Hpb最新文献

{"title":"Comparison of radiofrequency ablation, microwave ablation and high-intensity focused ultrasound for hepatocellular carcinoma: a retrospective study","authors":"Wan S. Cheung ,&nbsp;Wong H. She ,&nbsp;Simon H.Y. Tsang ,&nbsp;Wing C. Dai ,&nbsp;Albert C.Y. Chan ,&nbsp;Tan T. Cheung","doi":"10.1016/j.hpb.2025.01.003","DOIUrl":"10.1016/j.hpb.2025.01.003","url":null,"abstract":"<div><h3>Background</h3><div>The recommended first-line treatment for respectable hepatocellular carcinoma (HCC) is surgical resection, but local ablation has gained popularity as a safe alternative. This study aims to compare the effectiveness of radiofrequency ablation (RFA), microwave ablation (MWA) and high-intensity focused ultrasound (HIFU) as first-line treatments for HCC.</div></div><div><h3>Methods</h3><div>In this single-centre retrospective study, 352 patients receiving RFA, MWA, or HIFU as first-line treatment for HCC were included. Pre- and post-treatment tumour sizes and overall and disease-free survival rates were analysed to compare the three local ablation modalities. Propensity-score matching was used to reduce the bias due to differences in pre-treatment liver function.</div></div><div><h3>Results</h3><div>Patients receiving HIFU had significantly higher pre-treatment MELD score and Child-Pugh grade. The complete response rates of HIFU patients were significantly lower than those of RFA and MWA groups (p &lt; 0.001) despite propensity-score matching. However, the three groups had similar disease-free survival (p = 0.216) and comparable one-year survival (p = 0.173).</div></div><div><h3>Discussion</h3><div>HIFU serves as a last resort rescue therapy for patients with poor pre-treatment liver function who are not eligible for other local ablative means. Despite the low complete response rate, the overall survival and disease-free survival rates of patients having HIFU were comparable to those having RFA or MWA.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 607-613"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The left renal vein: the optimal interposition graft for pancreatic surgery?","authors":"Ahmer Irfan,&nbsp;Peter Kim,&nbsp;Farah Ladak,&nbsp;David Chan,&nbsp;Sean Cleary,&nbsp;Carol-Anne Moulton,&nbsp;Gonzalo Sapisochin,&nbsp;Trevor Reichman,&nbsp;Chaya Shwaartz,&nbsp;Ian McGilvray","doi":"10.1016/j.hpb.2025.01.004","DOIUrl":"10.1016/j.hpb.2025.01.004","url":null,"abstract":"<div><h3>Background</h3><div>Porto-mesenteric venous resection (PMVR) is employed for advanced pancreatic cancer. When primary anastomosis is not feasible, an interposition graft can be used. At our centre, the left renal vein (LRV) is the preferred choice.</div></div><div><h3>Methods</h3><div>A retrospective analysis of patients undergoing pancreatic resection was performed over a 6-year period. Patients who underwent LRV harvest for a PMVR interposition graft were identified. All patients underwent a contrast-enhanced CT scan on post-operative day 1 to assess for portal vein thrombosis.</div></div><div><h3>Results</h3><div>Pancreatic resection with PMVR was performed in 183 patients. LRV graft was used in 41 patients. Severe complications were observed in 10 patients. There were two deaths within 90 days of the index operation and six readmissions within 30 days of discharge. Post-operative PV thrombus was observed in 4 patients.</div><div>The serum creatinine increased by 15.7 % on POD1 and peaked at 30.8 %. The majority of patients had returned to a serum creatinine within 10 % or better of their pre-operative creatinine.</div></div><div><h3>Conclusion</h3><div>We present the largest series using the LRV as an interposition graft for PMVR. We propose that the LRV should be used as the first-choice interposition graft. This graft does not cause long-term renal dysfunction and avoids the morbidity of an additional incision.