The scope of my research focus on the diagnosis, surgical treatment, and post operative care of hepatobiliary and pancreatic tumors. Current technologies are the one thing researched in my field include modern visualization technology, which help with precision surgery planning and the guiding operation. Precision medicine uses genetic and molecular details to design treatments to each patient.
AI improves data study, diagnosis, and the right therapy strategy, making outcomes better for patients. During the surgery, challenges include standardizing minimally invasive procedures to ensure cancer-free principles. Another challenge is creating effective treatment plans for each patient include immunotherapy, target therapy, and chemotherapy.
Also, improved PEARS operative management is essential to reduce surgical risk and improve recovery. Once the patient is ready and absence of distant metastasis is confirmed using surgical tools, dissect the cystic artery and cystic duct. Then use an ultrasonic scalpel to dissect and suspend the common hepatic artery and its branches.
After that, ligate and divide the right gastric artery and the left hepatic artery. Next, employ surgical scissors to transect the common bile duct at the superior border of the pancreas. Using an ultrasonic scalpel, dissect and mobilize the portal vein.
Remove the extra hepatic bile duct and lymph node groups eight, 12, and 13 en bloc along the portal vein towards the hepatic hilum achieving skeletonization of the hepato-duodenal ligament. Ligate and divide the left branch of the portal vein and branches of the caudate lobe portal vein. Then dissect the left hepatic ligaments using surgical tools and divide the short hepatic veins of the caudate lobe, delineating the ischemic line between the right and left liver lobes.
After marking the demarcation line, confirm that the fluorescence boundary matches the ischemic line using fluorescence imaging. Using the Pringle maneuver, intermittently occlude the main portal vein. Use an ultrasonic scalpel to transect the liver parenchyma along the demarcation line.
Continue transection along the plane of the middle hepatic vein, ensuring the division of its V4b and V4a branches. Transect the right hepatic duct approximately one centimeter from the tumor using surgical scissors. Then using an endoscopic linear cutter stapler, transect the left hepatic vein.
Completely resect the left hemi liver and the caudate lobe and place the specimen in a retrieval bag. Next, transect the jejunum approximately 20 centimeters distal to the ligament of Treitz using surgical scissors. Elevate the distal loop posterior to the colon for an end-to-side anastomosis with the right hepatic duct using continuous sutures for the anterior and posterior walls.
Then perform a side-to-side jejunojejunostomy approximately 45 centimeters distal to the right hepatic duct jejunal anastomosis. Once the abdominal cavity is irrigated, carefully inspect the surgical field for active bleeding, bile leaks, and gastrointestinal side branch injuries. Then place drainage tubes in the left liver section and Winslow's foramen.
