Advancements and Challenges in Managing Hepato-Pancreato-Biliary Cancers

Dear Colleagues,

Hepatobiliary and pancreatic cancers represent two of the deadliest malignances. The aggressive behavior of the diseases and the often-advanced stages at the moments of diagnosis are the main causes for the high mortality rate of these patients. However, in recent years, several advances have been made in the management of this family of diseases. The improvement of surgical techniques, more targeted chemo- and radiotherapy, and radiological and endoscopic techniques are at the core of the research in the hepatobiliary and pancreatic field. Advanced imaging techniques like 3D CT scans, MRI, and PET scans provide detailed views of the liver, pancreas, and biliary structures. These images are used to create 3D models, allowing surgeons to plan complex surgeries with greater accuracy and tailor their approach to individual patients. Real-time navigation systems, similar to GPS for surgery, guide surgeons during procedures. Augmented reality (AR) overlays and intraoperative ultrasound provide continuous updates on the surgical field, helping to identify critical structures and avoid complications. Robotic surgical systems, such as the Da Vinci Surgical System, offer enhanced dexterity, precision, and control. These systems filter out hand tremors and provide high-definition 3D views of the surgical site, allowing for minimally invasive procedures with smaller incisions, less pain, and quicker recovery times. Improvements in laparoscopic equipment, including high-definition cameras and specialized instruments, enable more complex HPB surgeries to be performed laparoscopically. This reduces the need for open surgeries, leading to shorter hospital stays and faster patient recovery. Enhanced recovery protocols and remote monitoring technologies have transformed postoperative care. Wearable devices and mobile apps track patients' vital signs and recovery progress in real-time, allowing for early detection of complications and timely interventions, thus improving overall outcomes. These technologies collectively improve the precision, safety, and efficacy of HPB surgeries, leading to better patient outcomes and advancing the field significantly.

Multidisciplinary approaches represent one of the most powerful weapons against this group of diseases. In fact, the adoption of this type of approach makes it possible to adopt increasingly advanced and complex strategies that allow obtaining increasingly encouraging results.

You are kindly invited to share your knowledge, perspectives, and recent advances in the management of hepatobiliary and pancreatic malignancies in this Special Issue of the Journal of Clinical Medicine.

Dr. Alessandro D. Mazzotta
Dr. Niccolò Petrucciani
Guest Editors

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• liver
• pancreas
• HPB technology
• artificial intelligence for HPB
• surgical oncology
• MIS