Hpb最新文献_第8页

3-D reconstruction in liver surgery: a systematic review 肝脏手术中的三维重建：系统性综述。

IF 2.7 3区医学

Hpb Pub Date : 2024-10-01 DOI: 10.1016/j.hpb.2024.06.006

{"title":"3-D reconstruction in liver surgery: a systematic review","authors":"","doi":"10.1016/j.hpb.2024.06.006","DOIUrl":"10.1016/j.hpb.2024.06.006","url":null,"abstract":"<div><h3>Background</h3><div>Three-dimensional reconstruction of the liver offers several advantages to the surgeon before and during liver resection. This review discusses the factors behind the use of liver 3-D reconstruction.</div></div><div><h3>Methods</h3><div>Systematic electronic search, according to PRISMA criteria, was performed. A literature search of scientific papers was performed until October 2023. Articles were chosen based on reference to 3-D liver reconstruction and their use in liver surgery. GRADE methodology and the modified Newcastle–Ottawa scale were used to assess the quality of the studies.</div></div><div><h3>Results</h3><div>The research included 47 articles and 7724 patients were analyzed.</div><div>Preoperative planning was performed with 3-D liver reconstruction in the 87.2% of the studies.</div><div>Most of preoperative 3-D liver reconstructions were performed in the planning of complex or major hepatectomies. Complex hepatectomies were performed in 64.3% patients.</div><div>The 55.3% of the studies reported an improved navigation and accuracy during liver resection. Four studies (8.6%) on living donor liver transplant (LDLT) concluded that 3-D liver reconstruction is useful for graft selection and vascular preservation. Nine papers (19.1%) reported an accurate measurement of future liver remnant.</div></div><div><h3>Conclusion</h3><div>Liver 3-D reconstruction helps surgeons in the planning of liver surgery, especially in liver graft and complex liver resections, increasing the accuracy of the surgical resection.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"26 10","pages":"Pages 1205-1215"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141497919","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

Identifying suitable candidates for pancreaticoduodenectomy with extended lymphadenectomy for pancreatic ductal adenocarcinoma 确定胰腺十二指肠切除术和胰腺导管腺癌淋巴腺扩大切除术的合适人选

IF 2.7 3区医学

Hpb Pub Date : 2024-10-01 DOI: 10.1016/j.hpb.2024.07.405

Jiali Yang, Junfeng Zhang, Mingda Tan, Jianyou Gu, Li Tang, Yao Zheng, Qiang Zhou, Xianxing Wang, Renpei Xia, Tao Zhang, Yongjun Yang, Shixiang Guo, Huaizhi Wang

{"title":"Identifying suitable candidates for pancreaticoduodenectomy with extended lymphadenectomy for pancreatic ductal adenocarcinoma","authors":"Jiali Yang, Junfeng Zhang, Mingda Tan, Jianyou Gu, Li Tang, Yao Zheng, Qiang Zhou, Xianxing Wang, Renpei Xia, Tao Zhang, Yongjun Yang, Shixiang Guo, Huaizhi Wang","doi":"10.1016/j.hpb.2024.07.405","DOIUrl":"10.1016/j.hpb.2024.07.405","url":null,"abstract":"<div><h3>Background</h3><div>To evaluate long-term quality of life and survival in pancreatic ductal adenocarcinoma (PDAC) patients after pancreatoduodenectomy with extended lymphadenectomy (PDEL) and identify candidates.</div></div><div><h3>Methods</h3><div>Patients with resectable PDAC with ≥1 examined lymph node (LN) during pancreatoduodenectomy (PD), and were divided into the PD with standard lymphadenectomy (PDSL) and PDEL groups. Perioperative data, long-term quality of life and survival were compared, and the prognostic effect of LNs ± in every peripancreatic station were analysed.</div></div><div><h3>Results</h3><div>Screening 446 PDAC patients, 237 and 126 were included in the PDSL and PDEL groups, respectively. The PDEL group showed a longer operation time, greater intraoperative blood loss, severe diarrhoea, a higher incidence of grade III complications. Notably, the PDEL patients experienced significant relief from low back pain and diarrhoea, with an obvious survival advantage (p = 0.037), especially in patients with preoperative tumor contact with vascular and pathological N0; however, LNs+ in any station (No. 8p, 12, 14, or 16) were associated with a poorer prognosis. The vascular reconstruction, T and N stage were independent risk factors for survival.</div></div><div><h3>Conclusion</h3><div>PDEL can relieve symptoms and prolong the survival of PDAC patients with acceptable complications, and EL should be performed regardless of preoperative LN enlargement.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"26 10","pages":"Pages 1291-1301"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141715413","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

