IF 2.4 3区医学

Hpb Pub Date : 2025-05-28 DOI: 10.1016/j.hpb.2025.05.009

Irena Stefanova , Rosie Callahan , Vandana B. Giriradder , Tarak Chouari , Javed Latif , Lydia Renardson , Eslam Hassan , Somaiah Aroori , Altaf Awan , Imran Bhatti , Esther Platt , Rajesh Kumar , Angela Riga , Timothy R. Worthington , Adam E. Frampton , Rajiv P. Lahiri , Tim D. Pencavel , Jawad Ahmad

{"title":"A multi-centre, UK-based, cohort study assessing the role of robotic common bile duct exploration for complex choledocholithiasis","authors":"Irena Stefanova , Rosie Callahan , Vandana B. Giriradder , Tarak Chouari , Javed Latif , Lydia Renardson , Eslam Hassan , Somaiah Aroori , Altaf Awan , Imran Bhatti , Esther Platt , Rajesh Kumar , Angela Riga , Timothy R. Worthington , Adam E. Frampton , Rajiv P. Lahiri , Tim D. Pencavel , Jawad Ahmad","doi":"10.1016/j.hpb.2025.05.009","DOIUrl":"10.1016/j.hpb.2025.05.009","url":null,"abstract":"<div><h3>Background</h3><div><span>There is no consensus on the gold-standard treatment for choledocholithiasis<span>. This retrospective multicentric cohort study aimed to assess the safety, efficacy, and role of robotic </span></span>common bile duct exploration (RCBDE) in treating choledocholithiasis.</div></div><div><h3>Methods</h3><div>All adult (≥18 years) consecutive patients undergoing RCBDE either alongside or following cholecystectomy between 2018 and 2024 were included. Primary outcome was success in stone clearance. Secondary outcomes included open conversion, length of hospital stay, post-operative complications and interventions, 30-day re-admission, and 90-day mortality rates.</div></div><div><h3>Results</h3><div>A total of 102 consecutive RCBDEs were performed. Biliary access was transcholedochal in 86.3 % (88/102) and transcystic in 13.7 % (14/102). Stone clearance was achieved in 92.2 % (94/102) of cases, with a bile leak rate of 2.9 % (3/102), and an overall morbidity rate of 19.6 % (20/102), including 7.8 % (8/102) with Clavien-Dindo grade ≥3 complications. Overall conversion rate was 9.8 %, with significantly lower rates in single-stage procedures, where RCBDE was performed alongside cholecystectomy, compared to RCBDE alone, 1.4 % (1/73) vs 30.4 % (7/23), (<em>P</em> < 0.001), respectively.</div></div><div><h3>Conclusion</h3><div>This study highlights the high success rate in stone clearance and low bile leak rate associated with RCBDE. However, open conversion rate was significantly increased when RCBDE was performed following previous cholecystectomy.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 9","pages":"Pages 1142-1149"},"PeriodicalIF":2.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266059","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 FDG-PET/CT on the diagnostic pathway of surgically treated pancreatic ductal adenocarcinoma: the Surg-Panc-UK study FDG-PET/CT对手术治疗胰腺导管腺癌诊断途径的影响：surgery - panc - uk研究

IF 2.4 3区医学

Hpb Pub Date : 2025-05-27 DOI: 10.1016/j.hpb.2025.05.003

Siobhan C. McKay , Thomas W. Thorne , Samir Pathak , Richard J.W. Wilkin , Jenifer Barrie , John Moir , Keith J. Roberts , The Surg-Panc-UK Study Group

