnose intraductal papillary mucinous neoplasms (IPMNs), a type of pancreatic growth. It involved 180 patients and found that while the cytology test detected cancer cells with high accuracy (88%), it missed a lot of cases (only 39% sensitivity). The blood test for carcinoembryonic antigen (CEA) showed a median level of 525.5 ng/mL for IPMNs, which was much higher than in nonmucinous cysts, helping to identify IPMNs with a sensitivity of 77% and specificity of 83%. Who this helps: This research benefits doctors by providing better tools to diagnose potential pancreatic cancers.

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This study looked at the growing use of laparoscopic surgery for liver operations and aimed to provide guidance for its future use. The expert panel found that minor laparoscopic liver surgeries are now considered standard practice, while major surgeries are still being developed and require more research for safe implementation. They emphasized the need for higher-quality studies and better training for surgeons to improve patient safety and outcomes. Who this helps: This helps patients undergoing liver surgery and the doctors who perform these operations.

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This research paper looks at a problem called pancreatic exocrine insufficiency, which happens when the pancreas doesn't produce enough enzymes for digestion, particularly in people with pancreatic cancer. The findings show that both non-surgical and surgical treatments for pancreatic cancer lead to this condition, but results can vary based on the type of treatment. Understanding this is important because it highlights the need for enzyme replacement therapy to help improve digestion in these patients. Who this helps: Patients with pancreatic cancer and their healthcare providers.

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This study looked at a surgical method called laparoscopic hernia repair combined with a technique to move the abdominal muscles. The researchers treated 4 patients and found that using this combined approach might lower the chances of the hernia coming back compared to traditional methods. This matters because it could lead to better outcomes for patients who have larger hernias or higher body weight. Who this helps: This helps patients with large ventral hernias and higher body mass index.

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This study looked at adrenal cortical cancer (ACC) in the United States to see if advances in imaging technology led to earlier diagnoses and better survival rates over 15 years. They found that out of 602 patients, only about 39.5% had early-stage cancer, and the average tumor size was 11.8 cm, with survival rates remaining unchanged during this time. This is important because it shows that despite better imaging, patients are not being diagnosed earlier or living longer after diagnosis. Who this helps: This helps patients with adrenal cortical cancer and their families.

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This study examined the safety and effectiveness of laparoscopic gallbladder removal (cholecystectomy) in patients with complicated conditions, such as acute inflammation or previous surgeries. Out of 360 patients, 138 faced complications, but the techniques used led to no complications or deaths. This matters because it shows that even difficult gallbladder surgeries can be safely performed with laparoscopic methods, improving patient outcomes. Who this helps: Patients with complicated gallbladder diseases.

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This study examined how sodium and chloride move in the intestines of mice that were treated with a substance known to potentially cause cancer. The researchers found that in healthy mice, the sodium movement was about 5.1 and 4.6 units in different parts of the colon, while chloride movement was at 6.1 in one area and only 0.8 in another. However, after treatment with the chemical, the normal sodium transport in the cancer-prone area of the colon was disrupted, which suggests early changes that could lead to cancer development. Who this helps: This research benefits patients at risk for colon cancer by highlighting potential early changes in the intestines that could lead to better monitoring and treatment.

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This study looked at how changes in electrical signaling and sodium movement occur at the points where the intestines are stitched together after surgery in mice that are prone to developing colon cancer. The researchers found that after treatment with a cancer-causing substance, the electrical signals at the surgery sites changed significantly: the potential difference dropped from -2.6 mV in control mice to -1.5 mV with silk sutures and -1.6 mV with chromic sutures, indicating altered conditions that could promote cancer growth. Understanding these changes is crucial because it may help identify why tumors often develop at these suture sites after surgery. Who this helps: This helps patients recovering from bowel surgery by improving our understanding of cancer recurrence risks.