Hpb最新文献

{"title":"Genomic predictors of pathologic response to hepatic artery infusion pump chemotherapy in colorectal liver metastases","authors":"Naaz F. Nasar,&nbsp;Joanne F. Chou,&nbsp;Jashodeep Datta,&nbsp;Maya T. Evenhaim,&nbsp;Mithat Gonen,&nbsp;Kevin C. Soares,&nbsp;Vinod P. Balachandran,&nbsp;Jeffrey Drebin,&nbsp;T. Peter Kingham,&nbsp;Alice C. Wei,&nbsp;William R. Jarnagin,&nbsp;Remo Alessandris,&nbsp;Jinru Shia,&nbsp;Andrea Cercek,&nbsp;Eileen M. O'Reilly,&nbsp;Louise Connell,&nbsp;Nancy Kemeny,&nbsp;Michael I. D'Angelica","doi":"10.1016/j.hpb.2026.07.005","DOIUrl":"10.1016/j.hpb.2026.07.005","url":null,"abstract":"<div><h3>Background</h3><div>Preoperative hepatic artery infusion pump chemotherapy (HAIP) in colorectal liver metastases (CRLM) is associated with greater pathologic response (PR). We aimed to identify genomic predictors of PR in initially unresectable (IU)-CRLM treated with preoperative HAIP.</div></div><div><h3>Methods</h3><div>Three-hundred-fifty patients treated with HAIP for IU-CRLM from 2000 to 2021 were reviewed retrospectively; 96 underwent resection. Specimens were evaluated for PR and next-generation sequencing was performed. Wilcoxon rank-sum test was used to determine the association between genomic alterations and PR (continuous outcome). PR was categorized as minor (0%–74%), major (75%–99%), and complete (100%). Association between co-mutation <em>TP53-RAS</em> and PR was assessed using multivariable linear regression. Cox regression was used to examine the association between PR and survival.</div></div><div><h3>Results</h3><div>Median PR was 51% in patients with <em>TP53-RAS</em>; 91% in those without the co-mutation (Others) (<em>P</em> &lt; 0.001). <em>TP53-RAS</em> remained associated with lower PR (β −0.25, <em>P</em> &lt; 0.001) on multivariate analysis. PR was associated with event-free survival (EFS) (HR 0.92, 95% CI: 0.85–0.98; <em>P</em> 0.013), not with overall survival (OS) (HR 0.94, 95% CI: 0.86–1.03).</div></div><div><h3>Conclusion</h3><div><em>TP53-RAS</em> in IU-CRLM is associated with lower rates of PR to preoperative HAIP than Others. PR was associated with EFS, not with OS.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 10","pages":"Pages 1393-1401"},"PeriodicalIF":3.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148591279","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":"Umbilical versus epigastric port for gallbladder extraction in laparoscopic cholecystectomy: an updated systematic review and meta-analysis of randomized controlled trials with trial sequential analysis and GRADE assessment","authors":"Osama M. Aldeeb,&nbsp;Ahmad O. Saleh,&nbsp;Bara M. Hammadeh,&nbsp;Rania Rashed,&nbsp;Tuqa M. Alfreijat,&nbsp;Rahaf Hanoun,&nbsp;Rahaf Aljibarat,&nbsp;Juman Habboub,&nbsp;Ramez M. Odat,&nbsp;Mohammad A. Hilal,&nbsp;Mohammad Alzoubi","doi":"10.1016/j.hpb.2026.06.018","DOIUrl":"10.1016/j.hpb.2026.06.018","url":null,"abstract":"<div><h3>Background</h3><div>In laparoscopic cholecystectomy, the gallbladder is removed via the umbilical or epigastric/subxiphoid port.</div></div><div><h3>Aims</h3><div>We aim to compare the umbilical and epigastric ports for gallbladder extraction in laparoscopic cholecystectomy in terms of postoperative pain, surgical site infection, postoperative hernia, operating time, and gallbladder retrieval time.</div></div><div><h3>Methods</h3><div>Systematic review and meta-analysis of randomized controlled trials from PubMed, Scopus,WOS, CENTRAL, and <span><span>Clinicaltrials.gov</span><svg><path></path></svg></span> from inception to 18 June 2025. PROSPERO ID (<u>CRD420251143624</u>).