Hpb最新文献

{"title":"Improved glycaemic control in pancreatic diabetes mellitus following conversion from multiple daily insulin injections to continuous subcutaneous insulin infusion.","authors":"Omar Alkhatib, Kiran Altaf, Abidullah Khan, Phil Whelan, Declan Dunne, Michael Raraty, Kulbir Mann, Paula Ghaneh, Christopher Halloran, Peter Szatmary, Ryan Baron, Philip Weston, Robert Sutton","doi":"10.1016/j.hpb.2025.08.009","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.08.009","url":null,"abstract":"","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":"145086012","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":"Between cutting-edge guidelines and neglected vulnerabilities: an implementation agenda for HCC in the Asia-Pacific.","authors":"Giancarlo Ceccarelli, Francesco Branda, Marta Giovanetti, Fabio Scarpa, Massimo Ciccozzi","doi":"10.1016/j.hpb.2025.08.013","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.08.013","url":null,"abstract":"","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145052387","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":"Prospective, randomized, controlled clinical study on single-incision laparoscopic cholecystectomy: an analysis of 449 cases from a single center.","authors":"Xiang Pan, Liufan Zha, Huanbing Zhu, Jinhong Wu, Zhiquan Chen, Chao Li, Yangming Hou, Dan Ye, Daren Liu","doi":"10.1016/j.hpb.2025.08.004","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.08.004","url":null,"abstract":"<p><strong>Background: </strong>Single-incision laparoscopic cholecystectomy (SILC), a minimally invasive alternative to conventional laparoscopic cholecystectomy (CLC), may improve postoperative recovery and cosmetic outcomes but faces concerns about complications and technical demands. This randomized controlled trial compares SILC and CLC using conventional laparoscopic instruments.</p><p><strong>Materials and methods: </strong>891 patients were randomized to SILC (n = 449) or CLC (n = 442). Operative parameters, postoperative recovery, complications, and patient-reported outcomes were evaluated. Primary endpoints were operative time, blood loss, and complication rates. Secondary outcomes included hospital stay, pain scores, and cosmetic satisfaction (Vancouver scar scores).</p><p><strong>Results: </strong>SILC showed similar operative time (55.11 ± 22.88 vs 51.81 ± 23.61 min, p = 0.907) and blood loss (10.89 ± 26.37 vs 10.14 ± 14.38 ml, p = 0.475) versus CLC. SILC patients had shorter hospitalization (1.94 ± 1.87 vs 2.25 ± 2.49 days, p < 0.001), lower pain scores (2.19 ± 0.88 vs 2.80 ± 0.75, p = 0.016), and better scar outcomes (2.41 ± 1.81 vs 3.54 ± 1.61, p = 0.020). Complication rates like bile leakage and hernias were marginally higher in SILC but not statistically significant.</p><p><strong>Conclusion: </strong>SILC is a safe, effective alternative to CLC, offering better postoperative recovery and cosmetic results. However, patient selection and surgical expertise are crucial to optimize outcomes and minimize complications.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130761","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":"Peri-hilar cholangiocarcinoma: results from the UK nationwide CAPBIL study.","authors":"Jane McClements, Amanda Koh, Harivinthan Sellappan, Lauren Blackburn, Adam Brooks, Jake Clements, Nabeel Merali, Adam Frampton, Syeda Gulbahar, Brian Davidson, Eyas Almomani, David Bartlett, Georgios Papadopoulos, Dimitrios Karavias, Alistair Rowcroft, James Lucocq, Ewen M Harrison, Victoria Morrison-Jones, Fenella Welsh, Adithya Pathanki, Gabriele Marangoni, Paris Bruno, James Skipworth, Harry Spiers, Vasilis Kosmoliaptsis, Timothy Gilbert, Hassan Malik, Aarathi Vijayashanker, Krishna Menon, Waqqas Patel, Mohammed Bekheit, Lulu Tanno, Michael Silva, Christopher Brown, Nagappan Kumar, Joel Triance, Nehal Shah, Tareq Alsaoudi, Neil Bhardwaj, Hussein Nassar, Omar Mownah, Derek Yeung, Ricky Bhogal, Ruth Blanco-Colino, Shahid Farid, Rami Aljaberi, Sanjay Pandanaboyana, Omar Abdelmohsin, Somaiah Aroori, Daisy Evans, Tejinderjit Athwal, Peter Lodge, Dhanwant Gomez","doi":"10.1016/j.hpb.2025.08.003","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.08.003","url":null,"abstract":"<p><strong>Background: </strong>The role of liver transplantation as a treatment option for de novo resectable peri-hilar cholangiocarcinoma (pCCA) is controversial. This study investigated the outcomes following resection of early-stage pCCA in the UK.