Hpb最新文献 - Book学术

IF 2.7 3区医学

Hpb Pub Date : 2025-06-27 DOI: 10.1016/S1365-182X(25)00618-5

引用次数: 0

Letter to the editor: recurrent cholangitis in patients with a non-stenotic hepaticojejunostomy: incidence and risk factors. 致编辑：非狭窄性肝空肠吻合术患者复发性胆管炎：发病率和危险因素。

IF 2.7 3区医学

Hpb Pub Date : 2025-06-26 DOI: 10.1016/j.hpb.2025.06.004

Antonio Manenti, Stefania Caramaschi, Luca Reggiani Bonetti, Gianrocco Manco

引用次数: 0

Robotic pancreatectomy for pancreatic adenocarcinoma: evolving trends in patient selection and practice patterns across a decade. 机器人胰腺切除术治疗胰腺腺癌：十年来患者选择和实践模式的演变趋势。

IF 2.7 3区医学

Hpb Pub Date : 2025-06-23 DOI: 10.1016/j.hpb.2025.06.009

Paul Wong, Aaron Lewis, Lucas W Thornblade, Ajay V Maker, Yuman Fong, Laleh G Melstrom

{"title":"Robotic pancreatectomy for pancreatic adenocarcinoma: evolving trends in patient selection and practice patterns across a decade.","authors":"Paul Wong, Aaron Lewis, Lucas W Thornblade, Ajay V Maker, Yuman Fong, Laleh G Melstrom","doi":"10.1016/j.hpb.2025.06.009","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.06.009","url":null,"abstract":"Background: Robotic surgery has been developed as an additional minimally invasive approach to pancreatectomy. We assessed case selection and perioperative outcomes in patients undergoing robotic pancreatectomy for pancreatic adenocarcinoma over time.Methods: The National Cancer Database (2010-2019) was queried to identify all pancreatic adenocarcinoma patients that underwent robotic pancreatoduodenectomy (RPD) or distal pancreatectomy (RDP). Two periods were established: Early cohort (2010-2014) and Modern cohort (2015-2019).Results: Of 2245 patients who underwent RPD or RDP, 78.4 % of RPD and 77.6 % of RDP were in the Modern cohort. Robotic approach increased from 2010 to 2019 (RPD: 1.1 %-7.5 %, RDP: 2.2 %-19.4 %; both p < 0.001). Compared to Early, Modern RPD patients were more likely to have non-private insurance (68.5 % vs. 58.7 %), and both RPD (47.0 % vs. 23.4 %) and RDP (47.3 % vs. 32.1 %) patients were more frequently treated in non-academic hospitals (all p < 0.01). Shorter LOS was noted in the Modern RPD (6 vs. 8 days) and RDP cohorts (5 vs. 6 days, both p < 0.001), without differences in readmission/mortality. In RPD and RDP, no differences in overall survival were observed between the eras.Conclusions: Robotic pancreatectomy for pancreatic adenocarcinoma has increased over time with greater inclusion of patients and hospital types while outcomes have remained similar.","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608243","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

Finetuning and optimizing an enhanced recovery protocol for liver surgery in the era of minimally invasive liver surgery: a single centre experience with 630 liver resections. 在微创肝手术时代，对肝脏手术的增强恢复方案进行微调和优化：630例肝脏切除术的单中心经验。

IF 2.7 3区医学

Hpb Pub Date : 2025-06-20 DOI: 10.1016/j.hpb.2025.06.008

Julie Vercauteren, Celine De Meyere, Isabelle Parmentier, Pieter J Steelant, Mathieu D'Hondt

