IF 2.7 3区医学

Hpb Pub Date : 2025-04-14 DOI: 10.1016/j.hpb.2025.04.004

Melissa E Chen, Chirag S Desai

{"title":"Natural history and management of IPMN in solid organ transplant patients: is it any different?","authors":"Melissa E Chen, Chirag S Desai","doi":"10.1016/j.hpb.2025.04.004","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.04.004","url":null,"abstract":"<p><strong>Background: </strong>Intraductal papillary mucinous neoplasms (IPMNs) are premalignant lesions with established surveillance and surgical resection guidelines. This systematic review aims to provide evidence-based guidance for managing IPMNs in transplant patients.</p><p><strong>Methods: </strong>A search of MEDLINE, Embase, and Scopus identified studies published between January 1, 2004, and July 31, 2024, describing transplant candidates or recipients with IPMNs. Covidence software was used to screen and synthesize articles. Data were reviewed to determine whether IPMNs should preclude transplant, delay listing, require different surveillance, necessitate adjusted immunosuppression, or affect surgical complexity or cancer conversion rates.</p><p><strong>Results: </strong>Seventeen studies involving 7023 transplant patients, including 339 with suspected or confirmed IPMNs (4.82 %), were analyzed. No evidence suggested IPMNs should preclude transplant candidacy or delay listing. IPMN surveillance guidelines for transplant patients should align with those for non-transplant patients. Transplant recipients did not experience higher rates of IPMN conversion to pancreatic cancer, indicating no need to modify immunosuppression.</p><p><strong>Conclusion: </strong>This qualitative systematic review found no evidence that the natural history or management of IPMNs differs between transplant and non-transplant patients, suggesting no need for special management in transplant populations.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998259","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

Model for estimating the risk of postoperative morbidity and optimizing patients' management after hepatectomy. 肝切除术后并发症风险评估及患者管理优化模型。

IF 2.7 3区医学

Hpb Pub Date : 2025-04-12 DOI: 10.1016/j.hpb.2025.04.008

Fabio Procopio, Jacopo Galvanin, Guido Costa, Laura Rocchi, Federico Piccioni, Maurizio Cecconi, Guido Torzilli

{"title":"Model for estimating the risk of postoperative morbidity and optimizing patients' management after hepatectomy.","authors":"Fabio Procopio, Jacopo Galvanin, Guido Costa, Laura Rocchi, Federico Piccioni, Maurizio Cecconi, Guido Torzilli","doi":"10.1016/j.hpb.2025.04.008","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.04.008","url":null,"abstract":"<p><strong>Background: </strong>Early detection of major complications and immediate therapeutic interventions may improve patient outcome after hepatectomy. The aim of the present study was to develop a model predicting the risk of postoperative complications after hepatectomy and help identify patients who require close-monitoring in intensive care unit (ICU).</p><p><strong>Methods: </strong>Patients underwent hepatectomy at Humanitas Research Hospital, Italy, between 2010 and 2021 were considered. We used preoperative, intraoperative and combined predictors to build three models predicting Clavien-Dindo III-V complications. Model performances was evaluated internally via bootstrapping.</p><p><strong>Results: </strong>Of 1497 patients, 7% had Clavien-Dindo III-V complications. Tumor pathology, tumor burden, previous chemotherapy, liver characteristics, clinical portal hypertension, cardiopathy, creatinine and total protein level were incorporated in the preoperative model. In addition to these variables, type of hepatectomy, operation time, additional surgical procedure, and transfusion were incorporated into the combined model. The bootstrap corrected C-indices for preoperative, intraoperative and combined models were 0.68, 0.70 and 0.72. The median predicted probability of major complications over-1000 bootstraps was close to observed probabilities for all models.</p><p><strong>Conclusion: </strong>These prognostic models may help identify patients at high-risk of major complication and guide decision-making for individual patients and postoperative ICU-care assessment. Observed optimism in model performance necessitates external validation.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008294","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

Development of the liver resection transfusion (LiReT) score to assess the requirement for blood transfusion during open liver surgery. 肝切除输血（LiReT）评分的发展，以评估开放肝手术中输血的需求。

