IF 2.4 3区医学

Hpb Pub Date : 2025-09-05 DOI: 10.1016/j.hpb.2025.09.001

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

{"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":"Background/aim: 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.Methods: 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.Results: 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.Discussion: Robotic platforms are increasingly incorporated into HPB surgery. However, their widespread adoption is limited by economic, logistical, and utilization constraints.","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}

引用次数: 0

Intraductal papillary neoplasm of the bile duct. 胆管内乳头状肿瘤。

IF 2.4 3区医学

Hpb Pub Date : 2025-09-05 DOI: 10.1016/j.hpb.2025.08.017

Hassan Aziz, Peyton Seda, Matthew Gosse, Yashant Aswani, Timothy M Pawlik

{"title":"Intraductal papillary neoplasm of the bile duct.","authors":"Hassan Aziz, Peyton Seda, Matthew Gosse, Yashant Aswani, Timothy M Pawlik","doi":"10.1016/j.hpb.2025.08.017","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.08.017","url":null,"abstract":"Background: Intraductal papillary neoplasm of the bile duct (IPNB) was formally adopted in the 2010 WHO classification as a distinct clinical and pathological entity. We herein review the concept, clinical and pathologic features, as well as the prognosis of IPNB.Methods: A comprehensive review was conducted using MEDLINE/PubMed, Google Scholar, Cochrane Library, and the Web of Science, which were accessed between 2004 and 2025. The main search focused on \"Intraductal papillary neoplasm of the bile duct.\"Results: IPNB often present with intermittent right upper quadrant abdominal pain, recurrent episodes of acute cholangitis, obstructive jaundice with macroscopic or microscopic mucin, and dilation of the proximal bile duct. On histology, IPNB is characterized by papillary proliferation of neoplastic biliary epithelial cells with delicate fibrovascular stalks within the bile duct. MRI, including MRCP, has the highest diagnostic sensitivity (65.5 %) followed by CT (50 %). Surgical resection with a negative margin is the treatment of choice. In contrast to flat intraductal neoplasia-associated cholangiocarcinoma, IPNB has a better prognosis and postoperative outcome with a 5-year survival of 70-81 % although risk of recurrence can be high.Conclusion: Clinicians need to be familiar with the presentation, diagnosis, and treatment of IPNB lesions.","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":"145174851","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

Ultrafine percutaneous transhepatic cholangioscopy for biliary biopsy among patients with suspected malignant biliary obstruction. 超细经皮经肝胆道镜检查在疑似恶性胆道梗阻患者中的应用。

IF 2.4 3区医学

Hpb Pub Date : 2025-09-05 DOI: 10.1016/j.hpb.2025.08.016

Hai-Feng Zhou, Wei-Zhong Zhou, Hai-Bin Shi, Wei Yang, Zhong-Wei Xu, Bi-Fei Wu, Xiang-Cheng Li, Sheng Liu

引用次数: 0

Achieving quality and standards in Hepato-Pancreato-Biliary surgery: the Baltic chapter of E-AHPBA framework. 实现肝胰胆手术的质量和标准：E-AHPBA框架的波罗的海章节。

IF 2.4 3区医学

Hpb Pub Date : 2025-09-04 DOI: 10.1016/j.hpb.2025.08.010

Sander Kütner, Artūrs Ozolinš, Aiste Gulla

引用次数: 0

Highlights in this issue 本期重点报道

IF 2.4 3区医学

Hpb Pub Date : 2025-08-29 DOI: 10.1016/S1365-182X(25)01557-6

引用次数: 0

Hospital admission during neoadjuvant therapy for pancreatic ductal adenocarcinoma: prevalence, predictors, and prognosis. 胰腺导管腺癌新辅助治疗期间住院：患病率、预测因素和预后。

IF 2.4 3区医学

Hpb Pub Date : 2025-08-29 DOI: 10.1016/j.hpb.2025.08.015

Patrick W Underwood, Thomas Leuschner, Amanda K Walsh, Eric D Miller, Kenneth L Pitter, Anne M Noonan, Ashish Manne, Shafia Rahman, Pannaga Malalur, Arjun Mittra, Mary E Dillhoff, Susan Tsai, Timothy M Pawlik, Jordan M Cloyd

