IF 2.4 3区医学

Hpb Pub Date : 2025-08-01 DOI: 10.1016/j.hpb.2025.04.012

Chien-Ming Chiang, Pei-Tseng Chao, Kun-Ru Chou, Meng-Ying Lin, Wei-Lun Chang

引用次数: 0

Safety and efficacy of tranexamic acid in hepatic surgery: a meta-analysis of randomized controlled trials 氨甲环酸在肝脏手术中的安全性和有效性：一项随机对照试验的荟萃分析。

IF 2.4 3区医学

Hpb Pub Date : 2025-08-01 DOI: 10.1016/j.hpb.2025.05.006

Breno G.A.S. de Jesus, Eduardo S.R. Barreto, Gabriel S. Medrado Nunes, Caio F. Nascimento, Maria E.M. Vassoler, Felipe C.A. Meira, Eduardo F. Viana

{"title":"Safety and efficacy of tranexamic acid in hepatic surgery: a meta-analysis of randomized controlled trials","authors":"Breno G.A.S. de Jesus, Eduardo S.R. Barreto, Gabriel S. Medrado Nunes, Caio F. Nascimento, Maria E.M. Vassoler, Felipe C.A. Meira, Eduardo F. Viana","doi":"10.1016/j.hpb.2025.05.006","DOIUrl":"10.1016/j.hpb.2025.05.006","url":null,"abstract":"<div><h3>Background</h3><div>Hepatic surgeries involve substantial bleeding risk, associated with perioperative morbidity and mortality. While tranexamic acid (TXA) reduces blood loss in other surgeries, its efficacy in hepatic procedures remains unclear. This meta-analysis evaluates TXA's safety and effectiveness in liver surgeries.</div></div><div><h3>Methods</h3><div>We systematically reviewed randomized controlled trials published until April 2025 from PubMed, Scopus, Embase, and Cochrane CENTRAL. Studies comparing TXA with placebo in adult elective liver surgeries were included. Primary outcomes were blood loss and mortality, while secondary outcomes encompassed blood transfusion needs, thromboembolic, and adverse events. The Cochrane Risk of Bias tool was used for quality assessment.</div></div><div><h3>Results</h3><div>Six trials comprising 1875 patients undergoing liver resections or transplants were included. TXA did not reduce intraoperative blood loss (MD = −0.16 L; 95 % CI: −0.50 to 0.18; I<sup>2</sup> = 92 %) or mortality (RR = 1.04; 95 % CI: 0.58 to 1.87; I<sup>2</sup> = 4 %). Thromboembolic risk showed no significant difference overall (RR = 1.58; 95 % CI: 0.94 to 2.64; I<sup>2</sup> = 0 %), but sensitivity analysis indicated a potential increased risk (RR = 1.70; 95 % CI: 1.01 to 2.87).</div></div><div><h3>Conclusion</h3><div>Our findings suggest that TXA does not improve bleeding or mortality outcomes in liver surgeries and may increase thromboembolic risk. (PROSPERO number, CRD42024585513)</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 8","pages":"Pages 1009-1019"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247675","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

First results from the international registry on liver venous deprivation (EuroLVD) 来自国际肝静脉剥夺登记（EuroLVD）的第一批结果。

IF 2.4 3区医学

Hpb Pub Date : 2025-08-01 DOI: 10.1016/j.hpb.2025.02.017

Gaëtan-Romain Joliat , Patrick Chevallier , Stephen Wigmore , David Martin , Ismail Labgaa , Emilie Uldry , Nermin Halkic , Timothy Newhook , Antony Haddad , Jean-Nicolas Vauthey , Riccardo Memeo , Bobby V.M. Dasari , Eva Braunwarth , Raffaele Brustia , Daniele Sommacale , Giorgia A. Rodda , Hicham Kobeiter , Rafael Duran , Alban Denys , Nicolas Demartines , Emmanuel Melloul