{"title":"Finetuning and optimizing an enhanced recovery protocol for liver surgery in the era of minimally invasive liver surgery: a single centre experience with 630 liver resections.","authors":"Julie Vercauteren, Celine De Meyere, Isabelle Parmentier, Pieter J Steelant, Mathieu D'Hondt","doi":"10.1016/j.hpb.2025.06.008","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.06.008","url":null,"abstract":"Background: Enhanced recovery after surgery (ERAS) principles are increasingly applied in liver surgery. The aim of this retrospective cohort study was to evaluate the effectiveness of optimized clinical pathways in liver surgery in conjunction with patient adherence to the ERAS-protocol.Methods: Our centre implemented a first liver clinical pathway in 2015(CP1), followed by an optimized version in 2019(CP2). New ERAS-elements were introduced, such as no routine use of epidural analgesia and avoidance of surgical drains. More attention was paid to patient mobilization and resumption of a normal diet intake. Outcome measures included length of hospital stay, readmission rate, complications, and mortality. Adherence was measured by the percentage of patients who were discharged on or before the scheduled day.Results: 630 patients were included in the study, of which 329 (52.2 %) followed CP2 and 301 (47.8 %) followed CP1. The length of hospital stay after surgery significantly reduced in CP2(2[1-4]days vs 4[3-6]days; P < 0.001), without an increase in readmission rate (5.5 % vs 4.0% p:0.38), postoperative morbidity (12.5 % vs 14.3 %; P = 0.50) and 90-day mortality (0.91 % vs 1.00 %; P = 0.58). Adherence improved significantly in CP2(67.8 % vs 55.8 %; P = 0.002).Conclusion: The implementation of an optimized CP in liver surgery resulted in a shorter hospital stay and higher adherence rate to the ERAS-protocol.","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591153","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

Financial toxicity in patients followed for branch-duct intraductal papillary mucinous neoplasms: the risk that arises from "too much" for nothing. 支管导管内乳头状黏液性肿瘤患者的财务毒性：因“过多”而产生的风险。

IF 2.7 3区医学

Hpb Pub Date : 2025-06-20 DOI: 10.1016/j.hpb.2025.06.007

Claudio Ricci, Vincenzo D'Ambra, Laura Alberici, Carlo Ingaldi, Chiara Giagnorio, Cristina Mosconi, Marina Migliori, Riccardo Casadei

{"title":"Financial toxicity in patients followed for branch-duct intraductal papillary mucinous neoplasms: the risk that arises from \"too much\" for nothing.","authors":"Claudio Ricci, Vincenzo D'Ambra, Laura Alberici, Carlo Ingaldi, Chiara Giagnorio, Cristina Mosconi, Marina Migliori, Riccardo Casadei","doi":"10.1016/j.hpb.2025.06.007","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.06.007","url":null,"abstract":"Background: No data exist about financial toxicity (FT) for branch duct intraductal papillary mucinous neoplasms (BD-IPMNs).Methods: This prospective study analyzed patients with BD-IPMNs from 2023 to 2024. Demographics, clinical data of interest, and radiological and endoscopic information were recorded for each patient. The \"Comprehensive Score for Financial Toxicity\" (COST) patient-reported outcome measure was used to assess financial toxicity (FT). Lower COST values indicate greater FT. A multilevel, multivariate mixed-effects model was employed.Results: One hundred sixteen patients were interviewed during routine outpatient follow-up visits. Eighty patients agreed to complete the survey (68.9 %). The COST score was 18 (15-21, IQR), showing a fairly normal distribution (Shapiro-Wilk p = 0.054). The older the age at diagnosis, the greater the perception of FT (p < 0.001). As educational status increased, the FT burden also increased (-1.4 ± 0.6; p = 0.047). Private/self-employed patients (-3.7 ± 1.3; p = 0.004) and unemployed patients (-2.3 ± 1.0; p = 0.016) reported a higher perception of FT compared to pensioners or publicly employed individuals. WFs increase FT (-1.9 ± 0.8; p = 0.014). The longer the follow-up duration, the greater the FT (-0.3 ± 0.1; p = 0.043).Conclusion: FT can be seen in the BD-IPMN population. The patient's perspective must be taken into account during follow-up.","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567385","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

Post-pancreatectomy acute pancreatitis (PPAP) - A global definition with variable regional recognition. 胰腺切除术后急性胰腺炎(PPAP) -一个具有可变区域识别的全球定义。