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 614-618"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic versus open pancreaticoduodenectomy outcomes in patients ≥ 75 years old: an NSQIP analysis of 4343 patients","authors":"Nazgol K. Shahbaz ,&nbsp;Kevin Verhoeff ,&nbsp;Tyrell Wees ,&nbsp;Sukhdeep Jatana ,&nbsp;Douglas Quan ,&nbsp;Juan Glinka ,&nbsp;Anton Skaro ,&nbsp;Ephraim S. Tang","doi":"10.1016/j.hpb.2025.01.015","DOIUrl":"10.1016/j.hpb.2025.01.015","url":null,"abstract":"<div><h3>Background</h3><div>The benefits of MIS in older adults are conflicting. This study evaluates demographics and early outcomes, for older patients (≥75) undergoing minimally invasive (MIS) versus open pancreaticoduodenectomy (PD).</div></div><div><h3>Method</h3><div>We categorized elderly patients who underwent PD from 2017 to 2021 NSQIP databases by surgical approach (open vs MIS). Baseline characteristics were examined with bivariate analysis, and multivariate logistic regression assessed the independent effect of minimally invasive surgery on 30-day serious complications and mortality.</div></div><div><h3>Results</h3><div>Amongst 4137 patients, 150 (3.63 %) underwent MIS PD. Patients demographics were similar. Open cohorts were older (79.1 vs 78.4 years; p = 0.011) with greater tumor invasion (36.6 % vs. 27.0 %; p = 0.018). MIS had longer operations (133.1 vs 119.6 min; p &lt; 0.001). Multivariate analysis demonstrated that MIS approach was associated with increased serious complications (OR 2.21; p &lt; 0.001), but not mortality (OR 2.11; p = 0.173). <em>Post hoc</em> analysis excluding cases converted to open demonstrated no difference in serious complications (OR 1.94; p = 0.070) or mortality (OR 3.58; p = 0.094). PSM analysis estimated a 14.7 % higher rate of serious complications in MIS but similar mortality (p = 0.291).</div></div><div><h3>Conclusions</h3><div>MIS PD uptake in elderly patients remains limited, with early findings indicating longer operations and higher complications. Further research on patient selection differences, technique modifications, and center expertise is required.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 696-705"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunogenicity and safety of COVID-19 vaccines in patients with pancreatic cancer","authors":"Leonoor V. Wismans ,&nbsp;Rory D. de Vries ,&nbsp;Casper W.F. van Eijck ,&nbsp;Maaike Verheij ,&nbsp;Susanne Bogers ,&nbsp;Joachim G.J.V. Aerts ,&nbsp;Corine H. GeurtsvanKessel ,&nbsp;Casper H.J. van Eijck ,&nbsp;Annemiek A. van der Eijk","doi":"10.1016/j.hpb.2025.02.002","DOIUrl":"10.1016/j.hpb.2025.02.002","url":null,"abstract":"<div><h3>Background</h3><div>Patients with pancreatic ductal adenocarcinoma (PDAC) are at increased risk for severe COVID-19. Although COVID-19 vaccines are highly recommended for this population, studies on immunogenicity are lacking. We aimed to investigate the immunogenicity of COVID-19 vaccines in PDAC patients, compared to controls.</div></div><div><h3>Methods</h3><div>This observational study evaluated SARS-CoV-2 spike-specific IgG (S-IgG) levels after priming and booster vaccination in PDAC patients. Primary outcomes were seroprevalence and S-IgG levels compared to matched controls. Secondary outcomes included safety and the association of S-IgG levels with clinical and therapeutic characteristics.</div></div><div><h3>Results</h3><div>In 81 PDAC patients, a total of 86 matched S-IgG levels were available (33 post-priming; 53 post-booster). After priming, 88% (29/33) of PDAC patients were seropositive compared to 97% (32/33) of controls (<em>P</em>=0.16). After booster, seropositivity increased to 98% (52/53) in PDAC patients and to 53/53 (100%) in controls (<em>P</em>=0.31). Patients with active disease during booster vaccination had significantly lower S-IgG levels compared to patients with a history of PDAC (<em>P</em>=0.002). Cancer therapies were not associated with distinct S-IgG levels (<em>P</em>&gt;0.05). No serious adverse events occurred.