Hpb最新文献

{"title":"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.","authors":"Yuanming Zhang","doi":"10.1016/j.hpb.2026.08.007","DOIUrl":"https://doi.org/10.1016/j.hpb.2026.08.007","url":null,"abstract":"","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864829","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":"Reliability of artificial intelligence in hepato-pancreato-biliary clinical decision-making: a retrospective comparative analysis with multidisciplinary team meetings.","authors":"Ioannis Katsaros, Andreas Panagakis, Adam Mylonakis, Maria Sotiropoulou, Panagiotis Sakarellos, Chrysovalantis Vergadis, Dimitrios Schizas, Evangelos S Felekouras, Michail Vailas","doi":"10.1016/j.hpb.2026.08.006","DOIUrl":"https://doi.org/10.1016/j.hpb.2026.08.006","url":null,"abstract":"<p><strong>Background: </strong>The integration of Artificial Intelligence (AI) into clinical decision-making is accelerating, yet its reliability compared to Multidisciplinary Team (MDT) meetings in Hepato-Pancreato-Biliary (HPB) surgery remains underexplored. This study evaluated the concordance between AI recommendations and MDT consensus in real-world HPB oncology.</p><p><strong>Methods: </strong>A retrospective comparative analysis of all HPB cases discussed at the MDT meetings of the 1st Department of Surgery, National and Kapodistrian University of Athens, between July 1st and December 31st 2025, was conducted. Anonymized text-only clinical summaries were processed using a large language model (Gemini 3.1 Pro) to generate treatment recommendations. The primary endpoint was the agreement rate between the AI and the MDT decision.</p><p><strong>Results: </strong>An overall agreement rate of 91.7% (k = 0.841; p < 0.01) was observed. Concordance was exceptionally high in straightforward cases (96.7%; k = 0.938; p < 0.01), mirroring standard oncologic workflows. Conversely, in complex scenarios agreement dropped significantly to 62.5% (k = 0.304; p = 0.09). In these instances, AI recommendations diverged from the individualized, clinical judgment applied by the MDT.</p><p><strong>Conclusions: </strong>AI platforms demonstrate high concordance with MDTs in routine HPB scenarios, suggesting potential for streamlining standard workloads. Nevertheless, human multidisciplinary expertise remains indispensable for complex cases requiring nuanced clinical intuition.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812676","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":"Hepatic artery aneurysm repair: selection bias, sex-specific risk, and follow-up standardization.","authors":"Zhenxing Wang, Weikai Dong","doi":"10.1016/j.hpb.2026.08.004","DOIUrl":"https://doi.org/10.1016/j.hpb.2026.08.004","url":null,"abstract":"","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818402","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":"Is a simplified textbook outcome sensitive enough to capture the true impact of vascular resection during pancreatoduodenectomy ?","authors":"Imen Ben Ismail, Mariem Marzouki","doi":"10.1016/j.hpb.2026.08.005","DOIUrl":"https://doi.org/10.1016/j.hpb.2026.08.005","url":null,"abstract":"","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792459","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":"Partial hepatectomy after liver transplantation: systematic review and pooled analysis of indications, techniques and outcomes.","authors":"Lorenzo Bernardi, Raffaello Roesel, Alessandra Cristaudi, Shu Sasaki, Pietro Majno-Hurst, Davide Ghinolfi, Emanuele Balzano","doi":"10.1016/j.hpb.2026.08.002","DOIUrl":"https://doi.org/10.1016/j.hpb.2026.08.002","url":null,"abstract":"<p><strong>Background: </strong>Partial hepatectomy after orthotopic liver transplantation (OLT) is a graft-saving option that may be used to avoid or delay re-transplantation. We assessed the indications, techniques and outcomes of partial hepatectomy in OLT recipients.</p><p><strong>Methods: </strong>A PRISMA-compliant systematic review was performed on PubMed, Scopus, and Web of Science. Original studies reporting partial hepatectomy in OLT recipients were eligible for inclusion. Pooled analysis was used to report clinical outcomes.</p><p><strong>Results: </strong>Sixteen studies (n = 135 patients) were included in the systematic review. Main indications for partial hepatectomy were recurrent HCC (41.5%), biliary complications of OLT (25.9%) and other de novo tumors (16.3%). Pooled analysis showed a mean interval between OLT and partial hepatectomy of 47.0 months, heterogeneous based on the indication for resection. Major hepatectomy was used in 40.2% of cases, minimally invasive liver surgery (MILS) in 8.8%. Postoperative morbidity, major morbidity and mortality rates were 48.0%, 17.0% and 7.4% respectively. Additional long-term morbidity and re-transplantation rates were 20.3% and 11.1%.</p><p><strong>Conclusions: </strong>In carefully selected OLT recipients, partial hepatectomy is feasible and safe. The use MILS should be further explored. Prospective data with detailed stratification of patients based on the perioperative risks and expected long-term outcomes are needed.