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IF 2.4 3区医学

Hpb Pub Date : 2026-04-01 Epub Date: 2026-04-02 DOI: 10.1016/S1365-182X(26)00102-4

引用次数: 0

Clinical and molecular features of resected early onset pancreatic ductal adenocarcinoma: insights from the NCDB and cBioPortal 切除的早发性胰腺导管腺癌的临床和分子特征：来自NCDB和cBioPortal的见解。

IF 2.4 3区医学

Hpb Pub Date : 2026-04-01 Epub Date: 2025-12-15 DOI: 10.1016/j.hpb.2025.12.026

Nabiha A. Mughal , Omar Mahmud , Ingmar F. Rompen , Mansour E. Riachi , Brian D. Kaplan , Daniel B. Hewitt , Greg D. Sacks , Christopher L. Wolfgang , Ammar A. Javed

{"title":"Clinical and molecular features of resected early onset pancreatic ductal adenocarcinoma: insights from the NCDB and cBioPortal","authors":"Nabiha A. Mughal , Omar Mahmud , Ingmar F. Rompen , Mansour E. Riachi , Brian D. Kaplan , Daniel B. Hewitt , Greg D. Sacks , Christopher L. Wolfgang , Ammar A. Javed","doi":"10.1016/j.hpb.2025.12.026","DOIUrl":"10.1016/j.hpb.2025.12.026","url":null,"abstract":"<div><h3>Background</h3><div>Pancreatic cancer with early onset is increasing but comparisons with average onset cases have yielded mixed results (EOPC versus AOPC; age <50 versus ≥50). We compared clinicopathologic features, prognosis, and molecular traits of resected EOPC versus AOPC.</div></div><div><h3>Methods</h3><div>We retrospectively included patients with PDAC resected between 2010 and 2017 from The National Cancer Database (NCDB). Clinicopathologic data were compared across EOPC versus AOPC. Kaplan–Meier curves and cox-regression were used to perform survival analysis. Molecular features were compared using data from the cBioPortal.</div></div><div><h3>Results</h3><div>24,078 patients with resected PDAC were included, of whom 1698 (7.1 %) had EOPC. Poor prognostic factors, including high grade, advanced T-stage, and lymphovascular invasion, were less prevalent in EOPC (All <em>p</em> < 0.05). Patients with EOPC more frequently received neoadjuvant (28 % vs. 22 %; <em>p</em> < 0.001) and adjuvant chemotherapy (68 % vs. 58 %; <em>p</em> < 0.001) and experienced improved OS (median OS 29.5 vs 25.9 months, <em>p</em> = 0.023; 5-year OS: 26.9 % vs 20.8 %). No differences in the presence of key driver mutations were observed between the two groups but some distinct oncogenic mutations were observed in EOPC.</div></div><div><h3>Conclusion</h3><div>EOPC and AOPC are clinically similar but some cases of EOPC may harbor divergent molecular changes. These patients may have only marginally improved survival.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 4","pages":"Pages 515-523"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145896160","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

Optimizing surgical indication in patients with borderline resectable pancreatic ductal adenocarcinoma to prevent futile pancreatectomy 优化交界性可切除胰导管腺癌患者的手术指征，预防无效胰切除术。

IF 2.4 3区医学

Hpb Pub Date : 2026-04-01 Epub Date: 2025-12-15 DOI: 10.1016/j.hpb.2025.12.021

Yusuke Kazami , Yoshikuni Kawaguchi , Tatsunori Suzuki , Kazunaga Ishigaki , Naminatsu Takahara , Sho Kiritani , Satoru Abe , Yuichiro Mihara , Yujiro Nishioka , Akihiko Ichida , Takeshi Takamoto , Nobuhisa Akamatsu , Mitsuhiro Fujishiro , Kiyoshi Hasegawa

