Hepatobiliary surgery and nutrition最新文献

{"title":"Surgery-related factors for pancreatic fistula after pancreatectomy: an umbrella review.","authors":"Yu Teng, Yaoqun Wang, Sishu Yang, Guilin Nie, Ningyuan Wen, Yingyi Zhang, Nansheng Cheng, Xianze Xiong, Jiong Lu, Geng Liu, Bei Li","doi":"10.21037/hbsn-23-601","DOIUrl":"10.21037/hbsn-23-601","url":null,"abstract":"<p><strong>Background: </strong>Multiple risk or protective factors for postoperative pancreatic fistula (POPF) have been suggested in the literature of surgical specialities. We aimed to map existing evidence regarding the risk factors for POPF to help guide future clinical treatment.</p><p><strong>Methods: </strong>We performed an umbrella review by searching the Web of Science, PubMed, Embase, and Cochrane databases until June 19, 2023. Meta-analyses (MAs) that included ≥2 studies were included. Methodological quality was assessed using AMSTAR2 scores and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tools were used to quantify the strength of the evidence.</p><p><strong>Results: </strong>Of the 42 MAs, 1 was rated as having high methodological quality, and 4 were rated as moderate. Among the 82 outcomes, 6 were supported by high-quality evidence. Moderate-quality evidence was found for 13 outcomes. The remaining outcomes had either low- or very low-quality evidence. In pancreaticoduodenectomy (PD), protective factors for all-grade POPF include pancreaticogastrostomy (PG) [<i>vs.</i> pancreaticojejunostomy (PJ), moderate quality], external pancreatic ductal stent (<i>vs.</i> no stents, high quality). Risk factors for all-grade POPF in PD include pancreatic duct occlusion (<i>vs.</i> no occlusion, moderate quality) and sealant (<i>vs.</i> no sealant, moderate quality). Polyglycolic acid mesh [<i>vs.</i> no mesh, moderate quality] was a protective factor for clinically relevant POPF (CR-POPF) in PD, omental/falciform ligament wrapping (<i>vs.</i> no wrapping, low quality), and artery-first PD (<i>vs.</i> standard, low quality). In distal pancreatectomy (DP), no factors for all-grade POPF were rated as high- or moderate-quality evidence. Polyglycolic acid mesh (<i>vs.</i> no mesh, moderate quality) was a protective factor for CR-POPF in DP. No factors were rated as high- or moderate-quality evidence in other types of pancreatectomy. In addition, high- and moderate-quality evidence showed that there was little difference in the incidence of pancreatic fistula in PD between minimally invasive and open surgery, duct-to-mucosa and invaginated PJ, Roux-en-Y and conservative reconstruction, extended and standard lymphadenectomy, and in the incidence of pancreatic fistula in DP between fibrin sealant patch and no patch.</p><p><strong>Conclusions: </strong>This umbrella review found varying levels of evidence for the associations between different surgery-related risk factors for POPF. Given the wealth of existing evidence of relatively low quality, future research should focus on improving its credibility.</p>","PeriodicalId":12878,"journal":{"name":"Hepatobiliary surgery and nutrition","volume":"14 3","pages":"442-459"},"PeriodicalIF":6.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316771","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":"Type IVa bile duct dilatation in an adult female treated with living donor liver transplantation.","authors":"Hongqiang Zhao, Guangxun Xu, Xiaojun Li, Xuan Tong, Guangdong Wu, Lihan Yu, Qian Lu, Rui Tang","doi":"10.21037/hbsn-24-563","DOIUrl":"10.21037/hbsn-24-563","url":null,"abstract":"","PeriodicalId":12878,"journal":{"name":"Hepatobiliary surgery and nutrition","volume":"14 3","pages":"526-530"},"PeriodicalIF":6.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316777","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":"Choledochoscopic photodynamic therapy combined with biliary stent implantation for the treatment of unresectable hilar cholangiocarcinoma.","authors":"Langqing Sheng, Yao Xiao, Man Lin","doi":"10.21037/hbsn-2025-123","DOIUrl":"10.21037/hbsn-2025-123","url":null,"abstract":"","PeriodicalId":12878,"journal":{"name":"Hepatobiliary surgery and nutrition","volume":"14 3","pages":"519-521"},"PeriodicalIF":6.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316757","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":"Navigating the artificial intelligence (AI) era: a paradigm shift in clinical surgical education.","authors":"Erqian Wang, Zuyi Yang, Dianzhe Tian, Lei Zhang","doi":"10.21037/hbsn-2025-298","DOIUrl":"10.21037/hbsn-2025-298","url":null,"abstract":"","PeriodicalId":12878,"journal":{"name":"Hepatobiliary surgery and nutrition","volume":"14 3","pages":"497-499"},"PeriodicalIF":6.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316763","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":"Stepping forward, treading wisely: a crossed frontier in robotic liver transplantation.","authors":"Mohamed Ali Chaouch, Stylianos Tzedakis, Karim Boudjema, Heithem Jeddou","doi":"10.21037/hbsn-2025-167","DOIUrl":"10.21037/hbsn-2025-167","url":null,"abstract":"","PeriodicalId":12878,"journal":{"name":"Hepatobiliary surgery and nutrition","volume":"14 3","pages":"460-463"},"PeriodicalIF":6.