Long-term results of liver-first approach strategy in patients with advanced synchronous liver metastases from colorectal cancer.

Eric Herrero, María Galofré, Alba Zárate, Maribel García-Domingo, Judith Camps, Fernando Pardo, Francisco Espin y Esteban Cugat.

Retrospective descriptive analysis from a prospective database of hepatectomies from liver metastases (LM) from CRC in two centers. Between 2007-2019, 88 patients with CRC-ASLM (advanced synchronous liver metastases) were included in a LFA scheme. Bilobar (LM) was present in 65.9%, the mean number of lesions was 5.5 and mean size 42.7 mm. Response to treatment was assessed by RECIST criteria. Progression-free survival (PFS) and overall survival (OS) were estimated using Kaplan-Meier survival curves.

In patients with CRC-ASLM the LFA allows control of the liver disease beforehand and an assessment of the tumor response to neoadjuvant chemotherapy, optimising the chance of potentially curative liver resection, which influences long-term survival.

Doctors who have participated

Dra. Zárate

Consultant in Hepatobiliopancreatic Surgery

Dr. Alba Zárate (Barcelona, 1989) is a Digestive surgeon specializing in hepatobiliopancreatic surgery and pancreatic transplantation.

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Dr. Cugat

Clinical Head of the Hepatobiliopancreatic Surgery Team

Dr. Esteban Cugat (Barcelona, 1960) is a medical specialist in General and Digestive System Surgery. Specialized in Hepatobiliopancreatic Surgery. Clinical Associate Professor at the Faculty of Medicine of the Autonomous University of Barcelona. 

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Dr. Pardo

Consultant in Hepatobiliopancreatic Surgery

Dr. Fernando Pardo (Madrid, 1986) is a Digestive surgeon specializing in hepatobiliopancreatic surgery and pancreatic transplantation.

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Dr. Espín

Consultant in Hepatobiliopancreatic Surgery

Dr. Francisco Espín is a  Medical specialist in hepatobiliopancreatic (HPB) surgery and pancreatic transplantation. Associate Professor at the Faculty of Medicine at the Autonomous University of Barcelona (Germans Trias Teaching Unit).

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Luces y sombras de la duodenopancreatectomía cefálica laparoscópica

Francisco Espin, María Isabel García-Domingo, Manel Cremades, Eric Herrero, Jordi Navinés, Judith Camps, Fernando Pardo y Esteban Cugat.

En este estudio se analizan 138 cirugías de duodenopancreatectomía (DPC) realizadas en un periodo de dos años (2017-2019). 23 DPC laparoscópicas, incluyendo patología benigna y maligna. Se valora la eficacia y seguridad y se compara con 31 DPC abiertas en el mismo periodo.

En un grupo seleccionado, la DPC laparoscópica puede realizarse de forma segura y eficaz si se realiza por grupos expertos en cirugía pancreática y en laparoscopia avanzada. Obtiene los mismos resultados que la cirugía abierta en el postoperatorio y es oncológicamente adecuada con menor estancia hospitalaria. Una selección adecuada de los pacientes, un programa establecido por pasos con una conversión laxa y precoz evita accidentes operatorios graves.

Doctors who have participated

Dr. Espín

Consultant in Hepatobiliopancreatic Surgery

Dr. Francisco Espín is a  Medical specialist in hepatobiliopancreatic (HPB) surgery and pancreatic transplantation. Associate Professor at the Faculty of Medicine at the Autonomous University of Barcelona (Germans Trias Teaching Unit).

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Dr. Navinés

Consultant in Hepatobiliopancreatic Surgery

Surgeon Specialist in General and Digestive System Surgery and Doctor of Surgery from the Universitat Autònoma de Barcelona.

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Dr. Cremades

Consultant in Hepatobiliopancreatic Surgery

Dr. Manel Cremades is a Medical specialist in hepatobiliopancreatic (HPB) surgery and pancreatic transplantation. He is also an Associate Professor at the Faculty of Medicine at the Autonomous University of Barcelona (UAB – Germans Trias Teaching Unit), collaborates on management committees for the implementation of hospital transformation projects, and is the co-founder of two startups in the health sector.

