Feasibility and safety of ALPPS procedure: our experience S. Caringi, A. Delvecchio, M. Dezio, A. Casella, V. Ferraro, R. Filippo, M. Stasi, S. Marini, R. Calbi, R. Inchingolo, T. M. Manzia, M. Tedeschi, R. Memeo Surgical Endoscopy, 2025 Background The associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a surgical strategy for patients with advanced liver tumors and inadequate future liver remnants (FLR). This study compares post-operative outcomes between open (oALPPS) and robotic (rALPPS) ALPPS in our institution. Methods This retrospective monocentric study includes eleven patients who underwent ALPPS procedure between January 2023 and February 2024. Demographics, tumor characteristics, and intra- and post-operative outcomes were collected and analyzed. Results In the first-stage ALPPS, the frequency of intermittent hilum clamp and the estimated blood loss were higher in the oALPPS group, while operative time and complications were similar, and total hospital stay was higher in the rALPPS group. In the second-stage ALPPS, the data regarding intraoperative and post-operative data were similar. In rALPPS, there were no post-discharge complications, readmissions, or deaths within 30 days. Conclusion This single-center study has an exploratory setting given the small cohort, but if confirmed in larger studies, rALPPS could be a viable alternative to oALPPS.
Hot Topics in the Surgical Treatment of Intrahepatic Cholangiocarcinoma: A Narrative Review of Current Managements Silvio Caringi, Antonella Delvecchio, Annachiara Casella, Valentina Ferraro, Michele Dezio, Stefania Marini, Roberto Calbi, Francesco Cortese, Rosalinda Filippo, Matteo Stasi, Tommaso Maria Manzia, Michele Tedeschi, Riccardo Inchingolo, Riccardo Memeo Cancers, 2025 Intrahepatic cholangiocarcinoma (iCCA) is the second most common primary liver cancer with a poor prognosis. Negative-margin resection is presently the only potentially curative treatment option. Emerging trends with direct applicability to surgical strategy include margin thickness, lymphadenectomy, optimization of future liver remnant (FLR), minimally invasive techniques, incorporation of systemic therapy, and reconsideration of liver transplantation. This review emphasizes areas of consensus and ongoing debate. Margins ≥5–10 mm are associated with improved results, but biology generally takes precedence over prognosis. Regional lymphadenectomy enhances staging accuracy, although its therapeutic benefit remains unsettled. PVE is standard for FLR enlargement, LVD provides faster hypertrophy, and ALPPS remains reserved for highly selective cases. Minimally invasive and robotic hepatectomy share oncologic results in skilled institutions. Systemic therapies, including immunotherapy and biomarker-directed targeted therapy, are increasingly being incorporated perioperatively. Liver transplant may be of potential value in early-stage disease or on strict indications after neoadjuvant treatment. The modern surgical management of iCCA encompasses a blend of oncologic considerations, FLR optimization, minimally invasive surgery, and systemic therapy according to tumor biology. Multidisciplinary planning and participation in clinical trials are necessary to align surgical innovation with advancements in molecular and systemic treatments, ultimately leading to improved long-term outcomes.
Imaging assessment and radiological features of pancreatic cystic lesions Nicolò Brandi, Emanuela Giampalma, Riccardo Inchingolo, Onofrio Antonio Catalano, Marco Midulla, Matteo Renzulli Best Practice and Research Clinical Gastroenterology, 2025 The present review provides a comprehensive analysis of the current role and limitations of imaging in the evaluation and management of pancreatic cystic lesions (PCLs). High-resolution modalities such as Magnetic Resonance Imaging (MRI) and Computed Tomography (CT), especially when integrated with Magnetic Resonance Cholangiopancreatography (MRCP), remain fundamental for lesion detection, characterization, and surveillance. However, significant variability in measurement practices, guideline recommendations, and imaging protocols poses ongoing challenges. Advances in artificial intelligence and radiomics show potential in improving diagnostic precision and risk stratification, though widespread clinical adoption is still constrained by methodological and infrastructural barriers. Emphasis is placed on the need for standardized imaging strategies and multidisciplinary collaboration to improve outcomes and tailor surveillance to individual patient risk.
