IF 2.7 3区医学

Hpb Pub Date : 2025-03-25 DOI: 10.1016/j.hpb.2025.03.452

Isaac Tranter-Entwistle, Lucy Culshaw, Roma Vichhi, Yiu Luke, Carole Addis, Imanol Luengo, Maria Grammatikopoulou, Karen Kerr, Danail Stoyanov, Tim Eglinton, Saxon Connor

{"title":"Towards determining clinical factors influencing critical structure identification using Artificial Intelligence.","authors":"Isaac Tranter-Entwistle, Lucy Culshaw, Roma Vichhi, Yiu Luke, Carole Addis, Imanol Luengo, Maria Grammatikopoulou, Karen Kerr, Danail Stoyanov, Tim Eglinton, Saxon Connor","doi":"10.1016/j.hpb.2025.03.452","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.03.452","url":null,"abstract":"<p><strong>Background: </strong>Studys into factors influencing critical view of safety achievement depends on large volumes of video data and granular anatomical annotations, which are limited by the burden of inefficient manual work. Artificial intelligence (AI) has the potential to radically scale the size of clinical studies by automating operative video analysis.</p><p><strong>Methods: </strong>481 videos of laparoscopic cholecystectomy were recorded at Christchurch Hospital, New Zealand over three years. AI algorithms analysed the videos, marking time points where the cystic duct and cystic artery were visible and operative phases. Metrics were stratified by surgeon experience (trainee or consultant) and case complexity (North Shore Grading scale). Nine timing metrics were derived based on the outputs of the AI algorithms and compared against the clinical variables.</p><p><strong>Results: </strong>Operative time increased with increasing operative difficulty. Significantly consultants demonstrated a higher proportional duration of anatomy visualisation than trainees in complex patients The cystic duct was commonly identified prior to the cystic artery independent of complexity grade.</p><p><strong>Conclusion: </strong>Surgical video review offers the potential of significant new insights with substantive benefits to patients but is often limited by the costly effort of manual analysis. This paper correlates AI-derived analytics with clinical factors demonstrating real-world utility of AI video analysis.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293575","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

Surface microdialysis to monitor hepatic metabolism in liver surgery 表面微透析监测肝脏手术中肝脏代谢。

IF 2.7 3区医学

Hpb Pub Date : 2025-03-21 DOI: 10.1016/j.hpb.2025.03.451

Niklas Löfgren , Per-Jonas Blind , Hanna Nyström , Bijar Ghafouri , Mikael Öman , Oskar Hemmingsson

{"title":"Surface microdialysis to monitor hepatic metabolism in liver surgery","authors":"Niklas Löfgren , Per-Jonas Blind , Hanna Nyström , Bijar Ghafouri , Mikael Öman , Oskar Hemmingsson","doi":"10.1016/j.hpb.2025.03.451","DOIUrl":"10.1016/j.hpb.2025.03.451","url":null,"abstract":"<div><h3>Background</h3><div>Microdialysis (μD) monitors local metabolism in tissues. Traditional μD requires intraparenchymal catheters, risking tissue damage, interfering with the analysis. This study evaluated the safety and feasibility of monitoring liver metabolism with a novel surface μD probe after liver resection.</div></div><div><h3>Methods</h3><div>Two μD catheters were attached to the liver surface intraoperatively. Concentrations of glucose, lactate, and pyruvate were determined and related to venous blood samples. Complications were registered 30 days postoperatively and graded according to Clavien–Dindo Classification and CTCAE guidelines.</div></div><div><h3>Results</h3><div>Samples were collected for a median of 4.7 days in 17 patients. No major complications related to μD were observed. The coefficients of variation for glucose, lactate, pyruvate, and the lactate/pyruvate ratio (L/P) were 18 %, 22 %, 28 %, and 21 %. Lactate in liver μD was significantly higher than in plasma and further increased in an ischemic area. Postoperative μD L/P was significantly correlated to a later increase in alanine aminotransferase. μD sampling from a hepatocellular carcinoma indicated elevated lactate compared with healthy liver.</div></div><div><h3>Conclusions</h3><div>Surface μD is a safe and feasible method to monitor liver metabolism postoperatively and may survey tumour metabolism <em>in vivo</em>. Biomarker trends can be monitored <em>in vivo</em> and may precede changes in systemic venous samples.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 7","pages":"Pages 930-936"},"PeriodicalIF":2.7,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012035","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