</div></div><div><h3>Conclusion</h3><div>Priming and booster COVID-19 vaccines are safe and immunogenic in PDAC patients, comparable to controls. The antibody response was effectively increased by the booster vaccination and not impaired by cancer therapies.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 716-722"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Highlights in this issue","authors":"","doi":"10.1016/S1365-182X(25)00557-X","DOIUrl":"10.1016/S1365-182X(25)00557-X","url":null,"abstract":"","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Page iii"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Biological R2” resection for intrahepatic cholangiocarcinoma: identification of patients at risk for poor oncologic outcomes after curative-intent resection","authors":"Jun Kawashima ,&nbsp;Yutaka Endo ,&nbsp;Selamawit Woldesenbet ,&nbsp;Mujtaba Khalil ,&nbsp;Miho Akabane ,&nbsp;François Cauchy ,&nbsp;Feng Shen ,&nbsp;Shishir Maithel ,&nbsp;Irinel Popescu ,&nbsp;Minoru Kitago ,&nbsp;Matthew J. Weiss ,&nbsp;Guillaume Martel ,&nbsp;Carlo Pulitano ,&nbsp;Luca Aldrighetti ,&nbsp;George Poultsides ,&nbsp;Andrea Ruzzente ,&nbsp;Todd W. Bauer ,&nbsp;Ana Gleisner ,&nbsp;Hugo Marques ,&nbsp;Bas Groot Koerkamp ,&nbsp;Timothy M. Pawlik","doi":"10.1016/j.hpb.2025.01.006","DOIUrl":"10.1016/j.hpb.2025.01.006","url":null,"abstract":"<div><h3>Introduction</h3><div>We sought to define a cohort of patients with “biological R2” (bR2) resection, defined as recurrence within 12 weeks, following curative-intent resection for intrahepatic cholangiocarcinoma (ICC). In addition, we sought to identify factors associated with bR2 risk.</div></div><div><h3>Methods</h3><div>Patients who underwent upfront curative-intent surgery for ICC were identified from an international, multi-institutional database. The weighted beta-coefficients of preoperative risk factors were used to construct an online tool to predict bR2.</div></div><div><h3>Results</h3><div>Among 1138 patients, 106 (9.3 %) patients had a bR2 resection. Patients with bR2 were more likely to be younger (OR 0.97) and non-White (OR 2.19), as well as more often had cirrhosis (OR 2.11), a higher neutrophil-to-lymphocyte ratio (OR 1.07), a higher tumor burden score (OR 1.16), and metastatic nodal disease on preoperative imaging (OR 1.92). Patients categorized as low-risk had a 3.2 % risk of bR2, intermediate-risk patients had an 11.1 % risk of bR2, whereas patients in the high-risk category had a 27.6 % risk of bR2 (p &lt; 0.001). An online tool was made available at <span><span>https://junkawashima.shinyapps.io/bR2_ICC/</span><svg><path></path></svg></span>, <span><span>https://junkawashima.shinyapps.io/CRLMfollwingchemotherapy/</span><svg><path></path></svg></span>.</div></div><div><h3>Conclusions</h3><div>Approximately one in ten patients with resectable ICC had a bR2 resection. An online calculator can may help clinicians identify patients with ICC at highest risk of a bR2 resection.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 619-629"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Residency robotic biotissue curriculum: the next frontier in robotic surgical training","authors":"Sarah B. Hays ,&nbsp;Kristine Kuchta ,&nbsp;Aram E. Rojas ,&nbsp;Syed A. Mehdi ,&nbsp;Jason L. Schwarz ,&nbsp;Mark S. Talamonti ,&nbsp;Melissa E. Hogg","doi":"10.1016/j.hpb.2025.01.014","DOIUrl":"10.1016/j.hpb.2025.01.014","url":null,"abstract":"<div><h3>Introduction</h3><div>Virtual reality has been shown to be a strong introduction to the robot. However, we hypothesized that a biotissue curriculum including common surgical anastomoses can further enhance robotic technical skills in surgical residents.