{"title":"First results from the international registry on liver venous deprivation (EuroLVD)","authors":"Gaëtan-Romain Joliat , Patrick Chevallier , Stephen Wigmore , David Martin , Ismail Labgaa , Emilie Uldry , Nermin Halkic , Timothy Newhook , Antony Haddad , Jean-Nicolas Vauthey , Riccardo Memeo , Bobby V.M. Dasari , Eva Braunwarth , Raffaele Brustia , Daniele Sommacale , Giorgia A. Rodda , Hicham Kobeiter , Rafael Duran , Alban Denys , Nicolas Demartines , Emmanuel Melloul","doi":"10.1016/j.hpb.2025.02.017","DOIUrl":"10.1016/j.hpb.2025.02.017","url":null,"abstract":"<div><h3>Background</h3><div>An international registry on liver venous deprivation (LVD, simultaneous portal and hepatic vein embolization) was created in 2020. This study assessed the outcomes after LVD in patients included in the registry.</div></div><div><h3>Methods</h3><div>Eight international centers participated. Future liver remnant (FLR) and standardized FLR ratios were defined as FLR/total functional liver volume and FLR/total estimated liver volume.</div></div><div><h3>Results</h3><div>216 patients were included (80 women, median age 63). Main surgical indication was colorectal metastases (n=124). Median and standardized FLR ratios before LVD were 33% (IQR27-47) and 32% (IQR24-39). In one patient, right hepatic vein embolization failed. Complications after LVD occurred in 14 patients (6.5%). After LVD, median and standardized FLR ratios significantly increased to 46% (IQR38-60, p<0.001) and 44% (IQR35-51, p<0.001), corresponding to a median kinetic growth rate of 3.4%/week (IQR1.5–6.0). Hepatectomy was performed in 160 patients (72 extended hepatectomies), while 56 dropped out (4% insufficient hypertrophy, 13% tumor progression). Seventy-seven patients had postoperative complications (48%; 5 postoperative liver failures, 3%). Median Comprehensive Complication Index was 20.9 (IQR0-30.8).</div></div><div><h3>Conclusion</h3><div>Preliminary data of this international registry showed that LVD had a high technical success rate with few post-procedural complications and significant kinetic growth. Major hepatectomy after LVD appeared to be safe.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 8","pages":"Pages 1020-1027"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003528","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 impact of obesity on in-hospital outcome of patients who underwent hepatic resection surgeries; a US national-wide study 肥胖对肝切除术患者住院预后的影响一项美国全国性的研究。

IF 2.4 3区医学

Hpb Pub Date : 2025-08-01 DOI: 10.1016/j.hpb.2025.05.004

Ali Esparham , Saeed Shoar , Venkat R. Modukuru , George Agriantonis , Jennifer Whittington , Zahra Shafaee

{"title":"The impact of obesity on in-hospital outcome of patients who underwent hepatic resection surgeries; a US national-wide study","authors":"Ali Esparham , Saeed Shoar , Venkat R. Modukuru , George Agriantonis , Jennifer Whittington , Zahra Shafaee","doi":"10.1016/j.hpb.2025.05.004","DOIUrl":"10.1016/j.hpb.2025.05.004","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies have shown conflicting results on the effect of obesity on the outcome of liver resection. The current study investigates the impact of obesity in these patients.</div></div><div><h3>Methods</h3><div>We included all the patients with hepatobiliary cancer who underwent liver resection between 2016 and 2020 using the International Classification of Diseases, 10th Revision, Procedure Coding System (ICD-10-PCS) codes. A propensity score matching analysis was performed to match obese and non-obese groups.</div></div><div><h3>Results</h3><div>A total of 8,731 patients were included in the study. The trend of obesity increased significantly from 14.6% in 2016 to 19.0% in 2020. After PSM, obesity was independently associated with increased odds of mechanical ventilation (OR: 1.82, 95% CI: 1.30-2.56, p-value<0.001), acute kidney injury (OR: 1.31, 95% CI: 1.04-1.65, p-value=0.023), and vasopressor need (OR: 2.11, 95% CI: 1.32-3.38, p-value=0.002). However, rates of blood transfusion, surgical site infection, pneumonia, sepsis, postoperative delirium, bowel obstruction, cardiac arrest, deep vein thrombosis/pulmonary thromboembolism, ileus, nausea and vomiting, postoperative anemia, post-procedural shock, and in-hospital mortality did not differ significantly between groups. The hospitalization costs were higher in the obese group ($28,272 [19,516-40,842] vs. $26,402 [18,099-37,810], p-value<0.001, respectively).</div></div><div><h3>Conclusion</h3><div>Obesity is linked to higher postoperative complications and hospitalization costs after hepatectomy.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 8","pages":"Pages 1095-1102"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301982","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

Does a robotic approach decrease morbidity and mortality following pancreaticoduodenectomy for octogenarians? An American multi-center analysis. 机器人方法能降低八十多岁老人胰十二指肠切除术后的发病率和死亡率吗？美国的多中心分析。

IF 2.4 3区医学

Hpb Pub Date : 2025-07-30 DOI: 10.1016/j.hpb.2025.07.016

Sarah B Hays, Kristine Kuchta, Andres A Abreu, Asmita Chopra, Emile Farah, Amudhan Kannan, Syed A Mehdi, Imad Radi, Kristen Ranson, Aram E Rojas, Adam Tcharni, Brian A Boone, Alessandro Paniccia, Patricio M Polanco, Carl R Schmidt, Mark S Talamonti, Herbert J Zeh, Amer H Zureikat, Melissa E Hogg