</div></div><div><h3>Results</h3><div>Analysis of 20 RCTs showed that gallbladder extraction via the umbilical port was associated with significant reduction in postoperative pain at 1 h (SMD:-1.31, 95%CI:-2.14; −0.49, p = 0.0018), 6 h (SMD:-3.21, 95%CI:-5.71; −0.70, p = 0.0121), 12 h (SMD:-3.06, 95%CI:-5.40; −0.71, p = 0.0107), 24 h (SMD:-1.96, 95%CI:-3.71; −0.21, p = 0.0283), and 36 h (SMD:-0.98, 95%CI:-1.28; −0.69, p &lt; 0.0001). PIs crossed the null for time points except 36 h. No significant differences were observed at 48, 72 h, 7, or 30 days. Umbilical port was associated with longer hospital stay (MD:1.79 days, 95%CI:0.54; 3.04, p = 0.0050, PI:-0.24; 3.82). No differences were found for surgical site infection, hernia, operative time, extraction time, or retrieval difficulty, PIs frequently crossed the null.</div></div><div><h3>Conclusion</h3><div>Extraction via the umbilical port was associated with statistically significant reduction in early postoperative pain. Wide PIs crossing the null indicate substantial uncertainty. Neither port site demonstrates definitive advantage; selection should be guided by surgeon preference and patient-specific factors.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 10","pages":"Pages 1298-1310"},"PeriodicalIF":3.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148602126","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":"Surgical antibiotic prophylaxis for elective pancreatoduodenectomy: a propensity score–weighted comparative analysis","authors":"Kaique F.X.C. Filardi,&nbsp;Sara Saeidishahri,&nbsp;Oscar K. Serrano","doi":"10.1016/j.hpb.2026.07.002","DOIUrl":"10.1016/j.hpb.2026.07.002","url":null,"abstract":"<div><h3>Background</h3><div>Pancreatoduodenectomy (PD) is a morbid procedure often associated with high rates of postoperative infectious complications, contributing to worse prognosis. We sought to investigate the optimal surgical prophylaxis antibiotic for PD patients using the ACS-NSQIP.</div></div><div><h3>Study design</h3><div>The ACS–NSQIP (2016–2023) was queried for elective PDs and their prophylactic antibiotics. Patients were categorized by antibiotic type: first-generation cephalosporin (FC), second/third-generation cephalosporin (STC), and broad-spectrum (BS – e.g., piperacillin-tazobactam, cefoxitin, and fourth-generation cephalosporins). The primary outcomes were surgical site infection (SSI) and Clostridium difficile colitis. Inverse probability weighting using multinomial propensity scores was applied to balance groups and estimate adjusted probabilities and pairwise risk differences.</div></div><div><h3>Results</h3><div>Among 23,258 PD patients, adjusted SSI probabilities were 22.7% (21.7–23.8%), 22.3% (21.3–23.3%), and 20.0% (19.2–20.8%) for FC, STC, and BS, respectively (p &lt; 0.001). BS antibiotics consistently reduced SSI risk without significant differences in other outcomes, including pancreatic fistula, readmission, reoperation, mortality, or major complications. Infection rates differed by biliary drainage status (p &lt; 0.001). C. difficile rates were low and comparable across groups (1.1% vs. 1.9% vs. 1.7%).</div></div><div><h3>Conclusion</h3><div>Broader prophylactic coverage in elective PD reduces postoperative infections without increasing C. difficile risk, especially benefiting patients with preoperative biliary instrumentation.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 10","pages":"Pages 1360-1370"},"PeriodicalIF":3.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148602171","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":"Robotic distal pancreatectomy with a modified transpancreatic mattress suture-based stump management strategy is associated with lower clinically relevant POPF than reinforced stapling: a propensity score–matched cohort study","authors":"Ryoji Furuya,&nbsp;Ryuji Yoshioka,&nbsp;Kenta Aso,&nbsp;Shoichi Irie,&nbsp;Yoshinori Takeda,&nbsp;Hirofumi Ichida,&nbsp;Yoshihiro Mise,&nbsp;Akio Saiura","doi":"10.1016/j.hpb.2026.07.004","DOIUrl":"10.1016/j.hpb.2026.07.004","url":null,"abstract":"<div><h3>Background</h3><div>The optimal stump-closure method to prevent clinically relevant postoperative pancreatic fistula (CR-POPF) in robot-assisted distal pancreatectomy (RDP) remains unsettled. We evaluated whether a modified transpancreatic mattress suture (mTMP) strategy was associated with reduced CR-POPF compared with reinforced stapler closure.