“Obesity Paradox” as a new insight from long-term survivors in pancreatic cancer patients “肥胖悖论”作为胰腺癌患者长期幸存者的新见解。

IF 2.7 3区医学

Hpb Pub Date : 2025-03-19 DOI: 10.1016/j.hpb.2025.03.450

Boram Lee, Ho-Seong Han, Yoo-Seok Yoon, Yeshong Park, MeeYoung Kang, Jinju Kim

{"title":"“Obesity Paradox” as a new insight from long-term survivors in pancreatic cancer patients","authors":"Boram Lee, Ho-Seong Han, Yoo-Seok Yoon, Yeshong Park, MeeYoung Kang, Jinju Kim","doi":"10.1016/j.hpb.2025.03.450","DOIUrl":"10.1016/j.hpb.2025.03.450","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is traditionally associated with poor outcomes. However, the recently emerging concept of the “obesity paradox” suggests that obese cancer patients have better survival rates than non-obese patients. While this phenomenon has been confirmed in several cancers, its relevance to pancreatic cancer remains unclear. This retrospective study explores whether the obesity paradox applies to pancreatic cancer (PC) after pancreatectomy.</div></div><div><h3>Methods</h3><div>A total of 404 PC patients who underwent surgery between 2004 and 2022 were studied. Patients were classified into the non-obese (BMI <25.0) (n = 313) and obese (BMI ≥25.0) (n = 91) groups. A subgroup analysis examined the impact of the visceral fat to subcutaneous fat ratio (VSR) on survival within the obese cohort.</div></div><div><h3>Results</h3><div>Obese patients had a significantly better 5-year overall survival (p = 0.040) and cancer-specific survival (p = 0.047) than non-obese patients. Within the obese cohort, a lower VSR was associated with improved survival (p = 0.012), indicating the importance of fat distribution in outcomes.</div></div><div><h3>Conclusion</h3><div>Obesity is associated with improved survival in patients with PC, highlighting the potential benefits of a nuanced approach to manageing obese patients. Distribution of adipose tissue, particularly subcutaneous fat relative to visceral fat, further influences survival, suggesting that tailored treatment strategies may improve outcomes.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 7","pages":"Pages 922-929"},"PeriodicalIF":2.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795281","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

Global survey on surgeon preference and current practice for pancreatic neck and body cancer with portomesenteric venous involvement 全球调查研究胰腺癌伴肠系膜静脉累及的外科医生偏好和现状。

IF 2.7 3区医学

Hpb Pub Date : 2025-03-15 DOI: 10.1016/j.hpb.2025.03.005

Hiroyuki Ishida , Thomas F. Stoop , Atsushi Oba , Philippe Bachellier , Daisuke Ban , Itaru Endo , Oskar Franklin , Tsutomu Fujii , Aiste Gulla , Thilo Hackert , Asif Halimi , Satoshi Hirano , Jin-Young Jang , Matthew H.G. Katz , Aya Maekawa , William H. Nealon , Giampaolo Perri , Jose M. Ramia , Ingmar F. Rompen , Sohei Satoi , Nicholas J. Zyromski

