IF 2.7 3区医学

Hpb Pub Date : 2025-03-11 DOI: 10.1016/j.hpb.2025.03.007

Qian Dong, Wenli Xiu, Benjie Tang, Eiso Hiyama, Mary T Austin, Yeming Wu, Xiaojun Yuan, Chengzhan Zhu, Chengli Liu, Hiroki Ishibashi, Karthik K Tappa, Huanmin Wang, Chuandong Sun, YunTao Ma, Hongwei Xi, Jian Wang, Jianghua Zhan, Kyong Ihn, Mitsuo Shimada, Mingman Zhang, Mary E Brindle, Patrick B Thomas, Shigehisa Fumino, Tao Liu, Thom Lobe, Udo Rolle, Shan Wang, Xiaowen Zhai, Yoshinori Koga, Yoshiaki Kinoshita, Yuzuo Bai, Zhaozhu Li, Zhe Wen, Weikang Pan, Krysta M Sutyak, Pier C Giulianotti

{"title":"International multidisciplinary consensus recommendations on clinical application of three-dimensional visualization in precision surgery for pediatric liver tumors.","authors":"Qian Dong, Wenli Xiu, Benjie Tang, Eiso Hiyama, Mary T Austin, Yeming Wu, Xiaojun Yuan, Chengzhan Zhu, Chengli Liu, Hiroki Ishibashi, Karthik K Tappa, Huanmin Wang, Chuandong Sun, YunTao Ma, Hongwei Xi, Jian Wang, Jianghua Zhan, Kyong Ihn, Mitsuo Shimada, Mingman Zhang, Mary E Brindle, Patrick B Thomas, Shigehisa Fumino, Tao Liu, Thom Lobe, Udo Rolle, Shan Wang, Xiaowen Zhai, Yoshinori Koga, Yoshiaki Kinoshita, Yuzuo Bai, Zhaozhu Li, Zhe Wen, Weikang Pan, Krysta M Sutyak, Pier C Giulianotti","doi":"10.1016/j.hpb.2025.03.007","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.03.007","url":null,"abstract":"Background: Pediatric liver tumors are predominantly primary malignant tumors, and complete tumor resection with sufficient preservation of liver tissue is crucial for improving prognosis. However, due to the delicate anatomical structure of the pediatric liver and the relatively large size of the tumors, especially in difficult cases, the surgical challenges are substantial. While precision liver surgery are widely applied in clinical practice, pediatric cases require more customized approaches. The application of three-dimensional (3D) visualization technology is crucial for enhancing surgical accuracy, allowing for precise preoperative planning and intraoperative guidance.Methods: This consensus was collaboratively developed by 36 experts from eight countries, using the Glaser's state-of-the-art method to review and refine the draft.Results: The final consensus resulted in 15 international multidisciplinary consensus recommendations on clinical application of 3D visualization in precision surgery for pediatric liver tumors.Conclusion: This consensus will standardize the application of 3D visualization technology in precision surgery for pediatric liver tumors to improve outcomes and reduce risks.","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709702","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

Split liver transplantation in high MELD score adult recipients: a reappraisal. MELD评分高的成人肝移植：再评价。

IF 2.7 3区医学

Hpb Pub Date : 2025-03-10 DOI: 10.1016/j.hpb.2025.03.004

Lucia Paiano, Daniel Azoulay, Frédérique Blandin, Marc-Antoine Allard, Daniel Pietrasz, Oriana Ciacio, Gabriella Pittau, Chady Salloum, Eleonora De Martin, Antonio Sa Cunha, René Adam, Daniel Cherqui, Eric Vibert, Nicolas Golse

{"title":"Split liver transplantation in high MELD score adult recipients: a reappraisal.","authors":"Lucia Paiano, Daniel Azoulay, Frédérique Blandin, Marc-Antoine Allard, Daniel Pietrasz, Oriana Ciacio, Gabriella Pittau, Chady Salloum, Eleonora De Martin, Antonio Sa Cunha, René Adam, Daniel Cherqui, Eric Vibert, Nicolas Golse","doi":"10.1016/j.hpb.2025.03.004","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.03.004","url":null,"abstract":"Background: Split liver transplantation (SLT) from deceased donors is a potential solution to the global organ shortage. While effective in patients with mild disease, outcomes in high MELD score recipients remain uncertain and conflicting. This study compares survival in high vs. low MELD score recipients.Methods: This retrospective single-centre study included all consecutive patients transplanted with a split liver graft between 2010 and 2022. Two groups of recipients with MELD<25 and ≥ 25 at LT were compared.Results: The study population included 119 patients (n = 98 with MELD<25, n = 21 with MELD≥25) with an average follow-up of 55 months. Both groups were comparable in terms of indication for transplantation and donor characteristics. The high MELD group required more blood transfusions (7 vs. 3 units; p < 0.001) during LT and had a longer stay in intensive care unit (7 vs. 5 days; p = 0.011). Biliary, arterial, and venous complications were similar between groups, as well as graft survival (5 years: 75 % vs. 61 %, p = 0.35) and long-term overall survival (5 years: 83 % vs. 75 %, p = 0.17).Discussion: Our results indicate that SLT for patients with MELD≥25 improves access to grafts, is feasible and safe, without significant increased risk of severe complications or decreased long-term overall patient or graft survivals.","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709707","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

