Hpb最新文献

{"title":"Factors influencing failure of progression to completion hepatectomy following liver venous deprivation procedures (PVE or DVE): a longitudinal observational study.","authors":"Swizel A Cardoso, George Clarke, Ananya Nayak, Kunal Joshi, Ramanivas Sudereyan, Salil Karkhanis, Nikolaos Chatzizacharias, Keith J Roberts, Naveen Condati, Michail Papamichail, Ravi Marudanayagam, David Bartlett, Syed S Raza, Robert P Sutcliffe, Homoyoon Mehrzad, Bobby V M Dasari","doi":"10.1016/j.hpb.2024.11.011","DOIUrl":"https://doi.org/10.1016/j.hpb.2024.11.011","url":null,"abstract":"<p><strong>Background: </strong>Two-staged hepatectomy (TSH) with portal (PVE) or dual vein embolization (DVE) gained acceptance in liver surgery. The current study assesses the incidence and causes of failure to progress to completion hepatectomy following PVE/DVE and its influence on overall survival (OS).</p><p><strong>Methods: </strong>This is a longitudinal observational study of patients who underwent PVE or DVE between April 2010-December 2023. Future liver remnant (FLR) volume was measured at least four weeks later. Restaging and resectability was assessed on imaging performed within 6-8 weeks of planned completion surgery.</p><p><strong>Results: </strong>130 patients underwent PVE (90) or DVE (40) during the study period. Of these, 73 (56 %) patients proceeded to definitive resection. Reasons for failure to progress to completion surgery were: disease progression (79 %), declined fitness for surgery (3.5 %) and inadequate FLR volume (14 %). Synchronous disease is a poor prognostic factor for achieving completion hepatectomy CRLM patients (p = 0.009). The median OS with and without completion hepatectomy was 38 months vs. 13 months in CRLM patients (p=<.001) and 31 months vs. 26 months in pCCA groups respectively (p = 0.471).</p><p><strong>Conclusion: </strong>A significant percentage of patients did not progress to completion hepatectomy due to disease progression. Patient selection and efficient pathways are essential to improve resection rates following these resource-intensive procedures.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846582","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":"ChatGPT vs. surgeons on pancreatic cancer queries: accuracy & empathy evaluated by patients and experts.","authors":"Rosa Klotz, Thomas M Pausch, Jörg Kaiser, Maximilian C Joos, Rüdiger Hecktor, Azaz Ahmed, Colette Dörr-Harim, Arianeb Mehrabi, Martin Loos, Susanne Roth, Christoph W Michalski, Christoph Kahlert","doi":"10.1016/j.hpb.2024.11.012","DOIUrl":"https://doi.org/10.1016/j.hpb.2024.11.012","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) offers potential support in patient-clinician interactions, but its impact on such communication remains unexplored.</p><p><strong>Methods: </strong>In this study, ChatGPT was compared with two pancreatic surgeons in responding to ten pancreatic cancer surgery-related questions, co-designed with the Patient Advisory Board of the Surgical Society's Study Center. A blind evaluation of these responses, considering content congruency and clarity for non-specialists, was conducted by patients and surgeons.</p><p><strong>Results: </strong>From June 23 to July 21, 2023, 24 patients and 25 surgeons participated, of which eleven patients and ten surgeons completed the survey in full. Utilizing a quantitative scale from 1 (strong-disagreement) to 5 (full-agreement), consensus was observed among patients and specialists concerning the content delivered by ChatGPT. The metrics for comprehensibility to a non-specialist audience consistently showed positive reception. In the evaluation of empathetic resonance, ChatGPT's responses mirrored those of the surgeons in the patient's view. A significant proportion ranked Surgeon 1's contributions foremost, followed closely by ChatGPT.