{"title":"Global survey on surgeon preference and current practice for pancreatic neck and body cancer with portomesenteric venous involvement","authors":"Hiroyuki Ishida , Thomas F. Stoop , Atsushi Oba , Philippe Bachellier , Daisuke Ban , Itaru Endo , Oskar Franklin , Tsutomu Fujii , Aiste Gulla , Thilo Hackert , Asif Halimi , Satoshi Hirano , Jin-Young Jang , Matthew H.G. Katz , Aya Maekawa , William H. Nealon , Giampaolo Perri , Jose M. Ramia , Ingmar F. Rompen , Sohei Satoi , Nicholas J. Zyromski","doi":"10.1016/j.hpb.2025.03.005","DOIUrl":"10.1016/j.hpb.2025.03.005","url":null,"abstract":"<div><h3>Background</h3><div>Evidence regarding the optimal surgical approach for pancreatic neck/body cancer with portomesenteric vein (PV) involvement is scarce. We aimed to clarify the current practice using an international survey.</div></div><div><h3>Methods</h3><div>An online survey was distributed to members of nine international associations and study groups. Surgeons who performed pancreatectomy with PV resection (PVR) in the last 12 months were asked about three clinical scenarios with different PV involvement: scenarios A (<90°; length 1 cm), B (<90°; length 3 cm), and C (90–180°; length 3 cm), with or without common hepatic artery (CHA) involvement. PVR was defined according to the ISGPS definition.</div></div><div><h3>Results</h3><div>Overall, 222 surgeons from 49 countries in 6 continents completed the survey. The most selected procedures were left pancreatectomy with PVR ISGPS-type 1 for scenario A (52.3 %), PVR ISGPS-type 2 for B (28.8 %), and pancreatoduodenectomy with PVR ISGPS-type 3 for C (28.4 %). In patients with CHA involvement, the most selected procedures were left pancreatectomy without arterial reconstruction for A (57.7 %) and B (50.0 %), and total pancreatectomy for C (29.7 %).</div></div><div><h3>Conclusions</h3><div>The survey illustrates the heterogeneity in surgical management of pancreatic neck/body cancer with PV involvement, indicating the need for prospective studies and guidelines.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 7","pages":"Pages 910-921"},"PeriodicalIF":2.7,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989883","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

Implementation of robotic and laparoscopic hepatopancreatobiliary surgery in low- and middle-income settings: a systematic review and meta-analysis 实施机器人和腹腔镜肝胆管手术在低收入和中等收入的设置：系统回顾和荟萃分析。

IF 2.7 3区医学

Hpb Pub Date : 2025-03-14 DOI: 10.1016/j.hpb.2025.03.006

Adebayo Falola , Chioma Ezebialu , Sophia Okeke , Rhoda T. Fadairo , Oluwasina S. Dada , Ademola Adeyeye

{"title":"Implementation of robotic and laparoscopic hepatopancreatobiliary surgery in low- and middle-income settings: a systematic review and meta-analysis","authors":"Adebayo Falola , Chioma Ezebialu , Sophia Okeke , Rhoda T. Fadairo , Oluwasina S. Dada , Ademola Adeyeye","doi":"10.1016/j.hpb.2025.03.006","DOIUrl":"10.1016/j.hpb.2025.03.006","url":null,"abstract":"<div><h3>Background</h3><div>Despite numerous barriers, the application of minimally invasive surgery (MIS) for hepatopancreatobiliary (HPB) conditions has been increasing globally. This study aims to review the current status of HPB MIS in LMICs.</div></div><div><h3>Methods</h3><div>Relevant databases were searched, identifying 3452 publications, 38 of which met the inclusion criteria. Meta-analysis of outcomes was carried out using “R” statistical software.</div></div><div><h3>Results</h3><div>This study reviewed reports of application of MIS for HPB conditions in LMICs, analyzing a total of 3272 procedures. India (66.87 %) and Egypt (20.11 %) contributed majorly to the procedures reviewed. Others were from Indonesia (8.68 %), Colombia (3.06 %), Pakistan (0.67 %), Sri Lanka (0.34 %), Trinidad and Tobago (0.18 %), and Nigeria (0.09 %). India was the only LMIC with robotic HPB MIS. The majority of the procedures were biliary (74.88 %). Basic procedures accounted for 55.63 %, while 44.37 % were advanced. The overall conversion rate and prevalence of morbidity were 8 % [95 % CI: 5; 13], and 15 % [95 % CI: 9; 22], respectively. Robotics was associated with higher conversion (14 % vs 6 %, <em>p</em> < 0.01) but lower morbidity (10 % vs 16 %, <em>p</em> = 0.91), compared to laparoscopic surgery. There were 5 cases of mortality from laparoscopy.</div></div><div><h3>Conclusion</h3><div>The outcomes in this systematic review, compared to findings in other settings indicate successful implementation of HPB MIS in LMICs.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 7","pages":"Pages 869-883"},"PeriodicalIF":2.7,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811397","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

“Somatostatin analogues do not reduce the risk of clinically relevant post-operative fistula rates in patients undergoing pancreatic surgery”, a systematic review and meta-analysis 一项系统综述和荟萃分析显示，"体生长抑素类似物并不能降低胰腺手术患者术后出现临床相关瘘管的风险"。