Factors predicting lower hospital stay after liver transplantation using a comprehensive enhanced recovery after surgery (ERAS) protocol. 肝移植术后综合增强术后恢复（ERAS）方案缩短住院时间的预测因素

IF 2.7 3区医学

Hpb Pub Date : 2025-03-10 DOI: 10.1016/j.hpb.2025.03.001

Paola Melgar, Celia Villodre, Cándido Alcázar, Mariano Franco, Juan J Rubio, Pedro Zapater, Patricio Más, Sonia Pascual, Gonzalo P Rodríguez-Laiz, José M Ramia

{"title":"Factors predicting lower hospital stay after liver transplantation using a comprehensive enhanced recovery after surgery (ERAS) protocol.","authors":"Paola Melgar, Celia Villodre, Cándido Alcázar, Mariano Franco, Juan J Rubio, Pedro Zapater, Patricio Más, Sonia Pascual, Gonzalo P Rodríguez-Laiz, José M Ramia","doi":"10.1016/j.hpb.2025.03.001","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.03.001","url":null,"abstract":"Introduction: Enhanced recovery after surgery (ERAS) protocols facilitate patient recovery without increasing complication rates. An ERAS protocol designed for our liver transplant (LT) patients obtained a median hospital length of stay (LOS) of 4 days. However, a proportion of patients do not achieve early discharge. This study aimed to identify factors that predict an LOS≤ 4 days.Methods: Identifying factors associated with LOS <4 days in our LT patients.Results: We performed 293 LTs (2012-2021), LOS≤4 days in 171 (58.4 %). The following factors emerged as statistically predictors of LOS≤4 days in the univariate analysis: male sex, HCC or HCV patients, lower MELD score, lower BAR score, no DCD patients, shorter operative time, no intraoperative transfusion, shorter ICU stay, no Clavien-Dindo complications grade ≥ III, no primary graft dysfunction, no acute rejection, no readmission at 30 days and no retransplantation were associated to LOS≤4 days. However, in the multivariate analysis, the only independent risk factor that predicted LOS≤4 days was the presence of hepatocarcinoma. DCD donors and higher MELD score were negative factors.Conclusions: Applying ERAS programs in LT patients is beneficial, safe and extensible to all patients, but those with hepatocarcinoma obtain higher rates of LOS≤4 days.","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692024","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

The development of a person-centred self-report instrument to investigate quality-of-life aspects of gallstone surgery - The Gothenburg gallstone questionnaires (GGQ24pre & GGQ21post). 以人为中心的自我报告工具的发展，以调查胆结石手术的生活质量方面-哥德堡胆结石问卷（GGQ24pre & GGQ21post）。

IF 2.7 3区医学

Hpb Pub Date : 2025-03-08 DOI: 10.1016/j.hpb.2025.02.015

Simon H Pålsson, Cecilia Engström, Jenny Skoog, Stefan Redéen, Lars Enochsson, Lise-Lott Prebner, Johanna Österberg, Fredrik Linder, Eva-Lena Syrén, Gabriel Sandblom, John Eric Chaplin

