Hepatobiliary surgery and nutrition最新文献

{"title":"Association of a novel glycemic control index, time in range, with infectious complications after pancreatectomy.","authors":"Yuichiro Kohara, Satoshi Yasuda, Minako Nagai, Kyohei Matsumoto, Kota Nakamura, Yasuko Matsuo, Taichi Terai, Shunsuke Doi, Takeshi Sakata, Atsushi Shimizu, Hideki Motobayashi, Manabu Kawai, Masayuki Sho","doi":"10.21037/hbsn-24-392","DOIUrl":"https://doi.org/10.21037/hbsn-24-392","url":null,"abstract":"<p><strong>Background: </strong>Time in range (TIR) reflects glycemic variability and is a widely used index for glycemic control in patients with diabetes; however, it is unclear whether it is associated with infectious complications after pancreatectomy. Herein, we examine the association between TIR and infectious complications after pancreatectomy.</p><p><strong>Methods: </strong>This retrospective cohort study collected cases from two different institutions, with one institution providing the discovery cohort (n=543) and the other institution providing the validation cohort (n=540). In total, 1,083 patients who underwent pancreatectomy were included. TIR was defined as the percentage calculated based on a four-point glucose test using the formula: number of times within target range/total number of tests × 100%. The target range was set at 70-150 mg/dL. TIR cutoff value was set to 75% using the receiver operating characteristic curve for the onset of organ/space surgical site infection (SSI).</p><p><strong>Results: </strong>Of the 543 patients in the discovery cohort, 210 (39%) had TIR ≥75% (well-controlled), and 333 (61%) had TIR <75% (poorly controlled). To balance the clinical characteristics, patients underwent one-by-one propensity score matching, resulting in two groups of 143 patients each. Regarding infection type in the discovery cohort, only organ/space SSI was significantly higher in the poorly controlled group in all patients (19% <i>vs.</i> 27%, P=0.02) and matched patients (20% <i>vs.</i> 35%, P=0.008). TIR <75% was an independent risk factor for organ/space SSI in both cohorts [discovery: odds ratio (OR): 2.13, 95% confidence interval (CI): 1.30-3.50, P=0.003; validation: OR: 1.95, 95% CI: 1.10-3.47, P=0.02].</p><p><strong>Conclusions: </strong>TIR <75% after pancreatectomy is a risk factor for organ/space SSI. These findings may help provide a new method for glycemic management.</p>","PeriodicalId":12878,"journal":{"name":"Hepatobiliary surgery and nutrition","volume":"15 2","pages":"34"},"PeriodicalIF":7.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of adjuvant therapy on survival outcomes in resected gallbladder cancer: a systematic review and meta-analysis.","authors":"Di Zeng, Yaoqun Wang, Ningyuan Wen, Nansheng Cheng, Bei Li","doi":"10.21037/hbsn-24-433","DOIUrl":"https://doi.org/10.21037/hbsn-24-433","url":null,"abstract":"<p><strong>Background: </strong>Gallbladder cancer (GBC) is the most common malignancy of the biliary tract and ranks as the fifth most prevalent cancer of the digestive system. Despite surgical resection, the prognosis for GBC remains dismal, marked by high recurrence rates and poor overall survival (OS). This meta-analysis investigates the impact of adjuvant therapies-including chemotherapy (CT), radiotherapy (RT), and chemoradiotherapy (CRT)-on the prognosis of resectable GBC, aiming to elucidate their clinical benefits.</p><p><strong>Methods: </strong>A thorough search of PubMed, Embase, and Web of Science databases was conducted up to April 2024. Studies assessing the effects of adjuvant therapies on OS and disease-free survival (DFS) in patients with resectable GBC were included. Statistical analyses were performed using STATA 17.0 software, with random-effect models employed to address heterogeneity.