IF 2.7 3区医学

Hpb Pub Date : 2025-04-11 DOI: 10.1016/j.hpb.2025.04.007

Warangkana Lapisatepun, Tanyong Pipanmekaporn, Prangmalee Leurcharusmee, Jiraporn Khorana, Jayanton Patumanond, Worakitti Lapisatepun

{"title":"Development of the liver resection transfusion (LiReT) score to assess the requirement for blood transfusion during open liver surgery.","authors":"Warangkana Lapisatepun, Tanyong Pipanmekaporn, Prangmalee Leurcharusmee, Jiraporn Khorana, Jayanton Patumanond, Worakitti Lapisatepun","doi":"10.1016/j.hpb.2025.04.007","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.04.007","url":null,"abstract":"<p><strong>Background: </strong>Liver resection involves significant perioperative bleeding and blood transfusions, which may worsen outcomes. Blood products are scarce, and excessive preoperative cross-matching can deplete the blood supply. This study aimed to develop a clinical prediction score to assess the need for perioperative blood transfusions during liver resection.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using data from patients who underwent liver resections between 2006 and 2021. Independent predictors and a scoring system were analyzed using multivariable logistic regression. The model's effectiveness was assessed by the area under the ROC curve (AuROC) and calibration plots, with internal validation.</p><p><strong>Result: </strong>Among 1021 patients, 456 (44.7%) required perioperative blood transfusions. Eight predictors were identified: ASA classification >2, preoperative anemia, platelet count <100 × 10<sup>9</sup>/L, albumin <3.5 g/dL, total bilirubin >1.2 mg/dL, GFR <60 ml/min/1.73 m², maximum tumor diameter ≥5 cm, and major liver resection. The LiReT score categorized patients into low, moderate, and high-risk groups and showed good discriminative ability with an AuROC of 0.808 and good calibration.</p><p><strong>Conclusion: </strong>The LiReT score, with its good predictive accuracy, can guide clinicians in assessing perioperative blood transfusion risk, optimizing cross-matching and resource utilization, and facilitating patient blood management strategies during liver resection.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995273","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

Prognostic analysis of lymph node resection and liver resection for T1b and T2 gallbladder cancer: a multi-center retrospective study. T1b和T2胆囊癌淋巴结切除和肝切除的预后分析：一项多中心回顾性研究。

IF 2.7 3区医学

Hpb Pub Date : 2025-04-10 DOI: 10.1016/j.hpb.2025.04.003

Qiang Gao, Yun-Cheng Li, Ying-Nan You, En-Shan Li, Zeng-Li Liu, Yan-Chao Gao, Ke-Jian Sun, Guo-Zheng Pan, Da-Peng Yu, Li-Xin Du, Yu-Han Du, Xin Wang, Tie-Zhong Zhang, Shao-Hui Huang, Hui-Qiang Liu, Miao-Wang Hao, Yue-Xuan Xu, An-da Shi, Li-Zhuang Shu, Li-Ming Zhao, Yan Song, Kang-Shuai Li, Zong-Li Zhang