Differential impact of incrementally elevated CA 19-9 levels on prognosis of resected pancreatic ductal adenocarcinoma CA 19-9 水平逐渐升高对切除的胰腺导管腺癌预后的不同影响。

IF 2.7 3区医学

Hpb Pub Date : 2024-10-01 DOI: 10.1016/j.hpb.2024.06.004

{"title":"Differential impact of incrementally elevated CA 19-9 levels on prognosis of resected pancreatic ductal adenocarcinoma","authors":"","doi":"10.1016/j.hpb.2024.06.004","DOIUrl":"10.1016/j.hpb.2024.06.004","url":null,"abstract":"<div><h3>Background</h3><div>CA 19–9 is an extremely useful biomarker for pancreatic ductal adenocarcinomas (PDACs). However, the optimal cut-off and prognostic significance at higher cut-offs are yet to be determined.</div></div><div><h3>Methods</h3><div>Retrospective analysis included patients with PDAC who underwent curative resection from January 2010 to May 2020 at Tata Memorial Centre, Mumbai. The pretherapy CA 19–9 was dichotomized using various cut-off levels and analysed.</div></div><div><h3>Results</h3><div>In 244 included patients, the median overall survival (OS) for those with CA19-9 level (IU/ml) < or >78, 200, 500, 1000, and 2000 was 27, 24, 23, 22, 21 months versus 18, 16, 15, 14, 13 months; respectively, and was statistically significant (p-value- 0.002, 0.001, 0.002, 0.002 and 0.004, respectively). The number of recurrences and mortality had significant correlation with CA 19–9 cut-offs. On multivariate analysis<span>, adjuvant treatment completion (p-0.004) and decreasing or stable CA19-9 after Neoadjuvant therapy (NAT) (p- 0.031) were associated with improved OS.</span></div></div><div><h3>Conclusion</h3><div>The prognostic significance of CA 19–9 was observed at all the cut-off levels examined, beyond mere elevated value as per the standard cut-off level. In patients with high CA19-9 level, surgery should be offered if technically and conditionally feasible, only when a response in CA19-9 level to NAT is achieved.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"26 10","pages":"Pages 1237-1247"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141467617","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

Contrasting concerns: a retrospective cohort study evaluating intraoperative cholangiogram patients with allergies 对比关注：一项对术中胆管造影术过敏患者进行评估的回顾性队列研究

IF 2.7 3区医学

Hpb Pub Date : 2024-10-01 DOI: 10.1016/j.hpb.2024.07.001

Jenny H. Chang, Henry Stitzel, Chase Wehrle, Chao Tu, Robert Naples, Samer A. Naffouje, R. Matthew Walsh, Robert Simon

引用次数: 0

Sociodemographic variation in the utilization of minimally invasive surgical approaches for pancreatic cancer 利用微创手术治疗胰腺癌的社会人口学差异

IF 2.7 3区医学

Hpb Pub Date : 2024-10-01 DOI: 10.1016/j.hpb.2024.07.403

Andy Tran , Richard Zheng , Fabian Johnston , Jin He , William R. Burns , Christopher Shubert , Kelly Lafaro , Richard A. Burkhart

{"title":"Sociodemographic variation in the utilization of minimally invasive surgical approaches for pancreatic cancer","authors":"Andy Tran , Richard Zheng , Fabian Johnston , Jin He , William R. Burns , Christopher Shubert , Kelly Lafaro , Richard A. Burkhart","doi":"10.1016/j.hpb.2024.07.403","DOIUrl":"10.1016/j.hpb.2024.07.403","url":null,"abstract":"<div><h3>Background</h3><div><span>Minimally invasive pancreatic surgery (MIPS), when selectively utilized, has been shown to hasten recovery with outcomes comparable to open approaches, but access may not be equitable. This study explored variation in utilization of MIPS for </span>pancreatic cancer.</div></div><div><h3>Methods</h3><div>The National Cancer Database was queried to identify patients diagnosed with a primary pancreatic neoplasm from 2010 to 2020. Study participants had diagnoses of clinical or pathologic stage 1–3 disease and received curative-intent surgery. Multivariable analyses assessed the association between surgical approach and patient and disease factors.</div></div><div><h3>Results</h3><div>Inclusion criteria identified 73,137 patients: 51,408 underwent open surgery and 21,729 received MIPS. In our multivariable analysis, Black race was associated with reduced odds of MIPS (AOR 0.88; p = 0.02), while older age (AOR 1.17; p = 0.01), later year of diagnosis (AOR 1.57; p < 0.001), and private insurance coverage (AOR 1.30; p = 0.05) were associated with increased odds. When patients with adenocarcinoma were analyzed in isolation, disparities in MIPS utilization persisted even when controlling for disease stage.</div></div><div><h3>Conclusion</h3><div>Sociodemographic factors like age, race, and insurance coverage appear to vary in the utilization of MIPS technologies for the treatment of pancreatic malignancy. Addressing variation with robust mixed methods approaches in the future is proposed to incorporate prospective interventions with highly annotated outcomes for additional study.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"26 10","pages":"Pages 1280-1290"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141715634","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

