iLIVER最新文献

{"title":"Application of the Laennec approach in laparoscopic repeat liver resection","authors":"Chenfenglin Yang ,&nbsp;Shubing Wei ,&nbsp;Pinchu Chen ,&nbsp;Yao Li ,&nbsp;Weiming Ye ,&nbsp;Siyuan Dai ,&nbsp;Kejia Li ,&nbsp;Qifan Zhang","doi":"10.1016/j.iliver.2026.100221","DOIUrl":"10.1016/j.iliver.2026.100221","url":null,"abstract":"<div><div>Laparoscopic repeat liver resection (LRLR) is widely recognized as an effective therapeutic option for recurrent liver disease but is challenged by extensive adhesions and altered anatomical structures resulting from previous surgeries. The Laennec approach, which leverages the unique intrahepatic membranous structure of Laennec's capsule, has emerged as a promising surgical strategy to address these technical issues. This literature review comprehensively summarizes the anatomical basis, technical evolution, clinical applications, advantages, limitations, and prospects of the Laennec approach in LRLR. By systematically organizing evidence from clinical studies, case reports, and anatomical research, this review aims to provide a comprehensive understanding of the value of the Laennec approach in overcoming the complexities of LRLR and to provide insights for its standardized application and further research.</div></div>","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"5 1","pages":"Article 100221"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Somatostatin analog therapy in delaying progression of polycystic liver disease: A meta-analysis with trial sequential analysis","authors":"Mohammed S. Beshr ,&nbsp;Rana H. Shembesh ,&nbsp;Bisher Sawaf ,&nbsp;Shahem Abbarh ,&nbsp;Mohammed Abu-Rumaileh ,&nbsp;Monica Tincopa ,&nbsp;Muhammed Elhadi","doi":"10.1016/j.iliver.2026.100220","DOIUrl":"10.1016/j.iliver.2026.100220","url":null,"abstract":"<div><h3>Background and aims</h3><div>Polycystic liver disease (PLD) can occur independently or in association with autosomal dominant polycystic kidney disease and has no effective medical therapy. This meta-analysis evaluated whether somatostatin analog therapy slows progression of PLD.</div></div><div><h3>Methods</h3><div>The PubMed, Scopus, Web of Science, and Cochrane databases were searched through to May 1, 2025 to identify randomized controlled trials that evaluated somatostatin analogs in PLD. The primary endpoints were percentage change from baseline in total liver volume (TLV), total kidney volume (TKV), and estimated glomerular filtration rate (eGFR). Safety endpoints included cholelithiasis, cholecystitis, diarrhea, and abdominal pain. Effect sizes were estimated using mean differences (MDs) and odds ratios (ORs) within a random-effects framework. Trial sequential analysis was performed for TLV, TKV, and eGFR.</div></div><div><h3>Results</h3><div>Seven randomized controlled trials with 640 participants were included. Somatostatin analog therapy led to a significant reduction in TLV (MD −6.73%, 95% CI −8.68 to −4.78; <em>p</em> ​&lt; ​0.001; GRADE, low)]and TKV (MD −3.35%, 95% CI −4.97 to −1.74; <em>p</em> ​&lt; ​0.001; GRADE, moderate) compared with placebo. No significant effect was observed for eGFR (MD 0.32, 95% CI −4.55 to 5.19; <em>p</em> ​= ​0.90; GRADE, low). Adverse events, including cholelithiasis and cholecystitis (OR 4.66, 95% CI 1.19–18.26; <em>p</em> ​= ​0.03; GRADE, moderate), diarrhea, and abdominal pain, were more frequent in the somatostatin group. Trial sequential analysis showed good evidence of benefit for TLV and TKV and inconclusive evidence for eGFR.</div></div><div><h3>Conclusions</h3><div>Based on low-to-moderate evidence, somatostatin analogs were significantly associated with reduced TLV and TKV, but not eGFR, in patients with PLD, and with higher adverse event rates. Long-term trials are warranted to define their role in clinical management.</div><div><strong>Registration</strong>: PROSPERO, ID CRD420251045402.