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Article ; Online: Invited commentary: Machine learning versus logistic regression for the prediction of complications after pancreatoduodenectomy.

Kambakamba, Patryk

2023 Volume 174, Issue 3, Page(s) 441

MeSH term(s)	Humans ; Logistic Models ; Pancreaticoduodenectomy/adverse effects ; Machine Learning ; Risk Assessment
Language	English
Publishing date	2023-07-21
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	202467-6
ISSN	1532-7361 ; 0039-6060
ISSN (online)	1532-7361
ISSN	0039-6060
DOI	10.1016/j.surg.2023.06.011
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Article: Timing of surgical repair of bile duct injuries after laparoscopic cholecystectomy: A systematic review.

Kambakamba, Patryk / Cremen, Sinead / Möckli, Beat / Linecker, Michael

World journal of hepatology

2022 Volume 14, Issue 2, Page(s) 442–455

Abstract: Background: The surgical management of bile duct injuries (BDIs) after laparoscopic cholecystectomy (LC) is challenging and the optimal timing of surgery remains unclear. The primary aim of this study was to systematically evaluate the evidence behind ... ...

Abstract	Background: The surgical management of bile duct injuries (BDIs) after laparoscopic cholecystectomy (LC) is challenging and the optimal timing of surgery remains unclear. The primary aim of this study was to systematically evaluate the evidence behind the timing of BDI repair after LC in the literature. Aim: To assess timing of surgical repair of BDI and postoperative complications. Methods: The MEDLINE, EMBASE, and The Cochrane Library databases were systematically screened up to August 2021. Risk of bias was assessed Results: A total of 439 abstracts were screened, and 24 studies were included with 15609 patients included in this review. Of the 5229 BDIs reported, 4934 (94%) were classified as major injury. Timing of bile duct repair was immediate (14%, Conclusion: The lack of standardization among studies precludes any conclusive recommendation on optimal timing of BDI repair after LC. This finding indicates an urgent need for a standardized reporting system of BDI repair.
Language	English
Publishing date	2022-03-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	2573703-X
ISSN	1948-5182
ISSN	1948-5182
DOI	10.4254/wjh.v14.i2.442
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Article ; Online: The peer review at high risk from COVID-19 - are we socially distancing from scientific quality control?

Kambakamba, P / Geoghegan, J / Hoti, E

The British journal of surgery

2020 Volume 107, Issue 9, Page(s) e334–e335

MeSH term(s)	Bibliometrics ; COVID-19 ; Coronavirus Infections/epidemiology ; Editorial Policies ; Humans ; Pandemics ; Peer Review/standards ; Periodicals as Topic/standards ; Pneumonia, Viral/epidemiology ; Quality Control
Keywords	covid19
Language	English
Publishing date	2020-07-11
Publishing country	England
Document type	Letter
ZDB-ID	2985-3
ISSN	1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
ISSN (online)	1365-2168
ISSN	0263-1202 ; 0007-1323 ; 1355-7688
DOI	10.1002/bjs.11785
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Article: Outruling cholangiocarcinoma in patients with primary sclerosing cholangitis wait-listed for liver transplantation: A report on the Irish national experience.

Duggan, William P / Brosnan, Conor / Christodoulides, Natasha / Nolan, Niamh / Kambakamba, Patryk / Gallagher, Tom K

The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

2022 Volume 21, Issue 2, Page(s) e83–e88

Abstract: Background: The presence of diffuse biliary stricturing in Primary Sclerosing Cholangitis (PSC) makes the diagnosis of early Cholangiocarcinoma (CCA) in this context difficult. A finding of incidental CCA on liver explant is associated with poor ... ...