</p><p><strong>Methods: </strong>Patients undergoing resection for pCCA between 2014 and 2022 across 22 UK centres were included. Early-stage pCCA was defined as tumour size<3cm with no nodal disease (N0) on histopathology analysis. Clinical and survival data were collated.</p><p><strong>Results: </strong>Of the 450 patients included, 138 patients underwent resection for early-stage pCCA. In the early-stage pCCA group, CD ≥ IIIa morbidity was 39.1 % (n = 54) and 90-day mortality was 10.1 % (n = 14). Sixty-four (46.4 %) patients received adjuvant chemotherapy, but this was reduced in those with CD ≥ IIIa morbidity (n = 17, 31.5 %). Early-stage tumours had a significantly lower vascular invasion (n = 57, 41.3 %) and R1 margin (n = 46, 33.3 %) compared to later-stage pCCA [62.2 % (n = 194) and 54.2 % (n = 169) respectively, p < 0.001). The median disease-free and overall survival was significantly better in patients with early-stage pCCA compared to more advanced tumours (p < 0.001). Male gender (p = 0.039) and Post-Hepatectomy Liver Failure (PHLF, p = 0.010) were associated with significantly worse disease-free survival, while biliary drainage (p = 0.013), PHLF (p < 0.001) and vascular invasion (p = 0.030) were associated with significantly poorer overall survival.</p><p><strong>Conclusion: </strong>Resection of early-stage pCCA tumours is associated with good clinical and survival outcomes in centralised HPB centres.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023122","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":"Building effective relationships in global surgery: an exploratory qualitative study.","authors":"Dorothy Hughes, Betel Yibrehu, Peter Kingham, Kristoffer Lassen, Alejandro Serrablo, Catherine Teh, Lisa Yarrow, Brendan Visser, Mehan Siriwardhane","doi":"10.1016/j.hpb.2025.08.002","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.08.002","url":null,"abstract":"<p><strong>Background: </strong>The rise in malignant hepatopancreatobiliary tumors disproportionately affects low- and middle-income countries (LMICs) due to systemic challenges. In 2023, the International Hepatopancreatobiliary Association (IHPBA) launched a relationship-building initiative to mitigate outcome disparities by increasing capacity and quality. This study aimed to understand the dynamics and value of such collaborations.</p><p><strong>Methods: </strong>This was a qualitative, descriptive study utilizing virtual, semi-structured interviews of surgeons and proceduralists engaged in international HPB surgery collaborations. Transcripts were coded inductively, allowing themes to emerge.</p><p><strong>Results: </strong>Sixteen surgeons and one proceduralist participated from six world regions. Six were from high-income countries and 11 from LMICs. Overarching themes were: Interconnected Resources, Relationships, and Experiences. Country resources, professional relationships, and previous and ongoing collaborations were highly inter-connected. The IHPBA and individuals' resources presented both barriers and facilitators to collaboration.</p><p><strong>Conclusion: </strong>Increasing access to and mutual understanding of resources is foundational for successful partnerships. Professional networks are also essential, and access to networking should be expanded and diversified. Partners must understand environments' constraints and needs. Associations like IHPBA should be networking drivers, increasing surgeons' informal and formal platform use. Surgical associations have a responsibility to create a culture that promotes and prioritizes participants' experiences beyond productivity.