</p><p><strong>Discussion: </strong>This study demonstrates that surgeons and ChatGPT answer common queries from patients regarding pancreatic cancer surgery comparable regarding reliability, lay comprehension and empathy as evaluated by patients and surgical experts. These findings highlight the potential of AI in enhancing patient-provider interactions.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822031","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":"Incisional hernia after major pancreatic resection: long term risk assessment from two distinct sources – A large multi-institutional network and a single high-volume center","authors":"Nitzan Zohar,&nbsp;Eliyahu Gorgov,&nbsp;Theresa P. Yeo,&nbsp;Harish Lavu,&nbsp;Wilbur Bowne,&nbsp;Charles J. Yeo,&nbsp;Avinoam Nevler","doi":"10.1016/j.hpb.2024.08.009","DOIUrl":"10.1016/j.hpb.2024.08.009","url":null,"abstract":"<div><h3>Background</h3><div>Post-operative incisional hernia (IH) is a common complication following abdominal surgery. Data regarding IH after major pancreatic surgery are limited. We aim to evaluate the long-term risk of IH following major pancreatic resection.</div></div><div><h3>Methods</h3><div>A dual-approach study: a large multi-institutional research network (RN) was investigated for IH incidence and risk factors in propensity-score matched survivors after pancreaticoduodenectomy (PD) and distal pancreatectomy (DP), was complemented by a patient-reported questionnaire.</div></div><div><h3>Results</h3><div>RN analysis identified 22,113 patients that underwent pancreatic surgery. 11.0% of PD patients and 8.6% of DP patients developed IH (P &lt; 0.0001). IH rates were higher with open surgery compared with minimally invasive approaches in PD (OR = 1.56, P = 0.03) and DP (OR = 1.94, P = 0.003). BMI&gt;35 was found to correlate with increased IH rates for PD and DP (OR = 1.87, and OR = 1.86, respectively, P &lt; 0.0001 each), as did postoperative intraabdominal infections (P &lt; 0.0001). Patient-based survey of 104 patients, revealed that 16 patients (15%) reported post-operative IH during the follow-up period. BMI≥30, SSI and intra-abdominal abscesses were associated with increased IH risk (P &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Improved survival after pancreatic resection has led to an increased prevalence of long-term surgical sequela. In this study, we demonstrate significant rates of IH among long-term survivors and assess potential risk factors.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"26 12","pages":"Pages 1487-1494"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142180083","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":"Cannabis use and postoperative outcomes in patients undergoing hepatectomy","authors":"Michael J. Kirsch,&nbsp;Helen Paglia,&nbsp;Thiago Araujo,&nbsp;Helen Madsen,&nbsp;Salvador Rodriguez Franco,&nbsp;Patrick Hosokawa,&nbsp;Mona Hamermesh,&nbsp;Reed Weiss,&nbsp;Ana Gleisner,&nbsp;Richard D. Schulick,&nbsp;Marco Del Chiaro,&nbsp;Camille Stewart","doi":"10.1016/j.hpb.2024.09.007","DOIUrl":"10.1016/j.hpb.2024.09.007","url":null,"abstract":"","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"26 12","pages":"Pages 1560-1563"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142264586","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":"Nurturing the next generation of HPB surgeons: short term results of the pilot E-AHPBA mentorship program","authors":"Isabella Frigerio","doi":"10.1016/j.hpb.2024.09.003","DOIUrl":"10.1016/j.hpb.2024.09.003","url":null,"abstract":"","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"26 12","pages":"Pages 1564-1567"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142264588","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":"Rapid