Journal of Hepato‐Biliary‐Pancreatic Sciences最新文献

{"title":"Minimally invasive approach of hepatectomy and thrombectomy for hepatocellular carcinoma with right atrial tumor thrombus without sternotomy using percutaneous cardiopulmonary bypass.","authors":"Ryosuke Maki, Yoshifumi Iwagami, Shogo Kobayashi, Kazuki Sasaki, Daisaku Yamada, Yoshito Tomimaru, Takehiro Noda, Hidenori Takahashi, Yuichiro Doki, Hidetoshi Eguchi","doi":"10.1002/jhbp.12083","DOIUrl":"https://doi.org/10.1002/jhbp.12083","url":null,"abstract":"","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568323","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":"Prognostic significance of creatine kinase in resected pancreatic cancer.","authors":"Yuichiro Kohara, Satoshi Yasuda, Minako Nagai, Kota Nakamura, Yasuko Matsuo, Taichi Terai, Shunsuke Doi, Takeshi Sakata, Masayuki Sho","doi":"10.1002/jhbp.12081","DOIUrl":"https://doi.org/10.1002/jhbp.12081","url":null,"abstract":"<p><strong>Background: </strong>Creatine kinase (CK) levels decrease with cancer progression and muscle wasting, but its association with pancreatic ductal adenocarcinoma (PDAC) remains unclear. The aim of this study was to investigate CK as a prognostic biomarker and surrogate marker for muscle mass in patients with PDAC.</p><p><strong>Methods: </strong>A retrospective analysis of 476 patients with PDAC was conducted. CK levels were categorized into low and high groups using receiver-operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>Among the 476 patients, 200 (42.0%) and 276 (58.0%) were classified into the low and high CK groups, respectively. The low CK group had significantly poorer overall survival (p < .001) and recurrence-free survival (p < .001) compared to the high CK group. Multivariate analysis identified low CK as an independent poor prognostic factor (p < .001). The low CK group had significantly lower skeletal muscle index (p = .048) than the high CK group; however, the difference was slight and not significantly associated with sarcopenia. Additionally, combined risk assessment incorporating CK and resectability facilitated a more nuanced prognostic stratification.</p><p><strong>Conclusions: </strong>CK served as a reliable prognostic marker independent from resectability but was less effective as a marker for sarcopenia in PDAC.</p>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568388","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":"Short- and long-term outcomes of liver resection with hepatic vein reconstruction for liver tumors: A nationwide multicenter survey.","authors":"Hiroshi Sadamori, Kiyoshi Hasegawa, Atsushi Oba, Yutaro Kato, Yuji Soejima, Kazuteru Monden, Yuzo Umeda, Yuta Abe, Saiho Ko, Akio Saiura, Masayuki Ohtsuka, Shoji Kubo, Ken Shirabe, Hiroaki Nagano, Toshiyoshi Fujiwara, Masafumi Nakamura, Itaru Endo","doi":"10.1002/jhbp.12077","DOIUrl":"https://doi.org/10.1002/jhbp.12077","url":null,"abstract":"<p><strong>Background/purpose: </strong>This study clarifies the short- and long-term outcomes of liver resection with hepatic vein (HV) reconstruction for liver tumors and identifies the risk factors for poor outcome.</p><p><strong>Methods: </strong>We contacted 263 specialized centers in Japan and collected data on this surgical procedure. Patient characteristics, surgical procedures, and outcomes were then analyzed.</p><p><strong>Results: </strong>A total of 187 patients were enrolled from 36 institutions. Grade C post-hepatectomy liver failure (PHLF) and in-hospital mortality were 3.2% and 1.6%, respectively. The median overall survival (OS) and recurrence-free survival (RFS) were 49.9 and 9.8 months, respectively. Surgical outcomes, OS and RFS did not differ among three types of liver tumors, colorectal liver metastasis (CRLM) (n = 127), hepatocellular carcinoma (n = 27), and intrahepatic cholangiocarcinoma (n = 27). Patients with CRLM and seven or more courses of preoperative chemotherapy had significantly worse OS. Compared with HV reconstruction for securing liver remnant (LR) function (n = 148), reconstruction of the only main HV remaining in the LR (n = 39) had significantly worse short-term outcomes, but did not result in increased mortality, and showed equivalent OS and RFS.</p><p><strong>Conclusions: </strong>Liver resection with HV reconstruction can be achieved safely and contributes to a relatively good long-term outcome for patients with advanced liver malignancies.</p>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545873","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":"Frailty as a predictor of adverse outcomes in patients with hepatectomy - the importance of design studies to improve frailty: A systematic review and meta-analysis of 128 868 patients.","authors":"Fei Zhang, Ying Yan, Baifeng Li, Chunlin Ge","doi":"10.1002/jhbp.12075","DOIUrl":"https://doi.org/10.1002/jhbp.12075","url":null,"abstract":"<p><strong>Background: </strong>Frailty has been associated with increased mortality among patients with surgery. However, evidence about the frailty prevalence and outcomes in frail populations with hepatectomy is inconsistent and has not been clarified. The purpose of this study was to quantitatively synthesize the prevalence of frailty and the role of frailty on mortality in patients with hepatectomy.