{"title":"Prognostic analysis of lymph node resection and liver resection for T1b and T2 gallbladder cancer: a multi-center retrospective study.","authors":"Qiang Gao, Yun-Cheng Li, Ying-Nan You, En-Shan Li, Zeng-Li Liu, Yan-Chao Gao, Ke-Jian Sun, Guo-Zheng Pan, Da-Peng Yu, Li-Xin Du, Yu-Han Du, Xin Wang, Tie-Zhong Zhang, Shao-Hui Huang, Hui-Qiang Liu, Miao-Wang Hao, Yue-Xuan Xu, An-da Shi, Li-Zhuang Shu, Li-Ming Zhao, Yan Song, Kang-Shuai Li, Zong-Li Zhang","doi":"10.1016/j.hpb.2025.04.003","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.04.003","url":null,"abstract":"<p><strong>Background: </strong>Survival benefit of extended cholecystectomy including lymph node resection (LNR) and liver resection (LR) is still debating.</p><p><strong>Methods: </strong>Patients pathologically diagnosed with T1b and T2 stage GBC in 6 medical centers from 2012 to 2022 were included and retrospectively analyzed. Clinical variables, including patient characteristics, overall survival (OS), disease-free survival (DFS), surgical approaches, and adjuvant treatments were collected. Propensity score-matching was performed to compare the survival outcomes.</p><p><strong>Results: </strong>A total of 160 T1b/T2 GBC patients were included. 52 patients undergoing LNR were matched to 54 patients without LNR. After matching, LNR demonstrated significant survival benefit in OS (mOS 48.8 months vs not reached; p = 0.020) and DFS (mDFS 47.9 months vs 70.2 months; p = 0.038). Meanwhile, 61 patients undergoing LR were matched to 54 patients without LR. After matching, LR demonstrated no statistical difference in overall survival (mOS 68.2 months vs 78.5 months; p = 0.72) and disease-free survival (mDFS 67.1 months vs 42.6 months; p = 0.30).</p><p><strong>Conclusions: </strong>Our results revealed that pathological T1b and T2 GBC patients benefit from radical cholecystectomy including lymph node resection and may not benefit from liver resection.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994446","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

Impact of cannabis consumption on perioperative outcomes in patients undergoing hepatobiliary and pancreatic surgery: a nationwide analysis. 大麻消费对接受肝胆胰手术患者围手术期结局的影响：一项全国性分析。

IF 2.7 3区医学

Hpb Pub Date : 2025-04-10 DOI: 10.1016/j.hpb.2025.04.006

Amir H Sohail, Mohammed A Quazi, Abu B Sheikh, Alissa Greenbaum, Itzhak Nir, Matthew C Hernandez

{"title":"Impact of cannabis consumption on perioperative outcomes in patients undergoing hepatobiliary and pancreatic surgery: a nationwide analysis.","authors":"Amir H Sohail, Mohammed A Quazi, Abu B Sheikh, Alissa Greenbaum, Itzhak Nir, Matthew C Hernandez","doi":"10.1016/j.hpb.2025.04.006","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.04.006","url":null,"abstract":"<p><strong>Background: </strong>There is paucity of high-quality data on the effect of cannabis consumption on perioperative outcomes after hepatobiliary and pancreatic (HPB) surgery.</p><p><strong>Methods: </strong>Data from the Nationwide Inpatient Sample (2016-2020) were used. In-hospital complications, length-of-stay and hospitalisation charges were compared among patients undergoing HPB surgery.</p><p><strong>Results: </strong>We identified 191,315 patients, of which 1705 (0.89 %) were cannabis consumers. Cannabis consumers were more likely to be male (67.5 % vs 50.2 %), younger, and Black (22.6 % vs 11.0); p < 0.001 for all. Multivariate analysis demonstrated a significantly lower risk of pneumonia (OR 0.54, 95 % CI 0.29-0.99) among cannabis consumers. There was no significant difference in risk of in-hospital mortality (OR 0.64, 95 % CI 0.31-1.30), acute kidney injury, hemodialysis, blood transfusion, vasopressor use, invasive and non-invasive mechanical ventilation, venous thromboembolism, portal vein thrombosis, intraabdominal abscess, peritonitis, surgical site infection, post-procedure haemorrhage/hematoma, wound dehiscence, liver failure, or sudden cardiac arrest. There was no significant difference in length-of-stay (mean 10.99 vs 9.69 days; p = 0.348) or hospitalisation costs ($49,444 vs $43,661; p = 0.109).</p><p><strong>Conclusion: </strong>There is no significant difference in major perioperative complications after HPB surgery among patients with cannabis use disorder. Further, there is no significant difference in health services utilisation among consumers versus non-consumers.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985678","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

Prognostic implications of resection margin status in distal pancreatectomy for pancreatic ductal adenocarcinoma. 胰腺导管腺癌远端切除术切缘状态对预后的影响。

