IF 2.7 3区医学

Hpb Pub Date : 2025-05-01 DOI: 10.1016/j.hpb.2025.01.008

Iron P. De Abreu Neto , Vincenzo Pugliese , Paulo C.B. Massarollo , Bárbara B. Benini , Mirella M.M. Marta , Vanessa S. Takenaka , Francisco Monteiro , João Luis E. Pessoa , Raymundo.S. De Azevedo Neto , Adriano M. Gonzalez

{"title":"Retrospective comparative analyses of liver transplantation for intrahepatic cholangiocarcinoma and combined hepatocellular cholangiocarcinoma versus hepatocellular carcinoma in Brazil","authors":"Iron P. De Abreu Neto , Vincenzo Pugliese , Paulo C.B. Massarollo , Bárbara B. Benini , Mirella M.M. Marta , Vanessa S. Takenaka , Francisco Monteiro , João Luis E. Pessoa , Raymundo.S. De Azevedo Neto , Adriano M. Gonzalez","doi":"10.1016/j.hpb.2025.01.008","DOIUrl":"10.1016/j.hpb.2025.01.008","url":null,"abstract":"<div><h3>Background</h3><div>Despite the growing interest in liver transplantation for cholangiocarcinomas (CCA), conclusive evidence is lacking. We sought to evaluate the outcomes of liver transplantation for intrahepatic cholangiocarcinoma in Brazil.</div></div><div><h3>Methods</h3><div>Retrospective database analysis of patients undergoing liver transplantation for hepatocellular carcinoma (HCC) within Milan criteria in São Paulo, Brazil. Anatomopathological examination of the explanted liver with the presence of intrahepatic cholangiocarcinoma (iCCA) or combined hepatocellular-cholangiocarcinoma (cHCC-CCA) comprised the study group (50 patients). They were compared to a 1:3 HCC-matched cohort.</div></div><div><h3>Results</h3><div>Study group had lower survival rates than HCC controls (survival at 1, 3, and 5 years, 70.0 %, 57.5 %, and 57.5 % versus 78.7 %, 71.4 %, and 66.6 %, p = 0.019). 5-year survival rates of the control group, cHCC-CCA, and iCCA group were 66.6 %, 59.6 %, and 50.0 % (p = 0.017). There was no statistically significant difference in survival for study group patients with tumors up to 3 cm compared to their controls (p = 0.086).</div></div><div><h3>Discussion</h3><div>Patients with CCA had worse outcomes after liver transplantation than those with HCC. Interesting results were found in the more individualized analyses, but because of the limited number of patients, caution should be taken when analyzing them.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 640-648"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074211","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

Visual assessment of liver steatosis at retrieval predicts long term liver transplant outcomes in donation following circulatory death 肝脏脂肪变性的目视评估可预测供体在循环性死亡后的长期肝移植结果。

IF 2.7 3区医学

Hpb Pub Date : 2025-05-01 DOI: 10.1016/j.hpb.2025.01.007

Ning X. Ho , Samuel J. Tingle , Georgios Kourounis , Balaji Mahendran , Rebecca Bramley , Emily R. Thompson , Aimen Amer , Rodrigo Figueiredo , Stuart McPherson , Steve White , Colin Wilson

