Giovanni Marchegiani, MD PhD
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gio-marchegiani.bsky.social
Giovanni Marchegiani, MD PhD
@gio-marchegiani.bsky.social
Pancreas Surgeon 😷 Padova University 🎓 BJS Open editor 🗞️ ISGPS Secretary 🪡 EAHPBA / EPC / UEG / Pancreas2000 board
💦 Use and management of drains in pancreas surgery remains controversial

🔎 MA of 17 RCT - 4k patients out now in @bjsopen.bsky.social

🏆 Whipple level 1a: selective early drain removal
🏆 Left panc: no drain policy

🎖️ Do you stick to highest level of evidence?! 🫵

academic.oup.com/bjsopen/arti...
November 12, 2025 at 10:12 AM
A great honor to serve as faculty for the course in advanced pancreas surgery at @umeauniversitet.bsky.social 🇸🇪 led by @asifhalimi.bsky.social 🫶

An amazing experience to learn and exchange knowledge on an evolving / crucial issue!
October 23, 2025 at 5:51 AM
What is your anticoagulation practice 💉 after portal vein resection in pancreas surgery ?!

🧑‍🧑‍🧒‍🧒 1k pts / 90 days thrombosis 7% in Annals of Surgery

🔮 Predictors resection type / graft material

🩸 Therapeutic anticoagulation 📉 early thrombosis but 👎 at 90 days

journals.lww.com/annalsofsurg...
September 25, 2025 at 2:20 PM
It’s out!!! 🔥🔥🔥 The PREOPANC-2 is in @thelancet.com

Neoadjuvant FOLFIRINOX 🤜🤛 Gemcitabine based chemoradiotherapy in resecatble / BR

⚖️ No difference in overall survival
😰 Serious adverse events 40%

👍 Both regimens may be considered

www.thelancet.com/pdfs/journal...
September 11, 2025 at 8:29 AM
Pancreas2000 is the official postgraduate course of the EPC @myueg.bsky.social

Aimed at fostering the new generation of pancreatologists… almost 2 years with 5 in person meetings! #science #passion #education and #pancreas

🫵 Join us! Applications open in October
August 31, 2025 at 2:16 PM
Amazing #Yellowstone National Park 🏞️
August 18, 2025 at 3:08 PM
⏰ Early onset of GI cancers ⛑️ a window for prompt diagnosis / therapy @bjsurgery.bsky.social

☝️Incidence in <50 y/o rising particularly in 🚺

🧬 Germline mutations but most sporadic

🚬 Modifiable factors smoke/alcohol/diet

🔬 Multidisciplinarity + research needed

academic.oup.com/bjs/article/...
Early-onset gastrointestinal cancers: comprehensive review and future directions
The incidence of early-onset gastrointestinal cancers—commonly defined as being diagnosed in patients <50 years of age—is rising at an alarming rate glo
academic.oup.com
August 5, 2025 at 6:58 PM
Non-pancreatic neoplasms in and around the 🪷 ampulla of Vater: International Guidelines

🔬 Optimal pathology assessment 🤝 Multidisciplinary pathways leading to best treatment

🔜 Future research line have been defined in @myueg.bsky.social journal!

onlinelibrary.wiley.com/doi/10.1002/ue…
July 30, 2025 at 6:03 AM
🟣🟣 Liver Transplantation For Colorectal Cancer Liver Metastases: does sex matter?!

♐️ Post LT recurrence liver > F; 🫁 only in M

🔮 Survival predicted by CEA, 👉 sided CRC, tumor size, 🧬 KRAS mutation

🔑 Selection criteria key factor

www.jhep-reports.eu/article/S258...

@jhepatology.bsky.social
July 26, 2025 at 1:59 PM
What to do when recurrent acute pancreatitis 🤕 is the only worrisome feature of a BD-IPMN 🍇?!

Even more tricky in case of comorbidities like liver fibrosis … ⚖️ where do you set your threshold for surgery?! 🧐
July 21, 2025 at 7:32 PM
What is "Conversion surgery" 🐛➡️🦋 for upfront unresectable upper GI and HPB cancers ⁉️

💉 Triggered by improvements in non surgical therapies 🧰 Many techniques included
🏆 Able to improve survival!

💡 All u need to know ⬇ comprehensive review in @bjsopen.bsky.social

academic.oup.com/bjsopen/arti...
July 9, 2025 at 5:10 PM
Is it possible to attend 4️⃣ LAPC cases simultaneously?! 🙈 only at University Hospital Heidelberg (UKHD) 🇩🇪!!!