Meta analysis of radiofrequency ablation versus surgical resection in small and large nodule of hepatocellular carcinoma 射频消融与手术切除治疗肝细胞癌小结节和大结节的 Meta 分析

IF 2.7 3区医学

Hpb Pub Date : 2024-10-01 DOI: 10.1016/j.hpb.2024.06.009

Rino A. Gani, Maria Teressa, Refael A. Budiman, Kemal F. Kalista, Cosmas Rinaldi A. Lesmana

{"title":"Meta analysis of radiofrequency ablation versus surgical resection in small and large nodule of hepatocellular carcinoma","authors":"Rino A. Gani, Maria Teressa, Refael A. Budiman, Kemal F. Kalista, Cosmas Rinaldi A. Lesmana","doi":"10.1016/j.hpb.2024.06.009","DOIUrl":"10.1016/j.hpb.2024.06.009","url":null,"abstract":"<div><h3>Introduction</h3><div>Although studies have indicated comparable outcomes between RFA and surgical resection in early HCC, there is still unclear evidence of benefit in larger tumor sizes. This study aimed to assess the efficacy and safety of RFA versus surgical resection in HCC patients, considering nodule size with a cutoff at 3 cm.</div></div><div><h3>Methods</h3><div>A comprehensive search of multiple databases was conducted. The systematic review and meta-analysis followed the PRISMA guidelines.</div></div><div><h3>Result</h3><div>Surgical resection showed superior OS (HR = 1.18, 95% CI: 1.11–1.27, p = 0.008) and RFS (HR = 1.17, 95% CI: 1.11–1.25, p < 0.00001), compared to RFA. For nodules less than 3 cm or larger than 5 cm, the OS and RFS in the surgical resection group were significantly higher than those in the RFA group, while no significant differences were observed for nodules sized 3–5 cm. However, significantly more adverse events occurred following surgical resection (OR = 0.43, 95% CI: 0.33–0.56, P < 0.00001).</div></div><div><h3>Conclusion</h3><div>Surgical resection has better OS and RFS compared to RFA for liver tumors less than 3 cm or larger than 5 cm. For liver tumors sized 3–5 cm, RFA and surgical resection yield similar findings. RFA may become a preferable option in these 3–5 cm tumors due to its comparable efficacy and fewer adverse events for patients unsuitable for surgery.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"26 10","pages":"Pages 1216-1228"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141612210","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 effect of liver surgery and fluid strategy on renin activity and aldosterone and anti-diuretic hormone levels: a secondary analysis of the GALILEO trial 肝脏手术和输液策略对肾素活性、醛固酮和抗利尿激素水平的影响：GALILEO 试验的二次分析

IF 2.7 3区医学

Hpb Pub Date : 2024-10-01 DOI: 10.1016/j.hpb.2024.06.005

{"title":"The effect of liver surgery and fluid strategy on renin activity and aldosterone and anti-diuretic hormone levels: a secondary analysis of the GALILEO trial","authors":"","doi":"10.1016/j.hpb.2024.06.005","DOIUrl":"10.1016/j.hpb.2024.06.005","url":null,"abstract":"<div><h3>Background</h3><div>It is unknown whether liver surgery leads to increased RAAS activity and anti-diuretic hormone (ADH) levels and subsequent fluid accumulation. Furthermore, it is unknown whether the peri-operative fluid strategy changes this effect.</div></div><div><h3>Methods</h3><div>This is a pre-planned post hoc analysis of a randomised controlled trial which compared restrictive (<em>n</em> = 20) versus liberal fluid strategy (<em>n</em> = 20) in patients undergoing liver surgery. Primary outcomes for the current study were the difference in hormone levels after anaesthesia induction and after liver resection. Fluid overload was defined as a ≥10% increase in weight.</div></div><div><h3>Results</h3><div>Renin activity (6 [2.1–15.5] vs. 12 [4.6–33.5]) and ADH levels (6.0 [1.7–16.3] vs. 3.8 [1.6–14.7]) did not differ significantly before and after resection. However, aldosterone levels were significantly higher after resection (0.30 [0.17–0.49] vs. 0.69 [0.31–1.21] ). Renin activity and aldosterone levels did not differ between the groups. ADH was significantly higher in the restrictive strategy group (1.6 [1.1–2.1] vs 5.9 [3.8–16.0]). No differences in hormone levels were found in patients with and without fluid overload.</div></div><div><h3>Discussion</h3><div>Aldosterone levels increased after liver surgery but renin activity and ADH levels did not. ADH levels were higher in the restrictive group. Development of post-operative fluid overload was not associated with RAAS activity or ADH levels.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"26 10","pages":"Pages 1248-1253"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141501400","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