{"title":"Optimizing surgical indication in patients with borderline resectable pancreatic ductal adenocarcinoma to prevent futile pancreatectomy","authors":"Yusuke Kazami , Yoshikuni Kawaguchi , Tatsunori Suzuki , Kazunaga Ishigaki , Naminatsu Takahara , Sho Kiritani , Satoru Abe , Yuichiro Mihara , Yujiro Nishioka , Akihiko Ichida , Takeshi Takamoto , Nobuhisa Akamatsu , Mitsuhiro Fujishiro , Kiyoshi Hasegawa","doi":"10.1016/j.hpb.2025.12.021","DOIUrl":"10.1016/j.hpb.2025.12.021","url":null,"abstract":"<div><h3>Background</h3><div>Borderline resectable pancreatic ductal adenocarcinoma (BR-PDAC) carries a high risk of early recurrence (ER) despite neoadjuvant chemotherapy (NAC) and surgery. Identifying ER predictors is essential to optimize surgical indication.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 70 patients with BR-PDAC, of whom 48 underwent resection. ER was defined as recurrence within 8 months. Pre- and post-NAC carbohydrate antigen 19-9 (CA19-9) levels were assessed using Cox regression and receiver operating characteristic (ROC) curve analysis.</div></div><div><h3>Results</h3><div>ER occurred in 18 patients (38%). Both pre-NAC (median, 699 vs. 71 U/mL; <em>P</em> = 0.010) and post-NAC CA19-9 levels (149 vs. 27 U/mL; <em>P</em> = 0.002) were significantly higher in ER patients. ROC curve analysis identified a post-NAC CA19-9 cutoff of 100 U/mL (area under the curve, 0.77) predicting ER. Patients with post-NAC CA19-9 ≥100 U/mL had significantly worse progression-free (hazard ratio [HR], 5.84; <em>P</em> < 0.001) and overall survival (HR, 6.36; <em>P</em> = 0.002). Notably, patients with ER had a similar OS to those who did not undergo surgery (HR, 0.93; <em>P</em> = 0.87).</div></div><div><h3>Conclusions</h3><div>Persistently elevated CA19-9 after NAC predicts ER and poor survival, suggesting limited benefit from resection. Post-NAC CA19-9 may help prevent futile pancreatectomy.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 4","pages":"Pages 480-490"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145911006","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

Validation of postoperative period of care and textbook outcome as quality measures regarding gallstone surgery 验证术后护理期和教科书结果作为胆结石手术的质量指标。

IF 2.4 3区医学

Hpb Pub Date : 2026-04-01 Epub Date: 2025-12-16 DOI: 10.1016/j.hpb.2025.12.023

Linda N. Nilsson , Agnieszka Popowicz , Folke Hammarqvist , Gabriel Sandblom

{"title":"Validation of postoperative period of care and textbook outcome as quality measures regarding gallstone surgery","authors":"Linda N. Nilsson , Agnieszka Popowicz , Folke Hammarqvist , Gabriel Sandblom","doi":"10.1016/j.hpb.2025.12.023","DOIUrl":"10.1016/j.hpb.2025.12.023","url":null,"abstract":"<div><h3>Background</h3><div>A universally accepted quality measure for gallstone surgery is lacking. In this retrospective study, we evaluated the duration of postoperative care, completion with laparoscopic approach, absence of procedure-related complications, and no readmission as criteria for Textbook Outcome (TO).</div></div><div><h3>Methods</h3><div>Data was collected from the Swedish National Register for Gallstone Surgery (GallRiks) 2007–2022. We analyzed postoperative stay as exposure and postoperative complications as outcome using Receiver Operation Characteristic (ROC). TO was defined as laparoscopically completed operations, discharge within three days after surgery, no postoperative complication > Clavien–Dindo 2, no contact with the care provider or new readmission/intervention within 30 days post-surgery. The outcome of TO was further validated based on patients 6 months postoperatively answering SF-36.</div></div><div><h3>Results</h3><div>A total of 193 201 cholecystectomies were analyzed. Using discharge within three days postoperatively as threshold, the sensitivity was 50 % and the specificity 87 % for predicting a surgery-related complication. The rate of TO in the entire cohort was 79,4 %. Those who met the TO criteria rated notably higher on physical and mental scoring 6 months postoperatively (both <em>p</em> < 0.05) than those who did not.</div></div><div><h3>Conclusion</h3><div>The postoperative period of care and TO are robust outcome measures for evaluating results after gallstone surgery.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 4","pages":"Pages 491-496"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145911151","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 2.4 3区医学