{"title":"The impact of FDG-PET/CT on the diagnostic pathway of surgically treated pancreatic ductal adenocarcinoma: the Surg-Panc-UK study","authors":"Siobhan C. McKay , Thomas W. Thorne , Samir Pathak , Richard J.W. Wilkin , Jenifer Barrie , John Moir , Keith J. Roberts , The Surg-Panc-UK Study Group","doi":"10.1016/j.hpb.2025.05.003","DOIUrl":"10.1016/j.hpb.2025.05.003","url":null,"abstract":"<div><h3>Background</h3><div>In the UK, NICE recommends FDG-PET/CT (PET/CT) in patients undergoing surgery for pancreatic ductal adenocarcinoma (PDAC) though the impact upon the patient pathway is unclear and was not tested in the PETPANC study.</div></div><div><h3>Methods</h3><div>National retrospective observational cohort study of consecutive patients undergoing surgery for PDAC. The primary outcome was the difference in diagnostic pathway length with and without a PET/CT. Secondary outcomes determined differences in investigations, resection rates and survival one year after surgery.</div></div><div><h3>Results</h3><div>Of 830 patients included, 26.5% underwent PET/CT, associated with a significantly longer diagnostic pathway (median 20.5 additional days). PET/CT was associated with more multidisciplinary meetings and investigations, but did not alter resectability rates (90.3% vs 89.1%, PET/CT vs no PET/CT; <em>p</em> = .600), or facilitate operating on patients with more borderline disease (vascular resection 15.1% vs 13.6% PET/CT vs no PET/CT; <em>p</em> = .651). There was no difference in intra-operative unresectability or 12-month survival. There was an increase in MRI use after implementation of the guidelines among patients not undergoing PET/CT, suggesting teams developed different staging strategies.</div></div><div><h3>Conclusion</h3><div>This national study demonstrates patients undergoing a PET/CT experience a diagnostic pathway that is one third longer, with more investigations, without a difference in resectability rates or survival.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 9","pages":"Pages 1175-1184"},"PeriodicalIF":2.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368829","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

Oncologic impact of perineural invasion in perihilar cholangiocarcinoma: an international multicenter study 肝门周围胆管癌神经浸润的肿瘤学影响：一项国际多中心研究。

IF 2.4 3区医学

Hpb Pub Date : 2025-05-27 DOI: 10.1016/j.hpb.2025.05.010

Jun Kawashima , Miho Akabane , Diamantis I. Tsilimigras , Selamawit Woldesenbet , Mujtaba Khalil , Yutaka Endo , Kota Sahara , Federico Aucejo , Hugo P. Marques , Beatriz Chumbinho , Tom Hugh , Shishir K. Maithel , Bas Groot Koerkamp , Andrea Ruzzenente , Itaru Endo , Timothy M. Pawlik

{"title":"Oncologic impact of perineural invasion in perihilar cholangiocarcinoma: an international multicenter study","authors":"Jun Kawashima , Miho Akabane , Diamantis I. Tsilimigras , Selamawit Woldesenbet , Mujtaba Khalil , Yutaka Endo , Kota Sahara , Federico Aucejo , Hugo P. Marques , Beatriz Chumbinho , Tom Hugh , Shishir K. Maithel , Bas Groot Koerkamp , Andrea Ruzzenente , Itaru Endo , Timothy M. Pawlik","doi":"10.1016/j.hpb.2025.05.010","DOIUrl":"10.1016/j.hpb.2025.05.010","url":null,"abstract":"<div><h3>Background</h3><div><span>We sought to evaluate the prognostic significance of perineural invasion (PNI) among patients undergoing curative-intent resection for </span>perihilar cholangiocarcinoma (pCCA), with a specific focus on early-stage disease.</div></div><div><h3>Methods</h3><div>Data from patients who underwent curative-intent resection for pCCA were collected from eight high-volume international hepatobiliary centers. The association between PNI status, clinicopathological features, and long-term survival was analyzed in both the overall cohort and a subset of patients with early-stage pCCA.</div></div><div><h3>Results</h3><div><span>Among 435 patients, 364 (83.7 %) were PNI-positive. At the time of surgery, 53 patients with PNI underwent margin re-resection; only 19 (35.8 %) achieved a final R0 margin, whereas 34 (64.2 %) had a persistent R1 margin on the final pathological examination. PNI was independently associated with worse overall survival in the entire cohort (HR 1.52), as well as among patients with T1/2 (HR 1.53) and node-negative (HR 1.60) disease. Although not associated with improved survival among node-negative patients, adjuvant chemotherapy provided a survival benefit among patients with node-negative disease who had PNI (50.8 months vs. 28.6 months; </span><em>p</em> = 0.044).</div></div><div><h3>Conclusion</h3><div>PNI was an independent predictor of long-term survival, particularly among patients with early-stage pCCA.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 9","pages":"Pages 1158-1167"},"PeriodicalIF":2.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266071","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