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316770","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":"Advancements and challenges in robotic donor hepatectomy: current evidence and unresolved questions.","authors":"Yasushi Hasegawa","doi":"10.21037/hbsn-2025-168","DOIUrl":"10.21037/hbsn-2025-168","url":null,"abstract":"","PeriodicalId":12878,"journal":{"name":"Hepatobiliary surgery and nutrition","volume":"14 3","pages":"467-469"},"PeriodicalIF":6.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316752","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":"Prognostic factors in gallbladder cancer: a comprehensive systematic review and meta-analysis.","authors":"Xiaoqian Hu, Di Zeng, Ningyuan Wen, Yaoqun Wang, Jiong Lu, Bei Li","doi":"10.21037/hbsn-23-502","DOIUrl":"10.21037/hbsn-23-502","url":null,"abstract":"<p><strong>Background: </strong>Gallbladder cancer (GBC) is one of the most common biliary cancers and is characterized by its high malignancy. Moreover, the incidence of GBC has been increasing over the decades, partly due to advancements in diagnostic techniques and devices. The purpose of this systematic review is to provide a comprehensive assessment of factors influencing the prognosis of GBC. We aim to identify and evaluate both established and controversial prognostic factors, including lymphocyte-monocyte ratio (LMR), adjuvant therapy, carbohydrate antigen 19-9 (CA199), carcinoembryonic antigen (CEA), tumor mutation status, surgical margins, the presence of gallstones, and jaundice.</p><p><strong>Methods: </strong>We conducted a systematic search of eligible studies in PubMed, Cochrane Library, and Embase. Our analysis focused on data from GBC patients who had undergone surgical resection, with the primary outcome being overall survival. Forest plots were generated using hazard ratios (HRs) to visualize the effect sizes, and the Quality in Prognostic Factor Studies (QUIPS) tool was employed to assess the risk of bias.</p><p><strong>Results: </strong>This study synthesized data from 52 studies, encompassing a total of 23,174 patients over the period of 2000 to 2022. Notably, several factors significantly influenced the outcomes of GBC, including LMR (HR =2.17), CEA (HR =1.81), CA199 (HR =1.56), lymph node stage (HR =2.03), T stage (HR =2.37), presence of invasion (HR =1.74), tumor location (HR =1.42), and surgical margins (HR =2.66). Additionally, chemotherapy (HR =0.75) and radiotherapy (HR =0.56) demonstrated marked improvements in overall survival compared to control arms. Jaundice and the presence of gallstones were not defined as independent predictors, as they reflect advanced stage symptoms in GBC.</p><p><strong>Conclusions: </strong>The findings from this comprehensive review offer valuable insights into the assessment of the necessity for aggressive treatment approaches and the prognostication of GBC patients. Furthermore, there is a need for well-designed, ongoing studies to further advance our understanding of this challenging malignancy.</p>","PeriodicalId":12878,"journal":{"name":"Hepatobiliary surgery and nutrition","volume":"14 3","pages":"374-397"},"PeriodicalIF":6.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316767","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":"Surgical resection for hepatocellular carcinoma in cirrhotic patients with clinically significant portal hypertension: a multidisciplinary team decision.","authors":"José M Tellado","doi":"10.21037/hbsn-2025-224","DOIUrl":"10.21037/hbsn-2025-224","url":null,"abstract":"","PeriodicalId":12878,"journal":{"name":"Hepatobiliary surgery and nutrition","volume":"14 3","pages":"494-496"},"PeriodicalIF":6.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316772","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":"Tract hemostasis using radiofrequency ablation for hepatic arterial bleeding after percutaneous transhepatic portal embolization.","authors":"Toshiro Masuda, Toru Beppu, Yasunori Nagayama","doi":"10.21037/hbsn-2025-194","DOIUrl":"10.21037/hbsn-2025-194","url":null,"abstract":"","PeriodicalId":12878,"journal":{"name":"Hepatobiliary surgery and nutrition","volume":"14 3","pages":"536-538"},"PeriodicalIF":6.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316776","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":"Beyond estimates: optimizing surgical strategies through accurate blood loss measurement.","authors":"Alessandro Furlanetto, Andrea Marchini, Eleonora Nieddu, Jacopo Lanari, Francesco Enrico D'Amico, Alessandro Vitale, Paolo Feltracco, Enrico Gringeri, Umberto Cillo","doi":"10.21037/hbsn-2025-75","DOIUrl":"10.21037/hbsn-2025-75","url":null,"abstract":"","PeriodicalId":12878,"journal":{"name":"Hepatobiliary surgery and nutrition","volume":"14 3","pages":"464-466"},"PeriodicalIF":6.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316755","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}