{"title":"Hospital admission during neoadjuvant therapy for pancreatic ductal adenocarcinoma: prevalence, predictors, and prognosis.","authors":"Patrick W Underwood, Thomas Leuschner, Amanda K Walsh, Eric D Miller, Kenneth L Pitter, Anne M Noonan, Ashish Manne, Shafia Rahman, Pannaga Malalur, Arjun Mittra, Mary E Dillhoff, Susan Tsai, Timothy M Pawlik, Jordan M Cloyd","doi":"10.1016/j.hpb.2025.08.015","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.08.015","url":null,"abstract":"Background: Neoadjuvant therapy (NT) is increasingly utilized for localized pancreatic ductal adenocarcinoma (PDAC). The incidence of hospital admission during NT and its impact on clinical outcomes is poorly understood.Methods: Patients with localized PDAC who received intent-to-treat NT between 2018 and 2023 at a single institution were retrospectively reviewed. Hospital admission rates, reasons, and the impact on overall survival (OS) were assessed.Results: Among 305 patients, 58.4 % were male, 90.7 % were white, and median age was 66. Patients had potentially resectable (31.1 %), borderline resectable (36.7 %), and locally advanced disease (32.1 %). The median duration of NT was 119 days. Overall, 80 (26.2 %) patients required hospital admission during NT (range 1-5). The most common reasons for admission were fever/infection (33.8 %) and gastrointestinal symptoms (20.8 %). Factors associated with hospital admission included LA anatomic stage (OR 2.56; 95%CI: 1.22-5.39; p = 0.013) and BMI (OR 1.09; 95%CI: 1.04-1.15; p < 0.001). Hospital admission was associated with reduced odds of undergoing surgical resection (OR 0.27; 95%CI: 0.14-0.54; p < 0.001) and worse OS (median 14.6 months; 95%CI: 11.3-18.0 vs 22.6 months; 95%CI: 17.2-28.1; p < 0.001).Conclusion: Hospital admission is common among patients with PDAC receiving NT and associated with worse outcomes. Further research on optimizing care delivery during NT is critical to improve outcomes.","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064679","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

Early cholecystectomy for cholecystitis in patients with severe comorbidity. 早期胆囊切除术治疗有严重合并症的胆囊炎患者。

IF 2.4 3区医学

Hpb Pub Date : 2025-08-29 DOI: 10.1016/j.hpb.2025.08.012

Erik Osterman, Olov Norlén, Fredrik Linder

{"title":"Early cholecystectomy for cholecystitis in patients with severe comorbidity.","authors":"Erik Osterman, Olov Norlén, Fredrik Linder","doi":"10.1016/j.hpb.2025.08.012","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.08.012","url":null,"abstract":"Background: This study aimed to investigate peri- and postoperative complications in severely comorbid patients undergoing early surgery for cholecystitis.Methods: Data for 32,463 patients who had emergency surgery for cholecystitis from the Swedish Cholecystectomy Registry, National Patient Register, National Prescribed Drug Register and the National Cause of Death Register were used. The odds ratios (OR) for complications were calculated using logistic regression. Specific postoperative complications were assessed for severely comorbid (ASA3) versus healthy (ASA1-2) patients.Results: It was more common with perioperative (OR 1.24, 95 % confidence interval 1.04-1.48) and postoperative complications (OR 1.21, 95 % confidence interval 1.13-1.3) in ASA3 than ASA1-2. The OR for postoperative complications in ASA3 remained stable in subgroup analyses of age >70, >5 days wait time and laparoscopic surgery. The OR for postoperative complications in ASA3 patients undergoing open surgery was 1.12 (95 % confidence interval 0.96-1.32). The complications that increased most in severely comorbid patients were bile leakage, bleeding and infection. The OR for severe complications (requiring intervention or ICU admission) was 1.69 (95 % confidence interval 1.47-1.94) in ASA3 versus ASA1-2.Conclusion: ASA3 patients had an increased risk of postoperative complications. Better perioperative care may reduce the risk for these patients.","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064719","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

Establishing alpha-fetoprotein reference ranges in patients with chronic liver disease and hepatocellular carcinoma. 慢性肝病和肝细胞癌患者甲胎蛋白参考范围的建立

IF 2.4 3区医学

Hpb Pub Date : 2025-08-28 DOI: 10.1016/j.hpb.2025.08.011

Anton Kalyuzhnyy, Hidenori Toyoda, Philip J Johnson

{"title":"Establishing alpha-fetoprotein reference ranges in patients with chronic liver disease and hepatocellular carcinoma.","authors":"Anton Kalyuzhnyy, Hidenori Toyoda, Philip J Johnson","doi":"10.1016/j.hpb.2025.08.011","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.08.011","url":null,"abstract":"Background: Alpha-fetoprotein (AFP) is the primary serum biomarker for hepatocellular carcinoma (HCC). However, the current diagnostic AFP thresholds for HCC are arbitrary and the definitive reference range has never been identified. Furthermore, some HCCs are AFP-negative, implying that these tumours do not synthesise AFP, making them difficult to characterise and diagnose.Methods: By analysing AFP distribution in over 4500 patients with chronic liver disease (CLD) from Japan and UK with and without HCC, as well as in a population of healthy patients without CLD, we defined accurate AFP reference ranges for HCC and characterised a group of AFP-negative HCC patients.Results: We identified 40 ng/mL as the upper AFP limit for CLD patients without HCC, indicating that HCC can be accurately diagnosed above this threshold with minimal risk of false positives. Furthermore, the upper AFP limit for the healthy population was 5 ng/mL which was used to characterise AFP-negative HCC patients. By this definition, 15 % of HCC patients were AFP-negative. Those patients had significantly better survival after diagnosis compared to their AFP-positive counterparts irrespective of treatment.Discussion: Our established AFP reference ranges provide an accurate cutoff for HCC diagnosis and can also be used to identify AFP-negative HCCs.","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174813","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