Functional outcomes & complications of hepatic artery infusion pumps by device manufacturer 按设备制造商分列的肝动脉输注泵的功能结果和并发症

IF 2.7 3区医学

Hpb Pub Date : 2024-10-01 DOI: 10.1016/j.hpb.2024.07.404

Jason M. Aubrey, Hordur M. Kolbeinsson, Pavitra Attanayake, Allison Swider, Hannah R. Liefeld, Mathew Chung, M. Mura Assifi, G. Paul Wright

引用次数: 0

Letter to the editor: Predictive score for identifying intrahepatic cholangiocarcinoma patients without lymph node metastasis: a basis for omitting lymph node dissection 致编辑的信：识别无淋巴结转移的肝内胆管癌患者的预测评分：省略淋巴结清扫的依据。

IF 2.7 3区医学

Hpb Pub Date : 2024-10-01 DOI: 10.1016/j.hpb.2024.07.406

Yu-Le Luo , Hai-Su Dai , Ting Yu, Zhi-Yu Chen, Zhi-Peng Liu

引用次数: 0

Is robotic liver resection feasible in patients with lesions in close proximity to major vessels? A propensity score matching analysis. 病变靠近大血管的患者是否可行机器人肝脏切除术？倾向得分匹配分析

IF 2.7 3区医学

Hpb Pub Date : 2024-09-29 DOI: 10.1016/j.hpb.2024.09.010

Edoardo M Muttillo, Leonardo L Chiarella, Francesca Ratti, Paolo Magistri, Andrea Belli, Giammauro Berardi, Giuseppe M Ettorre, Graziano Ceccarelli, Francesco Izzo, Marcello G Spampinato, Nicola De Angelis, Patrick Pessaux, Tullio Piardi, Fabrizio Di Benedetto, Luca Aldrighetti, Riccardo Memeo

{"title":"Is robotic liver resection feasible in patients with lesions in close proximity to major vessels? A propensity score matching analysis.","authors":"Edoardo M Muttillo, Leonardo L Chiarella, Francesca Ratti, Paolo Magistri, Andrea Belli, Giammauro Berardi, Giuseppe M Ettorre, Graziano Ceccarelli, Francesco Izzo, Marcello G Spampinato, Nicola De Angelis, Patrick Pessaux, Tullio Piardi, Fabrizio Di Benedetto, Luca Aldrighetti, Riccardo Memeo","doi":"10.1016/j.hpb.2024.09.010","DOIUrl":"https://doi.org/10.1016/j.hpb.2024.09.010","url":null,"abstract":"<p><strong>Introduction: </strong>Robotic surgery is widely diffused in the surgical field and is becoming increasingly prevalent, however several aspects need more detailed assessment. One of them concerns the role of robotic liver surgery for lesions in contact with major vascular (CMV) pedicles. The aim of our study is to evaluate and compare intra and post operative outcomes in patients undergoing robotic liver resections between lesions in contact or free from major vessels.</p><p><strong>Methods: </strong>A multicentric retrospective study was performed including 1030 patients who underwent robotic liver resection. Patients were divided into two groups according to vascular contact. Intra and post-operative outcomes were compared between the groups before and after Propensity Score Matching.</p><p><strong>Results: </strong>After propensity score matching 889 patients were included in the study. Among these lesions, 595 were not in contact with major vessels (NCMV) and 294 were in contact with major vessels (CMV). Use of Pringle Manoeuvre was more associated with CMV resections (49.8 % vs 31.2 %, p = 0,0001). No differences in terms of operative time, conversion rate, morbidity and type of complications were observed after PSM.</p><p><strong>Conclusion: </strong>The presents study shows how robotic surgery is a valid and safe technique also for resection of tumors close to vascular pedicles.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464201","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