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Eager to learn from experts to mitigate chyle leak in PD which we encounter in messesnteric root dissection for uncinate n ventral head/body mass. IHPBA TeamSurgery SoMe4HPB

CaGb neck with replaced rt HA infiltration which we embolised and extended chole with resection of extra hepatic biliary tree and replaced rt HA done. Dhiresh Maharjan Major hepatectomy avoided WWYD IHPBA TeamSurgery SoMe4HPB A-PHPBA Japanese Society of HBP Surgery

Being a collaborator to Prof Pierre Clavien's project on 'surgeon-scientists' does give the feeling of accomplishment. E-AHPBA Unispital_USZ

ICG to evaluate pancreatic stump perfusion in PD and refashioning it if needed. Applicable to any anastomosis Dhiresh Maharjan Roshan Ghimire Can it mitigate PPAPnPOPF? DOI: 10.1002/hsr2.70153 IHPBA A-PHPBA TeamSurgery Prof Steve Wigmore Giovanni Marchegiani Shridhar Iyer

IPMN with worrisome features Malignant cells inEUS guided FNA. Dhiresh Maharjan PD n pancreatoscopy of MPD IHPBA A-PHPBA TeamSurgery SoMe4HPB

ROOT OF MESSETRY dissection for ventra/ uncinate mass in PD technically n oncologically challenging Dhiresh Maharjan Inferior infracolic SMA approach in all post NACT Chyle leak high CL manageable with Ro margin IHPBA A-PHPBA TeamSurgery doi: 10.12998/wjcc.v13.i8.97887

Enteroatmospheric fistula managed with blood bag tube, vacuum dressing and stoma appliance. Dhiresh Maharjan Anyone using this technique?TeamSurgery Steven D Wexner MD, PhD SoMe4Surgery

Peritoneal patch for PV repair.Dhiresh Maharjan Suture mesothelial surface( not the edge of patch) with PV to prevent its inversion into the lumen. Coeliac Lymphatic draining into cysterna chyli ties n clipped @ihpba A-PHPBA TeamSurgery Giovanni Marchegiani Type 4 grading.

I met the 🔝 of the surgeons from the top 🏔️ of the world! Such a honor to be hosted by the 🇳🇵 HPB community in beautiful Kathmandu Great discussions and superb skills 🪡 in the OR for complex cases of PDAC 🙏 Prabin Bikram Thapa ⭐️ Dhiresh Maharjan see you in Dublin E-AHPBA

Thank you for inviting me as a faculty 🙏 a great learning opportunity AHPBA Melissa Hogg obliged us by including ourOR videos and manuscripts in her lecture on ICG in pancreas surgery. Fun was meeting son after months too. Dhiresh Maharjan IHPBA A-PHPBA TeamSurgery

HPD for cagb If done for Conglomerated LN 13, Ro achievable For biliary infiltration, proximal -ve margin?? NACT Acceptable perioperative outcome in selected cases in expert centres Dhiresh Maharjan doi.org/10.1002/jgh3.7… A-PHPBA IHPBA TeamSurgery

Root of messentry dissection for post NACT PDAC Infracolic approach Dhiresh Maharjan Dominant jejunal vein, Nonreconstructible iliocolic vein, MCV MCA sacrificed. RT colectomy for devascularised colon @ihpba A-PHPBA Giovanni Marchegiani TeamSurgery

We have done few. However, vascularity of remaining pancreas may be an issue leading to pancreatitis. Thus we use ICG.

My team mate for 13 yrs did liver transplant with only Nepalese team Roshan Ghimire Did his residency from our department,Dhiresh Maharjan LT training from super high volume centre in Delhi, involved in 25+ LDLTin KTM highest in Nepal IHPBA A-PHPBA 👏👏 A beginning for team

Role of ICG to look for vascularity of the pancreatic stump during Whipple’s procedure and its clinical implications in terms of PPAP and POPF : doi.org/10.1136/bmjsit… BMJ Surgery, Interventions, & Health Tech.Prabin Bikram Thapa Roshan Ghimire ISFGS Giovanni Marchegiani IHPBA

📢 New research indicates that ensuring sufficient vascular supply at the pancreatic remnant using indocyanine green may alleviate presumed post-pancreatectomy acute pancreatitis and associated complications. #IndocyanineGreen #Pancreaticoduodenectomy sit.bmj.com/content/7/1/e0…