IF 2.7 3区医学

Hpb Pub Date : 2025-03-12 DOI: 10.1016/j.hpb.2025.03.003

Carolyn Cullinane , Michael Devine , Mohammed Alazzawi , Criostoir O. Suilleabhain , Adrian O. Sullivan

{"title":"“Somatostatin analogues do not reduce the risk of clinically relevant post-operative fistula rates in patients undergoing pancreatic surgery”, a systematic review and meta-analysis","authors":"Carolyn Cullinane , Michael Devine , Mohammed Alazzawi , Criostoir O. Suilleabhain , Adrian O. Sullivan","doi":"10.1016/j.hpb.2025.03.003","DOIUrl":"10.1016/j.hpb.2025.03.003","url":null,"abstract":"<div><h3>Background</h3><div>The impact of Somatostatin Analogues (SSA) on Post-Operative Pancreatic Fistula (POPF) risk reduction lacks clarity and reports are conflicting. The aim of this study was to perform a systematic review and meta-analysis to explore the effect of SSA on POPF rates.</div></div><div><h3>Methods</h3><div>A systematic review was performed for studies reporting POPF in relation to SSA use following the consensus by the International Study Group of Pancreatic Fistula (ISGPF) to re-define what constitutes a clinically significant POPF in 2015. The primary outcome was the incidence of clinically relevant POPF among patients who received SSA peri-operatively.</div></div><div><h3>Results</h3><div>Twenty studies, including 6947 patients, were eligible for inclusion. Overall, SSA use did not significantly lower the risk of developing a POPF(OR 0.89, 95 % CI 0.66–1.20, <em>P</em> = 0.44, <em>I</em><sup>2</sup> = 73 %). Subgroup analysis was performed to determine whether SSA could reduce POPF in high-risk cohorts (soft pancreas, duct <5 mm). SSA did not significantly reduce POPF in the five studies reporting on high-risk cohorts (OR 1.42, 95 % CI 0.60–3.37, <em>P</em> = 0.43, I<sup>2</sup> = 73 %). Furthermore, subgroup analysis of both grade B and grade C POPF’s did not show any benefit of SSA.</div></div><div><h3>Conclusion</h3><div>SSA prophylaxis does not reduce the incidence of clinically relevant POPR and should not be routinely administered for pancreatic resections.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 6","pages":"Pages 746-757"},"PeriodicalIF":2.7,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779886","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

International multidisciplinary consensus recommendations on clinical application of three-dimensional visualization in precision surgery for pediatric liver tumors 三维可视化在小儿肝脏肿瘤精准手术中的临床应用的国际多学科共识建议。

IF 2.7 3区医学

Hpb Pub Date : 2025-03-11 DOI: 10.1016/j.hpb.2025.03.007

Qian Dong , Wenli Xiu , Benjie Tang , Eiso Hiyama , Mary T. Austin , Yeming Wu , Xiaojun Yuan , Chengzhan Zhu , Chengli Liu , Hiroki Ishibashi , Karthik K. Tappa , Huanmin Wang , Chuandong Sun , YunTao Ma , Hongwei Xi , Jian Wang , Jianghua Zhan , Kyong Ihn , Mitsuo Shimada , Mingman Zhang , Pier C. Giulianotti

{"title":"International multidisciplinary consensus recommendations on clinical application of three-dimensional visualization in precision surgery for pediatric liver tumors","authors":"Qian Dong , Wenli Xiu , Benjie Tang , Eiso Hiyama , Mary T. Austin , Yeming Wu , Xiaojun Yuan , Chengzhan Zhu , Chengli Liu , Hiroki Ishibashi , Karthik K. Tappa , Huanmin Wang , Chuandong Sun , YunTao Ma , Hongwei Xi , Jian Wang , Jianghua Zhan , Kyong Ihn , Mitsuo Shimada , Mingman Zhang , Pier C. Giulianotti","doi":"10.1016/j.hpb.2025.03.007","DOIUrl":"10.1016/j.hpb.2025.03.007","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric liver tumors are predominantly primary malignant tumors, and complete tumor resection with sufficient preservation of liver tissue is crucial for improving prognosis. However, due to the delicate anatomical structure of the pediatric liver and the relatively large size of the tumors, especially in difficult cases, the surgical challenges are substantial. While precision liver surgery are widely applied in clinical practice, pediatric cases require more customized approaches. The application of three-dimensional (3D) visualization technology is crucial for enhancing surgical accuracy, allowing for precise preoperative planning and intraoperative guidance.</div></div><div><h3>Methods</h3><div>This consensus was collaboratively developed by 36 experts from eight countries, using the Glaser’s state-of-the-art method to review and refine the draft.</div></div><div><h3>Results</h3><div>The final consensus resulted in 15 international multidisciplinary consensus recommendations on clinical application of 3D visualization in precision surgery for pediatric liver tumors.</div></div><div><h3>Conclusion</h3><div>This consensus will standardize the application of 3D visualization technology in precision surgery for pediatric liver tumors to improve outcomes and reduce risks.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 6","pages":"Pages 733-745"},"PeriodicalIF":2.7,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709702","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