Survival prediction for CA19-9 non-producers with resected pancreatic cancer 胰腺癌切除术后CA19-9非产生者的生存预测。

IF 2.4 3区医学

Hpb Pub Date : 2025-05-27 DOI: 10.1016/j.hpb.2025.05.007

Jurgis Alvikas , Ahmed Hamed , Nikhil Tirukkovalur , Sebastiaan Ceuppens , Adam Tcharni , Jiage Qian , Asmita Chopra , Genia Dubrovsky , Kenneth Lee , Amer Zureikat , Alessandro Paniccia

{"title":"Survival prediction for CA19-9 non-producers with resected pancreatic cancer","authors":"Jurgis Alvikas , Ahmed Hamed , Nikhil Tirukkovalur , Sebastiaan Ceuppens , Adam Tcharni , Jiage Qian , Asmita Chopra , Genia Dubrovsky , Kenneth Lee , Amer Zureikat , Alessandro Paniccia","doi":"10.1016/j.hpb.2025.05.007","DOIUrl":"10.1016/j.hpb.2025.05.007","url":null,"abstract":"<div><h3>Background</h3><div>CA 19-9 is the most commonly used biomarker for pancreatic ductal adenocarcinoma (PDAC) but prognostication is a challenge for patients with normal CA 19-9 levels. We aimed to define most important prognostic factors for overall survival in PDAC patients with normal range CA 19-9 levels.</div></div><div><h3>Methods</h3><div>We performed a single-center retrospective review of PDAC patients with CA 19-9 level at diagnosis <37 U/mL who underwent curative intent resection. Cohort was divided into CA 19-9 non-producers (CA 19-9 level of <3 U/mL) and normal range CA 19-9 (between 3 U/mL and 37 U/mL). We used a multivariable Cox regression model to define the predictors of overall survival and constructed a nomogram.</div></div><div><h3>Results</h3><div>271 patients were included (75 CA 19-9 non-producers and 196 with normal range CA 19-9). Non-producers had worse overall survival (27.2 months versus 33.6 months) and higher rate of recurrence after resection. Predictors of survival were CA 19-9 level, age, sex, lymph node ratio, perineural invasion, surgical margin status and adjuvant chemotherapy.</div></div><div><h3>Discussion</h3><div>PDAC patients who are CA 19-9 non-producers have worse survival. Our findings highlight this high-risk subgroup, identify useful prognostic features and emphasize the ongoing need for improved biomarker development.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 9","pages":"Pages 1185-1193"},"PeriodicalIF":2.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325536","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

Comparison of radiofrequency ablation, microwave ablation and high-intensity focused ultrasound for hepatocellular carcinoma: a retrospective study 射频消融、微波消融和高强度聚焦超声治疗肝细胞癌的回顾性研究。

IF 2.7 3区医学

Hpb Pub Date : 2025-05-01 DOI: 10.1016/j.hpb.2025.01.003

Wan S. Cheung , Wong H. She , Simon H.Y. Tsang , Wing C. Dai , Albert C.Y. Chan , Tan T. Cheung