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Dr. Cugat

Clinical Head of the Hepatobiliopancreatic Surgery Team

Dr. Esteban Cugat (Barcelona, 1960) is a medical specialist in General and Digestive System Surgery. Specialized in Hepatobiliopancreatic Surgery. Clinical Associate Professor at the Faculty of Medicine of the Autonomous University of Barcelona. 

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Dr. Pardo

Consultant in Hepatobiliopancreatic Surgery

Dr. Fernando Pardo (Madrid, 1986) is a Digestive surgeon specializing in hepatobiliopancreatic surgery and pancreatic transplantation.

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Laparoscopic and robotic distal pancreatectomy: The choice and the future.

Francisco Espin, María Isabel García-Domingo, Manel Cremades, Fernando Pardo, Laura Vidal, Eric Herrero, Jordi Navinés, Alba Zárate, Judith Camps y Esteban Cugat.

La pancreatectomía distal (PD) mínimamente invasiva (MIS) está actualmente bien establecida, ya sea mediante técnica laparoscópica (PDL) o robótica (PDR). De 83 PD realizadas entre enero del 2018 y marzo del 2022, se realizaron 57 casos (68,7%) mediante MIS, 35 PDL y 22 PDR (da Vinci Xi). Se evalúa la experiencia de ambos procedimientos y el valor del abordaje robótico. Se analizan en detalle los casos de conversión.

La PDMIS es un procedimiento seguro y factible en pacientes seleccionados. Una planificación quirúrgica y la implementación escalonada basada en la experiencia previa ayudan a afrontar procedimientos técnicamente exigentes. Se sugiere que la PDR podría ser el abordaje de elección en la pancreatectomía corporocaudal, no siendo inferior a la PDL.

Doctors who have participated

Dr. Espín

Consultant in Hepatobiliopancreatic Surgery

Dr. Francisco Espín is a  Medical specialist in hepatobiliopancreatic (HPB) surgery and pancreatic transplantation. Associate Professor at the Faculty of Medicine at the Autonomous University of Barcelona (Germans Trias Teaching Unit).

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Dr. Cremades

Consultant in Hepatobiliopancreatic Surgery

Dr. Manel Cremades is a Medical specialist in hepatobiliopancreatic (HPB) surgery and pancreatic transplantation. He is also an Associate Professor at the Faculty of Medicine at the Autonomous University of Barcelona (UAB – Germans Trias Teaching Unit), collaborates on management committees for the implementation of hospital transformation projects, and is the co-founder of two startups in the health sector.

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Dr. Pardo

Consultant in Hepatobiliopancreatic Surgery

Dr. Fernando Pardo (Madrid, 1986) is a Digestive surgeon specializing in hepatobiliopancreatic surgery and pancreatic transplantation.

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Dr. Navinés

Consultant in Hepatobiliopancreatic Surgery

Surgeon Specialist in General and Digestive System Surgery and Doctor of Surgery from the Universitat Autònoma de Barcelona.

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Dra. Zárate

Consultant in Hepatobiliopancreatic Surgery

Dr. Alba Zárate (Barcelona, 1989) is a Digestive surgeon specializing in hepatobiliopancreatic surgery and pancreatic transplantation.

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Dr. Cugat

Clinical Head of the Hepatobiliopancreatic Surgery Team

Dr. Esteban Cugat (Barcelona, 1960) is a medical specialist in General and Digestive System Surgery. Specialized in Hepatobiliopancreatic Surgery. Clinical Associate Professor at the Faculty of Medicine of the Autonomous University of Barcelona. 

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Robotic common bile duct exploration

Resección hepática Seg. 1, abordaje robótico.

Técnica ALPPS totalmente robótica con navegación 3D

Sección ligamento arcuato

Resección Seg. 3 robótico mediante abordaje anatómico extraglissoniano.

Resección robótica segmento 7 con abordaje de la vena hepática derecha

Puestow robótico en paciente con pancreatolitiasis y pancreatitis crónica