Modern approach to hepatocellular carcinoma treatment Francesco Cortese, Fotis Anagnostopoulos, Maria Vittoria Bazzocchi, Silvio Caringi, Antonio Rosario Pisani, Matteo Renzulli, Ioannis Paraskevopoulos, Letizia Laera, Alessia Surgo, Stavros Spiliopoulos, Riccardo Memeo, Riccardo Inchingolo World Journal of Hepatology, 2025 Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related mortality worldwide, necessitating innovative treatment strategies. Surgical resection and liver transplantation continue to be the gold standards for early-stage HCC; however, advances in imaging and minimally invasive techniques have improved patient selection and outcomes. Additionally, the emergence of targeted therapies and immunotherapy has transformed the treatment landscape for advanced HCC. This review highlights the efficacy of agents such as tyrosine kinase inhibitors, alongside emerging options like immune checkpoint inhibitors, which have shown promise in clinical trials. Furthermore, the role of locoregional therapies, including ablation in the setting of combined treatment, transarterial chemoembolization and transarterial radioembolization with flow catheters, cone-beam computed tomography and 4D navigation guidance, is examined in the context of bridging therapies for patients awaiting surgical intervention. The integration of multidisciplinary care approaches and personalized treatment plans is crucial for optimizing outcomes. Future directions for HCC treatment are discussed, including the potential of novel biomarkers in prognosis and treatment response. This comprehensive overview aims to equip clinicians with the latest insights and foster collaborative efforts to improve HCC patient management and survival rates.
Non-invasive imaging biomarkers in chronic liver disease Cesare Maino, Federica Vernuccio, Roberto Cannella, Laura Cristoferi, Paolo Niccolò Franco, Marco Carbone, Francesco Cortese, Riccardo Faletti, Elisabetta De Bernardi, Riccardo Inchingolo, Marco Gatti, Davide Ippolito European Journal of Radiology, 2024
Inferior Vena Cava Filter in Cancer-Associated Thrombosis: A Vade Mecum for the Treating Physicians: A Narrative Review Agnese Maria Fioretti, Daniele La Forgia, Pietro Scicchitano, Natale Daniele Brunetti, Riccardo Inchingolo, Carlo Gabriele Tocchetti, Stefano Oliva Biomedicines, 2024 Cancer is a remarkable prothrombotic disease, and cancer-associated thrombosis acts as a dreadful omen for poor prognosis. The cornerstone of venous thromboembolism therapy is anticoagulation; however, in patients with venous thromboembolism who are not suitable for anticoagulation (contraindication, failure, or complication), the inferior vena cava filter appears a valuable option in the therapeutic arsenal. The recently heightened trend of steady rise in filter placement mirrors the spread of retrievable devices, together with improvements in physicians’ insertion ability, medico-legal issue, and novel and fewer thrombogenic materials. Nevertheless, the exact role of the inferior vena cava filter in cancer has yet to be endorsed due to a dearth of robust evidence. Indeed, data that support the inferior vena cava filter are weak and even controversial, resulting in discrepancies in the interpretation and application of guidelines in daily practice. In this narrative review, we aim at clarifying the state of the art on inferior vena cava filter use in malignancies. Furthermore, we provide a feasible, conclusive 4-step algorithm for the treating physicians in order to offer a practical strategy to successfully employ the inferior vena cava filter as a priceless device in the current armamentarium against cancer.