{"title":"Visual assessment of liver steatosis at retrieval predicts long term liver transplant outcomes in donation following circulatory death","authors":"Ning X. Ho , Samuel J. Tingle , Georgios Kourounis , Balaji Mahendran , Rebecca Bramley , Emily R. Thompson , Aimen Amer , Rodrigo Figueiredo , Stuart McPherson , Steve White , Colin Wilson","doi":"10.1016/j.hpb.2025.01.007","DOIUrl":"10.1016/j.hpb.2025.01.007","url":null,"abstract":"<div><h3>Background</h3><div>The demand for liver transplantation is rising, as is the prevalence of steatotic liver disease. Steatotic grafts have inferior outcomes post-transplantation, due to increased sensitivity to ischaemia-reperfusion injury. We aimed to formally evaluate the impact of visually assessed liver steatosis in grafts donated following brainstem (DBD) versus circulatory death (DCD).</div></div><div><h3>Methods</h3><div>NHS registry on adult liver transplantation was reviewed retrospectively (2006–2019). We used multiple-imputation for missing data and adjusted regression models with interaction terms to compare the impact of visually assessed donor graft steatosis on transplant outcome.</div></div><div><h3>Results</h3><div>9217 recipients of deceased donor grafts were included (DBD = 7349; DCD = 1868). Multivariable cox regression revealed that the negative impact on graft survival was significantly different in DCD and DBD livers (interaction <em>P</em> = 0.011 and <em>P</em> = 0.043). The largest impact was in DCD livers (moderate steatosis: aHR = 1.851, 1.296–2.645, <em>P</em> = 0.001 and aHR = 5.426; severe steatosis: 1.723–17.090, <em>P</em> = 0.004). Visually assessed steatosis did not predict longer-term graft survival in the DBD cohort.</div></div><div><h3>Conclusion</h3><div>The impact of visually assessed steatosis on post-transplant outcome is far greater in DCD grafts, despite an identical method of steatosis assessment. This highlights novel therapeutics should be considered for steatotic DCD grafts to allow this growing sector of the donor pool to be safely utilised.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 630-639"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370816","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

Arterial and anastomotic wrapping in pancreaticoduodenectomy as a strategy to reduce complications: a systematic review and meta-analysis 胰十二指肠切除术中动脉和吻合口包裹术作为减少并发症的策略：系统回顾和荟萃分析

IF 2.7 3区医学

Hpb Pub Date : 2025-05-01 DOI: 10.1016/j.hpb.2025.02.001

Gabriele E. Lech , Patrícia Viana , Camila M. de Paiva Reis , Ana P. Valério-Alves , João L.R. Freitas , Raquel O. de Sousa Silva , Rafael Morriello

{"title":"Arterial and anastomotic wrapping in pancreaticoduodenectomy as a strategy to reduce complications: a systematic review and meta-analysis","authors":"Gabriele E. Lech , Patrícia Viana , Camila M. de Paiva Reis , Ana P. Valério-Alves , João L.R. Freitas , Raquel O. de Sousa Silva , Rafael Morriello","doi":"10.1016/j.hpb.2025.02.001","DOIUrl":"10.1016/j.hpb.2025.02.001","url":null,"abstract":"<div><h3>Background</h3><div>Pancreaticoduodenectomy is associated with high morbidity, with pancreatic fistulas and hemorrhages being the most dangerous complications. We performed a systematic review and meta-analysis to evaluate the efficacy of arterial and anastomotic wrapping in pancreaticoduodenectomy.</div></div><div><h3>Methods</h3><div>We searched PubMed, Embase, and Cochrane Central from inception to February 2024 for studies comparing omental or ligament flaps for arterial or pancreaticojejunostomy coverage in pancreaticoduodenectomies, evaluating common postoperative complications. Odds ratio (OR) was used for categorical variables and mean difference (MD) for continuous variables. We considered as significant <em>p</em>-values < 0.05.</div></div><div><h3>Results</h3><div>We included 15 studies, comprising 3232 patients. The intervention successfully reduced the rates of postpancreatectomy hemorrhage (OR 0.47; <em>p</em> < 0.001), with an additional reduction in postoperative pancreatic fistula when considering the use of omental wrapping (OR 0.48; <em>p</em> = 0.002). Delayed gastric emptying was not associated with a reduction when using the wrapping technique (OR 0.69; <em>p</em> = 0.06).</div></div><div><h3>Conclusion</h3><div>Our findings showed that the wrapping technique decreased the rate of major complications associated with pancreaticoduodenectomy without increasing operative time or reoperation rates.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 591-598"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887665","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