{"title":"Does a robotic approach decrease morbidity and mortality following pancreaticoduodenectomy for octogenarians? An American multi-center analysis.","authors":"Sarah B Hays, Kristine Kuchta, Andres A Abreu, Asmita Chopra, Emile Farah, Amudhan Kannan, Syed A Mehdi, Imad Radi, Kristen Ranson, Aram E Rojas, Adam Tcharni, Brian A Boone, Alessandro Paniccia, Patricio M Polanco, Carl R Schmidt, Mark S Talamonti, Herbert J Zeh, Amer H Zureikat, Melissa E Hogg","doi":"10.1016/j.hpb.2025.07.016","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.07.016","url":null,"abstract":"<p><strong>Background: </strong>Morbidity and mortality following pancreaticoduodenectomy (PD) have improved; however, the population is aging, and the use of robotic surgery is expanding. This study compares the selection of octogenarians who underwent PD, their outcomes, and whether robotic surgery provides an advantage.</p><p><strong>Methods: </strong>This is a multi-institutional retrospective review from 2007 to 2023 of patients who underwent PD, including open and robotic approach. Pre-, intra-, and post-operative outcomes were analyzed; multivariable analysis (MVA) and propensity score matching (PSM) were performed.</p><p><strong>Results: </strong>2175 patients underwent PD for all causes; <80 years: n=1,952, >80 (octogenarians): n=223. Octogenarians had higher age unadjusted Charlson Comorbidity Index (2.8 vs 2.6, p<0.001), and more prior surgeries (67.9 % vs 56.1 %, p<0.001). On univariate analysis, octogenarians had higher average Clavien-Dindo grade (2.0 vs 1.7, p=0.002) and higher 90-day mortality (9.9 % vs 3.1 %, p<0.001). On MVA, age >80 was associated with increased risk of major morbidity (OR 1.50 [1.10-2.04], p=0.011) and 90-day mortality (OR 3.20 [1.85-5.54], p<0.001). Robotic PD (RPD) was associated with decreased risk of major morbidity (OR 0.69 [0.56-0.86], p<0.001). After PSM of octogenarians who underwent RPD, there was no statistically significant difference in mortality.</p><p><strong>Conclusion: </strong>Pancreaticoduodenectomy has increased but acceptable morbidity in octogenarians. The increased risk may be mitigated by RPD.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855105","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

Close correlation between patients' positive mood and postoperative complication burden in hepato-biliary-pancreatic cancer: a prospective comparative cohort trial. 一项前瞻性比较队列试验：肝胆胰癌患者积极情绪与术后并发症负担密切相关。

IF 2.4 3区医学

Hpb Pub Date : 2025-07-26 DOI: 10.1016/j.hpb.2025.07.015

Shunsuke Onoe, Yukihiro Yokoyama, Tsuyoshi Igami, Junpei Yamaguchi, Takashi Mizuno, Yoshikuni Inokawa, Hideki Takami, Masaki Sunagawa, Nobuyuki Watanabe, Shoji Kawakatsu, Tatsuya Tokura, Takahiro Imaizumi, Tomoki Ebata

{"title":"Close correlation between patients' positive mood and postoperative complication burden in hepato-biliary-pancreatic cancer: a prospective comparative cohort trial.","authors":"Shunsuke Onoe, Yukihiro Yokoyama, Tsuyoshi Igami, Junpei Yamaguchi, Takashi Mizuno, Yoshikuni Inokawa, Hideki Takami, Masaki Sunagawa, Nobuyuki Watanabe, Shoji Kawakatsu, Tatsuya Tokura, Takahiro Imaizumi, Tomoki Ebata","doi":"10.1016/j.hpb.2025.07.015","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.07.015","url":null,"abstract":"<p><strong>Background: </strong>The impact of preoperative mood on complications remains poorly understood in hepato-biliary-pancreatic (HBP) surgery.</p><p><strong>Methods: </strong>This prospective cohort study included patients who underwent resection for pancreatic ductal carcinoma and cholangiocarcinoma. Preoperative positive mood were measured by Vigor-Activity score according to Profile of Mood States, 2nd edition. The primary outcome was the whole burden of complications, represented by the comprehensive complication index (CCI). Patients were divided into low- and high-positive mood groups by the median Vigor-Activity score. The impact of mood state on CCI was assessed by restricted cubic spline regression.</p><p><strong>Results: </strong>Between July 2021 and June 2022, 127 consecutive patients were enrolled. Preoperative findings and surgical procedures did not significantly differ between the low-positive (n = 64) and high-positive (n = 63) mood groups. The high-positive mood group had a significantly lower median CCI than the low-positive mood group (41.1 vs. 48.2, P = 0.026). The Vigor-Activity score had a nearly linear negative correlation with CCI and independently decreased CCI (P = 0.034).</p><p><strong>Conclusion: </strong>Patients with preoperative high-positive mood had a lower CCI than those with low-positive mood after major HBP surgery. A patient's preoperative mood could affect the total burden of postoperative complications.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834985","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