IF 2.7 3区医学

Hpb Pub Date : 2025-04-04 DOI: 10.1016/j.hpb.2025.04.001

Go-Won Choi, Won-Gun Yun, Mirang Lee, Hye-Sol Jung, Young J Cho, Youngmin Han, Wooil Kwon, Jin-Young Jang

{"title":"Prognostic implications of resection margin status in distal pancreatectomy for pancreatic ductal adenocarcinoma.","authors":"Go-Won Choi, Won-Gun Yun, Mirang Lee, Hye-Sol Jung, Young J Cho, Youngmin Han, Wooil Kwon, Jin-Young Jang","doi":"10.1016/j.hpb.2025.04.001","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.04.001","url":null,"abstract":"<p><strong>Background: </strong>Curative resection is a well known prognostic factor in pancreatectomy. However, definition and clinical significance of resection margin in distal pancreatectomy remains controversial.</p><p><strong>Methods: </strong>From 2010 to 2018, 203 patients with pancreatic cancer undergoing distal pancreatectomies were included. Patients were classified into three groups: R0-wide (tumor-free margin ≥1 mm), R0-narrow (0 mm < tumor-free margin <1 mm), and R1 margin (tumor-free margin = 0 mm). We also evaluated the prognostic impact of individual margins (transection, anterior, and posterior).</p><p><strong>Results: </strong>Patients with an R0-wide margin (36.6 %) exhibited superior 5-year disease free survival rate compared to those with R0-narrow (30.4 %, p = 0.059) or R1 margin (0.1 %, p = 0.014). However, in multivariate analyses, only R1 margin (hazard ratio [95 % confidence interval], 2.02 [1.32-3.12]; p = 0.001), unlike R0-narrow margin (1.17 [0.78-1.77]; p = 0.446), was linked to shorter overall survival compared to R0-wide margin. In multivariate analyses, posterior margin involvement was uniquely identified as a poor prognostic factor (1.83 [1.07-3.13]; p = 0.027).</p><p><strong>Conclusions: </strong>The 0 mm rule seems more suitable than the 1 mm rule for predicting prognosis in performing distal pancreatectomy, and especially, achieving microscopically negative posterior margin is crucial.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998100","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

Quantitative liver function imaging and whole genome sequencing – Effective modalities for a new era in personalised decision-making for operable colorectal liver metastases? 定量肝功能成像和全基因组测序——可手术结肠肝转移患者个性化决策的新时代的有效模式？

IF 2.7 3区医学

Hpb Pub Date : 2025-04-01 DOI: 10.1016/j.hpb.2024.12.023

Fenella Welsh , Senthil Sundaravadanan , Pulkit Sethi , Mohammad Kazeroun , Alessandro Fichera , Irdina Nadziruddin , Sarah J. Larkin , Naser Ansari-Pour , Tim Maughan , Michael Brady , Rajarshi Banerjee , Sarah Gooding , Myrddin Rees

{"title":"Quantitative liver function imaging and whole genome sequencing – Effective modalities for a new era in personalised decision-making for operable colorectal liver metastases?","authors":"Fenella Welsh , Senthil Sundaravadanan , Pulkit Sethi , Mohammad Kazeroun , Alessandro Fichera , Irdina Nadziruddin , Sarah J. Larkin , Naser Ansari-Pour , Tim Maughan , Michael Brady , Rajarshi Banerjee , Sarah Gooding , Myrddin Rees","doi":"10.1016/j.hpb.2024.12.023","DOIUrl":"10.1016/j.hpb.2024.12.023","url":null,"abstract":"<div><h3>Background</h3><div>The optimal strategy for patients with colorectal liver metastases (CRLM) is unclear. The Precision1 prospective, observational trial assessed whether pre-operative functional imaging and whole genome sequencing (WGS), could enhance individualized decision-making.</div></div><div><h3>Methods</h3><div>Patients with CRLM considered for hepatectomy were recruited. In addition to standard staging, patients underwent a quantitative multiparametric MRI (mpMRI) scan, to assess liver function. Use of mpMRI to aid surgical decision-making, was prospectively recorded, as were short-term clinical outcomes in patients who underwent hepatectomy. In the first 45 patients, WGS was performed on blood and liver tumour samples collected per-operatively.</div></div><div><h3>Results</h3><div>95 mpMRI scans were performed in 84 patients, who underwent 87 resections. The mpMRI scan affected surgical decision-making in 41 % (39/95) of scans, with 11 undergoing dual-vein embolization, 16 undergoing more conservative parenchymal-sparing surgery, 11 having more extensive surgery, and one patient following a low calorie diet pre-operatively. There were significant (Clavien-Dindo grades 3/4) complications in 5 % of patients, no Grade C post-hepatectomy liver failure, and zero 90-day mortality. WGS suggested additional therapeutic options and prognostic factors for 22 of 35 (63 %) evaluable patients.</div></div><div><h3>Conclusion</h3><div>Precision1 shows mpMRI can aid surgical decision-making, and optimise clinical outcomes. WGS provides additional information, to further enhance personalised decision-making.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 4","pages":"Pages 553-561"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Machine learning to predict the decision to perform surgery in hepatic echinococcosis 机器学习预测肝包虫病手术的决定。