A unique team led by Christoph Michalski paving the way to treat pancreas cancer in a modern fashion, taking into account biology 🧬 and “extreme” surgery 🪡
July 1, 2025 at 10:06 PM
Out now in @sages.org journal!

POPF 🐳 after distal pancreatectomy still a poorly understood complication 🙃

🌍 International validation of the fistula risk score 800 pts

🧯POPF predicted by BMI, NAT, robot approach 🤔

FRS insufficient discrimination 🧐 !!!

link.springer.com/article/10.1...
June 27, 2025 at 6:05 AM
So honored to be part of this!!!

👇🎓💪
#Horaest 🎓 @AnoukEmmen today 🙌
“Improving outcomes in minimally invasive #pancreatoduodenectomy” incl the #DIPLOMA2 RCT. @abuhilal.bsky.social

⏩️ hdl.handle.net/11245.1/5ba777…

Thank you @gio-marchegiani.bsky.social for being here with excellent discussion!
June 27, 2025 at 6:04 AM
I see #pancreas everywhere - Japan 🇯🇵 edition

#HPBSky
June 19, 2025 at 3:36 AM
🇯🇵 My keynote lecture at the 37th Japanese Society of HPB Surgery

From 🔮 prediction to 🧯prevention of complications in pancreas surgery… a risk based approach to 🐳 POPF assessing POH 🧪 and PPAP!

Thank you for having me, HPB conferences in Japan are simply impossible to beat 🤯
June 15, 2025 at 4:29 AM
My invited talk at @EAHPBA 2025 🇮🇪 was about IPMN 🍇 and related carcinoma

A very slippery 🧽 topic!!!

Indeed 2️⃣ different entities in 1️⃣…

IPMN derived cancer follow distinct 🧬 pathways 🆚 conventional PDAC but are way less explored (NOT a single RCT) 👉 knowledge gap!
June 12, 2025 at 7:01 AM
Super excited to meet this fantastic Pancreas star ⭐️ at the EAHPBA congress right from the @myueg.bsky.social presidency!!!

Thank you @maloehr.bsky.social

United for the pancreas, always!
June 11, 2025 at 7:51 AM
🔵 The European-African Hepato-Pancreato-Biliary Association (E-AHPBA) mentorship program is ready to take off 🛫 again!

So excited to serve as a mentor also for the second edition after a previous successful journey
June 11, 2025 at 7:49 AM
IPMN 🍇 without HRS and long term risk of cancer development @bmj.com

🇯🇵 2.5k pts > 5 years surveillance

🫧 IPMN size and growth predict cancer within 5 years

🤏 MPD diameter at 5 years predicts cancer after 5 years

gut.bmj.com/content/74/6...
June 2, 2025 at 11:14 AM
🚨 From @ascocancer.bsky.social 2025

👉 Preop chemo with PAXG 🆚 mFOLFIRINOX for extending event-free survival (EFS) in resectable or BR PDAC (phase 3 CASSANDRA trial)

🆙 PAXG 3-year EFS 31% vs. 13% P = .003

🫸 Immature analysis for survival but.. future practice changing?! 🧐

@ascopost.bsky.social
June 1, 2025 at 6:02 PM
Postop ⬆️ amylasemia and acute pancreatitis 🧪 systematic review and meta analysis

🐳 POH predicts POPF

⚡️ PPAP causes POPF, DGE, PPH and mortality

👉 Check amylase early and get ready to mitigate 🧯postop complications!

#HPBSky #SurgSky

www.sciencedirect.com/science/arti...
May 27, 2025 at 7:59 PM
✂️ Arterial resection and divestment 🔟 year comparative study in @bjsopen.bsky.social

🇯🇵 Analysis of 200 PDAC + artery

👗 Divestment (120 cases) most used in first 5 years

🎖️Last 5 years ⬆️ Neoadjuvant chemo + resection ⬇️ complications 👍

academic.oup.com/bjsopen/arti...
May 25, 2025 at 9:07 AM
Out now in @bjsopen.bsky.social

Anatomically resectable 🆚 biologically borderline PDAC

🩻 886 pts with identical imaging appearance

🪡 With upfront surgery 🧪 Biologically BR had worse DSS (54 vs. 27 months)

✌️different entities ✌️different approaches

academic.oup.com/bjsopen/arti...
May 24, 2025 at 7:29 AM
🚨 FOLFIRINOX vs. GEM Nab Paclitaxel for LAPC @ascocancer.bsky.social

💉 171 pts median PFS 9 months better in FOLFIRINOX group

🎯 FOLFIRINOX improves PFS significantly compared with gemcitabine and is well tolerated in LAPC

ascopubs.org/doi/10.1200/...
May 19, 2025 at 12:30 PM