{"title":"Comparison of radiofrequency ablation, microwave ablation and high-intensity focused ultrasound for hepatocellular carcinoma: a retrospective study","authors":"Wan S. Cheung , Wong H. She , Simon H.Y. Tsang , Wing C. Dai , Albert C.Y. Chan , Tan T. Cheung","doi":"10.1016/j.hpb.2025.01.003","DOIUrl":"10.1016/j.hpb.2025.01.003","url":null,"abstract":"<div><h3>Background</h3><div>The recommended first-line treatment for respectable hepatocellular carcinoma (HCC) is surgical resection, but local ablation has gained popularity as a safe alternative. This study aims to compare the effectiveness of radiofrequency ablation (RFA), microwave ablation (MWA) and high-intensity focused ultrasound (HIFU) as first-line treatments for HCC.</div></div><div><h3>Methods</h3><div>In this single-centre retrospective study, 352 patients receiving RFA, MWA, or HIFU as first-line treatment for HCC were included. Pre- and post-treatment tumour sizes and overall and disease-free survival rates were analysed to compare the three local ablation modalities. Propensity-score matching was used to reduce the bias due to differences in pre-treatment liver function.</div></div><div><h3>Results</h3><div>Patients receiving HIFU had significantly higher pre-treatment MELD score and Child-Pugh grade. The complete response rates of HIFU patients were significantly lower than those of RFA and MWA groups (p < 0.001) despite propensity-score matching. However, the three groups had similar disease-free survival (p = 0.216) and comparable one-year survival (p = 0.173).</div></div><div><h3>Discussion</h3><div>HIFU serves as a last resort rescue therapy for patients with poor pre-treatment liver function who are not eligible for other local ablative means. Despite the low complete response rate, the overall survival and disease-free survival rates of patients having HIFU were comparable to those having RFA or MWA.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 607-613"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023280","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 left renal vein: the optimal interposition graft for pancreatic surgery? 左肾静脉：胰腺手术的最佳间置移植物？

IF 2.7 3区医学

Hpb Pub Date : 2025-05-01 DOI: 10.1016/j.hpb.2025.01.004

Ahmer Irfan, Peter Kim, Farah Ladak, David Chan, Sean Cleary, Carol-Anne Moulton, Gonzalo Sapisochin, Trevor Reichman, Chaya Shwaartz, Ian McGilvray

{"title":"The left renal vein: the optimal interposition graft for pancreatic surgery?","authors":"Ahmer Irfan, Peter Kim, Farah Ladak, David Chan, Sean Cleary, Carol-Anne Moulton, Gonzalo Sapisochin, Trevor Reichman, Chaya Shwaartz, Ian McGilvray","doi":"10.1016/j.hpb.2025.01.004","DOIUrl":"10.1016/j.hpb.2025.01.004","url":null,"abstract":"<div><h3>Background</h3><div>Porto-mesenteric venous resection (PMVR) is employed for advanced pancreatic cancer. When primary anastomosis is not feasible, an interposition graft can be used. At our centre, the left renal vein (LRV) is the preferred choice.</div></div><div><h3>Methods</h3><div>A retrospective analysis of patients undergoing pancreatic resection was performed over a 6-year period. Patients who underwent LRV harvest for a PMVR interposition graft were identified. All patients underwent a contrast-enhanced CT scan on post-operative day 1 to assess for portal vein thrombosis.</div></div><div><h3>Results</h3><div>Pancreatic resection with PMVR was performed in 183 patients. LRV graft was used in 41 patients. Severe complications were observed in 10 patients. There were two deaths within 90 days of the index operation and six readmissions within 30 days of discharge. Post-operative PV thrombus was observed in 4 patients.</div><div>The serum creatinine increased by 15.7 % on POD1 and peaked at 30.8 %. The majority of patients had returned to a serum creatinine within 10 % or better of their pre-operative creatinine.</div></div><div><h3>Conclusion</h3><div>We present the largest series using the LRV as an interposition graft for PMVR. We propose that the LRV should be used as the first-choice interposition graft. This graft does not cause long-term renal dysfunction and avoids the morbidity of an additional incision.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 614-618"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079182","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

Laparoscopic versus open pancreaticoduodenectomy outcomes in patients ≥ 75 years old: an NSQIP analysis of 4343 patients ≥75岁患者的腹腔镜胰十二指肠切除术与开放式胰十二指肠切除术的结果：4343例患者的NSQIP分析

IF 2.7 3区医学

Hpb Pub Date : 2025-05-01 DOI: 10.1016/j.hpb.2025.01.015

Nazgol K. Shahbaz , Kevin Verhoeff , Tyrell Wees , Sukhdeep Jatana , Douglas Quan , Juan Glinka , Anton Skaro , Ephraim S. Tang