Microwave ablation followed by cTACE in 5-cm HCC lesions: does a single-session approach affect liver function? Chiara Floridi, Laura Maria Cacioppa, Nicolò Rossini, Marco Macchini, Alessandra Bruno, Andrea Agostini, Valeria Consoli, Riccardo Inchingolo, Fabrizio Acquafredda, Daniele Nicolini, Laura Schiadà, Gianluca Svegliati Baroni, Roberto Candelari Radiologia Medica, 2024 Purpose Microwave ablation (MWA) and conventional transarterial chemoembolization (cTACE) are locoregional treatments commonly performed in very early, early and intermediate stages of hepatocellular carcinoma (HCC). Despite combined locoregional approaches have shown encouraging results in obtaining complete tumor necrosis, their application in a single session is poorly described. Our aim was to evaluate the safety and efficacy of single-session MWA and cTACE treatment in 5-cm HCCs and its influence on liver function. Materials and methods All 5-cm HCCs treated by MWA and cTACE performed in a single-session in our Interventional Radiology unit between January 2020 and December 2022 were retrospectively recorded and analyzed. Patients with poor or missing pre- and post-treatment imaging were excluded. Technical success, clinical success, and complications rate were examined as primary endpoints. Pre- and post-treatment liver function laboratory parameters were also evaluated. Results A total of 15 lesions (mean lesion diameter, 5.0 ± 1.4 cm) in 15 patients (11 men; mean age, 67.1 ± 8.9 years) were retrospectively evaluated. Technical and clinical success were 100% and 73%, respectively. Four (27%) cases of partial response and no cases of progressive or stable disease were recorded. AST and ALT values have found to be significantly higher in post-treatment laboratory tests. No other significant differences between pre- and post-treatment laboratory values were registered. AST and ALT pre- and post-treatment higher differences (ΔAST and ΔALT) were significantly associated with a lower clinical success rate. Conclusion MWA and cTACE single-session approach is safe and effective for 5-cm HCCs, without significant liver function impairment. A post-treatment increase in AST and ALT values may be a predictor for clinical failure.
Robotic Major Hepatectomy in Elderly Patient Antonella Delvecchio, Maria Conticchio, Riccardo Inchingolo, Francesca Ratti, Paolo Magistri, Andrea Belli, Graziano Ceccarelli, Francesco Izzo, Marcello Giuseppe Spampinato, Nicola De’ Angelis, Patrick Pessaux, Tullio Piardi, Fabrizio Di Benedetto, Luca Aldrighetti, Riccardo Memeo Cancers, 2024
Radiomics and liver: Where we are and where we are headed? Cesare Maino, Federica Vernuccio, Roberto Cannella, Paolo Niccolò Franco, Valentina Giannini, Michele Dezio, Antonio Rosario Pisani, Antonino Andrea Blandino, Riccardo Faletti, Elisabetta De Bernardi, Davide Ippolito, Marco Gatti, Riccardo Inchingolo European Journal of Radiology, 2024
Peri-operative score for elderly patients with resectable hepatocellular carcinoma Maria Conticchio, Riccardo Inchingolo, Antonella Delvecchio, Francesca Ratti, Maximiliano Gelli, Massimiliano Ferdinando Anelli, Alexis Laurent, Giulio Cesare Vitali, Paolo Magistri, Giacomo Assirati, Emanuele Felli, Taiga Wakabayashi, Patrick Pessaux, Tullio Piardi, Fabrizio di Benedetto, Nicola de'Angelis, Javier Briceño, Antonio Rampoldi, Renè Adam, Daniel Cherqui, Luca Antonio Aldrighetti, Riccardo Memeo World Journal of Hepatology, 2023
