Hpb最新文献

{"title":"Treatment of patients with pancreatic injuries during the war after Russian invasion of Ukraine","authors":"Oleksandr Usenko ,&nbsp;Volodymyr Kopchak ,&nbsp;Liudmyla Pererva ,&nbsp;Ihor Khomiak ,&nbsp;Viktor Shkarban ,&nbsp;Ivan Tereshkevych ,&nbsp;Volodymyr Trachuk ,&nbsp;Vitalii Kondratiuk","doi":"10.1016/j.hpb.2025.06.013","DOIUrl":"10.1016/j.hpb.2025.06.013","url":null,"abstract":"<div><h3>Background</h3><div>Management of pancreas trauma is complex and not well understood. Pancreas injury associated with military trauma is associated with high morbidity and mortality. This study aims to analyze the results of surgical treatment of patients in a major HPB center with pancreatic injuries during the Ukraine conflict.</div></div><div><h3>Methods</h3><div>Between 24 February 2022 to 31 December 2023, prospectively collected data on patients admitted to Department of Pancreatic and Bile Ducts Surgery in the Shalimov National Scientific Center of Surgery and Transplantology was collected into a database. Patients with pancreas trauma were scrutinized treatment patterns identified.</div></div><div><h3>Results</h3><div>48 patients with pancreatic trauma were admitted. Acute posttraumatic pancreatitis occurred in – 39 patients, 9 patients presented with a pancreatic fistula. Among patients with pancreatic injuries the following procedures were performed: EUS drainage of pancreatic fluid collection (PFC) 2/48, US guided percutaneous drainage 11/48, laparotomy and necrosectomy 7/48, EUS–guided pancreatonecrsecctomy with cystogastrostomy or with cystoduodenostomy 4/48. In 15 patients we performed cystojejunostomy, cystogastrostomy or cystoduodenostomy, in 9 patients - fistulopancreatojejunostomy. Mortality occurred in 2 (4.2 %) patients.</div></div><div><h3>Conclusions</h3><div>Personalized tactics of surgical treatment, preferring the use of minimally invasive techniques allow to achieve recovery in the treatment of severely wounded with pancreatic injuries.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 10","pages":"Pages 1281-1283"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803996","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":"Endoscopic versus percutaneous drainage placement after left-sided pancreatectomy: multi-state model for defining objectifiable variables on interventional treatment for pancreatic fistula","authors":"Matthäus Felsenstein ,&nbsp;Sophie Dorfer ,&nbsp;Ann-Christin Amini ,&nbsp;Regina Stegherr ,&nbsp;Aboelyazid Elkilany ,&nbsp;Niklas M. Stephan Mirwald ,&nbsp;Uli Fehrenbach ,&nbsp;Dou Ma ,&nbsp;Cao Z. Jing Jin ,&nbsp;Mengwen Hu ,&nbsp;Ruonan Wang ,&nbsp;Lea Timmermann ,&nbsp;Karl H. Hillebrandt ,&nbsp;Ulrike Grittner ,&nbsp;Igor M. Sauer ,&nbsp;Christian Jürgensen ,&nbsp;Johann Pratschke ,&nbsp;Thomas Malinka","doi":"10.1016/j.hpb.2025.06.012","DOIUrl":"10.1016/j.hpb.2025.06.012","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative pancreatic fistula (POPF) remains a prevalent complication after left-sided pancreatectomy. Interventional treatment is regularly required and relies on interdisciplinary concepts, including interventional radiology and endoscopy. Evidence on the correct indication and clinical algorithms for available treatment modalities are needed.</div></div><div><h3>Methods</h3><div>During a 5-year observational period, we followed the clinical courses of 200 patients after left-sided pancreatectomy. Patients who fulfilled clinical and radiographic criteria for interventionally-relevant(IR-) POPF were identified. Interventional treatment groups were stratified via established step-up concepts for descriptive analyses and via a decision-based algorithm for comparative analyses. We used a Multi-State Time-to-Event Model (MSM) to assess clinical resolution efficacy.</div></div><div><h3>Results</h3><div>Following surgery, patients with IR-POPF needed multiple (58.2 %) and multimodal (49.4 %) interventions to achieve final resolution. Technical success rates were higher in ED (57.7 %) versus PD (32.7 %), and resulted in earlier resolution (8.4d, 95%C [5.5–11.2d]) when compared to the PD group (23.4d, 95%CI[2.8–17.9d]). At any given time, probability of reaching clinical resolution were higher for ED in multifaceted MSM analysis (HR 1.39, 95%CI[0.854, 2.25]).</div></div><div><h3>Conclusion</h3><div>The present study highlights the importance of endoscopy-guided drainage placement after left-sided pancreatic resection. CRP value appeared to be a single objectifiable parameter for optimized treatment allocation.