Hpb最新文献 - Book学术

Benefits and barriers to accreditation of HPB center and fellowship programs in Europe: a strength-weakness-opportunity-and-threats (SWOT) analysis by an E-AHPBA-ESSO-UEMS ad hoc working committee 欧洲 HPB 中心和研究金项目认证的优势和障碍：E-AHPBA-ESSO-UEMS 特设工作委员会的优势-劣势-机会-威胁（SWOT）分析。

IF 2.7 3区医学

Hpb Pub Date : 2024-10-01 DOI: 10.1016/j.hpb.2024.06.011

{"title":"Benefits and barriers to accreditation of HPB center and fellowship programs in Europe: a strength-weakness-opportunity-and-threats (SWOT) analysis by an E-AHPBA-ESSO-UEMS ad hoc working committee","authors":"","doi":"10.1016/j.hpb.2024.06.011","DOIUrl":"10.1016/j.hpb.2024.06.011","url":null,"abstract":"<div><h3>Background</h3><div>Training in HPB surgery lacks uniformity across regions covered by the E-AHPBA. Accreditation has been in place for centers and fellowship programs, but with low uptake. The decision whether to continue, change or cease such accreditation is being discussed. Thus, a strengths, weaknesses, opportunities, and threats (SWOT) analysis was conducted.</div></div><div><h3>Methods</h3><div>A mixed-methods, cross-sectional study among stakeholders in E-AHPBA, ESSO and UEMS under the E-AHPBA executive council was founded, ensuring representation by gender and geographic distribution.</div></div><div><h3>Results</h3><div>Responses were collected from across E-AHPBA regions, with response from 15 of 24 subchapters. The most frequent and recurring themes are presented in a SWOT matrix which allows for paired evaluations of factors deemed to be <em>helpful</em> (Strengths and Opportunities), those that are <em>harmful</em> (Weaknesses and Threats).</div></div><div><h3>Conclusion</h3><div>This study identified both helpful and harmful effects to an accreditation process of HPB centers or HPB fellowship training across the E-AHPBA membership region.</div><div>Formal accreditation of centers is not within the scope, nor jurisdiction nor financial capacity for E-AHPBA in the current situation. A strong interest in formal HPB training should be capitalized into E-AHPBA strategic planning towards a structured accreditation system for HPB fellowship programs or HPB training tracks.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603519","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}

引用次数: 0

Adjuvant therapy may improve overall survival in high-risk periampullary adenocarcinomas patients – A match-pair analysis from a multi-institutional cohort study (The MIPPAP study) 辅助治疗可提高高危胰周腺癌患者的总生存率 - 一项多机构队列研究（MIPPAP 研究）的配对分析

IF 2.7 3区医学

Hpb Pub Date : 2024-10-01 DOI: 10.1016/j.hpb.2024.06.010

{"title":"Adjuvant therapy may improve overall survival in high-risk periampullary adenocarcinomas patients – A match-pair analysis from a multi-institutional cohort study (The MIPPAP study)","authors":"","doi":"10.1016/j.hpb.2024.06.010","DOIUrl":"10.1016/j.hpb.2024.06.010","url":null,"abstract":"<div><h3>Background</h3><div>The role of adjuvant therapy in resected periampullary adenocarcinomas is equivocal due to contrasting data and limited prospective trials.</div></div><div><h3>Methods</h3><div>The Multicentre Indian Pancreatic & Periampullary Adenocarcinoma Project (MIPPAP), included data from 8 institutions across India. Of the 1679 pancreatic resections, 736 patients with T3/T4 and/or Node positive adenocarcinomas (considered as high risk for recurrence) were included for analysis. Three (adjuvant): one (observation) matching, using T3/T4 T staging, nodal positivity and ampullary subtype was performed by using the nearest neighbour matching method.</div></div><div><h3>Results</h3><div>Of 736 patients eligible for inclusion, 621 patients were matched of which 458 patients received adjuvant therapy (AT) (predominantly gemcitabine-based) and 163 patients were observed (O). With a median follow-up of 42 months, there was a statistical difference in overall survival in favour of patients receiving AT as compared to those on observation [68.7 months vs. 61.1 months, Hazard ratio: 0.73 (95% CI: 0.54–0.97); p = 0.03]. Besides AT, presence of nodal involvement (median OS: 65.4 months vs not reached; p = 0.04) predicted for inferior OS.</div></div><div><h3>Conclusions</h3><div>The results of the match-pair analysis suggest that adjuvant therapy improves overall survival in periampullary adenocarcinomas at high risk of recurrence with a greater benefit in T3/T4, node-positive and ampullary subtypes.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141612217","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

