IF 3.3 3区医学

Hpb Pub Date : 2026-09-01 Epub Date: 2026-06-11 DOI: 10.1016/j.hpb.2026.06.004

Pam E. van der Meeren, Sverre Beijer, Merve Rousian, Kay Pieterman, Dave Sprengers, Erik Vegt, Robert J. Porte, Jan N.M. Ijzermans, Roeland F. de Wilde

{"title":"Selective internal radiotherapy vs transarterial chemoembolization for unresectable hepatocellular carcinoma: a systematic review","authors":"Pam E. van der Meeren, Sverre Beijer, Merve Rousian, Kay Pieterman, Dave Sprengers, Erik Vegt, Robert J. Porte, Jan N.M. Ijzermans, Roeland F. de Wilde","doi":"10.1016/j.hpb.2026.06.004","DOIUrl":"10.1016/j.hpb.2026.06.004","url":null,"abstract":"<div><h3>Background</h3><div>Hepatocellular carcinoma (HCC) is the most common primary liver tumor, with transarterial chemoembolization (TACE) and selective internal radiotherapy (SIRT) as main therapeutic options for patients with intermediate-stage HCC. This review compares TACE and SIRT outcomes in unresectable HCC.</div></div><div><h3>Methods</h3><div>A literature search identified studies on HCC patients treated with TACE or SIRT. Quality was assessed using the Cochrane risk-of-bias 2 tool. Primary and secondary outcomes included overall survival (OS), time-to-progression (TTP), and progression-free survival (PFS).</div></div><div><h3>Results</h3><div>Ten studies met inclusion criteria, including a total of 1386 patients (64% TACE, 36% SIRT). Overall quality of studies was high, with moderate risk of bias in one study. TACE showed longer weighted median OS (812 days, range 475–1119) than SIRT (280 days, range 268–840). TACE showed longer median PFS (254 days, range 216–265) than SIRT (151 days, range 125–359). SIRT showed a trend toward longer TTP with weighted median of 213 days (range 185–520) compared to 111 days (range 76–365) for TACE.</div></div><div><h3>Discussion</h3><div>SIRT may improve local tumor control, while TACE offers better OS and PFS in intermediate HCC. Given the heterogeneity across studies, further research is needed to define optimal treatment for unresectable HCC.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 9","pages":"Pages 1149-1157"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360509","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

IHPBA news 2 IHPBA新闻2。

IF 3.3 3区医学

Hpb Pub Date : 2026-09-01 Epub Date: 2026-09-09 DOI: 10.1016/S1365-182X(26)00748-3

引用次数: 0

Pancreatic resection for metastatic renal cell carcinoma: outcomes in the era of immunotherapy and targeted therapy 胰腺切除术治疗转移性肾细胞癌：免疫治疗和靶向治疗时代的结果。

IF 3.3 3区医学

Hpb Pub Date : 2026-09-01 Epub Date: 2026-06-11 DOI: 10.1016/j.hpb.2026.06.003

Hala Muaddi, Leo Li-Han, Brian A. Costello, Stephen A. Boorjian, Vidit Sharma, Bradley C. Leibovich, Mark Truty, Michael Kendrick, Cornelius A. Thiels

{"title":"Pancreatic resection for metastatic renal cell carcinoma: outcomes in the era of immunotherapy and targeted therapy","authors":"Hala Muaddi, Leo Li-Han, Brian A. Costello, Stephen A. Boorjian, Vidit Sharma, Bradley C. Leibovich, Mark Truty, Michael Kendrick, Cornelius A. Thiels","doi":"10.1016/j.hpb.2026.06.003","DOIUrl":"10.1016/j.hpb.2026.06.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Pancreatic metastases from renal cell carcinoma (RCC) are rare and the role of pancreatectomy in the era of immunotherapy and targeted therapies remains unclear. This study evaluated outcomes following pancreatic resection for RCC metastases in the modern treatment era.</div></div><div><h3>Methods</h3><div>Patients with RCC who developed pancreatic metastases and underwent pancreatectomy were retrospectively reviewed. Patients were stratified by immunotherapy use, disease distribution (isolated pancreatic vs. multi-site), and number of lesions (single vs. multiple). Recurrence rate (RR) and overall survival (OS) were estimated using Kaplan–Meier analysis.</div></div><div><h3>Results</h3><div>Sixty-two patients were included (median age 67 years; 35.5% female). Isolated pancreatic metastases were present in 51.6%, and 64.5% had a solitary pancreatic lesion. Because immunotherapy was predominantly initiated after recurrence, RR at 1, 3, and 5 years was higher among treated patients (37%, 66%, 88%) compared with those not receiving immunotherapy (16%, 34%, 54%; p = 0.006). Despite this, OS remained comparable between groups (p = 0.53). Patients with isolated pancreatic metastases had lower 5-year recurrence rates than those with multi-site metastases (60% vs. 89%; p = 0.007), although OS did not differ. Lesion number did not impact RR or OS.</div></div><div><h3>Conclusion</h3><div>Pancreatectomy for RCC metastases is associated with good OS and remains a strategy, including as a means to defer immunotherapy.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 9","pages":"Pages 1222-1230"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338438","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