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 10","pages":"Pages 1270-1280"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690069","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":"Shaping the future of HPB surgery: the launch of the E-AHPBA Early Career Group","authors":"Martina Nebbia ,&nbsp;Stefan Gilg ,&nbsp;Aiste Gulla ,&nbsp;Olivia Sgarbura ,&nbsp;Giovanni Marchegiani ,&nbsp;Eduard Jonas ,&nbsp;Marc G. Besselink ,&nbsp;Alberto Balduzzi","doi":"10.1016/j.hpb.2025.07.009","DOIUrl":"10.1016/j.hpb.2025.07.009","url":null,"abstract":"","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 10","pages":"Pages 1248-1249"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764859","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":"Prehepatectomy chemotherapy for resectable but oncologically advanced colorectal liver metastases is not associated with improved survival","authors":"Yui Sawa,&nbsp;Yoshikuni Kawaguchi,&nbsp;Mei Nakamura,&nbsp;Yuhi Yoshizaki,&nbsp;Yusuke Seki,&nbsp;Yujiro Nishioka,&nbsp;Akihiko Ichida,&nbsp;Nobuhisa Akamatsu,&nbsp;Kiyoshi Hasegawa","doi":"10.1016/j.hpb.2025.07.004","DOIUrl":"10.1016/j.hpb.2025.07.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Multidisciplinary treatment strategies are effective for treating colorectal liver metastases (CLM). This study aimed to compare the overall survival (OS) in patients who had resectable but oncologically challenging CLM with reference to the use of prehepatectomy chemotherapy.</div></div><div><h3>Methods</h3><div>Data were extracted from a prospectively maintained database of patients who underwent liver resection or medical therapy for CLM from January 2005 to June 2022. Initially, our group treated resectable CLM with surgery alone. However, starting in 2015, we gradually adopted prehepatectomy chemotherapy for patients with CLM number ≥5. Survival analysis was adjusted using an inverse probability of treatment weighting (IPTW) analysis.</div></div><div><h3>Results</h3><div>Among the 587 patients, 332, 143, and 112 were categorized, on the basis of the European Society for Medical Oncology (ESMO) guideline, into the technically resectable CLM with oncologically good prognosis (R–OG), technically resectable CLM with oncologically bad prognosis (R–OB), and technically unresectable CLM (UR) groups, respectively. Among the 143 patients with R–OB, 70 and 73 underwent prehepatectomy chemotherapy and upfront surgery, respectively. OS did not differ significantly between the groups after adjusting for confounders using IPTW analysis (P = 0.438).</div></div><div><h3>Discussion</h3><div>Prehepatectomy chemotherapy was not associated with better OS in patients with R–OB CLM.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 10","pages":"Pages 1301-1308"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730114","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":"Surgery for metastasis to the pancreas: systematic review of observational cohort studies","authors":"Marcus T. Roalsø ,&nbsp;James Lucocq ,&nbsp;Sanjay Pandanaboyana ,&nbsp;Kjetil Søreide","doi":"10.1016/j.hpb.2025.07.003","DOIUrl":"10.1016/j.hpb.2025.07.003","url":null,"abstract":"<div><h3>Background</h3><div>Pancreatectomy of metastases to the pancreas from other cancers is uncommon. Despite the rarity, several tumour entities have been described to metastasise to the pancreas and having undergone resection. The aim of this review was to collect studies reporting all-sites of origin and compare survival after pancreatectomy.</div></div><div><h3>Methods</h3><div>A systematic review of PubMed/Medline for observational studies from 2009 to 2025 reporting all-sites of origin with metastasis to the pancreas.</div></div><div><h3>Results</h3><div>Fifteen cohort studies with 613 pancreatectomies for metastases were reported, with 346 (56.4 %) from renal cell carcinoma (RCC). Among non-RCC indications, colorectal cancer (10.1 %) gynaecological cancers (7.3 %), sarcomas (6.3 %) and melanoma (4.6 %) were most frequent. Distal pancreatectomy was the most frequent procedure (63.7 %) followed by pancreatoduodenectomy (30 %) and total pancreatectomy (11.4 %). Other procedures including enucleations were done in in 8.3 %. Overall survival was best for pancreatectomy from RCC-metastasis, approaching 10 years median survival in the most recent studies, with a significant difference compared to all non-RCC indications.