Prophylactic somatostatin analogs for postoperative pancreatic fistulas: a cross-sectional survey of AHPBA surgeons 胰腺瘘术后预防性使用体生长抑素类似物：对美国胰腺外科医生的横断面调查

IF 2.7 3区医学

Hpb Pub Date : 2024-10-01 DOI: 10.1016/j.hpb.2024.06.002

{"title":"Prophylactic somatostatin analogs for postoperative pancreatic fistulas: a cross-sectional survey of AHPBA surgeons","authors":"","doi":"10.1016/j.hpb.2024.06.002","DOIUrl":"10.1016/j.hpb.2024.06.002","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative pancreatic fistulas<span><span> lead to substantially increased morbidity, mortality, and healthcare costs after pancreatectomy. Studies have reported conflicting data on the role of prophylactic </span>somatostatin analogs in the reduction of postoperative pancreatic fistula. Current practice patterns, surgeon beliefs, and barriers to using these drugs in the Americas is not known.</span></div></div><div><h3>Methods</h3><div>An online 26-question cross-sectional survey was distributed via email to the members of the Americas Hepato-Pancreato-Biliary Association in April 2023.</div></div><div><h3>Results</h3><div>One hundred and two surgeons responded in spring 2023. 48.0% of respondents reported using prophylactic SSAs during their surgical training, however, only 29.4% do so in their current practice, most commonly when performing Whipple procedures. Octreotide<span> was the most frequently used SSA (34.3%), followed by octreotide LAR (12.7%) and pasireotide (11.8%). Reasons for not prescribing included a lack of high-quality data (62.7%), perception of limited efficacy (34.3%) and high cost (30.4%).</span></div></div><div><h3>Conclusion</h3><div>These results highlight key areas for future study including understanding surgeon rationale for patient and drug selection. Variable practice patterns amongst surgeons also underscore the importance of generalizability in the design of future clinical trials in order to maximize impact.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141395636","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

Short-term results of robot-assisted pancreatoduodeodenectomy: a retrospective cohort study of 146 patients operated in a high-volume center 机器人辅助胰十二指肠切除术的短期疗效：对一家高产量中心146名手术患者的回顾性队列研究。

IF 2.7 3区医学

Hpb Pub Date : 2024-10-01 DOI: 10.1016/j.hpb.2024.07.402

{"title":"Short-term results of robot-assisted pancreatoduodeodenectomy: a retrospective cohort study of 146 patients operated in a high-volume center","authors":"","doi":"10.1016/j.hpb.2024.07.402","DOIUrl":"10.1016/j.hpb.2024.07.402","url":null,"abstract":"<div><h3>Background</h3><div>Pancreaticoduodenectomy (PD) is a challenging operation because of complex anatomy and difficult and multiple reconstructions. Robot-assisted PD (RPD) is a novel minimally invasive technique, providing equivalent oncological outcomes to open surgery. The aim of this study is to evaluate the results of a single high-volume center series.</div></div><div><h3>Methods</h3><div>Patients who underwent RPD from 2014 to 2021 in a high-volume center were included. Patient and disease-specific data, operative details, postoperative complications including postoperative pancreatic fistula (POPF), length of stay (LOS) and long-term survival were recorded. Two groups were compared: Group 1: patients operated between 2014–2019 and Group 2 between 2020–2021.</div></div><div><h3>Results</h3><div>One hundred and forty-six patients had RPD on the study period (99 in Group 1 and 47 in Group 2). Operative time was 320 min (285–360), major complications were observed in 28% and clinically significant POPF in 20% of the cases. Conversion rate was 2.1%. LOS was 14 days (9–22). Postoperative mortality was 4.1%. Clinically significant POPF decreased from 24% in Group 1 to 11% in Group 2 (p = 0.05). LOS decreased from 16(11–26) days in Group 1 to 11(8–14) in Group 2 (p < 0.001).</div></div><div><h3>Conclusion</h3><div>RPD is safe and feasible. Technique standardization led to better post-operative outcomes, encouraging the dissemination and implementation of the procedure.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141716587","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 本期亮点