IF 2.7 3区医学

Hpb Pub Date : 2025-06-18 DOI: 10.1016/j.hpb.2025.06.005

Andrew J Thyen, Thomas K Maatman, Alex M Roch, Ryan J Ellis, Eugene P Ceppa, Michael G House, Christian M Schmidt, Nicholas J Zyromski

引用次数: 0

Application of trypsin-inhibitor in a fibrin sealant matrix might reduce fistula rate after left-sided pancreatic resection: a prospective pilot study. 在纤维蛋白密封基质中应用胰蛋白酶抑制剂可能会降低左侧胰腺切除术后的瘘率：一项前瞻性先导研究。

IF 2.7 3区医学

Hpb Pub Date : 2025-06-11 DOI: 10.1016/j.hpb.2025.06.006

Nick De Wever, Pieter Dries, An Verena Lerut, Niki Rashidian, Frederik Berrevoet

引用次数: 0

Laparoscopic liver resection in high-risk anesthesia patients A French nationwide study. 高危麻醉患者的腹腔镜肝切除术一项法国全国性研究。

IF 2.7 3区医学

Hpb Pub Date : 2025-06-09 DOI: 10.1016/j.hpb.2025.06.001

Marie Wieser, Chetana Lim, Claire Goumard, Olivier Soubrane, Louise Barbier, Jean-Marc Regimbeau, Christian Hobeika, Alexis Laurent, David Fuks, Laurence Chiche, Michel Rayar, Francis Navarro, Patrick Pessaux, Antonio Sa Cunha, Eric Vibert, Olivier Scatton

{"title":"Laparoscopic liver resection in high-risk anesthesia patients A French nationwide study.","authors":"Marie Wieser, Chetana Lim, Claire Goumard, Olivier Soubrane, Louise Barbier, Jean-Marc Regimbeau, Christian Hobeika, Alexis Laurent, David Fuks, Laurence Chiche, Michel Rayar, Francis Navarro, Patrick Pessaux, Antonio Sa Cunha, Eric Vibert, Olivier Scatton","doi":"10.1016/j.hpb.2025.06.001","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.06.001","url":null,"abstract":"Background: Studies evaluating the impact of the American Society of Anesthesiologists Physical status (ASA-PS) score on outcomes after liver resection (LR) are currently lacking. The aim was to evaluate the value of ASA-PS score on perioperative outcomes for laparoscopic liver resection (LLR).Methods: This is a retrospective analysis of patients who underwent LLR from 1996 to 2018 at 29 French medical centers. High-risk anesthesia patients were defined as those with ASA-PS scores ≥3. Postoperative outcomes including 90-day mortality, morbidity and failure to rescue (death within 90 days following any major postoperative complication) were compared between high- and low-risk anesthesia patients.Results: Of 3154 patients included, 734 (23.3 %) had ASA-PS scores ≥3. The 90-day mortality (2.6 % vs. 0.6 %), overall morbidity (42.0 % vs. 33.8 %), severe morbidity (11.2 % vs. 7.4 %) and failure to rescue (23.2 % vs. 7.9 %) rates were higher in the ASA-PS score ≥3 group (all p < 0.05). In the multivariable analysis, ASA-PS score ≥3 was an independent risk factor for failure to rescue after LLR in the study population.Conclusion: LLR in high-ASA patients can be performed with a higher rate of mortality and morbidity.","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484154","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

Post-operative morbidity and mortality of laparoscopic cholecystectomy in patients with cirrhosis: a systematic review and meta-analysis. 肝硬化患者腹腔镜胆囊切除术后的发病率和死亡率：一项系统回顾和荟萃分析。

IF 2.7 3区医学

Hpb Pub Date : 2025-06-06 DOI: 10.1016/j.hpb.2025.06.002

Vanessa Wiseman, Jonah Moore, Sandra McKeown, Isis Lunsky, Jennifer Flemming, Sulaiman Nanji, Sean Bennett