</p><p><strong>Results: </strong>The meta-analysis included 23 studies encompassing 36,214 patients. Adjuvant therapy was significantly associated with improved OS [hazard ratio (HR), 0.72; 95% confidence interval (CI): 0.66-0.78]. Specific types of adjuvant therapy showed distinct benefits: CT (HR, 0.80; 95% CI: 0.72-0.88), RT (HR, 0.76; 95% CI: 0.65-0.88), and CRT (HR, 0.56; 95% CI: 0.47-0.67). Subgroup analysis revealed a greater benefit in high-risk patients, including those with more severe tumor-node-metastasis (TNM) staging, R1 resection, and older age (HR, 0.62; 95% CI: 0.50-0.76).</p><p><strong>Conclusions: </strong>Adjuvant therapy significantly improves OS in patients with resectable GBC, with CRT offering the most substantial benefit. These results advocate for the inclusion of adjuvant therapy in treatment regimens, particularly for high-risk patients, and underscore the necessity for ongoing research to refine therapeutic approaches.</p>","PeriodicalId":12878,"journal":{"name":"Hepatobiliary surgery and nutrition","volume":"15 2","pages":"36"},"PeriodicalIF":7.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of two-stage hepatectomy: 25 years of modifications and lessons learned.","authors":"Zenichi Morise","doi":"10.21037/hbsn-2025-aw-772","DOIUrl":"https://doi.org/10.21037/hbsn-2025-aw-772","url":null,"abstract":"","PeriodicalId":12878,"journal":{"name":"Hepatobiliary surgery and nutrition","volume":"15 2","pages":"53"},"PeriodicalIF":7.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How does obesity develop-and are specific foods to blame?","authors":"Faidon Magkos, Ciarán G Forde","doi":"10.21037/hbsn-2025-743","DOIUrl":"https://doi.org/10.21037/hbsn-2025-743","url":null,"abstract":"","PeriodicalId":12878,"journal":{"name":"Hepatobiliary surgery and nutrition","volume":"15 2","pages":"51"},"PeriodicalIF":7.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does a patient who needs portal vein embolization (PVE) to proceed to major hepatectomy (MH) have the same hepatic functional reserve than a patient with no preoperative PVE?","authors":"Stéphanie Truant, Clio Baillet, Mehdi El Amrani, Katia Lecolle, Olivier Ernst, Sébastien Dharancy, Anthony Turpin, Damien Huglo, François-René Pruvot","doi":"10.21037/hbsn-24-478","DOIUrl":"https://doi.org/10.21037/hbsn-24-478","url":null,"abstract":"<p><strong>Background: </strong>While remnant liver function (RLF) gain after portal vein embolization (PVE) was reportedly higher than volume gain, some patients apparently fit for surgery develop post-hepatectomy liver failure (PHLF). This prospective study analyses the hepatic regeneration rates in terms of volume and function following a major hepatectomy (MH) preceded or not by PVE.</p><p><strong>Methods: </strong>Between 2012 and 2018, all non-cirrhotic candidates for MH had a volumetric-computed tomography evaluation and functional-single photon emission computed tomography (SPECT)-scintigraphy of RL preoperatively and postoperatively at day 7 (POD7) and 1 month (1M). RLF was calculated as intrinsic function (i.e., normalized to volume; %/min), and function/volume changes as relative ones (%). We investigated the impact of PVE on post-hepatectomy regeneration rates and related to 3-month outcome (I) in overall population (II) after excluding more risky patients (biliary drainage, severe complications) and (III) in PVE/no-PVE patients matched on remnant liver volume (RLV)/RLF (as the liver regeneration rate is proportional to the extent of resection).