Patient expectations about the oncologic benefit of pancreatectomy for pancreatic ductal adenocarcinoma. 患者对胰腺导管腺癌切除术的肿瘤学获益的期望。

IF 2.4 3区医学

Hpb Pub Date : 2025-07-25 DOI: 10.1016/j.hpb.2025.07.017

Benjamin A Y Cher, Christopher J Zimmermann, Juan G Favela, Linda C Stafford, Daniel Bolt, Shishir K Maithel, Mihir M Shah, Syed A Ahmad, Sameer H Patel, Robert Martin, Charles R Scoggins, Nipun Merchant, Jash Datta, Hj Kim, Michael LeCompte, Chet W Hammill, Rebecca A Snyder, Alexander A Parikh, Sharon M Weber, Daniel E Abbott

{"title":"Patient expectations about the oncologic benefit of pancreatectomy for pancreatic ductal adenocarcinoma.","authors":"Benjamin A Y Cher, Christopher J Zimmermann, Juan G Favela, Linda C Stafford, Daniel Bolt, Shishir K Maithel, Mihir M Shah, Syed A Ahmad, Sameer H Patel, Robert Martin, Charles R Scoggins, Nipun Merchant, Jash Datta, Hj Kim, Michael LeCompte, Chet W Hammill, Rebecca A Snyder, Alexander A Parikh, Sharon M Weber, Daniel E Abbott","doi":"10.1016/j.hpb.2025.07.017","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.07.017","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic resection offers the only chance for cure for pancreatic ductal adenocarcinoma, but resection is associated with significant morbidity. Data are lacking about whether patients understand the risks/benefits of surgical resection. This survey study prospectively assessed patient understanding of expected oncologic outcomes after pancreatectomy.</p><p><strong>Methods: </strong>A 14-question survey was distributed between 2020 and 2022 to patients planning to undergo pancreatectomy at eight geographically diverse institutions performing high-volume pancreatic surgery. The survey assessed demographics, expectations about post-resection outcomes, and perceived quality of patient-surgeon communication. Associations between demographics and survey responses were assessed with Fisher's exact test and Goodman-Kruskal's lambda.</p><p><strong>Results: </strong>152 surveys were received (response rate 39 %; n = 152/376). Almost all patients believed surgery was likely to prolong survival (146/147, 99 %); cure their cancer (126/141, 89 %); and/or ameliorate health problems due to cancer (127/136, 93 %). Regarding patient-surgeon communication, 134/150 (89 %) reported surgeons always listened carefully, and 134/150 (89 %) reported surgeons gave clear explanations. There were no meaningful associations between demographics and understanding of expected post-resection outcomes.</p><p><strong>Discussion: </strong>Most patients believed surgery was likely curative and were satisfied with patient-surgeon communication. These data outline a critical opportunity for surgical oncologists to improve pre-operative counseling and ensure patients have accurate information to support complex decision-making.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855107","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

Asia-Pacific modified Delphi consensus conference on large hepatocellular carcinoma. 亚太大肝癌修正Delphi共识会议。

IF 2.4 3区医学

Hpb Pub Date : 2025-07-23 DOI: 10.1016/j.hpb.2025.07.013

Adianto Nugroho, Arnetta N Lalisang, Toar J M Lalisang, Mohamed Rela, Pierce K H Chow, Stephen Chang, Koh P Soon, Tin T Mar, Amornetta Casupang, Rawisak Chanwat, Erik Prabowo, Indah Jamtani, Nguyen D S Huy, Norihiro Kokudo, Catherine Teh