</div></div>","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"5 1","pages":"Article 100220"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical treatment of refractory groove pancreatitis","authors":"Xin Yan ,&nbsp;Zhiyong Yang ,&nbsp;Guoliang Qiao ,&nbsp;Qian Zhu","doi":"10.1016/j.iliver.2026.100217","DOIUrl":"10.1016/j.iliver.2026.100217","url":null,"abstract":"<div><div>Groove pancreatitis is a rare form of chronic pancreatitis localized to the pancreatoduodenal groove. Diagnosis is challenging because of nonspecific symptoms and imaging findings that often mimic malignancy. Although conservative management is considered first-line therapy, surgical intervention may become necessary in refractory cases. We report a case of refractory groove pancreatitis successfully treated with laparoscopic pancreaticoduodenectomy, highlighting the role of surgery and the importance of addressing modifiable risk factors.</div></div>","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"5 1","pages":"Article 100217"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145996461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-guided PTCL’s successful treatment of bronchobiliary fistula and benign biliary stricture after multiple partial hepatectomy and hepaticojejunostomy: A case report and literature review","authors":"Xinyue Xia ,&nbsp;Weirong Li ,&nbsp;Gang Huang,&nbsp;Tian Tao,&nbsp;Min Hu","doi":"10.1016/j.iliver.2026.100218","DOIUrl":"10.1016/j.iliver.2026.100218","url":null,"abstract":"<div><div>Bronchobiliary fistulas (BBFs) are associated with a high mortality and morbidity rate. This article introduces a patient who had coughed up yellowish-green phlegm for two years with a history of multiple previous hepatobiliary surgeries and bronchobiliary fistulas. A preoperative chest CT revealed inflammatory exudation on the dorsal side of the right lower lung, which communicated with the terminal branch of the bronchus. An abdominal CT revealed intrahepatic bile duct dilatation with limited and narrow hilar hepatis, as well as a chaotic and unclear structure. Stones were displayed in the right posterior lobe. Based on the discussions, the patient was decided to perform ultrasound-guided percutaneous transhepatic cholangioscopic lithotony (U-PTCL) to relieve the obstruction and stone problems in the biliary tract. U-PTCL is a minimally invasive procedure. It enables the precise removal of stones, the accurate localization and dilation of the stenotic bile duct segment, and the placement of supportive drainage tubes. After U-PTCL, the patient experienced a reduction in intrahepatic bile duct stones, and the cough significantly improved. During a two-year follow-up, the patient did not complain of discomfort. This article introduces a minimally invasive method—U-PTCL—for solving bronchobiliary fistulas and benign biliary strictures after a multiple partial hepatectomy and hepaticojejunostomy.</div></div>","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"5 1","pages":"Article 100218"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomy of the right portal vein and right hepatic vein for anatomical minimally invasive liver resection","authors":"Pascalia Wikana Likalamu ,&nbsp;Wenjie Yu ,&nbsp;Nan Xia ,&nbsp;Yu Zhang ,&nbsp;Linfeng Sun ,&nbsp;Xiangdong Li ,&nbsp;Xuejiao Chen ,&nbsp;Sheng Han ,&nbsp;Ziyi Wang ,&nbsp;Liyong Pu","doi":"10.1016/j.iliver.2026.100226","DOIUrl":"10.1016/j.iliver.2026.100226","url":null,"abstract":"<div><h3>Background</h3><div>Anatomical minimally invasive liver resection requires an understanding of hepatic vascular anatomy to minimize complications and optimize outcomes. This study characterized variations in right portal vein (RPV) and right hepatic vein (RHV) anatomy using three-dimensional (3D) computed tomography (CT) reconstruction and established a practical classification system to guide surgical planning.</div></div><div><h3>Methods</h3><div>Contrast-enhanced CT images from 569 patients without known liver disease were analyzed at a single Chinese tertiary center. 3D reconstructions were performed using the Hisense CAS system. RPV and RHV vascular branching patterns were systematically evaluated and classified according to their origins, bifurcation points, and relationships to Couinaud segments and Glissonean pedicles.