IF 2.7 3区医学

Hpb Pub Date : 2025-04-01 DOI: 10.1016/j.hpb.2024.12.014

Raffaella Lissandrin , Ottavia Cicerone , Ambra Vola , Gianluca D’Alessandro , Simone Frassini , Tommaso Manciulli , Simone Famularo , Annalisa De Silvestri , Jacopo Viganò , Pietro Quaretti , Luca Ansaloni , Enrico Brunetti , Marcello Maestri

{"title":"Machine learning to predict the decision to perform surgery in hepatic echinococcosis","authors":"Raffaella Lissandrin , Ottavia Cicerone , Ambra Vola , Gianluca D’Alessandro , Simone Frassini , Tommaso Manciulli , Simone Famularo , Annalisa De Silvestri , Jacopo Viganò , Pietro Quaretti , Luca Ansaloni , Enrico Brunetti , Marcello Maestri","doi":"10.1016/j.hpb.2024.12.014","DOIUrl":"10.1016/j.hpb.2024.12.014","url":null,"abstract":"<div><h3>Background</h3><div>Cystic echinococcosis (CE) is a significant public health issue, primarily affecting the liver. While several management strategies exist, there is a lack of predictive tools to guide surgical decisions for hepatic CE. This study aimed to develop predictive models to support surgical decision-making in hepatic CE, enhancing the precision of patient allocation to surgical or non-surgical management pathways.</div></div><div><h3>Methods</h3><div>This retrospective analysis included 406 hepatic CE patients treated at our center (2009–2021). Clinical, imaging, and treatment data were used to develop a Cox regression and a decision tree model to identify factors influencing surgical intervention, with model performance validated using K-fold cross-validation, train/test split, bootstrapping.</div></div><div><h3>Results</h3><div>Imaging findings and symptomatology emerged as the most significant predictors. The Cox model demonstrated a concordance index of 0.94 and an AUC of 0.96, while the decision tree model identified imaging, cyst stage, and symptoms as critical factors, achieving strong performance across validation techniques (mean AUC 0.950; 95% CI: [0.889, 0.978]).</div></div><div><h3>Conclusion</h3><div>This study presents validated predictive models for assessing surgical risk in hepatic CE. Integrating these models into clinical practice offers a dynamic tool that surpasses static guidelines, optimizing patient allocation to surgical or non-surgical pathways and potentially improving outcomes.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 4","pages":"Pages 480-488"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927242","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

T1b gallbladder cancer: is extended resection warranted? T1b胆囊癌：延长切除是必要的吗？

IF 2.7 3区医学

Hpb Pub Date : 2025-04-01 DOI: 10.1016/j.hpb.2024.12.018

Montserrat Chavez , Xabier de Aretxabala , Hector Losada , Norberto Portillo , Felipe Castillo , Luis Bustos , Ivan Roa

