Hpb最新文献 - Book学术

Evaluating the impact of donor obesity on liver transplantation outcomes: the role of donor gender and age 评估供体肥胖对肝移植结果的影响：供体性别和年龄的作用。

IF 2.4 3区医学

Hpb Pub Date : 2026-05-01 Epub Date: 2026-01-31 DOI: 10.1016/j.hpb.2026.01.014

Toshihiro Nakayama, David T. Krist, Miho Akabane, Yuki Imaoka, Carlos O. Esquivel, Marc L. Melcher, Kazunari Sasaki

{"title":"Evaluating the impact of donor obesity on liver transplantation outcomes: the role of donor gender and age","authors":"Toshihiro Nakayama, David T. Krist, Miho Akabane, Yuki Imaoka, Carlos O. Esquivel, Marc L. Melcher, Kazunari Sasaki","doi":"10.1016/j.hpb.2026.01.014","DOIUrl":"10.1016/j.hpb.2026.01.014","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is increasing in the U.S., with more liver donors having body mass index (BMI)≥35. BMI is an imperfect indicator of visceral obesity and hepatosteatosis, complicating its impact on graft survival (GS).</div></div><div><h3>Methods</h3><div>Adult deceased donor data from the United Network for Organ Sharing database (2010–2023) were analyzed. The impact of donor obesity (BMI≥35) on short- and long-term GS was examined, stratified by donor gender and age, two factors related to visceral obesity.</div></div><div><h3>Results</h3><div>Donors with BMI≥35 doubled over the study period, comprising 18.2 % of donation after brain death donors in 2023. Grafts from male donors with BMI≥35 had worse 30-day GS than grafts from donors with BMI<35 (hazard ratio 1.47, P < 0.01), but not in grafts from female donors with BMI≥35 or in 5-year GS. Donor obesity increased risk only in grafts from male donors under 55 (hazard ratio 1.58, P < 0.01), with no effect in grafts from older male or female donors.</div></div><div><h3>Discussion</h3><div>Donor BMI≥35 was associated with increased risk of short-term graft loss, especially among grafts from male donors. However, grafts from female donors with BMI≥35 and from male donors aged≥55 with BMI≥35 may warrant broader use.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 5","pages":"Pages 690-699"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146213212","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}

引用次数: 0

Safety and clinical outcomes of feeding jejunostomy in pancreaticoduodenectomy: a systematic review and meta-analysis 胰十二指肠切除术中喂养式空肠造口的安全性和临床结果：一项系统综述和荟萃分析。

IF 2.4 3区医学

Hpb Pub Date : 2026-05-01 Epub Date: 2026-01-13 DOI: 10.1016/j.hpb.2026.01.003

Kai-Zheong Lim , Xin Wang , Jack V. Maida , Carmel Zoanetti , Marty Smith , Charles H.C. Pilgrim

{"title":"Safety and clinical outcomes of feeding jejunostomy in pancreaticoduodenectomy: a systematic review and meta-analysis","authors":"Kai-Zheong Lim , Xin Wang , Jack V. Maida , Carmel Zoanetti , Marty Smith , Charles H.C. Pilgrim","doi":"10.1016/j.hpb.2026.01.003","DOIUrl":"10.1016/j.hpb.2026.01.003","url":null,"abstract":"<div><h3>Background</h3><div>Feeding jejunostomy (FJ) is used for providing early enteral nutrition in patients undergoing pancreaticoduodenectomy (PD) but can be associated with complications. This study aims to provide an updated systematic review and meta-analysis of the recent literature to evaluate FJ-tube specific complications and clinical outcomes with FJ use in patients undergoing PD.</div></div><div><h3>Methods</h3><div>The analysis was performed by identifying eligible studies via search of Medline, PubMed and EMBASE databases. Studies comparing outcomes of patients undergoing PD with FJ and those without were included. Studies looking at tube-specific complications were separately reviewed.</div></div><div><h3>Results</h3><div>A total of 10 studies were included for review which included a total of 7097 patients undergoing PD which included 1712 patients with FJ, and 5385 patients with no FJ. Patients with FJ inserted were associated with a higher rate of DGE (OR 2.24 [1.62–3.10]), <em>p</em> < 0.00001) than those without FJ. FJ tube-specific complications include dislodgement, blockage, relaparotomy, jejunal emphysema with an incidence rate of 1.4–3.5 %.</div></div><div><h3>Conclusion</h3><div>Use of FJ, with its benefit and risk profile needs to be carefully considered in each select case of PD.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 5","pages":"Pages 623-634"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118900","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}