</div></div><div><h3>Results</h3><div>We identified four distinct RPV branching patterns: Type A (68.5%) showed classical bifurcation into right anterior and posterior portal veins from a common RPV trunk; Type B (19.9%) showed direct branching from the main portal vein; Type C (3.9%) showed anomalous branching with the right anterior portal vein (RAPV) originating from the left portal vein; and Type D (7.7%) showed trifurcation. For the right hepatic vein (RHV) drainage, we identified three types, with Type A (a single dominant trunk, 68%) being the most common. Accessory RHVs were present in 49.7% of the patients, making them the most frequently observed anatomical variation.</div></div><div><h3>Conclusion</h3><div>Our study demonstrates substantial anatomical variation in right-sided hepatic vasculature, with accessory RHVs present in nearly half of our patients. 3D CT reconstruction provides accurate preoperative vascular mapping that is essential for safe anatomical minimally invasive liver resection. Our classification system enables individualized surgical planning and facilitates the craniocaudal Glissonean approach for segment-oriented liver resection.</div></div>","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"5 1","pages":"Article 100226"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147398968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing hepatology through innovation and integration: iLIVER's vision for 2026","authors":"Zu-Chao Du ,&nbsp;Ke-Chun Wang ,&nbsp;Ming-Da Wang ,&nbsp;Lei Cai ,&nbsp;Jian-Hong Zhong ,&nbsp;Tian Yang","doi":"10.1016/j.iliver.2026.100224","DOIUrl":"10.1016/j.iliver.2026.100224","url":null,"abstract":"","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"5 1","pages":"Article 100224"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147398575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chemotherapy combined with pembrolizumab in advanced gallbladder cancer with subsequent radical resection: A case report","authors":"Yongjie Hu ,&nbsp;Yongpeng Wei ,&nbsp;Xinbo Liu ,&nbsp;Li Shen ,&nbsp;Yu Wang ,&nbsp;Jianyong Yuan","doi":"10.1016/j.iliver.2026.100219","DOIUrl":"10.1016/j.iliver.2026.100219","url":null,"abstract":"<div><div>Gallbladder cancer is often diagnosed at an advanced stage, preventing radical surgical intervention. Combined with its highly aggressive nature, this results in a generally poor prognosis. Although advancements in treatment strategies have expanded the application of conversion therapy for initially unresectable gallbladder cancer cases, achieving eligibility for radical resection remains uncommon. Here, we report a case of advanced gallbladder cancer where treatment with pembrolizumab combined with gemcitabine and cisplatin was followed by successful radical surgical resection, demonstrating a favorable therapeutic outcome. This case highlights the potential of combining immunotherapy and chemotherapy for improving treatment responses and surgical outcomes in advanced gallbladder cancer.</div></div>","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"5 1","pages":"Article 100219"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathogenesis of metabolic dysfunction-associated steatotic liver disease and donor liver damage","authors":"Chuheng Gou ,&nbsp;Wenjie Zhang ,&nbsp;Hao Xu,&nbsp;Hong Zhang,&nbsp;Rui Ding,&nbsp;Xuan Zhang","doi":"10.1016/j.iliver.2025.100195","DOIUrl":"10.1016/j.iliver.2025.100195","url":null,"abstract":"<div><div>Metabolic dysfunction-associated steatotic liver disease (MASLD) affects more than a quarter of adults worldwide. MASLD is associated with severe medical burdens and leads to further reduction of the donor pool for liver transplantation. However, there is a lack of systematic evaluation of the pathogenesis of MASLD development and MASLD graft damage. As a multisystem disorder, the pathogenesis of MASLD is closely related to genetics, metabolic and endocrine disorders, imbalanced intestinal flora, abnormal hepatocyte homeostasis, and hepatic inflammation. Mutations or single nucleotide polymorphisms and epigenetic modifications in multiple genes