Hpb最新文献

{"title":"Systematic review of randomised controlled trials on pain domains and assessment methods in post pancreatectomy patients","authors":"Vivek Peddakota ,&nbsp;Ruth Owen ,&nbsp;Nejo Joseph ,&nbsp;Litesh Chouhan Mudavath ,&nbsp;Cecilie Siggaard Knoph ,&nbsp;Louise Kuhlmann ,&nbsp;Esther Pogatzki-Zahn ,&nbsp;John Windsor ,&nbsp;Asbjorn M. Drewes ,&nbsp;Sanjay Pandanaboyana","doi":"10.1016/j.hpb.2026.02.006","DOIUrl":"10.1016/j.hpb.2026.02.006","url":null,"abstract":"<div><h3>Background</h3><div>This systematic review aims to identify the core outcome domains and assessment methods currently used in randomised controlled trials (RCTs) for acute postoperative pain following pancreatic surgery.</div></div><div><h3>Methods</h3><div>PubMed, Embase, Web of Science, and the Cochrane Library were searched without restrictions. Eligible studies were screened and data extracted for pain assessment tools, analgesic outcomes, adverse effects, pain interference and quality-of-life measures.</div></div><div><h3>Results</h3><div>Fifteen RCTs involving 1034 patients were included. All trials assessed pain intensity using a visual analogue scale (<em>n</em> = 11) or a numerical rating scale (<em>n</em> = 4). Analgesic consumption was reported in 13 trials, with significant variability in the reporting, rescue analgesia and adverse effects. Pain interference or physical function was described in 10 trials, including pain on coughing (<em>n</em> = 4), mobilisation (<em>n</em> = 3), % gait speed and % peak cough flow (<em>n</em> = 2). Multidimensional tools were rarely used, with a single RCT employing three different scales. Psychological function was assessed in one trial using anxiety and depression scales.</div></div><div><h3>Conclusion</h3><div>There was notable heterogeneity in pain domains assessed and the tools used across pain management RCTs post-pancreatectomy. This highlights the need for standardized core outcome domains and multidimensional tools specific to pancreatic surgery to enable comparability of data and robust analysis.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 5","pages":"Pages 611-622"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147316883","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":"Risk factors for unplanned intensive care unit admission after liver resection: a cohort study","authors":"Alejandro Brañes ,&nbsp;Brianna Greenberg ,&nbsp;Alexandra W. Acher ,&nbsp;Keying Xu ,&nbsp;Myriam Lafreniere-Roula ,&nbsp;Kevin E. Thorpe ,&nbsp;Paul J. Karanicolas ,&nbsp;HPB CONCEPT Team","doi":"10.1016/j.hpb.2026.02.004","DOIUrl":"10.1016/j.hpb.2026.02.004","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative unplanned intensive care unit (ICU) admission is associated with increased cost and poor survival. The impact of perioperative factors on unplanned ICU admission after hepatectomy is unclear.</div></div><div><h3>Methods</h3><div>An analysis of participants in the Hemorrhage During Liver Resection: Tranexamic Acid (HeLiX) randomized trial was conducted. Participants were stratified by ICU admission status: no, planned, and unplanned. Multivariable multinomial logistic regression analysis was performed to determine variables associated with unplanned ICU admission and 90-day mortality was calculated.</div></div><div><h3>Results</h3><div>Of 1240 patients included, 868 (70 %) had no, 322 (26 %) had planned, and 50 (4 %) had unplanned ICU admission. On multivariable multinomial logistic regression analysis, prior cardiovascular disease (Relative Risk Ratio (RRR) 2.03; 95 % Confidence Interval (CI) 1.01–4.08), major liver resection (RRR 2.18; 95 % CI 1.12–4.27) and estimated blood loss per 500 mL (RRR 1.38; 95 % CI 1.23–1.55) were significantly associated with unplanned ICU admission. 90-day mortality rate for no, planned, and unplanned ICU admission was 1 %, 5 % and 16 %, respectively.</div></div><div><h3>Conclusion</h3><div>Prior cardiovascular disease, major liver resection, and higher estimated blood loss were associated with unplanned ICU admission and increased perioperative mortality after hepatectomy. Consideration should be given to early monitoring of patients with these risk factors to decrease mortality.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 5","pages":"Pages 731-736"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147316852","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":"Neoadjuvant chemotherapy versus upfront surgery for perihilar cholangiocarcinoma: a propensity score matching analysis","authors":"Keita Sonoda ,&nbsp;Yuta Abe ,&nbsp;Naokazu Chiba ,&nbsp;Ryo Nishiyama ,&nbsp;Kisyo Mihara ,&nbsp;Shigeo Hayatsu ,&nbsp;Kiminori Takano ,&nbsp;Ryo Takemura ,&nbsp;Minoru Kitago ,&nbsp;Yasushi Hasegawa ,&nbsp;Shutaro Hori ,&nbsp;Masayuki Tanaka ,&nbsp;Kohei Mishima ,&nbsp;Yutaka Nakano ,&nbsp;Shigeyuki Kawachi ,&nbsp;Yuko Kitagawa","doi":"10.1016/j.hpb.2026.01.011","DOIUrl":"10.1016/j.hpb.2026.01.011","url":null,"abstract":"<div><h3>Background</h3><div>Neoadjuvant chemotherapy (NAC) may improve outcomes in perihilar cholangiocarcinoma (PHC); however, its efficacy compared with upfront surgery (US) for resectable PHC remains unclear. We compared survival and clinicopathological characteristics between NAC and US in patients with technically resectable PHC, using propensity score matching (PSM).