Hpb Pub Date : 2026-04-01 Epub Date: 2026-04-02 DOI: 10.1016/S1365-182X(26)00099-7

引用次数: 0

Comparing faecal Elastase-1 and 13C mixed triglyceride breath test in patients undergoing pancreatic surgery 比较胰腺手术患者粪便弹性酶-1和13C混合甘油三酯呼吸试验。

IF 2.4 3区医学

Hpb Pub Date : 2026-04-01 Epub Date: 2026-01-12 DOI: 10.1016/j.hpb.2026.01.001

Vera Hartman , Bart Bracke , Thiery Chapelle , Bart Hendrikx , Frederik Huysentruyt , Ellen Liekens , Ella Roelant , Eline Roeyen , Dirk Ysebaert , Geert Roeyen

{"title":"Comparing faecal Elastase-1 and 13C mixed triglyceride breath test in patients undergoing pancreatic surgery","authors":"Vera Hartman , Bart Bracke , Thiery Chapelle , Bart Hendrikx , Frederik Huysentruyt , Ellen Liekens , Ella Roelant , Eline Roeyen , Dirk Ysebaert , Geert Roeyen","doi":"10.1016/j.hpb.2026.01.001","DOIUrl":"10.1016/j.hpb.2026.01.001","url":null,"abstract":"<div><h3>Background</h3><div>The optimal test for diagnosing pancreatic exocrine insufficiency (PEI) remains debated. This study compares the diagnostic accuracy of faecal elastase-1 (FE-1) and the <sup>13</sup>C Mixed Triglyceride Breath Test (MTGT) in patients undergoing pancreatic surgery.</div></div><div><h3>Methods</h3><div>Patients undergoing pancreatic resection at Antwerp University Hospital (2016–2023) had FE-1 and MTGT testing before and after surgery. The MTGT was used as the reference standard. Agreement between both tests was evaluated using Cohen's kappa.</div></div><div><h3>Results</h3><div>Preoperatively, in a patient cohort of 249 patients, PEI was detected in 25.3 % using MTGT and 39.6 % using FE-1 (cutoff <200 μg/g). The sensitivity and specificity of FE-1 were 63.5 % and 68.3 %, respectively. Agreement was fair (κ = 0.27). After pancreatoduodenectomy, the prevalence of PEI increased to 60 % (MTGT) and 92.2 % (FE-1), with only slight agreement between tests (κ = 0.17). Although FE-1 demonstrated high sensitivity (98.1 %), its specificity was poor (16.7 %), resulting in an 83.5 % false-positive rate.</div></div><div><h3>Conclusions</h3><div>In patients undergoing pancreatic surgery, especially after pancreatoduodenectomy, the agreement between MTGT and FE-1 is substantially lower than expected. FE-1 demostrates low specificity and a high false-positive rate, resulting in overdiagnosis and unnecessary economic and patient burden.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 4","pages":"Pages 582-587"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046536","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

Comment on “Reappraisal of the impact of resection margin on outcomes after hepatectomy and perioperative treatment for alveolar echinococcosis: a single center experience” by Notte et al. (HPB 2025;27:1284) Notte等人对“重新评估切除边缘对肺泡包虫病肝切除术和围手术期治疗结果的影响：单中心经验”的评论（HPB 2025;27:1284）。

IF 2.4 3区医学

Hpb Pub Date : 2026-04-01 Epub Date: 2025-12-26 DOI: 10.1016/j.hpb.2025.12.034

İlgin Özden

引用次数: 0

Follow up and safety of use of hepatitis C virus discordant liver transplants 丙型肝炎病毒异型肝移植术后随访及安全性分析。