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The surgical burden score: a novel continuous metric to predict postoperative complications after hepatectomy for hepatocellular carcinoma.","authors":"Miho Akabane, Jun Kawashima, Selamawit Woldesenbet, Razeen Thammachack, François Cauchy, Federico Aucejo, Irinel Popescu, Minoru Kitago, Guillaume Martel, Francesca Ratti, Luca Aldrighetti, George A Poultsides, Yuki Imaoka, Andrea Ruzzenente, Itaru Endo, Ana Gleisner, Hugo P Marques, Vincent Lam, Tom Hugh, Nazim Bhimani, Feng Shen, Timothy M Pawlik","doi":"10.1016/j.hpb.2025.08.006","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.08.006","url":null,"abstract":"<p><strong>Background: </strong>No validated model incorporates surgical parameters for complication risk in hepatocellular carcinoma (HCC) resection. We evaluated a novel Surgical Burden Score (SBS), integrating adjusted blood loss (aBL; mL/kg) and operative time (hours) via a Pythagorean formula, and developed an SBS-based model to predict complications.</p><p><strong>Methods: </strong>Patients undergoing curative-intent hepatectomy for HCC(2000-2023) were identified from an international database. SBS was calculated as SBS²=(operative time)²+(aBL)². Outcomes were any and severe complications (Clavien-Dindo ≥ III). ROC curves and AUCs evaluated performance. A 3:1 training/testing split was used for model development, incorporating SBS plus clinical variables.</p><p><strong>Results: </strong>Among 801 patients, complications occurred in 39.1 %, and severe complications in 11.0 %. On multivariable analysis, operative time (HR:1.231; 95%CI:1.113-1.365; p < 0.001) and aBL (HR:1.021; 95%CI:1.002-1.041; p = 0.036) were independent predictors of any complications. SBS(median:6.07 [IQR:4.08-10.07]) outperformed its components (AUC:0.71vs0.67 for operative time and 0.69 for aBL). Stratified SBS groups demonstrated a dose-dependent increase in complications (p < 0.001). The SBS-based model achieved AUCs of 0.73 (training) and 0.76 (testing), outperforming existing models. An online calculator is available (https://makbn.shinyapps.io/SBS_shiny/).</p><p><strong>Conclusions: </strong>SBS, a Pythagorean-based metric combining operative time and aBL, accurately predicts complications. The SBS-based model offers strong predictive utility for risk stratification.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006027","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":"Appropriate extent of lymph node dissection in patients with muscle-invasive gallbladder cancer.","authors":"Won-Gun Yun, Youngmin Han, Yoon S Chae, Young J Cho, Hye-Sol Jung, Joon S Park, Jin-Young Jang, Wooil Kwon","doi":"10.1016/j.hpb.2025.08.005","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.08.005","url":null,"abstract":"<p><strong>Background: </strong>The appropriate extent of lymph node dissection has not yet been standardized in muscle-invasive gallbladder cancer.</p><p><strong>Methods: </strong>Patients who underwent surgery, and were histologically diagnosed with muscle-invasive gallbladder cancer were included. Patients were classified as having Na, Nb, or Nc disease if their nodal metastases were limited to the porta hepatis and extended to the posterosuperior pancreatic head lymph nodes (PSPLNs), nodes along the celiac axis, or superior mesenteric vessels.</p><p><strong>Results: </strong>Among 137 patients with node metastases, 96 (70.1 %), 30 (21.9 %), and 11 (8.0 %) were assigned to the Na, Nb, and Nc groups, respectively. The Na (52.9 %) and Nb (34.1 %) groups showed significantly higher 5-year overall survival rates than the palliative surgery group (3.9 %), whereas the 5-year overall survival rates were comparable between the Nc and palliative surgery groups (18.2 % vs. 3.9 %, P = 0.055). Among 230 patients without node metastases, those who underwent lymph node dissection including the PSPLNs (88.7 %) showed a significantly higher 5-year overall survival rate than those underwent node dissection only up to the nodes at the porta hepatis (78.7 %, P = 0.045).</p><p><strong>Conclusion: </strong>PSPLNs and nodes along the porta hepatis should be considered as regional nodes for gallbladder cancer and should be resected.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000451","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":"International survey on the use of preoperative chemotherapy in the setting of multimodality management of intrahepatic cholangiocarcinoma.","authors":"Elena Panettieri, Agostino M De Rose, Eduardo A Vega, William T Kawahara, Alessandro Coppola, Francesco Ardito, Felice Giuliante","doi":"10.1016/j.hpb.2025.08.001","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.08.001","url":null,"abstract":"<p><strong>Background: </strong>Indication to neoadjuvant chemotherapy and resectability of intrahepatic cholangiocarcinoma (iCCA) are not clearly defined. Aim of this survey was to assess practice patterns of iCCA treatment.