{"title":"The development of a person-centred self-report instrument to investigate quality-of-life aspects of gallstone surgery - The Gothenburg gallstone questionnaires (GGQ24pre & GGQ21post).","authors":"Simon H Pålsson, Cecilia Engström, Jenny Skoog, Stefan Redéen, Lars Enochsson, Lise-Lott Prebner, Johanna Österberg, Fredrik Linder, Eva-Lena Syrén, Gabriel Sandblom, John Eric Chaplin","doi":"10.1016/j.hpb.2025.02.015","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.02.015","url":null,"abstract":"Background: To develop and psychometrically test a condition-specific, patient-reported outcomes instrument for patients undergoing gallstone surgery.Methods: A mixed-methods design, including six gender-mixed patient focus-groups was used. Statements were thematically analysed and compared to PROMIS and the Gastrointestinal Quality of Life Index (GIQLI). A pilot questionnaire of 63 items and the full scale GIQLI was sent to preoperative and 30 items were sent to postoperative patients. Factor analysis identified structure and redundant items. Short versions were assessed to ensure internal reliability and validity. Unidimensionality was assessed via graded response model.Results: 273 patients completed the questionnaires (preoperatively n = 104 and postoperatively n = 169). Factor and IRT analysis identified 13 domains with 45 questions. Internal reliability 0.75 to 0.93 in the preoperative and 0.73 to 0.90 in the postoperative questionnaire. A PROM questionnaire was developed with pre- and postoperative modules (24 questions, 8 domains and 21 questions, 5 domains).Conclusion: This study has shown the validity of a disease specific Health Related Quality-of-Life (HRQoL) instrument in a population with gallstone disease and a post-operative module for follow-up. Further testing in a longitudinal cohort is recommended in order to establish responsiveness.","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772173","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

Frailty in robotic pancreaticoduodenectomy: quantifying the impact on perioperative outcomes. 机器人胰十二指肠切除术中的虚弱：量化对围手术期结果的影响。

IF 2.7 3区医学

Hpb Pub Date : 2025-03-07 DOI: 10.1016/j.hpb.2025.03.002

Steve Kwon, Martin Liberman, Ponnandai Somasundar, Abdul S Calvino, Ali Ahmad

{"title":"Frailty in robotic pancreaticoduodenectomy: quantifying the impact on perioperative outcomes.","authors":"Steve Kwon, Martin Liberman, Ponnandai Somasundar, Abdul S Calvino, Ali Ahmad","doi":"10.1016/j.hpb.2025.03.002","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.03.002","url":null,"abstract":"Background: We sought to determine the significance of age and frailty in predicting peri-operative outcomes of robotic pancreaticoduodenectomy (RPD).Methods: Data from our institution's prospectively collected robotic pancreaticoduodenectomy database was analyzed for the years 2018-2023. The 5-factor modified frailty index (mFI-5) was used as a concise stratification tool for frailty. Predictive models for composite adverse event (CAE) variable were created using adjusted logistic regressions.Results: 116 patients underwent RPD. Mean age of this cohort was 70.65 years (±11.44). The mean operative time was 311.47 min (±71.35) and the estimated blood loss was 107.07 mL (±128.49). The most common postoperative complications included in the CAE were pancreatic leak (n = 10, 8.62 %), delayed gastric emptying (n = 10, 8.62 %), bleeding (n = 5, 4.31 %), and atrial fibrillation (n = 2, 1.72 %). The 90-day mortality was 1.72 %. There was a gradual increase in the odds ratio of CAE with increasing mFI-5 score: OR 1.52 (95 % CI 0.25-9.20) for mFI-5 score of 1 and OR 31.92 (95 % CI 1.79-570.09) for mFI-5 score of 4 compared to score of 0.Discussion: Preoperative mFI-5 score may serve as a risk stratification tool for RPDs.","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656824","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

Analysis of a modified surgical desirability of outcome ranking (mDOOR) among patients undergoing surgery for Hepatocellular carcinoma. 对接受肝细胞癌手术的患者进行改良手术结果可取性排名（mDOOR）分析。

IF 2.7 3区医学

Hpb Pub Date : 2025-03-05 DOI: 10.1016/j.hpb.2025.02.013

Giovanni Catalano, Laura Alaimo, Odysseas P Chatzipanagiotou, Andrea Ruzzenente, Federico Aucejo, Hugo P Marques, Vincent Lam, Tom Hugh, Nazim Bhimani, Minoru Kitago, Itaru Endo, Guillaume Martel, Irinel Popescu, François Cauchy, George A Poultsides, Ana Gleisner, Timothy M Pawlik