Split liver transplantation in high MELD score adult recipients: a reappraisal MELD评分高的成人肝移植：再评价。

IF 2.7 3区医学

Hpb Pub Date : 2025-03-10 DOI: 10.1016/j.hpb.2025.03.004

Lucia Paiano , Daniel Azoulay , Frédérique Blandin , Marc-Antoine Allard , Daniel Pietrasz , Oriana Ciacio , Gabriella Pittau , Chady Salloum , Eleonora De Martin , Antonio Sa Cunha , René Adam , Daniel Cherqui , Eric Vibert , Nicolas Golse

{"title":"Split liver transplantation in high MELD score adult recipients: a reappraisal","authors":"Lucia Paiano , Daniel Azoulay , Frédérique Blandin , Marc-Antoine Allard , Daniel Pietrasz , Oriana Ciacio , Gabriella Pittau , Chady Salloum , Eleonora De Martin , Antonio Sa Cunha , René Adam , Daniel Cherqui , Eric Vibert , Nicolas Golse","doi":"10.1016/j.hpb.2025.03.004","DOIUrl":"10.1016/j.hpb.2025.03.004","url":null,"abstract":"<div><h3>Background</h3><div>Split liver transplantation (SLT) from deceased donors is a potential solution to the global organ shortage. While effective in patients with mild disease, outcomes in high MELD score recipients remain uncertain and conflicting. This study compares survival in high vs. low MELD score recipients.</div></div><div><h3>Methods</h3><div>This retrospective single-centre study included all consecutive patients transplanted with a split liver graft between 2010 and 2022. Two groups of recipients with MELD<25 and ≥ 25 at LT were compared.</div></div><div><h3>Results</h3><div>The study population included 119 patients (n = 98 with MELD<25, n = 21 with MELD≥25) with an average follow-up of 55 months. Both groups were comparable in terms of indication for transplantation and donor characteristics. The high MELD group required more blood transfusions (7 vs. 3 units; p < 0.001) during LT and had a longer stay in intensive care unit (7 vs. 5 days; p = 0.011). Biliary, arterial, and venous complications were similar between groups, as well as graft survival (5 years: 75 % vs. 61 %, p = 0.35) and long-term overall survival (5 years: 83 % vs. 75 %, p = 0.17).</div></div><div><h3>Discussion</h3><div>Our results indicate that SLT for patients with MELD≥25 improves access to grafts, is feasible and safe, without significant increased risk of severe complications or decreased long-term overall patient or graft survivals.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 7","pages":"Pages 899-909"},"PeriodicalIF":2.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709707","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

Factors predicting lower hospital stay after liver transplantation using a comprehensive enhanced recovery after surgery (ERAS) protocol 肝移植术后综合增强术后恢复（ERAS）方案缩短住院时间的预测因素

IF 2.7 3区医学

Hpb Pub Date : 2025-03-10 DOI: 10.1016/j.hpb.2025.03.001

Paola Melgar , Celia Villodre , Cándido Alcázar , Mariano Franco , Juan J. Rubio , Pedro Zapater , Patricio Más , Sonia Pascual , Gonzalo P. Rodríguez-Laiz , José M. Ramia