{"title":"Laparoscopic versus open pancreaticoduodenectomy outcomes in patients ≥ 75 years old: an NSQIP analysis of 4343 patients","authors":"Nazgol K. Shahbaz , Kevin Verhoeff , Tyrell Wees , Sukhdeep Jatana , Douglas Quan , Juan Glinka , Anton Skaro , Ephraim S. Tang","doi":"10.1016/j.hpb.2025.01.015","DOIUrl":"10.1016/j.hpb.2025.01.015","url":null,"abstract":"<div><h3>Background</h3><div>The benefits of MIS in older adults are conflicting. This study evaluates demographics and early outcomes, for older patients (≥75) undergoing minimally invasive (MIS) versus open pancreaticoduodenectomy (PD).</div></div><div><h3>Method</h3><div>We categorized elderly patients who underwent PD from 2017 to 2021 NSQIP databases by surgical approach (open vs MIS). Baseline characteristics were examined with bivariate analysis, and multivariate logistic regression assessed the independent effect of minimally invasive surgery on 30-day serious complications and mortality.</div></div><div><h3>Results</h3><div>Amongst 4137 patients, 150 (3.63 %) underwent MIS PD. Patients demographics were similar. Open cohorts were older (79.1 vs 78.4 years; p = 0.011) with greater tumor invasion (36.6 % vs. 27.0 %; p = 0.018). MIS had longer operations (133.1 vs 119.6 min; p < 0.001). Multivariate analysis demonstrated that MIS approach was associated with increased serious complications (OR 2.21; p < 0.001), but not mortality (OR 2.11; p = 0.173). <em>Post hoc</em> analysis excluding cases converted to open demonstrated no difference in serious complications (OR 1.94; p = 0.070) or mortality (OR 3.58; p = 0.094). PSM analysis estimated a 14.7 % higher rate of serious complications in MIS but similar mortality (p = 0.291).</div></div><div><h3>Conclusions</h3><div>MIS PD uptake in elderly patients remains limited, with early findings indicating longer operations and higher complications. Further research on patient selection differences, technique modifications, and center expertise is required.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 696-705"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448796","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

Immunogenicity and safety of COVID-19 vaccines in patients with pancreatic cancer COVID-19疫苗在胰腺癌患者中的免疫原性和安全性

IF 2.7 3区医学

Hpb Pub Date : 2025-05-01 DOI: 10.1016/j.hpb.2025.02.002

Leonoor V. Wismans , Rory D. de Vries , Casper W.F. van Eijck , Maaike Verheij , Susanne Bogers , Joachim G.J.V. Aerts , Corine H. GeurtsvanKessel , Casper H.J. van Eijck , Annemiek A. van der Eijk

{"title":"Immunogenicity and safety of COVID-19 vaccines in patients with pancreatic cancer","authors":"Leonoor V. Wismans , Rory D. de Vries , Casper W.F. van Eijck , Maaike Verheij , Susanne Bogers , Joachim G.J.V. Aerts , Corine H. GeurtsvanKessel , Casper H.J. van Eijck , Annemiek A. van der Eijk","doi":"10.1016/j.hpb.2025.02.002","DOIUrl":"10.1016/j.hpb.2025.02.002","url":null,"abstract":"<div><h3>Background</h3><div>Patients with pancreatic ductal adenocarcinoma (PDAC) are at increased risk for severe COVID-19. Although COVID-19 vaccines are highly recommended for this population, studies on immunogenicity are lacking. We aimed to investigate the immunogenicity of COVID-19 vaccines in PDAC patients, compared to controls.</div></div><div><h3>Methods</h3><div>This observational study evaluated SARS-CoV-2 spike-specific IgG (S-IgG) levels after priming and booster vaccination in PDAC patients. Primary outcomes were seroprevalence and S-IgG levels compared to matched controls. Secondary outcomes included safety and the association of S-IgG levels with clinical and therapeutic characteristics.</div></div><div><h3>Results</h3><div>In 81 PDAC patients, a total of 86 matched S-IgG levels were available (33 post-priming; 53 post-booster). After priming, 88% (29/33) of PDAC patients were seropositive compared to 97% (32/33) of controls (<em>P</em>=0.16). After booster, seropositivity increased to 98% (52/53) in PDAC patients and to 53/53 (100%) in controls (<em>P</em>=0.31). Patients with active disease during booster vaccination had significantly lower S-IgG levels compared to patients with a history of PDAC (<em>P</em>=0.002). Cancer therapies were not associated with distinct S-IgG levels (<em>P</em>>0.05). No serious adverse events occurred.</div></div><div><h3>Conclusion</h3><div>Priming and booster COVID-19 vaccines are safe and immunogenic in PDAC patients, comparable to controls. The antibody response was effectively increased by the booster vaccination and not impaired by cancer therapies.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 716-722"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541871","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