引用次数: 0

Futility of major hepatectomies after hypertrophy techniques: predictive factors from a bi-institutional cohort study 肥厚技术后大肝切除术的无效：来自双机构队列研究的预测因素。

IF 2.4 3区医学

Hpb Pub Date : 2026-05-01 Epub Date: 2026-01-23 DOI: 10.1016/j.hpb.2026.01.009

Cecilia Maina , Victor Lopez-Lopez , Domenico Santangelo , Beatrice Radaelli , José I. Tudela , Alvaro Navarro-Barrios , Roberto Brusadin , Guilliermo Carbonell , Simone Gusmini , Luigi Augello , Francesco De Cobelli , Ricardo Robles-Campos , Francesca Ratti

{"title":"Futility of major hepatectomies after hypertrophy techniques: predictive factors from a bi-institutional cohort study","authors":"Cecilia Maina , Victor Lopez-Lopez , Domenico Santangelo , Beatrice Radaelli , José I. Tudela , Alvaro Navarro-Barrios , Roberto Brusadin , Guilliermo Carbonell , Simone Gusmini , Luigi Augello , Francesco De Cobelli , Ricardo Robles-Campos , Francesca Ratti","doi":"10.1016/j.hpb.2026.01.009","DOIUrl":"10.1016/j.hpb.2026.01.009","url":null,"abstract":"<div><h3>Background</h3><div>hypertrophy techniques expanded surgical indications, but some patients still experience limited clinical benefit. We aimed to identify futility predictive factors in major hepatectomies after liver venous deprivation (LVD) or ALPPS-variants (tourniquet-ALPPS or hybrid-ALPPS).</div></div><div><h3>Methods</h3><div>a bi-institutional cohort study conducted between 01/2015 and 07/2024 including major hepatectomies for oncologic disease following one of the three augmentation strategies. Exclusion criteria: age <18, benign pathology, follow-up < 6-months, and interstage dropout. Futility corresponded to 90-days mortality or very early recurrence (≤6 months). Predictors of futile outcomes were identified by uni- and multi-variate analyses and utilized to build a futility score (0–10).</div></div><div><h3>Results</h3><div>84 patients completed the surgical process (dropout rate: 21.1 %): 40.5 % underwent LVD, 33.3 % tourniquet-ALPPS, and 26.2 % hybrid-ALPPS. Futility was observed in 35 patients (41.7 %) and logistic regression identified baseline sFLR (OR 0.89, <em>p</em> = 0.013), associated procedures (OR 3.07, <em>p</em> = 0.046), right trisectionectomy (OR 5.61, <em>p</em> = 0.031), and non-radical resection (OR 4.31, <em>p</em> = 0.01) as independent predictors. A futility score ≥4 (<em>n</em> = 36) predicted a futile outcome with good discrimination (AUC 0.802; <em>p</em> < 0.001).</div></div><div><h3>Conclusion</h3><div>Technical success after hypertrophy techniques not always equates clinical benefit. Recognizing predictors of futility may improve patient selection and guide more personalized therapeutic strategies.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 5","pages":"Pages 644-656"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137179","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}

引用次数: 0

Highlights in this issue 本期重点报道

IF 2.4 3区医学

Hpb Pub Date : 2026-05-01 DOI: 10.1016/S1365-182X(26)00579-4

引用次数: 0

The hidden opportunity-cost of minimally invasive pancreatoduodenectomy 微创胰十二指肠切除术的隐性机会成本。