Minimally invasive versus open surgery for insulinoma: a 20-year institutional experience 微创与开放手术治疗胰岛素瘤：20年的机构经验。

IF 3.3 3区医学

Hpb Pub Date : 2026-09-01 Epub Date: 2026-06-11 DOI: 10.1016/j.hpb.2026.06.002

Sagar D. Patel, Ranim Alsaad, John L. Cameron, Christopher R. Shubert, Richard A. Burkhart, William R. Burns, Jin He, Kelly J. Lafaro

{"title":"Minimally invasive versus open surgery for insulinoma: a 20-year institutional experience","authors":"Sagar D. Patel, Ranim Alsaad, John L. Cameron, Christopher R. Shubert, Richard A. Burkhart, William R. Burns, Jin He, Kelly J. Lafaro","doi":"10.1016/j.hpb.2026.06.002","DOIUrl":"10.1016/j.hpb.2026.06.002","url":null,"abstract":"<div><h3>Background</h3><div>There is a growing trend towards using a minimally invasive approach (MIS) for patients with insulinoma. We aim to compare the perioperative and oncologic outcomes of open approach versus MIS over a 20-year period.</div></div><div><h3>Methods</h3><div>We conducted a retrospective single institution cohort study of patients who underwent surgical resection for insulinoma between 2004 and 2024. Patients were grouped by surgical approach: open or MIS, and outcomes were analyzed.</div></div><div><h3>Results</h3><div>28 patients (37.8%) underwent an open approach, and 46 patients (62.2%) underwent an MIS approach. Parenchymal-preserving approach was more commonly done in the MIS group (54.3% vs. 28.6%, p = 0.009). Resection done by a MIS approach was associated with shorter length of stay (5.0 vs. 6.5 days, p = 0.011), fewer grade III/IV surgical complications (19.6% vs. 32.1%, p = 0.15), lower 30-day readmission rates (17.4% vs. 42.9%, p = 0.034), and no cases of incisional hernia (0% vs. 14.3%%, p = 0.018) within two years post-operatively. The difference in local recurrence rates was not statistically significant (4.3% vs. 3.6%, p = 1).</div></div><div><h3>Discussion</h3><div>Our experience highlights that an MIS approach allows for greater use of parenchymal-sparing techniques and improved short-term outcomes while maintaining oncologic integrity.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 9","pages":"Pages 1214-1221"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338485","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 paradox of escalating immunotherapy for uveal melanoma liver metastases 葡萄膜黑色素瘤肝转移免疫治疗升级的悖论。

IF 3.3 3区医学

Hpb Pub Date : 2026-09-01 Epub Date: 2026-06-04 DOI: 10.1016/j.hpb.2026.05.010

Paul Wong, Tommaso Pollini, Sophia Hernandez, Shao Tao, Guilin Qiao, Afsaneh Amouzegar, Guus M. Bol, Adil I. Daud, Derrick L. Tao, Katy K. Tsai, James Lee, Ajay V. Maker

引用次数: 0

Prognostic impact of severe postoperative complications after curative-intent resection for perihilar cholangiocarcinoma: an international multi-institutional analysis. 肝门周围胆管癌术后严重并发症对预后的影响：一项国际多机构分析

IF 3.3 3区医学

Hpb Pub Date : 2026-08-22 DOI: 10.1016/j.hpb.2026.08.010

Yutaka Endo, Kizuki Yuza, Jun Kawashima, Odysseas Chatzipanagiotou, Selamawit Woldesenbet, Andrea Ruzzenente, Hugo P Marques, Shishir K Maithel, Bas G Koerkamp, Carlo Pulitano, Federico Aucejo, Itaru Endo, Timothy M Pawlik