IHPBA White Paper - The improvement of management pathways and access to care in sub-Saharan Africa for patients with hepatocellular carcinoma IHPBA白皮书-改善撒哈拉以南非洲地区肝细胞癌患者的管理途径和获得护理的机会。

IF 2.7 3区医学

Hpb Pub Date : 2025-05-01 DOI: 10.1016/j.hpb.2025.02.007

Eduard Jonas , Martin Smith , Chris Kassianides , Emmanuel Luyirika , C. Wendy Spearman

{"title":"IHPBA White Paper - The improvement of management pathways and access to care in sub-Saharan Africa for patients with hepatocellular carcinoma","authors":"Eduard Jonas , Martin Smith , Chris Kassianides , Emmanuel Luyirika , C. Wendy Spearman","doi":"10.1016/j.hpb.2025.02.007","DOIUrl":"10.1016/j.hpb.2025.02.007","url":null,"abstract":"<div><div>During its 2022 World Congress in New York the International Hepato-Pancreato-Biliary Association (IHPBA) launched the Legacy Initiative, aiming to create sustainable, positive impacts in host countries or regions by addressing critical healthcare challenges in the field of Hepato-Pancreato-Biliary surgery. The 2024 Legacy Initiative focused on hepatocellular carcinoma (HCC) in sub-Saharan Africa (SSA), a region disproportionately burdened by this disease due to a high incidence, limited healthcare infrastructure and resources, lack of screening programs, low awareness, and financial constraints. HCC, the sixth most common malignancy globally, is often diagnosed at advanced stages in SSA, leading to dismal outcomes. The initiative aims to improve management pathways and access to care through a multidisciplinary approach, emphasizing prevention, early diagnosis, curative treatments, potentially life-prolonging treatments, and palliative care. Key strategies include expanding healthcare infrastructure, implementing screening programs, raising awareness, and advocating for policy reforms. The IHPBA has partnered with the African Viral Hepatitis Convention and the African Palliative Care Association to address risk factors for developing HCC, in particular viral hepatitis, a major HCC risk factor. The initiative also highlights the need for capacity building, research, and collaboration with regional and international stakeholders. The 2024 Legacy Initiative aims to drive meaningful change, improve HCC outcomes, and reduce the disease burden in SSA, aligning with the IHPBA’s mission to create long-lasting, positive impacts in global HPB healthcare.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 585-590"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556737","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

Decision to operate on hepatocellular cancer patients is not driven by comorbidities in Louisiana 在路易斯安那州，决定对肝细胞癌患者进行手术并不是由合并症驱动的。

IF 2.7 3区医学

Hpb Pub Date : 2025-05-01 DOI: 10.1016/j.hpb.2025.01.013

Annie Talbot , Denise Danos , Yong Yi , Lauren Maniscalco , Xiao-Cheng Wu , Omeed Moaven , Mary Maluccio , John Lyons III

{"title":"Decision to operate on hepatocellular cancer patients is not driven by comorbidities in Louisiana","authors":"Annie Talbot , Denise Danos , Yong Yi , Lauren Maniscalco , Xiao-Cheng Wu , Omeed Moaven , Mary Maluccio , John Lyons III","doi":"10.1016/j.hpb.2025.01.013","DOIUrl":"10.1016/j.hpb.2025.01.013","url":null,"abstract":"<div><h3>Background</h3><div>The mortality rate of Hepatocellular cancer (HCC) in Louisiana is second worst in the United States. This has been linked to underutilization of curative treatment (CT). This study aimed to identify risk factors associated with underutilization of CT in Louisiana.</div></div><div><h3>Methods</h3><div>Patients with AJCC T1 HCC diagnosed from 2011 to 2020 were identified from the Louisiana Tumor Registry (LTR) using site and histology codes. Patients who underwent CT (ablation, resection, and transplantation) were compared to those who did not undergo CT. Logistic regression was performed and results reported as adjusted odds ratios.</div></div><div><h3>Results</h3><div>CT was utilized in 462 (37 %) of 1247 patients with T1 HCC. There were no significant differences observed in age, race, BMI, poverty, or rurality between CT and non-CT patients. The percentage of cirrhosis was similar in both groups (35.3 % vs. 37.7 %, NS). On multivariant analysis, lack of CT was independently associated with low socioeconomic status (SES; <em>p</em> = 0.040), treatment outside a COC center (<em>p</em> < 0.001), and lack commercial/private insurance (<em>p</em> < 0.001).</div></div><div><h3>Conclusion</h3><div>Utilization of CT is driven not by comorbidities, but by insurance type, low SES, and treatment facility indicating the profound effect that care disparities have on HCC treatment.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 679-687"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482799","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