increase a person's susceptibility to developing MASLD. Lipid accumulation is a central pathogenic driver, and intestinal microbiota and endocrine disorders can exacerbate steatosis and inflammation. These issues cause endoplasmic reticulum stress in hepatocytes, leading to apoptosis and promoting the recruitment and activation of immune cells. Ultimately, hepatic stellate cells are activated, resulting in liver fibrosis. These molecular and pathological changes are important causes of why a MASLD donor liver is likely to suffer ischemia-reperfusion injury and cold ischemic injury. Lipid deposition, microcirculation disturbance, and inflammation in the MASLD donor liver exacerbates ischemia-reperfusion-related damage. During transplantation, cold ischemia time should be minimized, and machine perfusion implemented and treatments for MASLD used after transplantation to protect the graft. This systematic review describes the pathogenesis of MASLD and the mechanism of MASLD donor liver damage to potentially increase the use of MASLD donor livers and provide strategies to preserve organ function.</div></div>","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"4 4","pages":"Article 100195"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145223485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personalized management of metabolic dysfunction-associated steatotic liver disease","authors":"Zhen Sun,&nbsp;Kui Ming Chan,&nbsp;Haojie Jin","doi":"10.1016/j.iliver.2025.100207","DOIUrl":"10.1016/j.iliver.2025.100207","url":null,"abstract":"","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"4 4","pages":"Article 100207"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coagulation abnormalities in children with chronic liver disease and the association of these abnormalities with disease severity","authors":"Rubaiyat Alam,&nbsp;Mst Arifa Main,&nbsp;Khan Lamia Nahid,&nbsp;Mohammad Rukunuzzaman","doi":"10.1016/j.iliver.2025.100202","DOIUrl":"10.1016/j.iliver.2025.100202","url":null,"abstract":"<div><h3>Background and aims</h3><div>This study aimed to evaluate the coagulation profile in children with chronic liver disease (CLD) and to investigate the relationship between coagulation abnormalities and disease severity.</div></div><div><h3>Methods</h3><div>Fifty-one consecutive children (mean age 7.4 ± 4.9 years) diagnosed with CLD were prospectively included and stratified by the Child–Pugh class (A, B, C). Laboratory data, including the complete blood count, prothrombin time, activated partial thromboplastin time (APTT), international normalized ratio (INR), fibrinogen, D-dimer, and albumin-bilirubin (ALBI) score, were analyzed. Logistic regression identified predictors of the Child–Pugh class.</div></div><div><h3>Results</h3><div>Autoimmune hepatitis (31.3%) and Wilson's disease (27.4%) were the most common etiologies. Clinical features, such as gastrointestinal bleeding, ascites, and encephalopathy, were more common in Child–Pugh class C (<em>p</em> = 0.002). The INR (<em>p</em> = 0.017), the APTT (<em>p</em> = 0.018), and D-dimer concentrations (<em>p</em> = 0.001) increased with disease severity, while albumin concentrations decreased. The INR (OR: 86.8 for B vs A; OR: 82.4 for C vs A, <em>p</em> = 0.004) and hypoalbuminemia (OR: 0.11 for C vs A, <em>p</em> = 0.004) were the most robust independent predictors. D-dimer concentrations predicted advanced disease but lost significance after adjustment. The ALBI score was correlated with albumin, the INR, prothrombin time, the APTT, and D-dimer, while Child–Pugh score correlations were weaker. Fibrinogen concentrations were reduced in 64.7% of patients but not associated with severity.</div></div><div><h3>Conclusion</h3><div>The INR and albumin are reliable predictors of disease severity in pediatric CLD. The ALBI score provides more reproducible assessment of hepatic reserve than the Child–Pugh score and may be a useful tool for risk stratification in children.</div></div>","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"4 4","pages":"Article 100202"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}