{"title":"Analysis of a modified surgical desirability of outcome ranking (mDOOR) among patients undergoing surgery for Hepatocellular carcinoma.","authors":"Giovanni Catalano, Laura Alaimo, Odysseas P Chatzipanagiotou, Andrea Ruzzenente, Federico Aucejo, Hugo P Marques, Vincent Lam, Tom Hugh, Nazim Bhimani, Minoru Kitago, Itaru Endo, Guillaume Martel, Irinel Popescu, François Cauchy, George A Poultsides, Ana Gleisner, Timothy M Pawlik","doi":"10.1016/j.hpb.2025.02.013","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.02.013","url":null,"abstract":"Background: Composite measures represent a validated method for evaluating surgical care quality. We defined a modified Desirability Of Outcome Ranking (mDOOR) and compared it with textbook outcome (TO).Methods: In this cohort study, patients undergoing curative-intent surgery for HCC were identified from an international cohort. The performance and agreement of mDOOR, TO, and other measures of postoperative course with respect to overall survival (OS) were compared using Harrell's Concordance-index (C-index) and Cohen's kappa.Results: Among 2181 patients, 77.6 % (n = 1692) achieved the most desirable outcome (i.e., DOOR1), whereas roughly one-half of patients achieved TO (n = 1,171, 53.7 %). Patients with lower mDOOR had a better 5-year OS compared with patients with higher mDOOR (64.7 % vs. 51.9 %; p < 0.001). On multivariable analysis, higher mDOOR was associated with worse OS (HR 1.35, 95%CI 1.28-1.44; p < 0.001). The mDOOR demonstrated improved performance compared with the comprehensive complication index (C-index: 0.696 vs. 0.649; p < 0.001) and the Accordion score (C-index: 0.696 vs. 0.653; p = 0.002).Conclusion: Roughly 4 out of 5 patients achieved the most desirable outcome. Higher mDOOR was associated with worse long-term outcomes. A composite outcome ranking may provide more insight on surgical outcomes, complementing traditional metrics.","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639459","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

Predicting the complexity of minimally invasive liver resection for hepatocellular carcinoma using machine learning. 应用机器学习预测肝癌微创肝切除术的复杂性。

IF 2.7 3区医学

Hpb Pub Date : 2025-03-04 DOI: 10.1016/j.hpb.2025.02.014

Giovanni Catalano, Laura Alaimo, Odysseas P Chatzipanagiotou, Andrea Ruzzenente, Francesca Ratti, Luca Aldrighetti, Hugo P Marques, François Cauchy, Vincent Lam, George A Poultsides, Tom Hugh, Irinel Popescu, Sorin Alexandrescu, Guillaume Martel, Minoru Kitago, Itaru Endo, Ana Gleisner, Feng Shen, Timothy M Pawlik

{"title":"Predicting the complexity of minimally invasive liver resection for hepatocellular carcinoma using machine learning.","authors":"Giovanni Catalano, Laura Alaimo, Odysseas P Chatzipanagiotou, Andrea Ruzzenente, Francesca Ratti, Luca Aldrighetti, Hugo P Marques, François Cauchy, Vincent Lam, George A Poultsides, Tom Hugh, Irinel Popescu, Sorin Alexandrescu, Guillaume Martel, Minoru Kitago, Itaru Endo, Ana Gleisner, Feng Shen, Timothy M Pawlik","doi":"10.1016/j.hpb.2025.02.014","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.02.014","url":null,"abstract":"Background: Despite technical advancements, minimally invasive liver surgery (MILS) for hepatocellular carcinoma (HCC) remains challenging. Nonetheless, effective tools to assess MILS complexity are still lacking. Machine learning (ML) models could improve the accuracy of such tools.Methods: Patients who underwent curative-intent MILS for HCC were identified using an international database. An XGBoost ML model was developed to predict surgical complexity using clinical and radiological characteristics.Results: Among 845 patients, 186 (22.0 %) were classified as high-risk patients. In this subgroup, median Charlson Comorbidity Index (CCI) (5.0, IQR 3.0-7.0 vs. 2.0, IQR 2.0-5.0, p < 0.001) and tumor burden score (TBS) (median 4.12, IQR 3.0-5.1 vs. 4.22, IQR 3.2-7.1, p < 0.001) were higher. The model was able to effectively predict complexity of surgery in both the training and testing cohorts with high discriminating power (ROC-AUC: 0.86, 95%CI 0.82-0.89 vs. 0.73, 95%CI 0.65-0.81). The most influential variables were CCI, TBS, BMI, extent of resection, and sex. Patients predicted to have a complex surgery were more likely to develop severe complications (OR 4.77, 95%CI 1.82-13.9, p = 0.002). An easy-to-use calculator was developed.Conclusion: Preoperative ML-prediction of complex MILS for HCC may improve preoperative planning, resource allocation, and patient outcomes.","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639497","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

Indication model for laparoscopic repeat liver resection in the era of artificial intelligence: machine learning prediction of surgical indication. 人工智能时代腹腔镜重复肝切除术的适应症模型：手术适应症的机器学习预测。