</div></div><div><h3>Conclusion</h3><div>Pancreatectomy for metastasis is reported with an increase in non-RCC origins. Distal pancreatectomy is performed in two-thirds. Long-term survival up to 10 years was reported after surgery for RCC. Considerably lower survival was reported in other primary cancer sites (PROSPERO#CRD42025633602).</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 10","pages":"Pages 1290-1300"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742052","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":"The LBRA nomogram: a practical model for predicting 30-day mortality in ICU patients with acute pancreatitis","authors":"Guangyao Yang,&nbsp;Qifang Shi","doi":"10.1016/j.hpb.2025.07.008","DOIUrl":"10.1016/j.hpb.2025.07.008","url":null,"abstract":"","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 10","pages":"Pages 1351-1353"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742053","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":"Determining lymph node metastasis and dissection and following prognosis in pancreatic neuroendocrine tumors: risk prediction using preoperative factors.","authors":"Hyeong Seok Kim, Eyad Ebrahim, Hochang Chae, So Jeong Yoon, Sang Hyun Shin, In Woong Han, Jin Seok Heo, Hongbeom Kim","doi":"10.1016/j.hpb.2025.09.004","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.09.004","url":null,"abstract":"<p><strong>Background: </strong>The clinical significance of lymph node (LN) dissection in pancreatic neuroendocrine tumors (pNETs) remains unclear. This study aimed to identify preoperative risk factors associated with LN metastasis and prognosis, and to assess the need for LN dissection by risk stratification.</p><p><strong>Methods: </strong>Total 287 patients with pNETs who underwent surgery at a tertiary center (2010-2022) were retrospectively analyzed. Clinicodemographic and preoperative variables were used to stratify patients and assess their impact on survival and LN metastasis.</p><p><strong>Results: </strong>Among 274 evaluable patients, 21 had LN metastases, 87 had no metastases, and 166 did not undergo LN dissection. Tumor location, prominent LN, and suspected distant metastasis were predictors of LN metastasis. Age >70, tumor ≥2 cm, enlarged LN, and distant metastases were associated with overall survival. Survival differed significantly according to the risk factors (P<0.001). Patients with 0-1 factor had low LN metastasis (9.5 %) and showed no survival difference according to LN dissection. Those with ≥2 factors had higher LN metastasis (41.2 %), but LN dissection/metastasis status did not significantly affect survival.</p><p><strong>Conclusion: </strong>Risk stratification using preoperative factors can inform surgical decisions in pNETs. LN dissection may be omitted in low-risk patients, while high-risk cases require accurate staging and postoperative planning.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228516","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":"Duodenum-preserving pancreatic head resection in 1063 patients for benign, premalignant cystic, and neuroendocrine neoplasms - Short-term surgical outcomes and risk of recurrence - Results of a systematic review.","authors":"Hans G Beger, Benjamin Mayer, Bertram Poch","doi":"10.1016/j.hpb.2025.09.002","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.09.002","url":null,"abstract":"<p><strong>Background: </strong>To prevent malignant transformation to advanced cancer of premalignant cystic neoplasms and neuroendocrine tumors of the pancreatic head, the objective arises whether oncologic multiorgan PD or parenchyma-sparing, duodenum-preserving resection (DPPHR) should be performed.</p><p><strong>Methods: </strong>Pubmed, Medline, Embase and Cochrane libraries were searched for studies reporting postoperative results and late outcome after DPPHR. Data from 49 cohort studies including 1063 patients were assessed.</p><p><strong>Results: </strong>DPPHR was performed on 374 IPMN, 96 MCN, 154 SPN, 142 SCA, and 145 PNET patients. 90-day mortality was 5 of 1063 patients (0.47 %), pancreatic fistula B/C 15.7 %, biliary fistula 5.9 %. 39 of 228 IPMNs(17.1 %) revealed high-grade dysplasia, 10 of 374 IPMNs micro-carcinoma and 9 minimal invasive carcinoma. None of them developed disease recurrence after total DPPHR in the follow-up time of 42.05 months. 96.2 % of patients followed the postoperative tracking checks. Recurrent tumor, anastomotic or in remote pancreas, was observed in 21 of 374 IPMNs(5.61 %). Disease-specific survival for 2 and 5 years was 99.3 % and 97.3 %, respectively.