IF 2.4 3区医学

Hpb Pub Date : 2026-04-01 Epub Date: 2025-12-15 DOI: 10.1016/j.hpb.2025.12.027

Catherine G. Pratt , Nicolas Noriega , Jenna N. Whitrock , Michela M. Carter , Allison N. Moore , Tiffany E. Kaiser , Kristina H. Lemon , Keith Luckett , Michael Schoech , Khurram Bari , Ralph C. Quillin III , Shimul A. Shah

{"title":"Follow up and safety of use of hepatitis C virus discordant liver transplants","authors":"Catherine G. Pratt , Nicolas Noriega , Jenna N. Whitrock , Michela M. Carter , Allison N. Moore , Tiffany E. Kaiser , Kristina H. Lemon , Keith Luckett , Michael Schoech , Khurram Bari , Ralph C. Quillin III , Shimul A. Shah","doi":"10.1016/j.hpb.2025.12.027","DOIUrl":"10.1016/j.hpb.2025.12.027","url":null,"abstract":"<div><h3>Background</h3><div>Hepatitis C virus (HCV)-discordant liver transplants (LT), nonviremic and viremic, were first shown at our center as safe and efficacious for HCV-negative recipients in the short-term. This review evaluates HCV-discordant LT long-term outcomes.</div></div><div><h3>Methods</h3><div>All HCV-discordant deceased donor LT from 03/2016-06/2023 were reviewed in this retrospective, single-center study.</div></div><div><h3>Results</h3><div>194 HCV-discordant LTs (96 (49.5 %) nucleic acid test (NAT)-negative and 98 (50.5 %) NAT-positive) were evaluated with a median follow-up of 53 months. Baseline liver biopsies of 139 (71.6 %) allografts, report 47 (24.2 %) no fibrosis, 27 (13.9 %) stage 1 fibrosis, and 65 (33.5 %) stage 2 fibrosis. Stage 2 fibrosis was higher among NAT-positive allografts (46.9 % vs. 19.8 %). Seven (6.3 %) NAT-negative allograft recipients experienced HCV transmission. One (1.1 %) NAT-positive allograft recipient experienced early HCV relapse, requiring additional treatment. All treated recipients achieved sustained viral response (SVR). There was no difference in patient or graft survival by allograft NAT status or fibrosis stage.</div></div><div><h3>Conclusion</h3><div>This is first report to show HCV-discordant LT exhibit low rates of relapse, achieve long-term SVR and have similar patient and graft survival regardless of allograft HCV viremia or fibrosis; thus, justifying their use for transplantation in the long-term.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 4","pages":"Pages 524-533"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145900381","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

Duct to duct vs. hepaticojejunostomy for biliary reconstruction in adult living donor right lobe liver transplantation - a systematic review and meta-analysis 成人活体右叶肝移植中胆道重建的管对管vs肝空肠吻合术——系统回顾和荟萃分析。

IF 2.4 3区医学

Hpb Pub Date : 2026-04-01 Epub Date: 2026-01-23 DOI: 10.1016/j.hpb.2026.01.007

Swizel A. Cardoso , Rayner P. Cardoso , Prashant Bhangui , Bobby V.M. Dasari

{"title":"Duct to duct vs. hepaticojejunostomy for biliary reconstruction in adult living donor right lobe liver transplantation - a systematic review and meta-analysis","authors":"Swizel A. Cardoso , Rayner P. Cardoso , Prashant Bhangui , Bobby V.M. Dasari","doi":"10.1016/j.hpb.2026.01.007","DOIUrl":"10.1016/j.hpb.2026.01.007","url":null,"abstract":"<div><h3>Background</h3><div>The safety of living donor liver transplantation (LDLT) has improved over the years, and yet biliary anastomotic complications remain substantial occurring in up to 25%, affecting short-term and long-term outcomes. The meta-analyses is performed to compare biliary complication rates, based on the number of ducts, including bile leaks and strictures, in right-lobe living donor liver transplantation (RLLDLT) using duct-to-duct (DD) anastomosis versus Roux en Y Hepaticojejunostomy (HJ).</div></div><div><h3>Methods</h3><div>PubMed, Cochrane and Embase databases were searched comprehensively for studies on adult LDLT, focusing on the bile duct reconstruction method for RLLDLT.</div></div><div><h3>Results</h3><div>Fifteen retrospective studies with 1770 patients were included. DD anastomosis is associated with a significantly reduced rate of all biliary complications compared to HJ (OR 1.16, 95% CI (0.82-1.64), p= 0.40), and particularly a lower incidence of bile leak (OR 0.61, 95% CI (0.38-0.98), p=0.04), while the rates of biliary strictures (OR 1.49, 95% CI (0.83-2.69), p=0.18) did not differ significantly. Grafts with multiple bile ducts (1 vs. >1) were associated with higher complication rates (OR 0.80, 95% CI (0.54-1.19), p=0.27).</div></div><div><h3>Conclusion</h3><div>The meta-analyses supports DD over HJ where both are feasible, and highlights the importance of individualised biliary reconstruction strategies to improve patient outcomes in RLLDLT.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 4","pages":"Pages 470-479"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146157245","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

