Yun and colleagues found that living donor liver transplantation is not inferior to deceased donor liver transplantation in terms of graft and overall survival in patients with a MELD score of 35 or higher. With appropriate risk evaluation, living donation for patients with high MELD scores can help alleviate organ shortages.

Terasaki and colleagues analyzed the nationwide surgical outcomes of left trisectionectomy using the National Clinical Database of Japan. American Society of Anesthesiologists Physical Status 2 classification, portal vein resection, and intraoperative blood loss ≥30 mL/kg were identified as significant risk factors for severe morbidity after left trisectionectomy for biliary cancer.

Kato and colleagues investigated the clinical significance of extrahepatic bile duct resection for T2 gallbladder cancer using data from the Japanese Biliary Tract Cancer Registry. Extrahepatic bile duct resection improved prognosis in T2 gallbladder cancer patients with lymph node metastases, but its indication requires caution considering the risk of postoperative complications.

Of 18,888 cases of pancreatic adenocarcinoma in the Czech oncological registry from 1985 to 2015, 1,324 were early-onset (under 50 years). Whitley and colleagues found that clinicopathological traits were comparable between early and late onset cases. Median survival for early-onset cases was 5.9 months and for late-onset cases 4.5 months.

It is often difficult to determine the optimal surgical approach for early-stage pancreatic body cancer, in consideration of the balance between organ function and curability. Terai and colleagues conclude that central pancreatectomy for clinical T1 pancreatic body cancer is an acceptable treatment option to achieve cure and functional preservation.

In this multicenter retrospective study, Lee and colleagues analyzed the efficacy of arterial reinforcement by wrapping the hepatic artery with Neoveil, a polyglycolic acid sheet, during pancreaticoduodenectomy to reduce post-pancreatectomy hemorrhage. Analysis of 904 patients showed that this method significantly reduced the rate of post-pancreatectomy hemorrhage from the hepatic artery.

There have been several reports of endoscopic removal of biliary metal stents using forceps or stent-in-stent techniques. Nishikawa and colleagues describe the endoscopic recovery of a proximally migrated biliary metal stent using a large dilation balloon and endoscope passage through a difficult duodenal stricture in combination with a duodenal stent.

Transpapillary endoscopic biliary drainage is the gold standard for resolving malignant biliary obstruction. Stent migration occasionally occurs and is troublesome to retrieve. Yamamoto and colleagues report with accompanying video on the successful retrieval of a proximally migrated stent using biopsy forceps through a guiding sheath cannula.

Kawakami and colleagues report a case of duodenoscope insertion difficulty through the pyloric ring due to perigastric adhesions which was successfully overcome using an overtube. The overtube can be attached to both standard and therapeutic duodenoscopes, allowing successful biliary or pancreatic intervention in patients in whom duodenoscopic insertion is challenging.