metastatic recurrence after pancreatic cancer resection: a multi-center, regional analysis of trends in surgical failure over two decades","authors":"Ranish K. Patel ,&nbsp;Gustavo Salgado-Garza ,&nbsp;Thomas L. Sutton ,&nbsp;Jackie L. Phipps ,&nbsp;Pavlos Papavasiliou ,&nbsp;Jon M. Gerry ,&nbsp;Alicia J. Johnson ,&nbsp;Flavio G. Rocha ,&nbsp;Brett C. Sheppard ,&nbsp;Patrick J. Worth","doi":"10.1016/j.hpb.2024.08.006","DOIUrl":"10.1016/j.hpb.2024.08.006","url":null,"abstract":"<div><h3>Background</h3><div>Pancreatic ductal adenocarcinoma (PDAc) is a lethal malignancy, attributed in part to high rates of rapid recurrence (rrPDAc) following resection. We sought to characterize recurrence rates over time and investigate factors predictive of rrPDAc.</div></div><div><h3>Methods</h3><div>A regional multi-institutional cancer registry, augmented with data from the National Surgical Quality Improvement Program database, was queried for patients with PDAc from 1996 to 2020. rrPDAc was defined as recurrence within 6 months following curative-intent resection.</div></div><div><h3>Results</h3><div>We identified 924 patients who underwent resection for PDAc; rrPDAc occurred in 236 (26%) patients. Median incidence of rrPDAc was 25.3% (IQR 22–30.2%) per year. Median survival in rrPDAc, non-rapid recurrence, and no recurrence was 10.3, 25.2, and 56.1 months respectively (<em>p</em> &lt; 0.001). Variables independently associated with greater odds of rrPDAc included surgical site infection (SSI) (OR 2.06) and nodal positivity (OR 2.05); adjuvant therapy was associated with lower odds (OR 0.38). Neoadjuvant chemotherapy did not alter risk of rrPDAc. Three-year post-recurrence survival was no different in rrPDAc versus those without.</div></div><div><h3>Conclusion</h3><div>Despite therapeutic advances, incidence of rrPDAc remains unchanged. SSIs and nodal positivity are independently associated with increased risk of rrPDAc, while adjuvant chemotherapy is associated with lower risk. Strategies focused on preventing rapid recurrence may improve survival.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"26 12","pages":"Pages 1467-1476"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145586","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":"Outcomes following pancreaticoduodenectomy for octogenarians: a systematic review and meta-analysis","authors":"Joseph Phillipos ,&nbsp;Kai-Zheong Lim ,&nbsp;Helen Pham ,&nbsp;Yazmin Johari ,&nbsp;Charles H.C. Pilgrim ,&nbsp;Marty Smith","doi":"10.1016/j.hpb.2024.08.007","DOIUrl":"10.1016/j.hpb.2024.08.007","url":null,"abstract":"<div><h3>Background</h3><div>An increasing number of elderly patients are being diagnosed with pancreatic cancer, with increasing need to consider pancreatic surgery. This study aims to provide an updated systematic review and meta-analysis to evaluate the outcomes following pancreaticoduodenectomy in octogenarians.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis was performed via a search of Medline, PubMed and Cochrane databases. Studies comparing outcomes of patients &gt;80 years to younger patients undergoing PD were included.</div></div><div><h3>Results</h3><div>26 studies were included. This included 22481 patients, with 20134 (89.6%) aged &lt;80 years old, and 2347 (10.4%) octogenarians. Octogenarians were associated with higher rates of mortality (OR 2.37 (95%CI 1.91-2.94, p &lt; 0.00001)), all-cause morbidity (OR 1.60 (95%CI 1.30-1.96), p&lt;0.00001) and re-operation (OR 1.41 (95%CI 1.13-1.75), p = 0.002). Octogenarians had a two-fold risk of cardiac complications and respiratory complications (OR 2.13 (95%CI 1.67-2.73), p &lt; 0.00001), (OR 2.38 (95%CI 1.72-3.27), p &lt; 0.0001). There was no difference in postoperative pancreatic fistula, post-pancreatectomy hemorrhage or delayed gastric emptying. Younger patients were more likely to return to adjuvant therapy (OR 0.20 (95%CI 0.12-0.34), p &lt; 0.00001).