30-Second Takeaway
- Black patients receive more emergency and open operations with worse outcomes, even when minimally invasive options are available.
- Conventional laparoscopic hepatectomy offers perioperative advantages over open and tele-robotic approaches for HCC without compromising short-term oncologic surrogates.
- Adding pancreatic RFA to modern chemotherapy regimens worsens toxicity and quality of life without survival benefit in unresectable LAPC.
Week ending April 4, 2026
Practice-changing insights in emergency and perioperative general surgery, HPB oncology, and ambulatory care models
Black patients have less access to elective and minimally invasive emergency general surgery
In more than 2.4 million US cholecystectomy, hernia, and colorectal cases, Black patients were more likely to undergo emergency rather than elective surgery. Among emergency cases, Black patients also had higher adjusted odds of open versus minimally invasive surgery than White patients. EGS patients overall were more likely to be older, female, Black, publicly insured, comorbid, rural, and treated at nonteaching hospitals. Within EGS, Black patients undergoing minimally invasive surgery had higher 30-day readmission, longer length of stay, and more conversions to open.
Conventional laparoscopy outperforms open and tele-robotic hepatectomy for HCC on short-term outcomes
This multicenter cohort compared open, conventional laparoscopic, and tele-robotic hepatectomy for hepatocellular carcinoma across five high-volume centers. After propensity matching, conventional laparoscopy achieved lower blood loss, shorter operative time, and shorter hospital stay than open surgery. Tele-robotic hepatectomy reduced blood loss versus open surgery but did not improve operative time or length of stay. Compared with conventional laparoscopy, tele-robotic hepatectomy had longer operative times and longer hospital stays.
RFA adds toxicity without survival benefit in locally advanced pancreatic cancer
This randomized trial enrolled 188 patients with unresectable locally advanced pancreatic cancer and stable disease after at least two months of induction chemotherapy. Patients received radiofrequency ablation plus chemotherapy or chemotherapy alone, with most having received modified FOLFIRINOX as induction. Median overall survival was similar between groups, with no improvement from adding RFA to chemotherapy. Progression-free survival was also not improved by RFA, despite the additional intervention.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.