</p><p><strong>Methods: </strong>Embase, PubMed, Scopus, and Web of Science were searched for eligible studies that explored the prevalence and impact of frailty in hepatectomy from inception until January 24, 2024. The pooled prevalence of frailty and odds ratio (OR) corresponding 95% confidence intervals (CI) in mortality and major complications estimates were analyzed.</p><p><strong>Results: </strong>A total of 26 studies containing 128 868 patients with hepatectomy were included. The prevalence of frailty in hepatectomy was 23% (95% CI: 17-28; p = .000). Frailty was associated with an increased odds ratio for mortality (adjusted OR = 3.06; 95% CI: 1.85-5.04; p = .000). Furthermore, frailty was significantly associated with an increased odds ratio for major complications (adjusted OR = 3.20; 95% CI: 2.04-5.04; p < .01).</p><p><strong>Conclusion: </strong>The prevalence of frailty in patients with hepatectomy is prevalent, which has a significant adverse impact on the outcomes of patients with hepatectomy. These findings highlight the importance of frailty assessment in this population, which may provide prognostic details.</p>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467524","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":"Assessment of the biliary branching pattern of the caudate lobe in perihilar cholangiocarcinoma using ENBD-CT cholangiography.","authors":"Masayuki Akita, Hiroaki Yanagimoto, Daisuke Tsugawa, Keitaro Sofue, Hidetoshi Gon, Shohei Komatsu, Hirochika Toyama, Masahiro Kido, Tetsuo Ajiki, Takumi Fukumoto","doi":"10.1002/jhbp.12073","DOIUrl":"https://doi.org/10.1002/jhbp.12073","url":null,"abstract":"<p><strong>Background: </strong>Preoperative recognition of the anatomy of caudate biliary branches is important for the safe and complete resection of perihilar cholangiocarcinoma (PHC). In the present study, we identified these branches using an endoscopic nasobiliary drainage tube (ENBD).</p><p><strong>Methods: </strong>Between January 2012 and October 2022, 89 patients with suspected PHC underwent computed tomographic (CT) cholangiography through ENBD and caudate biliary branching patterns were examined. Multidetector raw CT (MDCT) scans on 85 patients with PHC without biliary drainage were also investigated. The caudate biliary branches detected by each modality were evaluated.</p><p><strong>Results: </strong>ENBD-CT cholangiography detected 206 caudate branches (2.44 branches/patient), while MDCT identified 62 branches (0.78 branches/patient). ENBD-CT cholangiography showed that 89 caudate branches drained into the left hepatic duct (LHD), 87 into the posterior hepatic duct (Bpost), and 30 into the right hepatic duct. LHD and Bpost were the common roots of the caudate branches. Some branches (20%) joined the contralateral hepatic duct across the left-right border, but not the anterior hepatic duct or infraportal-type Bpost.</p><p><strong>Conclusions: </strong>ENBD-CT cholangiography clearly showed the caudate biliary branches in patients with PHC after biliary drainage.</p>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348212","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":"The correlation between tumoral CD8 expression and clinical course in patients with unresectable pancreatic cancer using tissue samples acquired by endoscopic ultrasound-guided tissue acquisition.","authors":"Yuki Tanisaka, Shomei Ryozawa, Masafumi Mizuide, Akashi Fujita, Ryuhei Jinushi, Ryuichi Watanabe, Ryo Sato, Masanori Yasuda","doi":"10.1002/jhbp.12072","DOIUrl":"https://doi.org/10.1002/jhbp.12072","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to evaluate the correlation between tumoral CD8 expression and the clinical course in patients with unresectable pancreatic ductal adenocarcinoma (PDAC) using tissue samples acquired by endoscopic ultrasound-guided tissue acquisition (EUS-TA).</p><p><strong>Methods: </strong>Patients with unresectable PDAC who underwent EUS-TA prior to treatment between September 2017 and October 2021 were included. The localization of the CD8-positive areas was qualitatively evaluated. We divided the patients into high and low groups based on the median percentage of CD8-positive areas. The correlation between the number of CD8-positive areas and overall survival was assessed. Furthermore, the response to chemotherapy was assessed in patients who underwent chemotherapy.