</p><p><strong>Methods: </strong>Data were collected from an online survey approved by the International Hepato-Pancreato-Biliary Association consisting of 33 questions.</p><p><strong>Results: </strong>Of 167 surgeons surveyed from 44 countries, 83 % work at academic centers and 74.8 % routinely discuss iCCA cases in a multidisciplinary setting. Criteria of unresectability in absence of distant metastases included: insufficient future liver remnant volume (82.0 %), inability to obtain negative margins (71.3 %), contralateral nodules (62.9 %), contact with future remaining portal pedicles (49.1 %) and hepatic veins (44.3 %), multiple unilateral/satellite nodules (31.3 %), and positive regional lymph nodes (19.8 %). The most common indications for preoperative chemotherapy were initially unresectable disease (91.6 %) and radiologically enlarged regional lymph nodes (40.1 %). When planning hepatectomy for iCCA, 74.8 % of surgeons surveyed would consider administering neoadjuvant chemotherapy to increase the likelihood of achieving R0 resection (80.0 %), shrink tumor (81.6 %), and select patients with favorable tumor biology (73.6 %).</p><p><strong>Conclusion: </strong>While expert consensus would help define unresectability for iCCA, preoperative chemotherapy is considered a suitable tool to help downstage disease and select patients with favorable tumor characteristics to increase R0 resection rates.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952182","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":"Corrigendum to \"Short- and long-term outcomes of laparoscopic liver resection for non-alcoholic fatty liver disease-associated hepatocellular carcinoma: a retrospective cohort study\" [HPB 25 (2023) 1573-1586].","authors":"Yukihiro Watanabe, Masayasu Aikawa, Yuhei Oshima, Tomotaka Kato, Kenichiro Takase, Yuichiro Watanabe, Katsuya Okada, Kojun Okamoto, Isamu Koyama","doi":"10.1016/j.hpb.2025.07.014","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.07.014","url":null,"abstract":"","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816482","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":"Do routine narrative style CT reports provide sufficient information to adequately stage pancreatic cancer","authors":"Hasna Kazi ,&nbsp;Lin Li ,&nbsp;Samantha J. Ellis ,&nbsp;John R. Zalcberg ,&nbsp;Charles H.C. Pilgrim","doi":"10.1016/j.hpb.2025.05.001","DOIUrl":"10.1016/j.hpb.2025.05.001","url":null,"abstract":"<div><h3>Background</h3><div>Pancreatic ductal adenocarcinoma (PDAC) is staged using CT imaging generally reported in a <em>narrative prose style</em>, which can omit key details critical for an operating surgeon. This study assessed sixty-three potential radiological descriptors derived from the International Consensus Guidelines (ICG) to classify the resectability status of PDAC to determine whether reports adequately staged PDAC.</div></div><div><h3>Methods</h3><div>150 CT reports from patients with confirmed PDAC were collected from 19 hospitals across Australia (July–December 2023), as part of the SCANPatient trial. Reports were evaluated based on how many of the 63 relevant features were addressed.</div></div><div><h3>Results</h3><div>Less than half all relevant fields were appropriately addressed in prose reports (41.1 %, 10.7 of an average 26 relevant fields, as not all fields were relevant for each case). Less than 35 % of reports adequately addressed the tumour–vessel relationship with the superior mesenteric artery and vein. The coeliac artery was addressed in just 30 reports (20 %), and non-standard and vague terminology was common.</div></div><div><h3>Conclusion</h3><div>Prose CT reporting for PDAC resectability in Australia does not specifically address many important features determining resectability. Prose reporting is associated with high rates of omission of relevant negatives as well as some errors of commission and considerable language variability.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 8","pages":"Pages 1087-1094"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215708","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}