Abstract	Background: The presence of diffuse biliary stricturing in Primary Sclerosing Cholangitis (PSC) makes the diagnosis of early Cholangiocarcinoma (CCA) in this context difficult. A finding of incidental CCA on liver explant is associated with poor oncological outcomes, despite this; there remains no international consensus on how best to outrule CCA in this group ahead of transplantation. The objectives of this study were to report the Irish incidence of incidental CCA in individuals with PSC undergoing liver transplantation, and to critically evaluate the accuracy of diagnostic modalities in outruling CCA in our wait-listed PSC cohort. Methods: We conducted a retrospective analysis of our prospectively maintained database, which included all PSC patients wait-listed for liver transplant in Ireland. Results: 4.41% of patients (n = 3) were found to have an incidental finding of CCA on liver explant. Despite only being performed in 35.06% of wait-listed PSC patients (n = 27), Endoscopic Retrograde Cholangiopancreatogram (ERCP) with brush cytology was found to be the most effective tool in correctly outruling CCA in this context; associated with a specificity of 96.15%. Conclusion: Our findings support a future role for routine surveillance of PSC patients awaiting liver transplantation; however further research is required in order to identify which investigative modalities are of optimal diagnostic utility in this specific context.
MeSH term(s)	Humans ; Cholangitis, Sclerosing/complications ; Cholangitis, Sclerosing/surgery ; Cholangitis, Sclerosing/pathology ; Liver Transplantation/adverse effects ; Retrospective Studies ; Bile Duct Neoplasms/diagnosis ; Bile Duct Neoplasms/epidemiology ; Bile Duct Neoplasms/etiology ; Cholangiocarcinoma/diagnosis ; Cholangiocarcinoma/epidemiology ; Cholangiocarcinoma/etiology ; Bile Ducts, Intrahepatic/pathology
Language	English
Publishing date	2022-06-07
Publishing country	Scotland
Document type	Journal Article
ZDB-ID	2102927-1
ISSN	1479-666X
ISSN	1479-666X
DOI	10.1016/j.surge.2022.05.005
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Article ; Online: Applying augmented reality in teaching of surgical residents-telementoring, a "stress-free" way to surgical autonomy?

Kambakamba, Patryk / Naiem, Amir / Betz, Elise / Hotz, Anne-Sophie / Richetti, Katharina / Stein, Moritz / Abry, Lisa / Meier, Aline / Seeger, Nico / Grochola, Filip / Grieder, Felix / Breitenstein, Stefan

Langenbeck's archives of surgery

2024 Volume 409, Issue 1, Page(s) 100

Abstract: ... reduced intraoperative peak pulse rate from 131 to 119 bpm (p = 0.004), as compared with the semi ... group (p = 0.011).: Conclusion: AR can be applied in surgical training and may help to reduce stress ...

Abstract	Background: Achieving surgical autonomy can be considered the ultimate goal of surgical training. Innovative head-mounted augmented reality (AR) devices enable visualization of the operating field and teaching from remote. Therefore, utilization of AR glasses may be a novel approach to achieve autonomy. The aim of this pilot study is to analyze the feasibility of AR application in surgical training and to assess its impact on intraoperative stress. Methods: A head-mounted RealWear Navigator® 500 glasses and the TeamViewer software were used. Initial "dry lab" testing of AR glasses was performed in combination with the Symbionix LAP Mentor™. Subsequently, residents performed various stage-adapted surgical procedures semi-autonomously (SA) (on-demand consultation of senior surgeon, who is in theatre but not scrubbed) versus permanent remote supervision (senior surgeon not present) via augmented reality (AR) glasses, worn by the resident in theatre. Stress was measured by intraoperative heart rate (Polar® pulse belt) and State-Trait Anxiety Inventory (STAI) questionnaire. Results: After "dry lab" testing, N = 5 senior residents performed equally N = 25 procedures SA and with AR glasses. For both, open and laparoscopic procedure AR remote assistance showed satisfactory applicability. Utilization of AR significantly reduced intraoperative peak pulse rate from 131 to 119 bpm (p = 0.004), as compared with the semi-autonomous group. Likewise, subjectively perceived stress according to STAI was significantly lower in the AR group (p = 0.011). Conclusion: AR can be applied in surgical training and may help to reduce stress in theatre. In the future, AR has a huge potential to become a stepping stone to surgical autonomy.
MeSH term(s)	Humans ; Augmented Reality ; Internship and Residency ; Pilot Projects ; Laparoscopy/methods
Language	English
Publishing date	2024-03-19
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-024-03287-y
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Article: The peer review at high risk from COVID-19 - are we socially distancing from scientific quality control?

Kambakamba, P / Geoghegan, J / Hoti, E

Br J Surg

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #639866
Database	COVID19

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Article ; Online: The peer review at high risk from COVID-19 - are we socially distancing from scientific quality control? ; N/A

Kambakamba, P. / Geoghegan, J. / Hoti, E.