</p><p><strong>Results: </strong>A total of 169 patients were included in the analysis. The median overall survival was 171 days (95% confidence interval [CI]: 86-401). The median CD8-positive area was 0.10% (95% CI: 0.05-0.26). The median overall survival in the high (≥0.1%) and low (<0.1%) CD8-positive groups were 156 and 213.5 days, respectively (p = .33). The number of CD8-positive areas was not correlated with the overall survival and response to chemotherapy (p = .69).</p><p><strong>Conclusions: </strong>Tissue samples acquired using EUS-TA from patients with unresectable PDAC showed that CD8 expression did not affect the clinical course of patients.</p>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348221","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":"5-Fluorouracil metabolic pathway genes predict recurrence risk following adjuvant S-1 therapy: Results of an ancillary analysis from a phase III trial of resected biliary tract cancer (JCOG1202A1).","authors":"Shuichi Mitsunaga, Masafumi Ikeda, Shogo Nomura, Chigusa Morizane, Akiko Todaka, Naoto Yamamoto, Ken Kamata, Hiroo Yanagibashi, Nobumasa Mizuno, Yasuyuki Kawamoto, Kunihito Gotoh, Hirofumi Shirakawa, Naohiro Okano, Tatsuya Nomura, Kazunari Tanaka, Amane Takahashi, Shintaro Yagi, Koji Ohta, Yukiko Takayama, Haruo Miwa, Hiroaki Nagano, Yasushi Kojima, Terumasa Hisano, Munenori Tahara, Yasunaru Sakuma, Hiroyuki Arai, Ikuo Nakamura, Hiroshi Katayama, Masaru Konishi, Makoto Ueno","doi":"10.1002/jhbp.12071","DOIUrl":"https://doi.org/10.1002/jhbp.12071","url":null,"abstract":"<p><strong>Background: </strong>S-1, an oral fluoropyrimidine derivative, is standard adjuvant therapy for resected biliary tract cancer (BTC), based on the results of the JCOG1202, a phase III trial evaluating the survival benefit with adjuvant S-1 following curative resection for BTC compared to surgery alone. This multicenter ancillary study of the JCOG1202 aimed to evaluate the prognostic impact of the 5-fluorouracil (5-FU) metabolic pathway genes including thymidine phosphorylase (TP) and dihydropyrimidine dehydrogenase (DPD).</p><p><strong>Methods: </strong>The 5-FU metabolic pathway genes were measured in tumor cells from formalin-fixed paraffin-embedded resected specimens from 183 patients (surgery alone: n = 94; adjuvant S-1: n = 89). We randomly divided them into training (n = 96) and validation sets (n = 87) for evaluating the interaction between gene levels and RFS benefits in the treatment arm.</p><p><strong>Results: </strong>RFS benefits of adjuvant S-1 were observed in the low DPD (HR = 0.440 and 0.748, respectively in the training and validation sets) and the low TP groups (HR = 0.709 and 0.602, respectively). Clinicopathological characteristics were well balanced between low and high DPD populations. More advanced stage tumors were observed in high TP populations as compared to those in low TP populations (p = .0332).</p><p><strong>Conclusion: </strong>The results suggest the RFS benefit of adjuvant S-1 in resected BTC patients with low DPD and low TP gene expressions.</p>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348211","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":"Optimal treatment strategy for patients with pancreatic cancer having positive peritoneal cytology: A nationwide multicenter retrospective cohort study supervised by the Japanese Society of Hepato-Biliary-Pancreatic Surgery.","authors":"Kyohei Ariake, Masamichi Mizuma, Michiaki Unno, Sohei Satoi, Naoto Yamamoto, Masamichi Hayashi, Manabu Kawai, Hirofumi Akita, Eiji Toyoda, Tsutomu Fujii, Masaru Sasaki, Kenichi Hakamada, Jota Watanabe, Etsuro Hatano, Masaaki Hidaka, Satoshi Hirano, Hiroshi Kurahara, Ippei Matsumoto, Goro Honda, Toshiro Ogura, Masafumi Nakamura, Itaru Endo","doi":"10.1002/jhbp.12074","DOIUrl":"https://doi.org/10.1002/jhbp.12074","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to determine the optimal treatment for patients with pancreatic cancer (PaCa) having positive peritoneal cytology (PPC).</p><p><strong>Methods: </strong>This multicenter retrospective study included patients with PPC treated at 78 high-volume centers between January 2012 and December 2020. Prognoses after resection (S-group) and initiation of nonsurgical treatment (N-group) were compared. Prognostic factors for survival in both groups were analyzed. Detailed characteristics of conversion surgery (CS) in the N-group were evaluated.</p><p><strong>Results: </strong>In total, 568 enrolled patients were classified into an S-group (n = 445) or an N-group (n = 123). Median survival times (MSTs) were 19.0 months and 19.3 months, respectively, with no significant difference in prognosis (p = .845). The intervenable prognostic factors for survival were adjuvant treatment in the S-group (p < .001) and CS in the N-group (p < .001). Following CS, the MST was prolonged to 45.6 months, and peritoneal or liver recurrence decreased considerably. CS can be expected if PPC is diagnosed before neoadjuvant treatment and when combination treatment is initiated.