IF 2.4 3区医学

Hpb Pub Date : 2026-05-01 Epub Date: 2026-01-30 DOI: 10.1016/j.hpb.2026.01.013

Alessandro Cucchetti, Valentina Zucchini, Giorgio Ercolani

引用次数: 0

A decade of pancreatoduodenectomy outcomes for pancreatic adenocarcinoma: 2014–2023 analysis of the N SQIP pancreatectomy PUF database 十年胰十二指肠切除术治疗胰腺腺癌的结果：2014-2023年NSQIP胰腺切除术PUF数据库分析：十年胰十二指肠切除术在NSQIP。

IF 2.4 3区医学

Hpb Pub Date : 2026-05-01 Epub Date: 2026-02-03 DOI: 10.1016/j.hpb.2026.01.016

Frank G. Lee , Katherine A. Bews , Richa Bisht , Elizabeth B. Habermann , Susanne G. Warner , Cornelius A. Thiels

{"title":"A decade of pancreatoduodenectomy outcomes for pancreatic adenocarcinoma: 2014–2023 analysis of the N SQIP pancreatectomy PUF database","authors":"Frank G. Lee , Katherine A. Bews , Richa Bisht , Elizabeth B. Habermann , Susanne G. Warner , Cornelius A. Thiels","doi":"10.1016/j.hpb.2026.01.016","DOIUrl":"10.1016/j.hpb.2026.01.016","url":null,"abstract":"<div><h3>Background</h3><div>A decade of pancreas procedure-targeted NSQIP data can reveal trends in pancreatoduodenectomy (PD) at participating centers.</div></div><div><h3>Methods</h3><div>The pancreatectomy PUFs 2014–2023 were queried for PDs performed for pancreatic adenocarcinoma (PDAC). Trends in neoadjuvant therapy (NAT), minimally invasive surgical (MIS) approach, vascular resection, positive margins, length of stay (LOS), unplanned conversion, post-operative pancreatic fistula (POPF), delayed gastric emptying (DGE), and 30-day mortality were evaluated across years with Chi-square and Mann-Kendall trend tests.</div></div><div><h3>Results</h3><div>With 24,067 patients identified, NAT and MIS rates doubled 24.0%–50.0% and 6.3%–14.7% respectively, with the latter driven by robotic approach. Unplanned conversion rates remained stable at 24.0% with higher rates in laparoscopic vs. robotic (36.2% vs. 17.0%, p<0.001). Vascular resections increased 23.1%–26.5%. POPF rates improved 13.6%–10.2% (p=0.049). Thirty-day mortality and DGE remained stable at 1.8% and 15.0% respectively. Median LOS decreased from 9 to 7 days. Positive margin rate (available starting in 2021) increased 16.0%–18.1% (p=0.039). Laparoscopic had the highest positive margin rate, 25.4% vs. open 17.2% and robotic 15.4% (p=0.004).</div></div><div><h3>Conclusion</h3><div>Over the last decade, NAT, robotic MIS, and vascular resection increased while 30-day mortality and complication rates remained stable for PDAC PDs. Robotic had lower rates of unplanned conversion and positive margins compared to laparoscopic.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 5","pages":"Pages 709-720"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146213196","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}

引用次数: 0

Development and validation of six-parameter laboratory-based prognostic model (APHPBA score) for patients undergoing hepatectomy for hepatitis B virus-related hepatocellular carcinoma 基于实验室的六参数预后模型（APHPBA评分）的开发和验证，用于乙型肝炎病毒相关肝细胞癌的肝切除术患者。

IF 2.4 3区医学

Hpb Pub Date : 2026-05-01 Epub Date: 2026-01-19 DOI: 10.1016/j.hpb.2026.01.005

Yi-Fei Liu , Hong Wang , Ya-Hao Zhou , Xin Li , Zu-Chao Du , Zi-Jie Tang , Wen-Long Zhai , Yong-Yi Zeng , Ting-Hao Chen , Yong-Kang Diao , Zi-Chao Tu , Li-Hui Gu , Han Wu , Feng Shen , Ming-Da Wang , Lai Wang , Fei Wu , Tian Yang , Eastern HepatoBiliary Alliance (EHBA) group