IHPBA Legacy Declaration - The improvement of management pathways and access to care in sub-Saharan Africa for patients with hepatocellular carcinoma IHPBA遗产宣言-改善撒哈拉以南非洲地区肝细胞癌患者的管理途径和获得护理的机会。

IF 2.7 3区医学

Hpb Pub Date : 2025-05-01 DOI: 10.1016/j.hpb.2025.02.006

Eduard Jonas , Martin Smith , Chris Kassianides , Emmanuel Luyirika , C. Wendy Spearman

引用次数: 0

Exocrine pancreatic insufficiency after partial pancreatectomy: impact on primary healthcare utilization and expenditures 部分胰腺切除术后外分泌胰腺功能不全：对初级保健利用和支出的影响。

IF 2.7 3区医学

Hpb Pub Date : 2025-05-01 DOI: 10.1016/j.hpb.2025.01.016

Zayed Rashid, Selamawit Woldesenbet, Mujtaba Khalil, Erryk Katayama, Muhammad Muntazir Mehdi Khan, Yutaka Endo, Muhammad Musaab Munir, Abdullah Altaf, Susan Tsai, Mary Dillhoff, Timothy M. Pawlik

{"title":"Exocrine pancreatic insufficiency after partial pancreatectomy: impact on primary healthcare utilization and expenditures","authors":"Zayed Rashid, Selamawit Woldesenbet, Mujtaba Khalil, Erryk Katayama, Muhammad Muntazir Mehdi Khan, Yutaka Endo, Muhammad Musaab Munir, Abdullah Altaf, Susan Tsai, Mary Dillhoff, Timothy M. Pawlik","doi":"10.1016/j.hpb.2025.01.016","DOIUrl":"10.1016/j.hpb.2025.01.016","url":null,"abstract":"<div><h3>Introduction</h3><div>We sought to characterize the impact of exocrine pancreatic insufficiency (EPI) on primary healthcare utilization and expenditures following partial pancreatectomy (PP).</div></div><div><h3>Methods</h3><div>Patients who underwent PP between 2004 and 2019 were identified using SEER-Medicare. Patients who developed EPI within 6 months following surgery were included in the EPI cohort and were followed for 1-year post-surgery. Differences in post-surgery PCP visit frequency and healthcare expenditures within 1-year were evaluated.</div></div><div><h3>Results</h3><div>Among 1119 patients, median age was 74 years (IQR: 69–78), about one-half were female (52.5%), and the majority were White (85.2%). Following PP, 22.4% of patients developed EPI. Patients with EPI were more likely to be concomitantly diagnosed with diabetes following PP (EPI: 11.6% vs. no EPI: 3.7%; p < 0.001). On multivariable analyses, EPI was associated with increased PCP visits (Ref. No EPI; percent difference [%diff]: 29.62, 95%CI 15.15–45.90) and higher healthcare costs (Ref. No EPI; total postoperative expenditure: %diff 37.01, 95%CI 12.89–66.29; p < 0.01) within 1-year following PP.</div></div><div><h3>Conclusion</h3><div>Roughly 1 in 4 patients experienced EPI after PP. EPI was associated with increased PCP utilization and higher healthcare expenditures.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 706-715"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457866","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