</p><p><strong>Conclusion: </strong>Surgical resection may not be beneficial for improving survival when PPC is evident. Chemotherapy aiming for CS may be the optimal treatment for such patients.</p>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348220","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":"Evaluation of prognostic efficacy of liver immune status index in predicting postoperative outcomes in hepatocellular carcinoma patients: A multi-institutional retrospective study.","authors":"Yuki Imaoka, Masahiro Ohira, Tsuyoshi Kobayashi, Naruhiko Honmyo, Michinori Hamaoka, Takashi Onoe, Daisuke Takei, Koichi Oishi, Tomoyuki Abe, Toshihiro Nakayama, Miho Akabane, Kazunari Sasaki, Hideki Ohdan","doi":"10.1002/jhbp.12070","DOIUrl":"https://doi.org/10.1002/jhbp.12070","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) ranks third in cancer-related deaths globally. Despite treatment advances, high post-hepatectomy recurrence rates (RR), especially with liver fibrosis and hepatitis C virus infection, remain challenging. Key prognostic factors include vascular invasion and perioperative blood loss, impacting extrahepatic recurrence. Natural killer (NK) cells are crucial in countering circulating tumor cells through TRAIL-mediated pathways. The aim of this study was to validate the liver immune status index (LISI) as a predictive tool for liver NK cell antitumor efficiency, particularly in HCC patients with vascular invasion.</p><p><strong>Methods: </strong>A retrospective analysis of 1337 primary HCC hepatectomies was conducted by the Hiroshima Surgical Study Group of Clinical Oncology (HiSCO). Clinicodemographic data were extracted from electronic medical records. Prognostic indices (FIB-4, ALBI, ALICE, GNRI, APRI, and LISI) were evaluated using area under the receiver operating characteristic curve values. Survival analyses employed Kaplan-Meier estimations and log-rank tests.</p><p><strong>Results: </strong>LISI significantly correlated with other prognostic markers and stratified patients into risk groups with distinct overall survival (OS) and RR. It showed superior predictive performance for 2-year OS and RR, especially in patients with vascular invasion. Over longer periods, APRI and FIB-4 index reliabilities improved. The HISCO-HCC score, combining LISI, tumor burden score, and alpha-fetoprotein levels, enhanced prognostic accuracy.</p><p><strong>Conclusion: </strong>LISI outperformed existing models, particularly in HCC with vascular invasion. The HISCO-HCC score offers improved prognostic precision, guiding immunotherapeutic strategies and individualized patient care in HCC.</p>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307923","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":"Endoscopic assessment of minor papilla morphology: Predictors of successful cannulation and procedural pancreatitis risk in minor papilla endotherapy","authors":"Yasuhiro Kuraishi, Akira Nakamura, Shohei Kondo, Takumi Yanagisawa, Ichitaro Horiuchi, Masafumi Minamisawa, Nobukazu Sasaki, Yugo Iwaya, Tadanobu Nagaya, Takeji Umemura","doi":"10.1002/jhbp.12068","DOIUrl":"https://doi.org/10.1002/jhbp.12068","url":null,"abstract":"BackgroundWe evaluated for predictors of successful cannulation and post‐endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) in minor papilla endotherapy (MPE), emphasizing endoscopic minor papilla morphology.MethodsWe retrospectively analyzed 232 MPEs in 65 patients, assessing minor papilla morphology based on three features: bulge as “prominent” or “subtle,” mucosal appearance as “papilla‐like” resembling the main papilla or “SMT‐like” akin to a gastrointestinal submucosal tumor, and orifice visibility as “clear” or “unclear.” Cannulation success was evaluated in 65 enrolled patients, with PEP risk assessed in all 232 MPEs.ResultsMinor papilla morphology was categorized as prominent/subtle bulge in 42/23 patients, papilla‐like/SMT‐like mucosal appearance in 42/23, and clear/unclear orifice visibility in 24/41. Cannulation succeeded in 54/65 patients (83%). A papilla‐like appearance and clear orifice visibility was significantly associated with cannulation success. PEP incidence was 5.2% and predominantly mild. A papilla‐like appearance significantly decreased PEP incidence, while precutting technique and orifice dilation significantly increased PEP risk.ConclusionEvaluating minor papilla morphology may help predict cannulation success and PEP risk in MPE. A papilla‐like mucosal appearance prognosticates cannulation success and reduced PEP risk, with clear orifice visibility serving as a success predictor. These findings provide practical guidance for preprocedural planning by emphasizing the importance of minor papilla morphology evaluation.","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142213279","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}