{"title":"Factors predicting lower hospital stay after liver transplantation using a comprehensive enhanced recovery after surgery (ERAS) protocol","authors":"Paola Melgar , Celia Villodre , Cándido Alcázar , Mariano Franco , Juan J. Rubio , Pedro Zapater , Patricio Más , Sonia Pascual , Gonzalo P. Rodríguez-Laiz , José M. Ramia","doi":"10.1016/j.hpb.2025.03.001","DOIUrl":"10.1016/j.hpb.2025.03.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Enhanced recovery after surgery (ERAS) protocols facilitate patient recovery without increasing complication rates. An ERAS protocol designed for our liver transplant (LT) patients obtained a median hospital length of stay (LOS) of 4 days. However, a proportion of patients do not achieve early discharge. This study aimed to identify factors that predict an LOS≤ 4 days.</div></div><div><h3>Methods</h3><div>Identifying factors associated with LOS <4 days in our LT patients.</div></div><div><h3>Results</h3><div>We performed 293 LTs (2012–2021), LOS≤4 days in 171 (58.4 %). The following factors emerged as statistically predictors of LOS≤4 days in the univariate analysis: male sex, HCC or HCV patients, lower MELD score, lower BAR score, no DCD patients, shorter operative time, no intraoperative transfusion, shorter ICU stay, no Clavien-Dindo complications grade ≥ III, no primary graft dysfunction, no acute rejection, no readmission at 30 days and no retransplantation were associated to LOS≤4 days. However, in the multivariate analysis, the only independent risk factor that predicted LOS≤4 days was the presence of hepatocarcinoma. DCD donors and higher MELD score were negative factors.</div></div><div><h3>Conclusions</h3><div>Applying ERAS programs in LT patients is beneficial, safe and extensible to all patients, but those with hepatocarcinoma obtain higher rates of LOS≤4 days.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 6","pages":"Pages 844-852"},"PeriodicalIF":2.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692024","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 development of a person-centred self-report instrument to investigate quality-of-life aspects of gallstone surgery - The Gothenburg gallstone questionnaires (GGQ24pre & GGQ21post) 以人为中心的自我报告工具的发展，以调查胆结石手术的生活质量方面-哥德堡胆结石问卷（GGQ24pre & GGQ21post）。

IF 2.7 3区医学

Hpb Pub Date : 2025-03-08 DOI: 10.1016/j.hpb.2025.02.015

Simon H. Pålsson , Cecilia Engström , Jenny Skoog , Stefan Redéen , Lars Enochsson , Lise-Lott Prebner , Johanna Österberg , Fredrik Linder , Eva-Lena Syrén , Gabriel Sandblom , John Eric Chaplin

{"title":"The development of a person-centred self-report instrument to investigate quality-of-life aspects of gallstone surgery - The Gothenburg gallstone questionnaires (GGQ24pre & GGQ21post)","authors":"Simon H. Pålsson , Cecilia Engström , Jenny Skoog , Stefan Redéen , Lars Enochsson , Lise-Lott Prebner , Johanna Österberg , Fredrik Linder , Eva-Lena Syrén , Gabriel Sandblom , John Eric Chaplin","doi":"10.1016/j.hpb.2025.02.015","DOIUrl":"10.1016/j.hpb.2025.02.015","url":null,"abstract":"<div><h3>Background</h3><div>To develop and psychometrically test a condition-specific, patient-reported outcomes instrument for patients undergoing gallstone surgery.</div></div><div><h3>Methods</h3><div>A mixed-methods design, including six gender-mixed patient focus-groups was used. Statements were thematically analysed and compared to PROMIS and the Gastrointestinal Quality of Life Index (GIQLI). A pilot questionnaire of 63 items and the full scale GIQLI was sent to preoperative and 30 items were sent to postoperative patients. Factor analysis identified structure and redundant items. Short versions were assessed to ensure internal reliability and validity. Unidimensionality was assessed via graded response model.</div></div><div><h3>Results</h3><div>273 patients completed the questionnaires (preoperatively n = 104 and postoperatively n = 169). Factor and IRT analysis identified 13 domains with 45 questions. Internal reliability 0.75 to 0.93 in the preoperative and 0.73 to 0.90 in the postoperative questionnaire. A PROM questionnaire was developed with pre- and postoperative modules (24 questions, 8 domains and 21 questions, 5 domains).</div></div><div><h3>Conclusion</h3><div>This study has shown the validity of a disease specific Health Related Quality-of-Life (HRQoL) instrument in a population with gallstone disease and a post-operative module for follow-up. Further testing in a longitudinal cohort is recommended in order to establish responsiveness.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 6","pages":"Pages 816-831"},"PeriodicalIF":2.7,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772173","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}

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