IF 2.7 3区医学

Hpb Pub Date : 2024-10-01 DOI: 10.1016/S1365-182X(24)02304-9

引用次数: 0

Corrigendum to “Changes in activity of heat shock protein-70 association with early acute pancreatitis severity” [HPB 25 (Supplement 1) (2023) S176] 热休克蛋白-70活性的变化与早期急性胰腺炎严重程度的关系"[HPB 25 (Supplement 1) (2023) S176]的更正

IF 2.7 3区医学

Hpb Pub Date : 2024-10-01 DOI: 10.1016/j.hpb.2024.03.1156

引用次数: 0

3-D reconstruction in liver surgery: a systematic review 肝脏手术中的三维重建：系统性综述。

IF 2.7 3区医学

Hpb Pub Date : 2024-10-01 DOI: 10.1016/j.hpb.2024.06.006

{"title":"3-D reconstruction in liver surgery: a systematic review","authors":"","doi":"10.1016/j.hpb.2024.06.006","DOIUrl":"10.1016/j.hpb.2024.06.006","url":null,"abstract":"<div><h3>Background</h3><div>Three-dimensional reconstruction of the liver offers several advantages to the surgeon before and during liver resection. This review discusses the factors behind the use of liver 3-D reconstruction.</div></div><div><h3>Methods</h3><div>Systematic electronic search, according to PRISMA criteria, was performed. A literature search of scientific papers was performed until October 2023. Articles were chosen based on reference to 3-D liver reconstruction and their use in liver surgery. GRADE methodology and the modified Newcastle–Ottawa scale were used to assess the quality of the studies.</div></div><div><h3>Results</h3><div>The research included 47 articles and 7724 patients were analyzed.</div><div>Preoperative planning was performed with 3-D liver reconstruction in the 87.2% of the studies.</div><div>Most of preoperative 3-D liver reconstructions were performed in the planning of complex or major hepatectomies. Complex hepatectomies were performed in 64.3% patients.</div><div>The 55.3% of the studies reported an improved navigation and accuracy during liver resection. Four studies (8.6%) on living donor liver transplant (LDLT) concluded that 3-D liver reconstruction is useful for graft selection and vascular preservation. Nine papers (19.1%) reported an accurate measurement of future liver remnant.</div></div><div><h3>Conclusion</h3><div>Liver 3-D reconstruction helps surgeons in the planning of liver surgery, especially in liver graft and complex liver resections, increasing the accuracy of the surgical resection.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141497919","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

Identifying suitable candidates for pancreaticoduodenectomy with extended lymphadenectomy for pancreatic ductal adenocarcinoma 确定胰腺十二指肠切除术和胰腺导管腺癌淋巴腺扩大切除术的合适人选