</p><p><strong>Conclusion: </strong>DPPHR for cystic neoplasms and PNETs is a low-risk surgical treatment and leads to cure of patients. Total duodenum- and CBD-preserving pancreatic head resection extends surgeons' skills for treatment of cystic, premalignant neoplasms of the pancreatic head.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148655","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":"Long-term evaluation of gastric electrophysiology, symptoms and quality of life after pancreaticoduodenectomy.","authors":"Tim Hsu-Han Wang, Chris Varghese, Stefan Calder, Armen Gharibans, Gabriel Schamberg, Adam Bartlett, Sanket Srinivasa, Greg O'Grady","doi":"10.1016/j.hpb.2025.09.003","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.09.003","url":null,"abstract":"<p><strong>Background: </strong>Pancreaticoduodenectomy (PD) is typically performed for pancreatic and biliary malignancies. Post-operative gastric dysfunction is common and the underlying pathophysiology is still poorly understood. This study aimed to evaluate the gastric electrophysiology, symptoms and quality of life (QoL) following PD, using the novel non-invasive Gastric Alimetry mapping system.</p><p><strong>Methods: </strong>PD patients from Auckland between 2017 and 2022 were recruited. Gastric Alimetry® (Alimetry, New Zealand) was employed, comprising a stretchable wearable array (8×8 electrodes) and a validated app for symptom logging. A 30-min pre-prandial and a 4-hour post-prandial recording was performed. Data collected includes Principal Gastric Frequency, BMI-adjusted amplitude, Gastric Alimetry Rhythm Index, meal response, symptoms and QoL questionnaires (PAGI-QOL, EQ-5D-5L). Data was compared to matched healthy controls. Pearson's correlation analysis was performed.</p><p><strong>Results: </strong>19 patients and 19 healthy controls were recruited. Moderate to severe symptoms and QoL were found in 8/19 (42 %) and at least one abnormal electrophysiology parameter in 8/19 (42 %), albeit uncorrelated (p=0.43). Significant differences were found in PAGI-QOL and EQ-5D-5L with controls (p<0.01).</p><p><strong>Conclusion: </strong>Moderate to severe upper GI symptoms are common after PD. Although altered gastric electrophysiology is common, other factors are likely more relevant to long-term QoL. Notably, short term associations remain uninvestigated.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113076","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":"Diffusion of robotic platforms and new devices in HPB surgery: a European-African Hepato-Pancreato-Biliary Association (E-AHPBA) survey.","authors":"Matteo De Pastena, Salvatore Paiella, Gabriella Lionetto, Francesca Ratti, Gregor A Stavrou, Andrew J Healey, Niki Rashidian, Andrew A Gumbs, Martina Guerra, Andrea Belli, Aiste Gulla, Alessandro Esposito, Stefan A Bouwense, Angelakoudis Apostolos, Sven A Lang, Victor López-López, Luca Aldrighetti, Oliver Strobel","doi":"10.1016/j.hpb.2025.09.001","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.09.001","url":null,"abstract":"<p><strong>Background/aim: </strong>Robotic platforms in Hepato-Pancreato-Biliary (HPB) surgery improved surgical precision and recovery. However, their adoption remains inconsistent. This study aims to assess the current status of robotic surgery in HPB procedures.</p><p><strong>Methods: </strong>The Innovation Committee of the European-African Hepato-Pancreato-Biliary Association (E-AHPBA) developed a web-based survey. The survey collected data from 82 European and African centers on the availability, usage, and surgical volumes of robotic platforms in liver and pancreatic resections. Descriptive statistics were used to analyze responses.</p><p><strong>Results: </strong>The survey found that 94% (77/82) of centers use robotic platforms for HPB surgery, but only 6% (5/82) rely solely on robotic systems. The Da Vinci Surgical System was the most commonly used platform, present in 88% (72/82) of centers. Regarding surgical volumes, 62% (51/82) of centers perform at least 20 robot-assisted liver resections annually, whereas only 2% (2/82) exceed 80 procedures. In pancreatic surgery, 28% (23/82) of centers do not utilize robotic platforms. Additionally, 37% (30/82) of centers perform fewer than 10 robot-assisted HPB resections per year. Conversely, 38% (31/82) report using robotic platforms 2-3 days per week.</p><p><strong>Discussion: </strong>Robotic platforms are increasingly incorporated into HPB surgery. However, their widespread adoption is limited by economic, logistical, and utilization constraints.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102821","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}