</div></div><div><h3>Methods</h3><div>107 consecutive RDPs at a single center (June 2020–October 2024) were grouped by stump-closure method (stapler, n = 50; mTMP, n = 57). The mTMP strategy comprised main duct ligation, stump coagulation, polyglycolic acid reinforcement, fibrin sealant, and transpancreatic mattress suturing. The primary outcome was CR-POPF (ISGPS 2016 grades B/C). Confounding was addressed with 1:1 propensity score matching on 10 covariates (38 matched pairs) and multivariable logistic regression, with a prespecified subgroup analysis in thick-pancreas patients (&gt;12 mm, 31 pairs).</div></div><div><h3>Results</h3><div>After matching, the mTMP strategy was associated with lower CR-POPF (15.8% vs 42.1%, P=0.011) and fewer major complications (5.3% vs 26.3%, P=0.012). On multivariable analysis, stapler closure and age ≤60 years independently predicted CR-POPF. In the thick-pancreas subgroup, CR-POPF remained lower with the mTMP strategy (16.1% vs 48.4%, P = 0.024).</div></div><div><h3>Conclusions</h3><div>The mTMP strategy showed an association with lower CR-POPF than reinforced stapling, including in thick-pancreas patients. These findings are hypothesis-generating and warrant prospective validation.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 10","pages":"Pages 1383-1392"},"PeriodicalIF":3.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584332","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":"Clinical outcomes of histotripsy for liver malignancies: a systematic review of early clinical evidence","authors":"Jiro Kimura,&nbsp;Ayham Asassfeh,&nbsp;Matthew Cooper,&nbsp;Kondragunta R. Prasad","doi":"10.1016/j.hpb.2026.06.015","DOIUrl":"10.1016/j.hpb.2026.06.015","url":null,"abstract":"<div><h3>Background</h3><div>Histotripsy is an emerging non-thermal, non-invasive focused ultrasound technology. This systematic review aims to evaluate the early clinical safety and efficacy of histotripsy in the treatment of liver malignancies.</div></div><div><h3>Methods</h3><div>A systematic search was conducted across Web of Science, Medline, Scopus, and Cochrane CENTRAL up to February 2026. The search strings combined terms for “histotripsy” and “liver tumor/cancer/metastasis”. Studies reporting technical success rate or complications of histotripsy for liver tumors were included.</div></div><div><h3>Results</h3><div>Six studies involving 414 patients and 679 treated tumors were included. The majority of patients had colorectal liver metastases or hepatocellular carcinoma. Technical success rates ranged from 97.0% to 100%. Major complications (Clavien-Dindo classification ≥ III) were rare, though portal vein thrombosis was observed in some cases (up to 8.0%). Data on survival and quality of life were unavailable. Only one study specified the trial was for bridging therapy prior to liver transplantation. Ongoing trials are expanding the evidence base for the use of multidisciplinary approaches and immune modulation.</div></div><div><h3>Conclusion</h3><div>Early clinical evidence indicates that histotripsy is a feasible and safe non-thermal ablative technique for liver malignancies. However, it also identified urgent need for long-term efficacy data. Ongoing research into its biological effects and integration with systemic therapies suggests significant future potential. Furthermore, the significance of histotripsy as a bridging therapy to liver transplantation should be clarified in future studies.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 10","pages":"Pages 1289-1297"},"PeriodicalIF":3.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148420979","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":"Editorial Board / Aims and Scope","authors":"","doi":"10.1016/S1365-182X(26)02755-3","DOIUrl":"10.1016/S1365-182X(26)02755-3","url":null,"abstract":"","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 10","pages":"Page IFC"},"PeriodicalIF":3.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149125371","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}