IF 2.7 3区医学

Hpb Pub Date : 2025-03-04 DOI: 10.1016/j.hpb.2025.02.016

Sung Jun Jo, Jinsoo Rhu, Jongman Kim, Gyu-Seong Choi, Jae-Won Joh

{"title":"Indication model for laparoscopic repeat liver resection in the era of artificial intelligence: machine learning prediction of surgical indication.","authors":"Sung Jun Jo, Jinsoo Rhu, Jongman Kim, Gyu-Seong Choi, Jae-Won Joh","doi":"10.1016/j.hpb.2025.02.016","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.02.016","url":null,"abstract":"Background: Laparoscopic repeat liver resection (LRLR) is still a challenging technique and requires a careful selection of indications. However, the current difficulty scoring system is not suitable for selecting indications. The purpose of this study is to develop the indication model for LRLR using machine learning and to identify factors associated with open conversion (OC).Methods: Patients who underwent repeat hepatectomy (2017-2021) at Samsung Medical Center 2021 were investigated. Multiple indication models were developed using machine learning techniques (random forest, SVM, XGB) and logistic regression. The predictive performance of these models was compared, and risk factors associated with OC were analyzed.Results: Among 221 patients (110 LRLR, 111 ORLR), the ORLR group had a higher previous open approach rate (75.7% vs. 38.2%, p<0.001). Twice previous abdominal surgery was the only independent OC risk factor (OR 6.56, p=0.009). The indication model showed moderate predictive power (random forest AUC=0.779, logistic regression AUC=0.725, p=0.710). Important variables were previous laparoscopic approach, present subsegmentectomy, and left-sided tumor location.Conclusion: The performance of the indication model for LRLR showed moderate predictive power in both machine learning and logistic regression. The important variables for LRLR were previous laparoscopic approach, present subsegmentectomy, and left side location.","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639465","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

Postoperative pancreatic fistula risk assessment using digital pathology based analyses at the parenchymal resection margin of the pancreas – Results from the randomized multicenter RECOPANC trial 基于数字病理分析的胰腺实质切除边缘术后胰瘘风险评估——来自随机多中心RECOPANC试验的结果

IF 2.7 3区医学

Hpb Pub Date : 2025-03-01 DOI: 10.1016/j.hpb.2024.12.012

Ambrus Màlyi , Peter Bronsert , Oliver Schilling , Kim C. Honselmann , Louisa Bolm , Szilárd Szanyi , Zoltán Benyó , Martin Werner , Tobias Keck , Ulrich F. Wellner , Sylvia Timme , the RECOPANC Study group

{"title":"Postoperative pancreatic fistula risk assessment using digital pathology based analyses at the parenchymal resection margin of the pancreas – Results from the randomized multicenter RECOPANC trial","authors":"Ambrus Màlyi , Peter Bronsert , Oliver Schilling , Kim C. Honselmann , Louisa Bolm , Szilárd Szanyi , Zoltán Benyó , Martin Werner , Tobias Keck , Ulrich F. Wellner , Sylvia Timme , the RECOPANC Study group","doi":"10.1016/j.hpb.2024.12.012","DOIUrl":"10.1016/j.hpb.2024.12.012","url":null,"abstract":"<div><h3>Background</h3><div>In pancreatic surgery Postoperative pancreatic fistula (POPF) represents the most dreaded complication, for which pancreatic texture is acknowledged as one of the strongest predictors. No consensual objective reference has been defined to evaluate the pancreas composition. The presented study aimed to mine histology data of the pancreatic tissue composition with AI assist and correlate it with clinic–pathological parameters derived from the RECOPANC study.</div></div><div><h3>Method</h3><div>From 320 patients originally included in the RECOPANC multicentric study, after series of exclusions slides of 134 patients were selected of AI-assisted analysis.For each slide tissue training fields were defined. Machine learning was trained to differentiate the tissue compartments: acinar, fibrotic, and adipose tissue, followed by quantification of the tissue area compartments.</div></div><div><h3>Results</h3><div>Relative fibrotic tissue area revealed as the strongest determinant for the prediction of clinically relevant POPF in multivariable analysis (p = 0.027). The AI assessed amount of fibrotic tissue performed significantly better in prediction of fistula development compared to the surgical palpatory assessment of the pancreatic texture.</div></div><div><h3>Conclusion</h3><div>The present study is the first correlating AI-assisted quantified pancreatic tissue composition and POPF within a multicentric cohort.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 3","pages":"Pages 393-401"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004788","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

Highlights in this issue 本期重点报道

IF 2.7 3区医学

Hpb Pub Date : 2025-03-01 DOI: 10.1016/S1365-182X(25)00040-1

引用次数: 0

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