Effect of duration of neoadjuvant therapy on pancreatic cancer outcomes: a systematic review and meta-analysis 新辅助治疗持续时间对胰腺癌预后的影响：系统回顾和荟萃分析。

IF 2.4 3区医学

Hpb Pub Date : 2026-04-01 Epub Date: 2025-12-16 DOI: 10.1016/j.hpb.2025.12.018

Shahin Hajibandeh , Shahab Hajibandeh , Syed S. Raza , David C. Bartlett , Bobby V.M. Dasari , Nikolaos Chatzizacharias , Ravi Marudanayagam , Robert P. Sutcliffe , Keith J. Roberts

{"title":"Effect of duration of neoadjuvant therapy on pancreatic cancer outcomes: a systematic review and meta-analysis","authors":"Shahin Hajibandeh , Shahab Hajibandeh , Syed S. Raza , David C. Bartlett , Bobby V.M. Dasari , Nikolaos Chatzizacharias , Ravi Marudanayagam , Robert P. Sutcliffe , Keith J. Roberts","doi":"10.1016/j.hpb.2025.12.018","DOIUrl":"10.1016/j.hpb.2025.12.018","url":null,"abstract":"<div><h3>Background</h3><div>The aim of theis study was toevaluate impact of duration of neoadjuvant treatment (NAT) on surgical resection rate, resection margin, response to treatment, and survival in patients with pancreatic ductal adenocarcinoma (PDAC).</div></div><div><h3>Methods</h3><div>All randomised controlled trials (RCTs) of NAT in patients with PDAC were included. Effect sizes were determined for surgical resection rate, R0 resection, radiological response to NAT and 1- to 5-years survival.</div></div><div><h3>Results</h3><div>Twenty-three RCTs (1880 patients) were included. NAT duration≤8 weeks was associated with significantly higher surgical resection rate [66.7 % (95 % CI 57.4 %–76.1 %)] compared with NAT duration >8 weeks [33.5 % (95 % CI 22.1 %–45.0 %)]. The difference remained significant when only resectable [73.9 % (95 % CI 64.3 %–83.5 %) vs 44.7 % (95 % CI 15.9 %-60.6.%)], borderline resectable [66.4 % (95 % CI 46.6 %–86.1 %) vs 22.5 % (95 % CI 18.2 %–26.8 %)], or mixed borderline resectable/locally advanced PDAC [60.6 % (95 % CI 48.2 %–73.0 %) vs 35.0 % (95 % CI 27.6 %–42.4 %)] were considered. Moreover, when only NAT with chemotherapy considered, resection rate remained significant in favour of NAT duration≤8. No significant difference was found in R0 resection rate, partial response, stable disease, or disease progression between two groups. Intention-to-treat respected 1-, 3-, 5-years survival were comparable.</div></div><div><h3>Conclusions</h3><div>NAT duration >8 weeks may be associated with a reduced surgical resection rate and no apparent improvement in negative resection margin in patients with PDAC, particularly borderline resectable cases. However, it may have comparable survival to NAT duration ≤8 weeks. Future randomised evidence is needed to overcome the limitations associated with current evidence.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 4","pages":"Pages 447-462"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145878288","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