</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 261 patients with resectable PHC who underwent surgical treatment (2016–2024) across multiple institutions. Among them, 50 received NAC and 199 underwent US. The 38 patients receiving NAC were matched 1:1 with patients undergoing US using PSM. Overall survival (OS) and progression-free survival (PFS) were compared between groups. Pathological response to NAC and its association with chemotherapy doses were also evaluated.</div></div><div><h3>Results</h3><div>Before PSM, OS and PFS did not differ significantly between the US and NAC groups. After PSM, OS did not differ significantly between groups, but PFS was significantly longer in the NAC group, where patients with a therapeutic-effect grade ≥1b had better PFS than those with US. Grade ≥1b response was associated with receiving ≥7 NAC doses.</div></div><div><h3>Discussion</h3><div>NAC may improve PFS in selected patients with resectable PHC, especially those showing major pathological responses. Prospective studies should validate these findings and define optimal selection criteria and regimens.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 5","pages":"Pages 666-675"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147283497","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":"Cover","authors":"","doi":"10.1016/S1365-182X(26)00576-9","DOIUrl":"10.1016/S1365-182X(26)00576-9","url":null,"abstract":"","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 5","pages":"Page OFC"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147756879","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":"Challenging anatomy, comparable outcomes: a multicenter propensity score-matched analysis of robotic hepatectomy in posterosuperior versus anterolateral segments","authors":"Silvio Caringi ,&nbsp;Annachiara Casella ,&nbsp;Rebecca Marino ,&nbsp;Paolo Magistri ,&nbsp;Andrea Belli ,&nbsp;Annarita Libia ,&nbsp;Graziano Ceccarelli ,&nbsp;Francesco Izzo ,&nbsp;Marcello G. Spampinato ,&nbsp;Nicola de’ Angelis ,&nbsp;Patrick Pessaux ,&nbsp;Tullio Piardi ,&nbsp;Fabrizio Di Benedetto ,&nbsp;Francesca Ratti ,&nbsp;Riccardo Memeo","doi":"10.1016/j.hpb.2026.02.002","DOIUrl":"10.1016/j.hpb.2026.02.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Robotic liver resection has become increasingly adopted for minor hepatectomies, including lesions in the anatomically challenging posterosuperior (PS) segments. This study compares the perioperative and pathological outcomes of robotic minor resections in PS versus anterolateral (AL) segments across high-volume centers in Europe.</div></div><div><h3>Materials and methods</h3><div>A multicenter database of 730 robotic liver resections performed from 2011 to 2023 in nine European institutions was reviewed. After excluding major hepatectomies, patients were analyzed in three steps: overall cohort, comparison of PS vs AL resections, and two consecutive propensity score matches.</div></div><div><h3>Results</h3><div>PS resections consistently had longer operative times, increased blood loss, and increased frequency and duration of Pringle maneuver use in all analyses. Following propensity matching, postoperative outcome measures such as overall morbidity, major complications, readmission, mortality, length of stay, and R1 rates were similar for PS and AL resections.</div></div><div><h3>Discussion</h3><div>Despite greater intraoperative complexity, robotic surgery seems to offset the technical disadvantages of PS segments to obtain postoperative and pathological results comparable to AL resections.</div></div><div><h3>Conclusion</h3><div>Robotic minor liver resections in PS segments are safe and feasible when performed in experienced centers, supporting their broader adoption in advanced minimally invasive hepatobiliary surgery.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 5","pages":"Pages 721-730"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147316892","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":"Benchmarking Pancreaticoduodenectomy Outcomes in Peru: a 15-year Single-Institution Experience Using Global Quality Metrics","authors":"Gustavo Reaño-Paredes ,&nbsp;Fritz Kometter ,&nbsp;David Callacondo ,&nbsp;Fernando Revoredo Rego ,&nbsp;Guillermo Ángel Herrera-Chávez ,&nbsp;Wuilber Ludeña Hurtado ,&nbsp;Mónica del Rocío Uribe-León ,&nbsp;Jorge Tang ,&nbsp;Angela Daniela Basurco Valer ,&nbsp;José Luis Arenas Gamio ,&nbsp;Miguel Aníbal Apaza-Canaza ,&nbsp;Sheyla Alfaro Ita ,&nbsp;Vanessa Bermúdez-Alfaro ,&nbsp;Frederick Glenn Massucco Revoredo ,&nbsp;Ítalo Landeo Aliaga ,&nbsp;Liliana Del Pilar Fonseca Cavero ,&nbsp;Félix Carrasco ,&nbsp;Luis Villanueva Alegre ,&nbsp;José De Vinatea de Cárdenas ,&nbsp;Patricio M. Polanco","doi":"10.1016/j.hpb.2026.01.012","DOIUrl":"10.1016/j.hpb.2026.01.012","url":null,"abstract":"<div><h3>Background</h3><div>Reporting standards for pancreaticoduodenectomy (PD) in low- and middle-income countries remain uneven, and regional data continues to be scarce. In this study, we summarize 15 years of experience from a high-volume center in Peru using internationally recognized surgical quality metrics.