</div></div><div><h3>Methods</h3><div>Post-graduate-year three (PGY-3) general surgery residents completed a two-week robotic simulation rotation. The inanimate exercises used biotissue to simulate common robotic anastomoses, including the running hepaticojejunostomy (RHJ), gastrojejunostomy (GJ), interrupted hepaticojejunostomy (IHJ), and pancreaticojejunostomy (PJ). Drills were timed and graded according to modified Objective Structured Assessment of Technical Skills (OSATS; range 6–30).</div></div><div><h3>Results</h3><div>32 residents completed the curriculum. 81.3% of residents reported prior experience at the surgeon console (median=5 operations). Across all drills the average time to completion decreased from first to fourth attempt (RHJ: 33.7±8.9 vs. 26.3±8.1 min, p&lt;0.001; GJ: 57.2±15.1 vs. 44.6±9.5 min, p&lt;0.001; IHJ: 32.6±7.2 vs. 27.1±7.7 min, p&lt;0.001; PJ: 44.2±9.3 vs. 35.6±10.5 min, p&lt;0.001). Average OSATS score increased across all drills as well (RHJ: 16.0±3.8 vs. 23.3±3.4, p&lt;0.001; GJ: 19.4±2.1 vs. 26.0±2.5, p&lt;0.001; IHJ: 16.9±2.7 vs. 23.2±3.6, p&lt;0.001, PJ: 17.9±2.6 vs. 23.6±3.6, p&lt;0.001).</div></div><div><h3>Conclusion</h3><div>The robotic biotissue curriculum improves resident performance on robotic anastomoses. With the rise of the robotic platform, training in robotic procedures should be incorporated during surgical residency.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 688-695"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of intraoperative blood loss on postoperative morbidity after liver resection for primary and secondary liver cancer","authors":"Abdullah Altaf ,&nbsp;Miho Akabane ,&nbsp;Mujtaba Khalil ,&nbsp;Zayed Rashid ,&nbsp;Shahzaib Zindani ,&nbsp;Jun Kawashima ,&nbsp;Andrea Ruzzenente ,&nbsp;Luca Aldrighetti ,&nbsp;Todd W. Bauer ,&nbsp;Hugo P. Marques ,&nbsp;Guillaume Martel ,&nbsp;Irinel Popescu ,&nbsp;Mathew J. Weiss ,&nbsp;Minoru Kitago ,&nbsp;George Poultsides ,&nbsp;Shishir K. Maithel ,&nbsp;Vincent Lam ,&nbsp;Tom Hugh ,&nbsp;Ana Gleisner ,&nbsp;Kazunari Sasaki ,&nbsp;Timothy M. Pawlik","doi":"10.1016/j.hpb.2025.01.010","DOIUrl":"10.1016/j.hpb.2025.01.010","url":null,"abstract":"<div><h3>Background</h3><div>We sought to determine the association between intraoperative blood loss (IBL) and postoperative morbidity among patients undergoing surgery for liver cancer.</div></div><div><h3>Methods</h3><div>Patients undergoing surgery for primary and secondary liver cancer were identified from a multi-institutional database. Adjusted blood loss (aBL) was calculated by normalizing IBL to body weight; the comprehensive complication index (CCI) was used to evaluate postoperative complications.</div></div><div><h3>Results</h3><div>A total of 2491 patients were included. Mean CCI was 10.6 (±5.2) for patients with aBL &lt;10 mL/kg versus 15.2 (±7.2) for individuals with aBL ≥10 mL/kg (p &lt; 0.001). On cubic spline regression, a nonlinear correlation between aBL and CCI was observed. CCI increased exponentially for aBL ranging from 5 to 10 mL/kg, then reached a plateau between an aBL of 10–30 mL/kg before dramatically increasing for aBL &gt;30 mL/kg. Recursive partitioning technique demonstrated that an aBL threshold of 8.5 mL/kg best distinguished CCI (p &lt; 0.001). Additionally, patients with an aBL ≥8.5 mL/kg had worse recurrence-free and overall survival versus patients with an aBL &lt;8.5 mL/kg.</div></div><div><h3>Conclusion</h3><div>A nonlinear incremental correlation between aBL and CCI was identified among patients undergoing surgery for liver cancer. Maintaining an aBL &lt;8.5 mL/kg during LR may help reduce postoperative morbidity.