Highlights in this issue 本期重点报道

IF 2.7 3区医学

Hpb Pub Date : 2025-05-01 DOI: 10.1016/S1365-182X(25)00557-X

引用次数: 0

Impact of intraoperative blood loss on postoperative morbidity after liver resection for primary and secondary liver cancer 术中出血量对原发性和继发性肝癌肝切除术后发病率的影响。

IF 2.7 3区医学

Hpb Pub Date : 2025-05-01 DOI: 10.1016/j.hpb.2025.01.010

Abdullah Altaf , Miho Akabane , Mujtaba Khalil , Zayed Rashid , Shahzaib Zindani , Jun Kawashima , Andrea Ruzzenente , Luca Aldrighetti , Todd W. Bauer , Hugo P. Marques , Guillaume Martel , Irinel Popescu , Mathew J. Weiss , Minoru Kitago , George Poultsides , Shishir K. Maithel , Vincent Lam , Tom Hugh , Ana Gleisner , Kazunari Sasaki , Timothy M. Pawlik

{"title":"Impact of intraoperative blood loss on postoperative morbidity after liver resection for primary and secondary liver cancer","authors":"Abdullah Altaf , Miho Akabane , Mujtaba Khalil , Zayed Rashid , Shahzaib Zindani , Jun Kawashima , Andrea Ruzzenente , Luca Aldrighetti , Todd W. Bauer , Hugo P. Marques , Guillaume Martel , Irinel Popescu , Mathew J. Weiss , Minoru Kitago , George Poultsides , Shishir K. Maithel , Vincent Lam , Tom Hugh , Ana Gleisner , Kazunari Sasaki , Timothy M. Pawlik","doi":"10.1016/j.hpb.2025.01.010","DOIUrl":"10.1016/j.hpb.2025.01.010","url":null,"abstract":"<div><h3>Background</h3><div>We sought to determine the association between intraoperative blood loss (IBL) and postoperative morbidity among patients undergoing surgery for liver cancer.</div></div><div><h3>Methods</h3><div>Patients undergoing surgery for primary and secondary liver cancer were identified from a multi-institutional database. Adjusted blood loss (aBL) was calculated by normalizing IBL to body weight; the comprehensive complication index (CCI) was used to evaluate postoperative complications.</div></div><div><h3>Results</h3><div>A total of 2491 patients were included. Mean CCI was 10.6 (±5.2) for patients with aBL <10 mL/kg versus 15.2 (±7.2) for individuals with aBL ≥10 mL/kg (p < 0.001). On cubic spline regression, a nonlinear correlation between aBL and CCI was observed. CCI increased exponentially for aBL ranging from 5 to 10 mL/kg, then reached a plateau between an aBL of 10–30 mL/kg before dramatically increasing for aBL >30 mL/kg. Recursive partitioning technique demonstrated that an aBL threshold of 8.5 mL/kg best distinguished CCI (p < 0.001). Additionally, patients with an aBL ≥8.5 mL/kg had worse recurrence-free and overall survival versus patients with an aBL <8.5 mL/kg.</div></div><div><h3>Conclusion</h3><div>A nonlinear incremental correlation between aBL and CCI was identified among patients undergoing surgery for liver cancer. Maintaining an aBL <8.5 mL/kg during LR may help reduce postoperative morbidity.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 660-669"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433177","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

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