</div></div><div><h3>Conclusions</h3><div>Octogenerians are associated with higher mortality rate, postoperative complications, and reduced likelihood to undergo adjuvant therapy. Careful preoperative assessment and selection of elderly patients for consideration of pancreatic surgery is essential.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"26 12","pages":"Pages 1435-1447"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142180086","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":"Usefulness of Hem-o-lok® clips to ligate the gastroduodenal artery in pancreatoduodenectomy","authors":"Norio Kubo ,&nbsp;Shigemasa Suzuki ,&nbsp;Takahiro Seki ,&nbsp;Ryosuke Fukushima ,&nbsp;Shunsaku Furuke ,&nbsp;Naoki Yagi ,&nbsp;Takashi Ooki ,&nbsp;Ryusuke Aihara ,&nbsp;Kenichiro Araki ,&nbsp;Yasuo Hosouchi ,&nbsp;Ken Shirabe","doi":"10.1016/j.hpb.2024.08.014","DOIUrl":"10.1016/j.hpb.2024.08.014","url":null,"abstract":"<div><h3>Background/purpose</h3><div>Post-pancreatectomy hemorrhage (PPH) is a fatal complication of pancreatoduodenectomy. When complicated by a pancreatic fistula, pancreatic juice contacting the artery may form a pseudoaneurysm and cause arterial bleeding. We used Hem-o-lok® clips to prevent damage to the outer wall of the gastroduodenal artery (GDA). This study evaluated the usefulness of using Hem-o-lok® clips to ligate the GDA stump to prevent PPH.</div></div><div><h3>Methods</h3><div>Overall, 468 patients who underwent PD at our hospital were included. Before July 2020, we ligated the GDA stump using the knot-tying method, which involves double ligation. After July 2020, the GDA stump was double clipped using a 10-mm Hem-o-lok® clip to the residual side without tension on the GDA. Propensity score matching was used to compare cases of pancreatic fistulas that underwent clipping vs. knot-tying.</div></div><div><h3>Results</h3><div>Propensity score matching resulted in 37 patients in each group. PPH occurred in 12 (16.4%) and 4 (6.9%) patients in the knot-tying and clipping groups, respectively. PPH from the GDA stump occurred in eight (11.0%) and one (1.7%) patient in the knot tying and clipping groups, respectively (P = 0.044).</div></div><div><h3>Conclusions</h3><div>Hem-o-lok® clips are safe to apply on the GDA stump during pancreatoduodenectomy to prevent PPH.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"26 12","pages":"Pages 1521-1527"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142180082","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":"Preoperative frailty as a key predictor of short- and long-term outcomes among octogenarians undergoing hepatectomy for hepatocellular carcinoma: a multicenter comprehensive analysis","authors":"Yi-Fan Yang ,&nbsp;Ping Zhang ,&nbsp;Bo Wu ,&nbsp;Si-Yuan Wang ,&nbsp;Hong-Wei Guo ,&nbsp;Qi-Xuan Zheng ,&nbsp;Ting-Hao Chen ,&nbsp;Jie Li ,&nbsp;Xian-Ming Wang ,&nbsp;Ying-Jian Liang ,&nbsp;Hong Wang ,&nbsp;Xiao-Chang Wu ,&nbsp;Wei-Min Gu ,&nbsp;Ya-Hao Zhou ,&nbsp;Yong-Yi Zeng ,&nbsp;Yong-Kang Diao ,&nbsp;Lan-Qing Yao ,&nbsp;Li-Hui Gu ,&nbsp;Chao Li ,&nbsp;Jia-Hao Xu ,&nbsp;Tian Yang","doi":"10.1016/j.hpb.2024.08.010","DOIUrl":"10.1016/j.hpb.2024.08.010","url":null,"abstract":"<div><h3>Background</h3><div>When considering hepatectomy for elderly HCC patients, it's essential to assess surgical safety and survival benefits. This study investigated the impact of preoperative frailty, assessed with the Clinical Frailty Scale (CFS), on outcomes for octogenarians undergoing HCC hepatectomy.