Central hepatectomy for perihilar cholangiocarcinoma: an alternative technique for parenchymal-sparing hepatectomy to prevent post-hepatectomy liver failure 肝门周围胆管癌的中枢性肝切除术：一种保留实质肝切除术预防肝切除术后肝衰竭的替代技术。

IF 2.7 3区医学

Hpb Pub Date : 2025-05-01 DOI: 10.1016/j.hpb.2025.01.002

Masahiro Fujisawa, Ryuji Yoshioka, Atsushi Takahashi, Shoichi Irie, Yoshinori Takeda, Hirofumi Ichida, Hiroshi Imamura, Yoshihito Kotera, Yoshihiro Mise, Akio Saiura

{"title":"Central hepatectomy for perihilar cholangiocarcinoma: an alternative technique for parenchymal-sparing hepatectomy to prevent post-hepatectomy liver failure","authors":"Masahiro Fujisawa, Ryuji Yoshioka, Atsushi Takahashi, Shoichi Irie, Yoshinori Takeda, Hirofumi Ichida, Hiroshi Imamura, Yoshihito Kotera, Yoshihiro Mise, Akio Saiura","doi":"10.1016/j.hpb.2025.01.002","DOIUrl":"10.1016/j.hpb.2025.01.002","url":null,"abstract":"<div><h3>Background</h3><div>Perihilar cholangiocarcinoma (PHC) often requires major hepatectomy with extrahepatic bile duct resection, carrying the risk of post-hepatectomy liver failure (PHLF). Central hepatectomy (CH), an alternative technique, aims to preserve functional liver reserve. This study evaluated the feasibility of CH and outcomes for patients with PHC within the paradigm of parenchymal-sparing hepatectomy.</div></div><div><h3>Methods</h3><div>A retrospective analysis included PHC patients who underwent CH between March 2019 and January 2023. Preoperative evaluations involved multimodality imaging and assessment of future remnant liver volume.</div></div><div><h3>Results</h3><div>Fourteen patients underwent CH for PHC. Tumor locations were perihilar bile duct (10 patients), and entire extrahepatic bile duct involvement (four patients). Median operative time and intraoperative blood loss were 679.5 min and 450 mL, respectively. Clinically-relevant PHLF occurred in two patients, with one sepsis-related death. Nine patients achieved R0 resection. Functional liver reserve parameters exceeded the standard procedure (p < 0.01).</div></div><div><h3>Conclusion</h3><div>CH for PHC preserves functional liver reserve, potentially reducing PHLF risk. Adequate preoperative evaluation is crucial, and oncological outcomes require further investigation.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 599-606"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448865","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

Preferred content, construct, and duration of a fellowship structure in HPB surgery: a cross-sectional, pan-European survey among trainees and trainers HPB手术中奖学金结构的首选内容、结构和持续时间：一项横断面、泛欧的实习生和培训师调查。