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 660-669"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally invasive versus open liver resection for nonmetastatic hepatocellular carcinoma staged BCLC – B and – C: an Italian multicentric analysis","authors":"Gianluca Cassese ,&nbsp;Mariano C. Giglio ,&nbsp;Alessandro Vitale ,&nbsp;Andrea Lauterio ,&nbsp;Matteo Serenari ,&nbsp;Federica Cipriani ,&nbsp;Francesco Ardito ,&nbsp;Pasquale Perri ,&nbsp;Daniele Nicolini ,&nbsp;Giulio Di Gioia ,&nbsp;Andrea Pierluigi Fontana ,&nbsp;Quirino Lai ,&nbsp;Simone Conci ,&nbsp;Luca Fumagalli ,&nbsp;Maurizio Iaria ,&nbsp;Mattia Garancini ,&nbsp;Sarah Molfino ,&nbsp;Matteo Zanello ,&nbsp;Giuliano La Barba ,&nbsp;Maria Conticchio ,&nbsp;Renato Patrone","doi":"10.1016/j.hpb.2025.01.009","DOIUrl":"10.1016/j.hpb.2025.01.009","url":null,"abstract":"<div><h3>Background</h3><div>Recent papers report significant survival gain after liver resection in BCLC-B and -C HCC patients. The results of minimally invasive liver surgery (MILS) in such patients have not been widely investigated so far.</div></div><div><h3>Methods</h3><div>Data regarding patients undergoing MILS or open liver resection (OLR) for HCC staged BCLC -B and -C were extracted from the HERCOLES database. An inverse probability of treatment weighting (IPTW) method was adopted to balance the confounders. The primary outcome was a composite endpoint including post-hepatectomy liver failure, severe postoperative complications and in-hospital mortality.</div></div><div><h3>Results</h3><div>627 patients were included (459 undergoing OLR and 168 receiving MILS). After IPTW, no difference was found in the composite endpoint between MILS and OLR (OR 0.86 [95%CI 0.46-1-60]; p = 0.62). MILS reduced the risk of receiving intra-operative transfusions (OR 0.28 [95%CI 0.13-0.58]; p &lt; 0.001) and of developing postoperative ascites (OR 0.56 [95%CI 0,32-0,98]; p = 0.039), with reduced length of stay (OR 0.82 [95%CI 0.66-1.01]; p = 0.045). The survival analysis showed no differences between MILS and OLR for both OS (p = 0.13) and DFS (p = 0.491).</div></div><div><h3>Conclusion</h3><div>MILS was shown to be safe and feasible for selected non-metastatic HCC patients staged BCLC B and C, reducing the risk of perioperative transfusions and postoperative ascites, and shortening the length of stay.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 649-659"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 10-year (2013–2023) analysis of incidence, etiology and mortality of acute pancreatitis in England","authors":"James Lucocq ,&nbsp;Fraser Barbour ,&nbsp;Kim Keltie ,&nbsp;Edward O'Toole ,&nbsp;Manu Nayar ,&nbsp;Sanjay Pandanaboyana","doi":"10.1016/j.hpb.2025.02.003","DOIUrl":"10.1016/j.hpb.2025.02.003","url":null,"abstract":"<div><h3>Introduction</h3><div>The aim of the present study was to report epidemiological data on the incidence of acute pancreatitis (AP) in England between 2013 and 2023 and report contemporary post-AP outcomes.</div></div><div><h3>Methods</h3><div>A search of patients admitted with AP (2013–2023) was performed within the Hospital Episode Statistics (HES) which covers all admitted patients within England using diagnosis (ICD-10) code K85.</div></div><div><h3>Results</h3><div>A total of 260,009 patients (median age, 59 years; IQR, 30; F:M, 1.02:1) were identified from 185 NHS trusts (2013–2023), with an incidence of 456 cases per million and an annual increase of 2.6 %. A total of 8.0 % patients required ITU admission. The AP readmission rate was 30.2 % after a median follow-up time of 45 months (Q1-Q3, 17–80 months). The in-hospital mortality rate was 4.5 % (n = 11,711). The overall survival at 1, 2, 5 and 10 years was 88.9 [95%CI 88.7,89], 85.2 [85.1,85.4], 76.1 [75.9,76.3] and 63.9 [63.6,64.2]. Long-term survival (10-year) was higher with biliary aetiology (p &lt; 0.01), younger age groups (p &lt; 0.05) and those without ITU admission (p &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>The incidence of AP in England is increasing and in-hospital mortality rates remain significant. These findings have implications for resource allocation to mitigate risk factors for developing AP in addition to the need for long-term follow-up for at-risk groups.</div></div><div><h3>Clinical trial registration</h3><div>N/A.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 723-731"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}