</div></div><div><h3>Methods</h3><div>A retrospective cohort study of octogenarians who had hepatectomy for HCC between 2010 and 2022 at 16 hepatobiliary centers was conducted. Patients were categorized as frail or non-frail based on preoperative CFS, with frailty defined as CFS ≥5. The primary endpoints were overall survival (OS), recurrence-free survival (RFS), and cancer-specific survival (CSS), with perioperative outcomes as secondary endpoints.</div></div><div><h3>Results</h3><div>Among 240 octogenarians, 105 were characterized as being frail. Frail patients had a higher incidence of postoperative 30-day morbidity and postoperative 30-day and 90-day mortality versus non-frail patients. Meanwhile, 5-year OS, RFS and CSS among frail patients were lower compared with non-frail patients. Univariable and multivariable analysis revealed that preoperative frailty was an independent risk factor of postoperative 30-day morbidity (OR: 2.060), OS (HR: 2.384), RFS (HR: 2.190) and CSS (HR: 2.203).</div></div><div><h3>Conclusion</h3><div>Preoperative frailty, as assessed by the CFS, was strongly associated with both short-term outcomes and long-term survival among octogenarians undergoing hepatectomy for HCC. Incorporating frailty assessment into the preoperative evaluation may help optimize patient selection and perioperative care.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"26 12","pages":"Pages 1495-1504"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142223707","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":"Combined portal and hepatic vein embolisation in perihilar cholangiocarcinoma","authors":"Jens Smits ,&nbsp;Steven Chau ,&nbsp;Sinéad James ,&nbsp;Remon Korenblik ,&nbsp;Madita Tschögl ,&nbsp;Pieter Arntz ,&nbsp;Jan Bednarsch ,&nbsp;Luis Abreu de Carvalho ,&nbsp;Olivier Detry ,&nbsp;Joris Erdmann ,&nbsp;Thomas Gruenberger ,&nbsp;Laurens Hermie ,&nbsp;Ulf Neumann ,&nbsp;Per Sandström ,&nbsp;Robert Sutcliffe ,&nbsp;Alban Denys ,&nbsp;Emmanuel Melloul ,&nbsp;Maxime Dewulf ,&nbsp;Christiaan van der Leij ,&nbsp;Ronald M. van Dam ,&nbsp;Ijsbrand Zijlstra","doi":"10.1016/j.hpb.2024.07.407","DOIUrl":"10.1016/j.hpb.2024.07.407","url":null,"abstract":"<div><h3>Background</h3><div>Major hepatectomy in perihilar cholangiocarcinoma (pCCA) patients with a small future liver remnant (FLR) risks posthepatectomy liver failure (PHLF). This study examines combined portal and hepatic vein embolisation (PVE/HVE) to increase preoperative FLR volume and potentially decrease PHLF rates.</div></div><div><h3>Methods</h3><div>In this retrospective, multicentre, observational study, data was collected from centres affiliated with the DRAGON Trials Collaborative and the EuroLVD registry. The study included pCCA patients who underwent PVE/HVE between July 2016 and January 2023.</div></div><div><h3>Results</h3><div>Following PVE/HVE, 28% of patients (9/32) experienced complications, with 22% (7/32) necessitating biliary interventions for cholangitis. The median degree of hypertrophy after a median of 16 days was 16% with a kinetic growth rate of 6.8% per week. 69% of patients (22/32) ultimately underwent surgical resection. Cholangitis after PVE/HVE was associated with unresectability. After resection, 55% of patients (12/22) experienced complications, of which 23% (5/22) were Clavien-Dindo grade III or higher. The 90-day mortality after resection was 0%.</div></div><div><h3>Conclusion</h3><div>PVE/HVE quickly enhances the kinetic growth rate in pCCA patients. Cholangitis impairs chances on resection significantly. Resection after PVE/HVE is associated with low levels of 90-day mortality. The study highlights the potential of PVE/HVE in improving safety and outcomes in pCCA undergoing resection.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"26 12","pages":"Pages 1458-1466"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141709852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}