{"title":"Development and validation of six-parameter laboratory-based prognostic model (APHPBA score) for patients undergoing hepatectomy for hepatitis B virus-related hepatocellular carcinoma","authors":"Yi-Fei Liu , Hong Wang , Ya-Hao Zhou , Xin Li , Zu-Chao Du , Zi-Jie Tang , Wen-Long Zhai , Yong-Yi Zeng , Ting-Hao Chen , Yong-Kang Diao , Zi-Chao Tu , Li-Hui Gu , Han Wu , Feng Shen , Ming-Da Wang , Lai Wang , Fei Wu , Tian Yang , Eastern HepatoBiliary Alliance (EHBA) group","doi":"10.1016/j.hpb.2026.01.005","DOIUrl":"10.1016/j.hpb.2026.01.005","url":null,"abstract":"<div><h3>Purpose</h3><div>HBV-related HCC shows prognostic heterogeneity not fully captured by current staging. We developed and validated the APHPBA score, a laboratory-based model for patients undergoing curative hepatectomy.</div></div><div><h3>Methods</h3><div>This multicenter retrospective study included patients who underwent hepatectomy for HBV-related HCC between 2018 and 2023. The APHPBA score incorporated six routine preoperative parameters: alpha-fetoprotein (AFP), protein induced by vitamin K absence-II (PIVKA-II), HBV-DNA, prothrombin time (PT), bilirubin (BIL), and albumin (ALB). Patients were stratified into three stages: Stage I (0–1 point), Stage II (2–3 points), and Stage III (4–6 points). Prognostic performance was compared with conventional systems using Cox regression and time-dependent receiver operating characteristic (ROC) analyses.</div></div><div><h3>Results</h3><div>Among 1100 patients, 36.7 % were Stage I, 48.5 % Stage II, and 14.8 % Stage III. After a median follow-up of 48.0 months, 5-year overall survival was 63.4 %, 43.3 %, and 26.4 % across Stages I–III (P < 0.001). The APHPBA score remained independently associated with overall survival after adjustment for clinicopathologic factors and consistently outperformed established staging systems with higher time-dependent AUCs.</div></div><div><h3>Conclusion</h3><div>The APHPBA score provides robust postoperative risk stratification for HBV-related HCC using routinely available laboratory parameters.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 5","pages":"Pages 635-643"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165171","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}

引用次数: 0

Laparoscopic ALPPS and future liver remnant hypertrophy: volume, function, and patient selection 腹腔镜下ALPPS和未来肝残余肥厚：体积、功能和患者选择。

IF 2.4 3区医学

Hpb Pub Date : 2026-05-01 Epub Date: 2026-02-08 DOI: 10.1016/j.hpb.2026.02.001

Yinxian Cui, Xiaojun Yang

引用次数: 0

Recurrence patterns and predictors after pancreaticoduodenectomy for ampullary carcinoma 壶腹癌胰十二指肠切除术后的复发模式及预测因素。

IF 2.4 3区医学

Hpb Pub Date : 2026-05-01 Epub Date: 2026-01-27 DOI: 10.1016/j.hpb.2026.01.010

Utpal Anand , Abhishek Arora , Punam Bhadani , Kunal Parasar , Basant Narayan Singh , Kislay Kant , Ramesh Kumar , Rajeev Priyadarshi , Pritanjali Singh , Rohith Kodali , Manasi Manasvi