British Journal of Surgery

2020 Volume 107, Issue 9, Page(s) e334–e335

Keywords	Surgery ; covid19
Language	English
Publisher	Wiley
Publishing country	us
Document type	Article ; Online
ZDB-ID	2985-3
ISSN	0263-1202 ; 0007-1323 ; 1355-7688
ISSN	0263-1202 ; 0007-1323 ; 1355-7688
DOI	10.1002/bjs.11785
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Article: Regenerative Liver Surgery - ALPPS and Associated Techniques.

Botea, Florin / Barcu, Alexandru / Verdea, Cosmin / Kambakamba, Patryk / Popescu, Irinel / Linecker, Michael

Chirurgia (Bucharest, Romania : 1990)

2021 Volume 116, Issue 4, Page(s) 387–398

Abstract: Hepatectomy is the only potentially curative treatment of hepatic tumors, but remains challenging in case of multiple, bilobar lesions and those located in the vicinity of the hepatic hilum and hepatic veins. Regenerative liver surgery utilizes the ... ...

Abstract	Hepatectomy is the only potentially curative treatment of hepatic tumors, but remains challenging in case of multiple, bilobar lesions and those located in the vicinity of the hepatic hilum and hepatic veins. Regenerative liver surgery utilizes the unique ability of the liver to re-grow after tissue loss and vascular deprivation. All concepts subsumed under this term aim to increase the resectability of hepatic tumors by stimulating growth of future liver remnant. Many of these techniques have evolved over the last decades. ALPPS (associated liver partition and portal vein ligation for staged hepatectomy) is an advanced technique combining portal vein ligation and parenchymal transection which gave rise to many variants, all with the common goal of extending resectability. This article reviews techniques currently available for regenerative liver surgery focusing on ALPPS, its mechanisms of liver regeneration, indications, advantages, drawbacks, results and future perspectives.
MeSH term(s)	Hepatectomy ; Humans ; Ligation ; Liver/surgery ; Liver Neoplasms/surgery ; Liver Regeneration ; Portal Vein/surgery ; Treatment Outcome
Language	English
Publishing date	2021-06-09
Publishing country	Romania
Document type	Journal Article ; Review
ZDB-ID	419244-8
ISSN	1842-368X ; 1221-9118 ; 0009-4730 ; 0377-5003
ISSN (online)	1842-368X
ISSN	1221-9118 ; 0009-4730 ; 0377-5003
DOI	10.21614/chirurgia.116.4.387
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Article ; Online: The evolution of surgery for colorectal liver metastases: A persistent challenge to improve survival.

Kambakamba, Patryk / Hoti, Emir / Cremen, Sinead / Braun, Felix / Becker, Thomas / Linecker, Michael

Surgery

2021 Volume 170, Issue 6, Page(s) 1732–1740

Abstract: Only a few decades ago, the opinion that colorectal liver metastases were a palliative diagnosis changed. In fact, previously, the prevailing view was strongly resistant against resecting colorectal liver metastases. Constant technical improvement of ... ...

Abstract	Only a few decades ago, the opinion that colorectal liver metastases were a palliative diagnosis changed. In fact, previously, the prevailing view was strongly resistant against resecting colorectal liver metastases. Constant technical improvement of liver surgery and, much later, effective chemotherapy allowed for a successful wider application of surgery. The clinical use of portal vein embolization was the starting signal of regenerative liver surgery, where insufficient liver volume can be expanded to an extent where safe resection is possible. Today, a number of these techniques including portal vein ligation, associating liver partition and portal vein ligation for staged hepatectomy, and bi-embolization (portal and hepatic vein) can be successfully used to address an insufficient future liver remnant in staged resections. It turned out that the road to success is embedding surgery in a well-orchestrated oncological concept of controlling systemic disease. This concept was the prerequisite that meant liver transplantation could enter the treatment strategy for colorectal liver metastases, ending up with a 5-year overall survival of 80% in highly selected cases. In particular, techniques combining principles of 2-stage hepatectomy and liver transplantation, such as "resection and partial liver segment 2-3 transplantation with delayed total hepatectomy" (RAPID) are on the rise. These techniques enable the use of partial liver grafts with primarily insufficient liver volume. All this progress also prompted a number of innovative local therapies to address recurrences ultimately transferring colorectal liver metastases from instantly deadly into a chronic disease in some cases.
MeSH term(s)	Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/mortality ; Colorectal Neoplasms/pathology ; Colorectal Neoplasms/therapy ; Disease-Free Survival ; Embolization, Therapeutic/methods ; Embolization, Therapeutic/trends ; Hepatectomy/methods ; Hepatectomy/trends ; Hepatic Veins/surgery ; Humans ; Ligation/methods ; Ligation/trends ; Liver/blood supply ; Liver/pathology ; Liver/surgery ; Liver Neoplasms/diagnosis ; Liver Neoplasms/mortality ; Liver Neoplasms/secondary ; Liver Neoplasms/therapy ; Liver Regeneration ; Liver Transplantation/methods ; Liver Transplantation/trends ; Neoplasm Recurrence, Local/epidemiology ; Portal Vein/surgery ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2021-07-22
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	202467-6
ISSN	1532-7361 ; 0039-6060
ISSN (online)	1532-7361
ISSN	0039-6060
DOI	10.1016/j.surg.2021.06.033
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Article ; Online: Early Postoperative Serum Phosphate Drop Predicts Sufficient Hypertrophy After Liver Surgery.