</div></div><div><h3>Methods</h3><div>We reviewed 414 PDs performed between 2009 and 2023. Outcomes were examined across three 5-year periods, using established definitions for morbidity, mortality, and key pancreatic complications. Composite indicators—Failure to Rescue (FTR) and Ideal Outcome (IO)—were also applied.</div></div><div><h3>Results</h3><div>Overall morbidity was 54.1 %; major morbidity was 30.7 %, and in-hospital mortality was 4.8 %. Ninety-day mortality was 6.0 %, FTR 15.7 %, and IO 60.1 %, all without significant temporal changes. Clinically relevant POPF occurred at 22 %, decreasing early on and rising again during the pandemic period. Delayed gastric emptying occurred at 10.4 %, while PPH (8.5 %), readmission (5.8 %), reoperation (10.6 %), and length of stay (11 days) remained stable. Periampullary adenocarcinoma accounted for most indications (78 %), with ampullary tumors being the most frequent.</div></div><div><h3>Conclusions</h3><div>This series—the largest contemporary Latin American report applying IO and FTR—shows outcomes comparable to international reference centers. These results were sustained despite increasing case complexity, the introduction of minimally invasive PD, and the disruptions caused by the COVID-19 pandemic.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 5","pages":"Pages 676-689"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364867","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)00577-0","DOIUrl":"10.1016/S1365-182X(26)00577-0","url":null,"abstract":"","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 5","pages":"Page IFC"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147756880","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":"IHPBA news 1","authors":"","doi":"10.1016/S1365-182X(26)00584-8","DOIUrl":"10.1016/S1365-182X(26)00584-8","url":null,"abstract":"","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 5","pages":"Page IBC"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147756962","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":"IHPBA news 2","authors":"","doi":"10.1016/S1365-182X(26)00585-X","DOIUrl":"10.1016/S1365-182X(26)00585-X","url":null,"abstract":"","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 5","pages":"Page OBC"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147756963","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":"Neoadjuvant therapy in gall bladder cancer improves resectability and survival: a prospective study","authors":"Anupam Lahiri ,&nbsp;Suchita Chowdhury ,&nbsp;Shaifali Goel ,&nbsp;Syed Assif Iqbal ,&nbsp;Abhishek Aggarwal ,&nbsp;Prerna Garg ,&nbsp;Varun Goel ,&nbsp;Vineet Talwar ,&nbsp;Jaskaran Sethi ,&nbsp;Shivendra Singh","doi":"10.1016/j.hpb.2026.01.015","DOIUrl":"10.1016/j.hpb.2026.01.015","url":null,"abstract":"<div><h3>Background</h3><div>Gallbladder carcinoma has dismal prognosis with &lt;20 % resectability at presentation. The role of Neoadjuvant chemotherapy (NACT) remains undefined.</div></div><div><h3>Methods</h3><div>This is a prospective single center study of 226 gallbladder carcinoma patients receiving NACT. Gemcitabine-platinum combinations were administered followed by response assessment. Primary endpoints included resectability and survival outcomes.</div></div><div><h3>Results</h3><div>Of 226 patients, 135 (59.7 %) completed NACT. Intention-to-treat resection rate was 36.2 % (82/226), increasing to 60.7 % (82/135) among treatment completers. R0 resection achieved in 95.1 % (78/82). Grade ≥3 toxicity occurred in 9.7 % with 1.7 % treatment-related mortality. Median overall survival: 27 months (resectable) versus 13 months (unresectable) (p &lt; 0.001). Two-year overall survival: 62.1 % versus 31.4 % respectively. Perioperative mortality: 3.7 %; major morbidity: 13.5 %. Incidental gallbladder cancer showed higher resectability (44.1 % vs 33.7 %) with 2-year overall survival 75 % versus 55.6 %. Multivariate analysis identified resectability (HR 2.714, p = 0.0002), perineural invasion (HR 2.986, p = 0.018), and advanced T-stage (HR 1.940, p = 0.041) as independent prognostic factors.</div></div><div><h3>Conclusions</h3><div>NACT enables curative resection in 60.7 % completing treatment with acceptable toxicity, supporting incorporation into treatment algorithms for locally advanced gallbladder cancer.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 5","pages":"Pages 700-708"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146226519","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}