{"title":"T1b gallbladder cancer: is extended resection warranted?","authors":"Montserrat Chavez , Xabier de Aretxabala , Hector Losada , Norberto Portillo , Felipe Castillo , Luis Bustos , Ivan Roa","doi":"10.1016/j.hpb.2024.12.018","DOIUrl":"10.1016/j.hpb.2024.12.018","url":null,"abstract":"<div><h3>Background</h3><div>Although the prognosis for gallbladder cancer (GBCA) improves with early diagnosis and aggressive surgical treatment, the management of patients with muscle layer invasion (T1b) remains controversial. This study aimed to analyze the optimal surgical approach for these patients.</div></div><div><h3>Methods</h3><div>A database was queried for patients with early T1b GBCA treated at four Chilean hospitals. Patients were prospectively treated and registered by the same surgical team at each hospital. Clinical outcomes, including survival rates according to the type of surgery, were analyzed.</div></div><div><h3>Results</h3><div>Between 1988 and 2023, 129 Chilean patients were pathologically diagnosed with T1b GBCA. Simple cholecystectomy (SC) was performed in 86 patients (66.7 %), while extended cholecystectomy (EC) was performed in 43 patients. The overall 5-year survival rate was 83 %, with no significant difference between SC and EC patients.</div></div><div><h3>Conclusion</h3><div>Simple cholecystectomy demonstrated survival rates comparable to extended cholecystectomy for patients with T1b GBCA. More extensive resections did not improve the prognosis.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 4","pages":"Pages 523-529"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004791","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

Impact of diabetes mellitus on postoperative complications in patients undergoing pancreatic surgery 糖尿病对胰腺手术患者术后并发症的影响。

IF 2.7 3区医学

Hpb Pub Date : 2025-04-01 DOI: 10.1016/j.hpb.2024.12.020

Sandra de Kalbermatten, David Martin, Emilie Uldry, Emmanuel Melloul, Nicolas Demartines, David Fuks, Gaëtan-Romain Joliat

{"title":"Impact of diabetes mellitus on postoperative complications in patients undergoing pancreatic surgery","authors":"Sandra de Kalbermatten, David Martin, Emilie Uldry, Emmanuel Melloul, Nicolas Demartines, David Fuks, Gaëtan-Romain Joliat","doi":"10.1016/j.hpb.2024.12.020","DOIUrl":"10.1016/j.hpb.2024.12.020","url":null,"abstract":"<div><h3>Background</h3><div>Enhanced Recovery After Surgery (ERAS) protocols decrease postoperative complications, but data on their effect on diabetic patients undergoing pancreatectomy are scarce. This study assessed whether diabetes mellitus (DM) was a morbidity predictor after pancreatectomy within an ERAS program.</div></div><div><h3>Methods</h3><div>A cross-sectional study including all patients who underwent pancreatectomy (2012–2022) and followed an ERAS pathway was performed. Multivariable analysis was used to determine whether DM was a morbidity predictor. Association between ERAS compliance and morbidity rate was assessed.</div></div><div><h3>Results</h3><div>A total of 558 patients were included (266 women, median age 66, median body-mass index 25). Most patients underwent open pancreatoduodenectomy (<em>n</em>=369, 66%). In diabetic patients with overall ERAS compliance<span><math><mrow><mo>≤</mo></mrow></math></span>60 %, morbidity was 38/40 (95%), whereas in diabetic patients with overall ERAS compliance>60 %, it decreased to 37/50 (74%, <em>p</em>=0.008). DM was not found as an independent complication predictor (OR 0.7, 95%CI 0.4–1.2, <em>p</em>=0.186), while body-mass index>25 kg/m<sup>2</sup> and preoperative biliary stenting were preoperative morbidity predictors (OR 1.1, 95%CI 1.0–1.1, <em>p</em>=0.049; OR 1.7, 95%CI 1.0–2.5, <em>p</em>=0.044).</div></div><div><h3>Conclusion</h3><div>This study showed that DM was not associated with postoperative complications after pancreatectomy within an ERAS program. It highlighted the importance of a good ERAS compliance to decrease the risk of postoperative complications in DM patients.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 4","pages":"Pages 530-537"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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