IF 2.7 3区医学

Hpb Pub Date : 2024-10-01 DOI: 10.1016/j.hpb.2024.07.405

{"title":"Identifying suitable candidates for pancreaticoduodenectomy with extended lymphadenectomy for pancreatic ductal adenocarcinoma","authors":"","doi":"10.1016/j.hpb.2024.07.405","DOIUrl":"10.1016/j.hpb.2024.07.405","url":null,"abstract":"<div><h3>Background</h3><div>To evaluate long-term quality of life and survival in pancreatic ductal adenocarcinoma (PDAC) patients after pancreatoduodenectomy with extended lymphadenectomy (PDEL) and identify candidates.</div></div><div><h3>Methods</h3><div>Patients with resectable PDAC with ≥1 examined lymph node (LN) during pancreatoduodenectomy (PD), and were divided into the PD with standard lymphadenectomy (PDSL) and PDEL groups. Perioperative data, long-term quality of life and survival were compared, and the prognostic effect of LNs ± in every peripancreatic station were analysed.</div></div><div><h3>Results</h3><div>Screening 446 PDAC patients, 237 and 126 were included in the PDSL and PDEL groups, respectively. The PDEL group showed a longer operation time, greater intraoperative blood loss, severe diarrhoea, a higher incidence of grade III complications. Notably, the PDEL patients experienced significant relief from low back pain and diarrhoea, with an obvious survival advantage (p = 0.037), especially in patients with preoperative tumor contact with vascular and pathological N0; however, LNs+ in any station (No. 8p, 12, 14, or 16) were associated with a poorer prognosis. The vascular reconstruction, T and N stage were independent risk factors for survival.</div></div><div><h3>Conclusion</h3><div>PDEL can relieve symptoms and prolong the survival of PDAC patients with acceptable complications, and EL should be performed regardless of preoperative LN enlargement.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141715413","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

Differential impact of incrementally elevated CA 19-9 levels on prognosis of resected pancreatic ductal adenocarcinoma CA 19-9 水平逐渐升高对切除的胰腺导管腺癌预后的不同影响。

IF 2.7 3区医学

Hpb Pub Date : 2024-10-01 DOI: 10.1016/j.hpb.2024.06.004

{"title":"Differential impact of incrementally elevated CA 19-9 levels on prognosis of resected pancreatic ductal adenocarcinoma","authors":"","doi":"10.1016/j.hpb.2024.06.004","DOIUrl":"10.1016/j.hpb.2024.06.004","url":null,"abstract":"<div><h3>Background</h3><div>CA 19–9 is an extremely useful biomarker for pancreatic ductal adenocarcinomas (PDACs). However, the optimal cut-off and prognostic significance at higher cut-offs are yet to be determined.</div></div><div><h3>Methods</h3><div>Retrospective analysis included patients with PDAC who underwent curative resection from January 2010 to May 2020 at Tata Memorial Centre, Mumbai. The pretherapy CA 19–9 was dichotomized using various cut-off levels and analysed.</div></div><div><h3>Results</h3><div>In 244 included patients, the median overall survival (OS) for those with CA19-9 level (IU/ml) < or >78, 200, 500, 1000, and 2000 was 27, 24, 23, 22, 21 months versus 18, 16, 15, 14, 13 months; respectively, and was statistically significant (p-value- 0.002, 0.001, 0.002, 0.002 and 0.004, respectively). The number of recurrences and mortality had significant correlation with CA 19–9 cut-offs. On multivariate analysis<span>, adjuvant treatment completion (p-0.004) and decreasing or stable CA19-9 after Neoadjuvant therapy (NAT) (p- 0.031) were associated with improved OS.</span></div></div><div><h3>Conclusion</h3><div>The prognostic significance of CA 19–9 was observed at all the cut-off levels examined, beyond mere elevated value as per the standard cut-off level. In patients with high CA19-9 level, surgery should be offered if technically and conditionally feasible, only when a response in CA19-9 level to NAT is achieved.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141467617","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

Contrasting concerns: a retrospective cohort study evaluating intraoperative cholangiogram patients with allergies 对比关注：一项对术中胆管造影术过敏患者进行评估的回顾性队列研究

IF 2.7 3区医学

Hpb Pub Date : 2024-10-01 DOI: 10.1016/j.hpb.2024.07.001

引用次数: 0