Kambakamba, Patryk / Schneider, Marcel A / Linecker, Michael / Kirimker, Elvan Onur / Moeckli, Beat / Graf, Rolf / Reiner, Cäcilia S / Nguyen-Kim, Thi Dan Linh / Kologlu, Meltem / Karayalcin, Kaan / Clavien, Pierre-Alain / Balci, Deniz / Petrowsky, Henrik

Annals of surgery

2023 Volume 278, Issue 5, Page(s) 763–771

Abstract: ... with increased liver hypertrophy ( P <0.001). Patients with a low drop of phosphate showed a higher incidence ... of posthepatectomy liver failure after ALPPS (7% vs 31%, P =0.041). Like in humans, phosphate drop correlated ... significantly with degree of hypertrophy in murine ALPPS and hepatectomy models ( P <0.001). Blocking ...

Abstract	Objective: The aim of this study was to assess the impact of postoperative hypophosphatemia on liver regeneration after major liver surgery in the scenario of Associating Liver Partition with Portal vein ligation for Staged hepatectomy (ALPPS) and living liver donation (LLD). Background: Hypophosphatemia has been described to reflect the metabolic demands of regenerating hepatocytes. Both ALPPS and LLD are characterized by an exceptionally strong liver regeneration and may be of particular interest in the context of posthepatectomy hypophosphatemia. Methods: Serum phosphate changes within the first 7 postoperative days after ALPPS (n=61) and LLD (n=54) were prospectively assessed and correlated with standardized volumetry after 1 week. In a translational approach, postoperative phosphate changes were investigated in mice and in vitro . Results: After ALPPS stage 1 and LLD, serum phosphate levels significantly dropped from a preoperative median of 1.08 mmol/L [interquartile range (IQR) 0.92-1.23] and 1.07 mmol/L (IQR 0.91-1.21) to a postoperative median nadir of 0.68 and 0.52 mmol/L, respectively. A pronounced phosphate drop correlated well with increased liver hypertrophy ( P <0.001). Patients with a low drop of phosphate showed a higher incidence of posthepatectomy liver failure after ALPPS (7% vs 31%, P =0.041). Like in humans, phosphate drop correlated significantly with degree of hypertrophy in murine ALPPS and hepatectomy models ( P <0.001). Blocking phosphate transporter (Slc20a1) inhibited cellular phosphate uptake and hepatocyte proliferation in vitro. Conclusion: Phosphate drop after hepatectomy is a direct surrogate marker for liver hypertrophy. Perioperative implementation of serum phosphate analysis has the potential to detect patients with insufficient regenerative capacity at an early stage.
MeSH term(s)	Humans ; Mice ; Animals ; Liver/surgery ; Hepatectomy/adverse effects ; Liver Regeneration ; Portal Vein/surgery ; Liver Neoplasms/surgery ; Hypertrophy/surgery ; Hepatomegaly ; Hypophosphatemia/surgery ; Phosphates ; Ligation ; Treatment Outcome
Chemical Substances	Phosphates
Language	English
Publishing date	2023-07-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	340-2
ISSN	1528-1140 ; 0003-4932
ISSN (online)	1528-1140
ISSN	0003-4932
DOI	10.1097/SLA.0000000000006013
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