Intraoperative high dose dexamethasone is associated with clinically relevant postoperative pancreatic fistula: a retrospective cohort study. 术中大剂量地塞米松与临床相关的术后胰瘘相关：一项回顾性队列研究

IF 2.4 3区医学

Hpb Pub Date : 2025-08-28 DOI: 10.1016/j.hpb.2025.08.008

Scott C Fligor, John Christopher Polanco-Santana, Ashley Lanys, Joao P G Kasakewitch, Maximilian S Schaefer, Umut Sarpel, Tara S Kent

{"title":"Intraoperative high dose dexamethasone is associated with clinically relevant postoperative pancreatic fistula: a retrospective cohort study.","authors":"Scott C Fligor, John Christopher Polanco-Santana, Ashley Lanys, Joao P G Kasakewitch, Maximilian S Schaefer, Umut Sarpel, Tara S Kent","doi":"10.1016/j.hpb.2025.08.008","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.08.008","url":null,"abstract":"Background: Intraoperative dexamethasone is routinely administered to prevent postoperative nausea and vomiting. Limited research has investigated dexamethasone safety during pancreatectomy. We investigated whether intraoperative dexamethasone administration affects clinically relevant postoperative pancreatic fistula (CR-POPF) development.Methods: We performed a retrospective cohort study of patients undergoing pancreatoduodenectomy or distal pancreatectomy at a single academic institution (2014-2021). Impact of dexamethasone administration on CR-POPF (ISGPF Grade B/C) was assessed using multivariable logistic regression and inverse probability weighted regression analysis.Results: 503 patients were included (pancreatoduodenectomy n=307; distal pancreatectomy n=196). Of these, 59 (11.7%) received low-dose dexamethasone (4-6 mg) and 100 (19.9%) received high-dose dexamethasone (8-10 mg). High dose dexamethasone (aOR:2.47, 95% CI:1.40-4.36), but not low dose dexamethasone (aOR:1.32, 95% CI:0.61-2.86), was associated with increased odds of CR-POPF. After inverse probability weighted regression adjustment, the average treatment effect of high dose dexamethasone on CR-POPF was +11.1% (95% CI:1.7-20.3%) above the baseline risk of 12.5% (95% CI:9.0-16.1%) in patients receiving no dexamethasone.Discussion: Intraoperative administration of high dose (8-10mg) dexamethasone was associated with a meaningfully increased risk of CR-POPF after pancreatectomy. High-dose dexamethasone is a modifiable risk factor for CR-POPF and should be avoided unless there is clear clinical indication.","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250996","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

Feasibility of an international multicentric HPB fellowship training program in Latin America. 拉丁美洲国际多中心HPB研究金培训计划的可行性。

IF 2.4 3区医学

Hpb Pub Date : 2025-08-28 DOI: 10.1016/j.hpb.2025.08.014

Jose D de Meira Junior, Gabriela Del Angel-Millán, Gabriela Ochoa, Morgan Bonds, Nicolas Jarufe, Carlos Chan, Brendan Visser, Adnan Alseidi, Martin Dib, Wellington Andraus, Paulo Herman, Ismael Dominguez-Rosado

{"title":"Feasibility of an international multicentric HPB fellowship training program in Latin America.","authors":"Jose D de Meira Junior, Gabriela Del Angel-Millán, Gabriela Ochoa, Morgan Bonds, Nicolas Jarufe, Carlos Chan, Brendan Visser, Adnan Alseidi, Martin Dib, Wellington Andraus, Paulo Herman, Ismael Dominguez-Rosado","doi":"10.1016/j.hpb.2025.08.014","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.08.014","url":null,"abstract":"Background: Hepatopancreatobiliary (HPB) surgery is a complex subspecialty requiring high-volume centers and structured training. In Latin America (LA), comprehensive training programs are scarce, leading many surgeons to seek education abroad, often limited by financial, certification, or migration barriers. This study describes the development and implementation of the first multinational, multicentric HPB fellowship in LA, established through collaboration among institutions in Brazil, Chile, and Mexico, and accredited by the Fellowship Council and the Americas Hepato-Pancreato-Biliary Association (AHPBA).Methods: This two-year program consists of three 8-month rotations, allowing fellows exposure to diverse surgical environments. Each center offers complementary strengths, including minimally invasive techniques, living donor liver transplantation, and complex biliary reconstruction. Program outcomes were evaluated using case logs, structured exit interviews, and faculty reports. Fellows were also assessed on educational activities, research participation, adaptability, and cultural integration.Results: All inaugural fellows exceeded surgical volume requirements and engaged in academic activities, simulation training, and research. Challenges such as migration, certification, and language barriers were eased by institutional support and peer collaboration.Conclusion: The LA HPB Fellowship shows that a multinational, multicenter rotational model can provide high-quality, accredited training in resource-limited settings, fostering professional growth and regional collaboration.","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039924","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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