{"title":"Post-operative morbidity and mortality of laparoscopic cholecystectomy in patients with cirrhosis: a systematic review and meta-analysis.","authors":"Vanessa Wiseman, Jonah Moore, Sandra McKeown, Isis Lunsky, Jennifer Flemming, Sulaiman Nanji, Sean Bennett","doi":"10.1016/j.hpb.2025.06.002","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.06.002","url":null,"abstract":"Background: Patients with cirrhosis are at increased risk of gallstone disease. The objective of this review was to assess the literature to better define the perioperative risks for patients with cirrhosis undergoing laparoscopic cholecystectomy.Methods: A systematic review was conducted using PRISMA guidelines. Inclusion criteria included papers published since 1990, with at least 25 patients with cirrhosis undergoing cholecystectomy. Outcomes of interest were post-operative liver decompensation, bile leak, surgical site infection (SSI), pneumonia, venous thromboembolism (VTE), transfusions and mortality.Results: Forty-two papers were included with 24 575 patients, 48 % were female, with mean age of 53 years. Most patients were Child-Turcotte-Pugh A (74 %), followed by B (23 %), and C (3 %). Emergent cholecystectomy was performed in 28.7 % of patients. Post-operative liver decompensation occurred in 7.1 % (0.9-13.3, 95 % CI) of patients, superficial SSI in 1.1 % (0.6-1.5), organ space SSI in 3.7 % (2.0-5.5), bile leak in 0.7 % (0.2-1.1), VTE in 1.8 % (0.7-2.9), pneumonia in 1.9 % (1.2-2.6) and transfusions in 4 % (2.7-5.2). Post-operative mortality was 1.8 % (1.2-2.4).Conclusion: Laparoscopic cholecystectomy is safe in most patients with cirrhosis, with notably higher complication rates compared to the general population. Continued efforts to decrease rates of bile leak, post-operative liver decompensation and mortality should be encouraged.","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511822","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 resection margin width on surgical outcomes for solitary hepatocellular carcinoma with sub-classification of microvascular invasion. 切除切缘宽度对微血管侵犯亚分类孤立性肝癌手术疗效的影响。

IF 2.7 3区医学

Hpb Pub Date : 2025-06-05 DOI: 10.1016/j.hpb.2025.06.003

Erlei Zhang, Yueyue Chen, Jian Li, Tong Yuan, Ran Tao, Yan Guan, Ronghua Zhu, Dong Chen, Zhiyong Huang, Xiaoping Chen, Jiang Li, Zunyi Zhang, Qi Cheng

{"title":"The impact of resection margin width on surgical outcomes for solitary hepatocellular carcinoma with sub-classification of microvascular invasion.","authors":"Erlei Zhang, Yueyue Chen, Jian Li, Tong Yuan, Ran Tao, Yan Guan, Ronghua Zhu, Dong Chen, Zhiyong Huang, Xiaoping Chen, Jiang Li, Zunyi Zhang, Qi Cheng","doi":"10.1016/j.hpb.2025.06.003","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.06.003","url":null,"abstract":"Background: The impact of resection margin width on surgical outcomes in hepatocellular carcinoma (HCC) patients with microvascular invasion (MVI) remains controversial. This study explores whether MVI sub-classification influences prognosis after curative resection for solitary HCC.Methods: We analyzed 601 solitary HCC patients who underwent hepatectomy between May 2018 and December 2019, classifying them into no vascular invasion (NVI), microvessel invasion (MI), and microscopic portal vein invasion (MPVI) groups. The effects of resection margin width on progression-free survival (PFS) and overall survival (OS) were evaluated.Results: MVI was identified in 133 patients (22.1 %). The 3-year OS rates for patients with NVI, MI, and MPVI were 87.4 %, 70.2 %, and 53.9 %, while PFS rates were 59.5 %, 47.7 %, and 29.9 %, respectively (p < 0.0001). A wide margin (≥1 cm) improved OS and PFS in MI patients (80.7 % vs. 50.0 %; 64.5 % vs. 23.7 %; p < 0.05) but not in NVI or MPVI groups. Multivariate analysis indicated that tumor size, MI and MPVI were the independent risk factors affecting RFS and OS after curative liver resection.Conclusion: MPVI was associated with a worse prognosis after resection compared to MI and NVI. A wide resection margin improved survival in MI patients but had no benefit in NVI or MPVI cases.","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484155","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