IF 2.7 3区医学

Hpb Pub Date : 2025-05-01 DOI: 10.1016/j.hpb.2025.01.012

Tim Reese , Stefan Gilg , Marc G. Besselink , Kjetil Soreide

{"title":"Preferred content, construct, and duration of a fellowship structure in HPB surgery: a cross-sectional, pan-European survey among trainees and trainers","authors":"Tim Reese , Stefan Gilg , Marc G. Besselink , Kjetil Soreide","doi":"10.1016/j.hpb.2025.01.012","DOIUrl":"10.1016/j.hpb.2025.01.012","url":null,"abstract":"<div><h3>Background</h3><div>Fellowships in HPB surgery are lacking across Europe. The aim of this survey was to investigate preferences towards an HPB-fellowship structure among trainees and trainers.</div></div><div><h3>Methods</h3><div>A cross-sectional pan-European survey of trainees and consultants in HPB across Europe. Preferred content, duration and construct of a fellowship program was explored.</div></div><div><h3>Results</h3><div>Responses from 221 eligible participants were analysed, covering all European regions (40 % trainees, of which 31 % women). Preferred duration was 2 years (53 %), international availability (71 %) and in English language (by two-thirds overall; 74 % among trainees). A majority About two-thirds (63 %) preferred an official fellowship teaching curriculum provided by the E-AHPBA. Most The vast majority of participants (n = 211; 95 %) supported accreditation of HPB-fellowships by the E-AHPBA. Trainees reported higher priorities towards technical training (i.e. time in operating room; first surgeon opportunity; minimal-invasive technique training) than consultants, while time for non-operative activities (i.e. ward rounds; responsibility for multidisciplinary team meetings etc) was valued higher by consultants.</div></div><div><h3>Conclusions</h3><div>We identified preferences and needs towards construct and competence in HPB fellowships with strong support for involvement of E-AHPBA in providing a involvement teaching curriculum and accreditation. A unified HPB fellowship construct and registry across Europe guided by E-AHPBA may take this into consideration.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 670-678"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382349","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

Textbook outcome in liver surgery after staged versus simultaneous resection for synchronous colorectal liver metastases. 同步结直肠肝转移患者分期切除与同步切除后肝脏手术的预后。

IF 2.7 3区医学

Hpb Pub Date : 2025-04-29 DOI: 10.1016/j.hpb.2025.04.014

Zayed Rashid, Abdullah Altaf, Mujtaba Khalil, Giovanni Catalano, Shahzaib Zindani, Andrea Ruzzenente, Irinel Popescu, Minoru Kitago, George A Poultsides, Kazunari Sasaki, Nazim Bhimani, Tom Hugh, Mathew Weiss, Luca Aldrighetti, Federico Aucejo, Itaru Endo, Timothy M Pawlik

{"title":"Textbook outcome in liver surgery after staged versus simultaneous resection for synchronous colorectal liver metastases.","authors":"Zayed Rashid, Abdullah Altaf, Mujtaba Khalil, Giovanni Catalano, Shahzaib Zindani, Andrea Ruzzenente, Irinel Popescu, Minoru Kitago, George A Poultsides, Kazunari Sasaki, Nazim Bhimani, Tom Hugh, Mathew Weiss, Luca Aldrighetti, Federico Aucejo, Itaru Endo, Timothy M Pawlik","doi":"10.1016/j.hpb.2025.04.014","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.04.014","url":null,"abstract":"<p><strong>Background: </strong>We sought to define the likelihood of textbook outcome in liver surgery (TOLS) among patients undergoing simultaneous versus staged resection for sCRLM.</p><p><strong>Methods: </strong>Patients with sCRLM who underwent curative-intent resection between 2000-2022 were identified from an international multi-institutional database. TOLS was defined by the absence of intraoperative grade ≥2 events, R1 resection margin, post-hepatectomy liver failure, bile leakage, major postoperative complications, in-hospital/90-day mortality, and 90-day readmission. Multivariable regression was utilized to study associations between surgical approach and TOLS.</p><p><strong>Results: </strong>Among 897 patients with median age of 62 (IQR 55-69) years, 376 (41.9 %) patients underwent synchronous resection whereas 521 (58.1 %) patients had staged resection of sCRLM. 62.8 % of patients had TOLS following sCRLM resection and patients who underwent staged resection were more likely to have TOLS (staged: 65.8 % vs. simultaneous: 58.5 %, p = 0.025). Staged resection was associated with 37 % higher odds of TOLS (OR 1.37, 95 % CI 1.04-1.80) than simultaneous resection. Incidence of TOLS decreased with extensive resection (low-risk colectomy and minor hepatectomy: 69.6 % vs. high-risk colectomy and major hepatectomy: 2.8 %; p < 0.001).</p><p><strong>Conclusion: </strong>62.8 % of patients had TOLS following sCRLM resection. Staged versus simultaneous resection was associated with 37 % higher odds of TOLS. Extent of resection should be considered when determining the optimal operative approach.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965095","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

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