{"title":"Prognostic impact of severe postoperative complications after curative-intent resection for perihilar cholangiocarcinoma: an international multi-institutional analysis.","authors":"Yutaka Endo, Kizuki Yuza, Jun Kawashima, Odysseas Chatzipanagiotou, Selamawit Woldesenbet, Andrea Ruzzenente, Hugo P Marques, Shishir K Maithel, Bas G Koerkamp, Carlo Pulitano, Federico Aucejo, Itaru Endo, Timothy M Pawlik","doi":"10.1016/j.hpb.2026.08.010","DOIUrl":"https://doi.org/10.1016/j.hpb.2026.08.010","url":null,"abstract":"<p><strong>Introduction: </strong>We sought to evaluate the impact of severe postoperative complications on recurrence-free survival (RFS) after curative-intent resection for pCCA with particular attention to tumor biology.</p><p><strong>Methods: </strong>An international multi-institutional database was queried to identify patients who underwent curative-intent liver resection for pCCA between 2000 and 2023. Patients who died within 90 days of surgery were excluded. Severe complications were defined as Clavien-Dindo grade ≥ III.</p><p><strong>Results: </strong>Among 453 patients, the median age was 67 years (IQR, 57-74), 62.3% were male, 29.3% had CA19-9 ≥400 U/mL, and 36.6% experienced severe postoperative complications. Overall, 3-year RFS was worse among patients with severe complications versus those without (26.7% vs 30.7%; p = 0.044). This association was more pronounced among patients with CA19-9 <400 U/mL (25.4% vs 32.9%; p = 0.014), whereas no difference was observed among patients with CA19-9 ≥400 U/mL (28.3% vs 24.9%; p = 0.88). On multivariable analysis, severe complications remained independently associated with worse RFS among patients with CA19-9 <400 U/mL (HR 1.39, 95% CI 1.03-1.88; p = 0.03), but not among individuals with CA19-9 ≥400 U/mL (HR 0.78, 95% CI 0.48-1.28; p = 0.32). On sensitivity analyses using a Fine-Gray competing risk model, severe postoperative complications were not independently associated with recurrence in either subgroup.</p><p><strong>Conclusions: </strong>The association between severe postoperative complications and long-term outcomes appeared more evident among patients with more favorable tumor biology.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891574","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

Practice composition and sub-specialization among fellowship-trained HPB surgeons: impact on outcomes following hepatopancreatic surgery. 在接受过奖学金培训的HPB外科医生中，实践组成和亚专业化：对肝胰手术后结果的影响。

IF 3.3 3区医学

Hpb Pub Date : 2026-08-20 DOI: 10.1016/j.hpb.2026.08.009

Diamantis I Tsilimigras, Selamawit Woldesenbet, Odysseas P Chatzipanagiotou, Timothy M Pawlik

{"title":"Practice composition and sub-specialization among fellowship-trained HPB surgeons: impact on outcomes following hepatopancreatic surgery.","authors":"Diamantis I Tsilimigras, Selamawit Woldesenbet, Odysseas P Chatzipanagiotou, Timothy M Pawlik","doi":"10.1016/j.hpb.2026.08.009","DOIUrl":"https://doi.org/10.1016/j.hpb.2026.08.009","url":null,"abstract":"<p><strong>Introduction: </strong>The impact of sub-specialization and practice composition among surgeons performing hepatopancreatic (HP) surgery in the United States has not been previously characterized.</p><p><strong>Methods: </strong>Medicare beneficiaries undergoing HP surgery (2016-2021) were identified. HP practice composition, defined as the proportion of HP procedures among all surgeries performed by each surgeon during the study period was assessed. The primary outcome was achievement of textbook outcome (TO) after HP surgery relative to HP practice composition.</p><p><strong>Results: </strong>A total of 20,614 HP procedures were performed by 710 fellowship-trained surgeons (CGSO:n = 578, 81.4%, AHPBA:n = 111, 15.6%, both n = 21, 3.0%). Most surgeons were low-volume for both hepatic and pancreatic surgery (H-low/P-low:41.1%). CGSO and AHPBA fellowship graduates had comparable liver and pancreas volume practices (p = 0.24). Median HP practice composition among all surgeons was 20.7% (IQR:10.1-35.7%). Higher HP-specific volume and higher HP practice composition were independently associated with a greater probability of TO after hepatectomy and pancreatectomy (both p < 0.05). Among CGSO graduates, HP practice composition varied significantly by graduating CGSO program.</p><p><strong>Conclusions: </strong>HP case composition varied markedly relative to fellowship training. Despite greater HP case composition being associated with improved outcomes, most fellowship-trained HP surgeons maintained broad-based and low volume HP practices.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874014","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 ductal subtype predict outcomes after resection of IPMN-derived pancreatic cancer? An international multi-center retrospective study. 导管亚型能预测ipmn源性胰腺癌切除术后的预后吗？一项国际多中心回顾性研究。