</p><p><strong>Results: </strong>Among 136 patients, 125 had one-stage MH, preceded by PVE in 33 patients (26.4%). PVE and no-PVE patients were comparable, except for smaller RLV and more frequent biliary drainages in the former, with higher operating times and blood losses. Preoperative intrinsic RLF was comparable between PVE (0.97%/min; range, 0.81-1.4%/min) and no-PVE groups (1.13%/min; range, 0.92-1.44%/min; P=0.30). At POD7, the volumetric gain was strictly comparable between PVE (+48.7%; range, 36.4-71%; P=0.80) and no-PVE patients (+49.8%; range, 26.8-73.3%), but not the functional gain [+10.7% (range, -3.2% to 42.4%) <i>vs.</i> +42% (range, 20.7-78.6%); P=0.002]. PVE patients showed intrinsic RLF drop (0.77%/min; range, 0.63-0.97%/min) in contrast to no-PVE patients (1.1%/min; range, 0.75-1.3%/min; P=0.001), persisting at 1M (0.93%/min; range, 0.73-1%/min) <i>vs.</i> overcompensation in no-PVE patients (1.27%/min; range, 1-1.5%/min; P=0.001). This was associated with significantly increased PHLF and morbi-mortality rates. Findings were similar after excluding patients with biliary drainage or severe complications or after matching patients on RLV or RLF.</p><p><strong>Conclusions: </strong>The current findings showed that some patients apparently fit for surgery after PVE are going to hepatic resection with some degree of disadvantage, displaying lower hepatic reserve and delayed functional recovery than no-PVE patients.</p>","PeriodicalId":12878,"journal":{"name":"Hepatobiliary surgery and nutrition","volume":"15 2","pages":"38"},"PeriodicalIF":7.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting the two-stage hepatectomy and hepatic arterial infusion chemotherapy for colorectal liver metastases: insights and long-term outcomes from a large cohort.","authors":"Tom Vandaele, Mathieu D'Hondt","doi":"10.21037/hbsn-2025-738","DOIUrl":"https://doi.org/10.21037/hbsn-2025-738","url":null,"abstract":"","PeriodicalId":12878,"journal":{"name":"Hepatobiliary surgery and nutrition","volume":"15 2","pages":"49"},"PeriodicalIF":7.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The ESSENCE of hope: what semaglutide's Food and Drug Administration approval means for metabolic dysfunction-associated steatohepatitis.","authors":"Mariam Alamgir, Aalam Sohal, Kris V Kowdley","doi":"10.21037/hbsn-2025-732","DOIUrl":"https://doi.org/10.21037/hbsn-2025-732","url":null,"abstract":"","PeriodicalId":12878,"journal":{"name":"Hepatobiliary surgery and nutrition","volume":"15 2","pages":"48"},"PeriodicalIF":7.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engineering the tumor microenvironment via 3D multicellular bioprinting for personalized immunotherapy assessment and resistance deciphering.","authors":"Feihu Xie, Meiheban Bazhabayi, Yun Zheng","doi":"10.21037/hbsn-2026-0163","DOIUrl":"https://doi.org/10.21037/hbsn-2026-0163","url":null,"abstract":"","PeriodicalId":12878,"journal":{"name":"Hepatobiliary surgery and nutrition","volume":"15 2","pages":"54"},"PeriodicalIF":7.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dapagliflozin for metabolic dysfunction-associated steatohepatitis with fibrosis: a promising therapeutic agent in biopsy-diagnosed patients.","authors":"Soo Kyoung Kim, Hyeong Seok An, Gu Seob Roh","doi":"10.21037/hbsn-2025-728","DOIUrl":"https://doi.org/10.21037/hbsn-2025-728","url":null,"abstract":"","PeriodicalId":12878,"journal":{"name":"Hepatobiliary surgery and nutrition","volume":"15 2","pages":"47"},"PeriodicalIF":7.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First randomized controlled trial comparing stereotactic body radiotherapy and radiofrequency ablation for hepatocellular carcinoma: lessons and key considerations for interpretation of results.","authors":"Masayuki Ueno, Satoshi Itasaka, Motowo Mizuno","doi":"10.21037/hbsn-2025-603","DOIUrl":"https://doi.org/10.21037/hbsn-2025-603","url":null,"abstract":"","PeriodicalId":12878,"journal":{"name":"Hepatobiliary surgery and nutrition","volume":"15 2","pages":"40"},"PeriodicalIF":7.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}