Background: Ciliated hepatic foregut cysts (CHFCs) are rare benign congenital lesions that typically occur within the hepatic parenchyma. Extrahepatic involvement is exceptionally rare and may present with biliary obstruction mimicking malignant biliary disease. Case presentation: A 56-year-old man presented with right upper quadrant pain, nausea, vomiting, and intermittent jaundice. Laboratory findings revealed cholestatic abnormalities and mildly elevated CA 19-9. Magnetic resonance imaging demonstrated a 22-mm cystic lesion at the hepatic hilum, associated with abrupt narrowing at the hepatic duct confluence and marked upstream intrahepatic biliary dilatation. Despite benign-appearing cystic characteristics, the pattern of hilar obstruction raised suspicion for perihilar cholangiocarcinoma. Surgical exploration revealed a cyst arising from the wall of the common hepatic duct, without a distinct plane separating it from the native bile duct. Complete excision required resection of the involved extrahepatic bile duct segment, followed by Roux-en-Y hepaticojejunostomy. Histopathological examination demonstrated a cyst lined by ciliated epithelium without significant cytological atypia, with TTF-1 and p63 positivity supporting the diagnosis of CHFC.Conclusion: Extrahepatic CHFC may cause significant hilar biliary obstruction and mimic the clinical and radiological presentation of perihilar cholangiocarcinoma despite its benign cystic morphology. Histopathological examination is essential for definitive diagnosis.
Hepatic resection (HR) remains the gold standard for colorectal liver metastases (CRLM), but radiofrequency ablation (RFA) is an important tissue-sparing alternative. This study evaluated their clinical efficacy, with a targeted synthesis of small tumors (≤ 3 cm) to inform individualized treatment selection. A systematic search of major databases (Medline, Embase, Cochrane Library, the Chinese Medical Association database, and the China Biology Medicine database) identified studies comparing RFA and HR for CRLM through October 2025. Pooled analyses of survival, recurrence, and perioperative parameters utilized Stata 18.0. For the ≤ 3 cm subgroup, a targeted synthesis was implemented using high-quality, size-matched cohorts to minimize heterogeneity associated with pooled modeling. Sixteen studies (2,214 patients) were included. In the general cohort, HR yielded significantly lower 3-year (RR = 0.79; 95
Anastomotic leak (AL) is a serious complication after McKeown minimally invasive esophagectomy (MIE). The right gastroepiploic artery (RGEA) is the primary blood supply for the gastric conduit. However, the correlation between the distance from the distal end of the RGEA to the anastomosis (anastomotic distance) and AL risk is not well understood. This study aims to investigate the association between anastomotic distance and AL incidence post-McKeown MIE. This retrospective cohort study included 270 esophageal cancer patients who underwent McKeown MIE by a single surgical team from March 2022 to October 2025. During surgery, the anastomotic distance was measured. The optimal cut-off value was determined using receiver operating characteristic (ROC) curve analysis. Univariate and multivariate logistic regression analyses were conducted to identify independent risk factors for AL. AL occurred in 33 out of 270 patients, accounting for 12.2
Background: Delayed gastric emptying (DGE) and subacute intestinal obstruction (SAIO) are important causes of prolonged postoperative morbidity after radical cystectomy and other major abdominal surgeries. While these complications are commonly attributed to surgical factors, endocrine causes such as hypothyroidism may be overlooked. This study evaluates hypothyroidism as a potentially reversible cause of persistent postoperative gastrointestinal dysmotility in patients undergoing radical cystectomy. Methods: Between January 2012 and June 2024, 200 patients underwent radical cystectomy with ileal conduit diversion at our tertiary care centre. Twenty-three patients developed persistent SAIO/DGE beyond 7 days despite standard conservative management and underwent thyroid function testing. Clinical characteristics, thyroid function parameters and outcomes following thyroid hormone replacement were analysed. Results: Seventeen of the 23 patients (73.9
Laparoscopic cholecystectomy is the standard treatment for symptomatic gallbladder disease. However, gallbladder perforation and spillage of infected bile or stones during specimen extraction remain common, frequently causing port-site infections (PSI). Whether using a specimen retrieval bag significantly mitigates this risk compared to direct extraction remains debated. To evaluate the efficacy of retrieval bag extraction versus direct extraction in preventing port-site infection during laparoscopic cholecystectomy. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, PubMed, Embase, Scopus, the Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov were searched through July 2026 for randomized studies. Risk ratios (RR) with 95