{"title":"Recurrence patterns and predictors after pancreaticoduodenectomy for ampullary carcinoma","authors":"Utpal Anand , Abhishek Arora , Punam Bhadani , Kunal Parasar , Basant Narayan Singh , Kislay Kant , Ramesh Kumar , Rajeev Priyadarshi , Pritanjali Singh , Rohith Kodali , Manasi Manasvi","doi":"10.1016/j.hpb.2026.01.010","DOIUrl":"10.1016/j.hpb.2026.01.010","url":null,"abstract":"<div><h3>Background</h3><div>Recurrence after Whipple for ampullary carcinoma remains incompletely defined; this retrospective cohort aimed to delineate patterns and predictors of failure to guide adjuvant strategies.</div></div><div><h3>Methods</h3><div>Consecutive patients undergoing standard Whipple for histologically proven ampullary adenocarcinoma (January 2018–December 2024) were analyzed (n=189); recurrence patterns were classified, survival estimated by Kaplan–Meier, and predictors assessed by multivariable logistic regression.</div></div><div><h3>Results</h3><div>Over a median 30.6 months, recurrence occurred in 29.6% (distant 23.3%, local 6.3%); independent predictors of distant recurrence included CA19‑9 >79 U/mL (aOR 2.62; P=0.027), nodal positivity (aOR 2.50; P=0.037), and delayed gastric emptying (aOR 3.17; P=0.006), while adjuvant therapy reduced risk (aOR 0.37; P=0.018). Perineural invasion predicted local recurrence on univariate analysis (OR 8.83; P<0.001); 3‑ and 5‑year overall survival were 69% and 46.1%, respectively, and adjuvant therapy in node‑positive patients reduced distant recurrence from 65.0% to 15.4% (OR 0.098; P<0.001).</div></div><div><h3>Conclusion</h3><div>Recurrence is predominantly systemic and driven by nodal status and CA19‑9, adjuvant chemotherapy mitigates distant failure—particularly in N1—and the identification of delayed gastric emptying as an independent predictor underscores the oncologic importance of perioperative optimization; histologic subtype was not independently prognostic.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 5","pages":"Pages 657-665"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146157249","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}

引用次数: 0

The impact of local and regional analgesia on pain and opioid consumption in patients undergoing open upper gastrointestinal surgery: a network meta-analysis of randomised controlled trials 局部和局部镇痛对开放性上消化道手术患者疼痛和阿片类药物消耗的影响：随机对照试验的网络meta分析

IF 2.4 3区医学

Hpb Pub Date : 2026-05-01 Epub Date: 2026-01-21 DOI: 10.1016/j.hpb.2026.01.008

Nicolas J. Smith , Serena Y. Peng , Simon D. Lai , Cameron I. Wells , Paul Gardiner , John A. Windsor , Adam St.J.R. Bartlett

{"title":"The impact of local and regional analgesia on pain and opioid consumption in patients undergoing open upper gastrointestinal surgery: a network meta-analysis of randomised controlled trials","authors":"Nicolas J. Smith , Serena Y. Peng , Simon D. Lai , Cameron I. Wells , Paul Gardiner , John A. Windsor , Adam St.J.R. Bartlett","doi":"10.1016/j.hpb.2026.01.008","DOIUrl":"10.1016/j.hpb.2026.01.008","url":null,"abstract":"<div><h3>Background</h3><div>Optimal perioperative analgesia for upper gastrointestinal (UGI) surgery remains uncertain despite multiple available options. This network meta-analysis (NMA) evaluated the comparative effectiveness of local and regional analgesic techniques on postoperative pain and opiate consumption following open UGI surgery.</div></div><div><h3>Methods</h3><div>A Bayesian NMA of randomised controlled trials (RCTs) was performed using MEDLINE, Embase, PubMed, and CENTRAL (January 2010–November 2023). The primary outcome was postoperative pain intensity at rest at 24 h.</div></div><div><h3>Results</h3><div>Fifty-three RCTs (<em>n</em> = 4207 patients) were included. Epidural analgesia provided the greatest reduction in 24-h pain (Mean Difference (MD) −0.976; Credible Interval (CrI) −0.558,-1.401) and opiate consumption (MD -24.717; CrI −16.541,-33.355). The transversus abdominis plane (TAP) block significantly reduced pain at 24 and 48 h, while local wound infiltration and continuous wound catheter infusion demonstrated strong opioid-sparing effects. Only the TAP block resulted in a significant reduction in hospital length of stay. Sensitivity and procedure-specific analyses showed results consistent with the primary analysis.</div></div><div><h3>Conclusion</h3><div>Epidural analgesia provides the greatest early analgesic and opioid-sparing benefit following open UGI surgery, though these effects do not consistently translate into improved recovery outcomes. TAP block and wound-based analgesic techniques offer effective, less invasive alternatives that may be preferable in selected patients.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 5","pages":"Pages 599-610"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146124774","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}

引用次数: 0