2023 WSES guidelines for the prevention, detection, and management of iatrogenic urinary tract injuries (IUTIs) during emergency digestive surgery Nicola de’Angelis, Carlo Alberto Schena, Francesco Marchegiani, Elisa Reitano, Belinda De Simone, Geoffrey Yuet Mun Wong, Aleix Martínez-Pérez, Fikri M. Abu-Zidan, Vanni Agnoletti, Filippo Aisoni, Michele Ammendola, Luca Ansaloni, Miklosh Bala, Walter Biffl, Graziano Ceccarelli, Marco Ceresoli, Osvaldo Chiara, Massimo Chiarugi, Stefania Cimbanassi, Federico Coccolini, Raul Coimbra, Salomone Di Saverio, Michele Diana, Marco Dioguardi Burgio, Gustavo Fraga, Paschalis Gavriilidis, Angela Gurrado, Riccardo Inchingolo, Alexandre Ingels, Rao Ivatury, Jeffry L. Kashuk, Jim Khan, Andrew W. Kirkpatrick, Fernando J. Kim, Yoram Kluger, Zaher Lakkis, Ari Leppäniemi, Ronald V. Maier, Riccardo Memeo, Ernest E. Moore, Carlos A. Ordoñez, Andrew B. Peitzman, Gianluca Pellino, Edoardo Picetti, Manos Pikoulis, Michele Pisano, Mauro Podda, Oreste Romeo, Fausto Rosa, Edward Tan, Richard P. Ten Broek, Mario Testini, Brian Anthony Tian Wei Cheng, Dieter Weber, Emilio Sacco, Massimo Sartelli, Alfredo Tonsi, Fabrizio Dal Moro, Fausto Catena World Journal of Emergency Surgery, 2023
Radiomics in colorectal cancer patients Riccardo Inchingolo, Cesare Maino, Roberto Cannella, Federica Vernuccio, Francesco Cortese, Michele Dezio, Antonio Rosario Pisani, Teresa Giandola, Marco Gatti, Valentina Giannini, Davide Ippolito, Riccardo Faletti World Journal of Gastroenterology, 2023
Liver metastases: The role of magnetic resonance imaging Cesare Maino, Federica Vernuccio, Roberto Cannella, Francesco Cortese, Paolo Niccolò Franco, Clara Gaetani, Valentina Giannini, Riccardo Inchingolo, Davide Ippolito, Arianna Defeudis, Giulia Pilato, Davide Tore, Riccardo Faletti, Marco Gatti World Journal of Gastroenterology, 2023
Current status of non-surgical treatment of locally advanced pancreatic cancer Stavros Spiliopoulos, Maria Teresa Zurlo, Annachiara Casella, Letizia Laera, Giammarco Surico, Alessia Surgo, Alba Fiorentino, Nicola de'Angelis, Roberto Calbi, Riccardo Memeo, Riccardo Inchingolo World Journal of Gastrointestinal Oncology, 2021
Radiofrequency ablation vs surgical resection in elderly patients with hepatocellular carcinoma in Milan criteria Maria Conticchio, Riccardo Inchingolo, Antonella Delvecchio, Letizia Laera, Francesca Ratti, Maximiliano Gelli, Ferdinando Anelli, Alexis Laurent, Giulio Vitali, Paolo Magistri, Giacomo Assirati, Emanuele Felli, Taiga Wakabayashi, Patrick Pessaux, Tullio Piardi, Fabrizio di Benedetto, Nicola de'Angelis, Javier Briceño, Antonio Rampoldi, Renè Adam, Daniel Cherqui, Luca Antonio Aldrighetti, Riccardo Memeo World Journal of Gastroenterology, 2021
The Role of Laparoscopic Surgery in Localized Pancreatic Neuroendocrine Tumours Valentina Ferraro, Michele Tedeschi, Letizia Laera, Michele Ammendola, Umberto Riccelli, Nicola Silvestris, Alba Fiorentino, Giammarco Surico, Riccardo Inchingolo, Francesco Decembrino, Nicola de Angelis, Riccardo Memeo Current Treatment Options in Oncology, 2021
Imaging assessment of portal venous system: pictorial essay of normal anatomy, anatomic variants and congenital anomalies European Review for Medical and Pharmacological Sciences, 2017
Hepatic splenosis presenting as arterialised liver lesion in a patient with NASH European Review for Medical and Pharmacological Sciences, 2013
Post-natal ultrasound morpho-dynamic evaluation of mild fetal hydronephrosis: A new management European Review for Medical and Pharmacological Sciences, 2013