{"title":"Asia-Pacific modified Delphi consensus conference on large hepatocellular carcinoma.","authors":"Adianto Nugroho, Arnetta N Lalisang, Toar J M Lalisang, Mohamed Rela, Pierce K H Chow, Stephen Chang, Koh P Soon, Tin T Mar, Amornetta Casupang, Rawisak Chanwat, Erik Prabowo, Indah Jamtani, Nguyen D S Huy, Norihiro Kokudo, Catherine Teh","doi":"10.1016/j.hpb.2025.07.013","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.07.013","url":null,"abstract":"<p><strong>Background: </strong>Approximately 80 % of primary liver cancer cases happen in Asia-Pacific and become the leading cause of cancer-related mortality. However, there is no consensus on defining and standardizing the optimal management of large HCCs.</p><p><strong>Methods: </strong>The Asia-Pacific Consensus Conference employed the Modified Delphi method, consisting of three rounds of surveys followed by a discussion panel. In this process, 31 experts anonymously contributed their opinions to refine statements and achieve a consensus on large HCC.</p><p><strong>Results: </strong>A large hepatocellular carcinoma (HCC) is a nodule measuring ≥5 cm. A distinct BCLC staging system is recommended for solitary large HCC (SLHCC) without vascular invasion or tumor dissemination, as these cases show prolonged survival and lower recurrence rates post-liver resection. Portal vein tumor thrombosis (PVTT) is a crucial prognostic factor. Diagnosis of SLHCC can rely on multiphasic contrast-enhancing radiology (CT/MRI) and AFP levels ≥400. Preoperative liver function assessments guide resection planning where liver volumetry is unavailable. Major hepatectomy and laparoscopic approaches are viable for SLHCC, and postoperative radiological surveillance is essential.</p><p><strong>Conclusion: </strong>Tailoring surgical approaches, ensuring readiness, and optimizing resources are key to successful single large HCC management. This consensus aims to guide surgeons, especially in the Asia-Pacific region.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834984","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

Enhancing management of pancreatic cancer: impact of a same day multidisciplinary clinic on access to guideline-directed care. 加强胰腺癌的管理：当日多学科门诊对获得指南指导护理的影响。

IF 2.4 3区医学

Hpb Pub Date : 2025-07-17 DOI: 10.1016/j.hpb.2025.07.012

Matthew I Ebia, Anser A Abbas, Abrahm Levi, John Davelaar, Elissa Rosenberg, Katelyn M Atkins, Mitchell Kamrava, Simon Lo, Srinivas Gaddam, Alexandra Gangi, Kambiz Kosari, Arpit Arora, Nanor Haladjian, Meghan Laszlo, Steven Oppenheim, Karen L Reckamp, Nicholas Nissen, Brent K Larson, Ashley Wachsman, Jun Gong, Cristina Ferrone, Andrew E Hendifar, Arsen Osipov

{"title":"Enhancing management of pancreatic cancer: impact of a same day multidisciplinary clinic on access to guideline-directed care.","authors":"Matthew I Ebia, Anser A Abbas, Abrahm Levi, John Davelaar, Elissa Rosenberg, Katelyn M Atkins, Mitchell Kamrava, Simon Lo, Srinivas Gaddam, Alexandra Gangi, Kambiz Kosari, Arpit Arora, Nanor Haladjian, Meghan Laszlo, Steven Oppenheim, Karen L Reckamp, Nicholas Nissen, Brent K Larson, Ashley Wachsman, Jun Gong, Cristina Ferrone, Andrew E Hendifar, Arsen Osipov","doi":"10.1016/j.hpb.2025.07.012","DOIUrl":"10.1016/j.hpb.2025.07.012","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic cancer (PC) requires a multimodal treatment approach. We evaluated the impact of our same-day pancreatic multidisciplinary clinic (PMDC) on genetic testing, ancillary service access, treatment timelines, clinical trial enrollment, and survival.</p><p><strong>Methods: </strong>We retrospectively compared guideline directed care, clinical metrics and outcomes in patients managed through our PMDC (n = 87; Oct 2021-June 2023) versus an age- and resectability-matched cohort from our internal registry who received standard sequential care non-PMDC (n = 87; Jan-Dec 2020).</p><p><strong>Results: </strong>PMDC patients were significantly more likely to undergo somatic (OR 3.69, p < 0.001) and germline testing (OR 15.41, p < 0.001), receive upfront access palliative care (OR 7.86, p < 0.001) and social services (OR 4.48, p = 0.028), initiate treatment sooner (14.3 vs. 30.9 days, p = 0.002), and enroll in clinical trials (OR 2.30, p = 0.042). Among newly diagnosed metastatic PC patients, PMDC care was independently associated with improved survival (487 vs. 267 days, p = 0.021).</p><p><strong>Conclusion: </strong>A same-day PMDC significantly improves access to guideline-recommended care and prolongs survival in patients with metastatic pancreatic cancer.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859136","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

Highlights in this issue 本期重点报道

IF 2.7 3区医学

Hpb Pub Date : 2025-06-27 DOI: 10.1016/S1365-182X(25)00618-5

引用次数: 0

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