{"title":"IHPBA news 2","authors":"","doi":"10.1016/S1365-182X(26)02762-0","DOIUrl":"10.1016/S1365-182X(26)02762-0","url":null,"abstract":"","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 10","pages":"Page OBC"},"PeriodicalIF":3.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149125369","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":"Trans-anastomotic stent does not impact the predictive value of drain fluid amylase after pancreatoduodenectomy","authors":"Giampaolo Perri,&nbsp;Aya Maekawa,&nbsp;Isabella Frigerio,&nbsp;Elisa Bannone,&nbsp;Riccardo Pellegrini,&nbsp;Alessio Marchetti,&nbsp;Alice Cattelani,&nbsp;Alessandro Giardino,&nbsp;Umberto Cillo,&nbsp;Giovanni Butturini,&nbsp;Giovanni Marchegiani","doi":"10.1016/j.hpb.2026.06.021","DOIUrl":"10.1016/j.hpb.2026.06.021","url":null,"abstract":"<div><h3>Background</h3><div>Drain fluid amylase (DFA) guides risk stratification and drain management after pancreatoduodenectomy (PD), but its interpretation in patients with trans-anastomotic stents (TS) remains poorly defined.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed multicenter PD data, focusing on TS-managed patients. DFA was measured on postoperative days (POD) 1, 3, and 5. The primary outcome was clinically relevant postoperative pancreatic fistula (CR-POPF), with major morbidity (Clavien-Dindo ≥ IIIa) as a secondary outcome. Discrimination was evaluated by adding log-transformed DFA to a baseline model including high-risk PD and center.</div></div><div><h3>Results</h3><div>Among 1156 patients, 464 (40.1%) received TS. The baseline model yielded an AUC of 0.645, which increased to 0.748 with POD1 log(DFA) and to 0.786 with POD3 log(DFA); POD3 was not significantly different from POD1 (P = 0.056). In complete-case analyses including POD5, POD5 further improved discrimination compared with POD1 (P = 0.008), but was not statistically different from POD3 (P = 0.126). Although median DFA values were higher in TS patients (reflecting a greater prevalence of high-risk PD), DFA dynamics were similar to those of non-TS patients.</div></div><div><h3>Discussion</h3><div>Early DFA remains informative with TS. Integrating DFA with pre- and intraoperative risk features supports serial risk assessment in the early postoperative period.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 10","pages":"Pages 1413-1419"},"PeriodicalIF":3.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470431","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}

{"title":"Geographic variation in utilization of minimally invasive approaches for pancreatic resection","authors":"Cody Lendon Mullens,&nbsp;Samantha L. Savitch,&nbsp;Jyothi R. Thumma,&nbsp;Kyle H. Sheetz,&nbsp;Bradley N. Reames","doi":"10.1016/j.hpb.2026.06.013","DOIUrl":"10.1016/j.hpb.2026.06.013","url":null,"abstract":"","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 10","pages":"Pages 1423-1426"},"PeriodicalIF":3.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470427","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":"Comment on: Multicenter machine learning model to predict very early recurrence after curative-intent resection of hilar cholangiocarcinoma","authors":"Zheyu Lu,&nbsp;Xu Qiu,&nbsp;Dong liang","doi":"10.1016/j.hpb.2026.06.014","DOIUrl":"10.1016/j.hpb.2026.06.014","url":null,"abstract":"","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 10","pages":"Page 1428"},"PeriodicalIF":3.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404672","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}