IF 3.3 3区医学

Hpb Pub Date : 2026-08-20 DOI: 10.1016/j.hpb.2026.08.011

Kate Mlouk, Camila Hidalgo Salinas, Jonah Levine, Joseph R Habib, Madeleine Hunter, Rami Imam, D Brock Hewitt, Michael D Kluger, Katherine Morgan, Lois A Daamen, Christopher L Wolfgang, I Quintus Molenaar, Marc G Besselink, Ammar A Javed, Greg D Sacks

{"title":"Does ductal subtype predict outcomes after resection of IPMN-derived pancreatic cancer? An international multi-center retrospective study.","authors":"Kate Mlouk, Camila Hidalgo Salinas, Jonah Levine, Joseph R Habib, Madeleine Hunter, Rami Imam, D Brock Hewitt, Michael D Kluger, Katherine Morgan, Lois A Daamen, Christopher L Wolfgang, I Quintus Molenaar, Marc G Besselink, Ammar A Javed, Greg D Sacks","doi":"10.1016/j.hpb.2026.08.011","DOIUrl":"10.1016/j.hpb.2026.08.011","url":null,"abstract":"<p><strong>Background: </strong>Although main duct (MD) and branch duct (BD) IPMNs differ in preoperative risk of malignant transformation, it remains unclear whether ductal subtype influences outcomes once invasive carcinoma develops and is resected. We compared recurrence and survival outcomes between these subtypes.</p><p><strong>Methods: </strong>We identified patients with resected IPMN-derived pancreatic ductal adenocarcinoma (PDAC) from three institutions. Overall survival (OS) and recurrence-free survival (RFS) were estimated using Kaplan-Meier methods and compared with log-rank tests. Multivariable Cox regression models adjusted for age, T-stage, N-stage, histologic subtype, and adjuvant chemotherapy.</p><p><strong>Results: </strong>Among 136 patients, 106 (78%) had MD-derived and 30 (22%) had BD-derived IPMN-associated PDAC. Median OS was 36.6 months and did not differ by subtype on log-rank (p = 0.472) or multivariable analysis (HR 0.45, 95% CI 0.15-1.31; p = 0.143). Median RFS was 41.8 months without significant difference by subtype on log-rank (p = 0.362) or adjusted analysis (HR 0.56, 95% CI 0.21-1.46; p = 0.234).</p><p><strong>Conclusions: </strong>In patients with resected IPMN-derived PDAC, ductal subtype was not significantly associated with OS. While clinically meaningful differences in RFS cannot be excluded, these findings suggest that once invasive cancer arises and is resected, ductal subtype alone may not provide additional prognostic information.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887301","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

Correspondence: international consensus on mesopancreas and total mesopancreas excision (MESODELPHI). 对应：国际间关于介胰腺和全介胰腺切除术（MESODELPHI）的共识。

IF 3.3 3区医学

Hpb Pub Date : 2026-08-19 DOI: 10.1016/j.hpb.2026.08.008

Tiago Bouça-Machado

引用次数: 0

Correspondence on: oncological outcomes following left-sided pancreatic resection for grade 1 and grade 2 pancreatic neuroendocrine tumours: a population-cohort study comparing open with minimally-invasive surgery. 1级和2级胰腺神经内分泌肿瘤左侧胰腺切除术后的肿瘤预后：一项比较开放手术和微创手术的人群队列研究。

IF 3.3 3区医学

Hpb Pub Date : 2026-08-19 DOI: 10.1016/j.hpb.2026.08.007

Yuanming Zhang

引用次数: 0

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