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792529","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":"Limitations of GATA6 and CK5 as surrogate markers for molecular subtyping in pancreatic cancer.","authors":"Jaewon J Lee, Mohammed Aldakkak, Saryn Doucette, Yusha Liu, Ian C McCabe, Naim U Rashid, Alina Iuga, Douglas B Evans, Susan Tsai, Jen Jen Yeh","doi":"10.1016/j.hpb.2026.08.001","DOIUrl":"https://doi.org/10.1016/j.hpb.2026.08.001","url":null,"abstract":"<p><strong>Background: </strong>Molecular subtyping of pancreatic ductal adenocarcinoma (PDAC) may inform prognosis and treatment selection, and its clinical application remains under investigation. Although PurIST is a validated transcriptomic classifier, immunohistochemical (IHC) markers such as GATA6 and CK5 have been proposed as practical surrogates. We evaluated whether GATA6 and CK5 IHC could substitute for transcriptomic PDAC subtyping.</p><p><strong>Methods: </strong>RNA-seq and GATA6/CK5 IHC were performed on 130 matched tumor samples. Most patients received neoadjuvant therapy. PurIST subtype assignment served as the reference. Concordance was assessed using Cohen's kappa and overall survival using log-rank tests.</p><p><strong>Results: </strong>PurIST classified 8 tumors (6%) as basal-like. GATA6 alone showed poor concordance with PurIST (kappa=0.18, 95% CI -0.06 to 0.42) and was not prognostic of survival (P=0.98). CK5 showed better concordance (kappa=0.39, 95% CI 0.07 to 0.70) but was not significantly prognostic (P=0.084). Combined GATA6/CK5 improved concordance modestly (kappa=0.54, 95% CI 0.18 to 0.90) and stratified OS in the survival cohort (P=0.041), but generated categories that did not align cleanly with established subtypes. GATA6 IHC correlated weakly with RNA-seq expression (rho=0.178, P=0.0429).</p><p><strong>Discussion: </strong>In predominantly post-neoadjuvant PDAC specimens, GATA6 and CK5 capture aspects of subtype biology but are not reliable substitutes for transcriptomic classification.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840212","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":"Indocyanine green for intraoperative characterization of liver tumors: a novel injection protocol adapted to routine clinical practice.","authors":"Rodrigue N Doamba, Nicolas Golse","doi":"10.1016/j.hpb.2026.07.011","DOIUrl":"https://doi.org/10.1016/j.hpb.2026.07.011","url":null,"abstract":"","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792435","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":"Robotic versus laparoscopic liver resection for intrahepatic cholangiocarcinoma: a head-to-head multicenter propensity score-matched analysis.","authors":"Antonella Delvecchio, Silvio Caringi, Rebecca Marino, Simone Conci, Laura Alaimo, Enrico Gringeri, Clarissa De Nardi, Francesco Ardito, Simone Famularo, Riccardo De Carlis, Leonardo Centonze, Federico Mocchegiani, Andrea Benedetti Cacciaguerra, Andrea Belli, Maria N Ringressi, Matteo Serenari, Fabio Giannone, Annarita Libia, Fabrizio Di Francesco, Declan McDonnell, Salvatore Gruttadauria, Marcello G Spampinato, Fabrizio Panaro, Matteo Cescon, Gian L Grazi, Francesco Izzo, Marco Vivarelli, Luciano De Carlis, Felice Giuliante, Umberto Cillo, Andrea Ruzzenente, Francesca Ratti, Riccardo Memeo","doi":"10.1016/j.hpb.2026.07.009","DOIUrl":"https://doi.org/10.1016/j.hpb.2026.07.009","url":null,"abstract":"<p><strong>Background: </strong>Intrahepatic cholangiocarcinoma (iCCA) is an aggressive primary liver cancer for which surgical resection with lymphadenectomy remains the only potentially curative treatment. Although minimally invasive liver surgery (MILS) provides benefits over open surgery, whether robotic liver resection (RLR) offers advantages over laparoscopic resection (LLR) in oncological adequacy and perioperative outcomes remains unclear.</p><p><strong>Methods: </strong>We retrospectively analyzed consecutive patients with iCCA who underwent MILS in 13 Italian hepatobiliary centers. Patients were stratified by surgical approach (LLR vs RLR) and matched 2:1 by propensity score matching (PSM). Primary endpoints were oncological outcomes and adequacy of lymph node dissection (LND). Secondary endpoints included intraoperative and short-term postoperative outcomes.</p><p><strong>Results: </strong>Overall, 645 patients (468 LLR, 177 RLR) were included; after PSM, 511 patients (334 LLR, 177 RLR) were analyzed. RLR achieved higher R0 resection rates (p = 0.002) and a greater mean lymph node yield (p = 0.001). Overall survival (OS) and disease-free survival (DFS) were comparable between groups. RLR was also associated with lower conversion rates, fewer postoperative complications, and shorter hospital stay.</p><p><strong>Conclusion: </strong>RLR for iCCA is safe and provides advantages in margin status, lymph node dissection, and perioperative outcomes, while long-term oncological outcomes (OS and DFS) are comparable to LLR.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758976","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":"IHPBA news 1","authors":"","doi":"10.1016/S1365-182X(26)00708-2","DOIUrl":"10.1016/S1365-182X(26)00708-2","url":null,"abstract":"","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 8","pages":"Page IBC"},"PeriodicalIF":3.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148666674","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":"Highlights in this issue","authors":"","doi":"10.1016/S1365-182X(26)00716-1","DOIUrl":"10.1016/S1365-182X(26)00716-1","url":null,"abstract":"","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 8","pages":"Page iii"},"PeriodicalIF":3.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148666873","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}