Journal of Hepato‐Biliary‐Pancreatic Sciences最新文献_第2页

Perioperative Blood Transfusion and Mortality After Pancreatic Surgery: A Nationwide Cohort Study With Propensity Score Matching. 胰腺手术围手术期输血与死亡率：一项倾向评分匹配的全国性队列研究。

IF 2.8 3区医学

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2026-04-21 DOI: 10.1002/jhbp.70116

Seonghae Kwon, Sunghee Hong, Seonju Kim, Junghyun Yoon, Yun Kyung Jung, Kyeong Geun Lee, Dongho Choi, Boyoung Park

{"title":"Perioperative Blood Transfusion and Mortality After Pancreatic Surgery: A Nationwide Cohort Study With Propensity Score Matching.","authors":"Seonghae Kwon, Sunghee Hong, Seonju Kim, Junghyun Yoon, Yun Kyung Jung, Kyeong Geun Lee, Dongho Choi, Boyoung Park","doi":"10.1002/jhbp.70116","DOIUrl":"https://doi.org/10.1002/jhbp.70116","url":null,"abstract":"Purpose: This study aimed to evaluate the association between perioperative blood transfusion and postoperative mortality in patients undergoing pancreatic surgery.Methods: This study used the Korean National Health Insurance Service database to identify patients who underwent pancreatic surgery (2012-2020). Transfusion was defined as the administration of ≥ 1 pack of whole blood or red blood cells within 7 days before to 30 days after surgery. Baseline characteristics were balanced using propensity score matching, and mortality risk was assessed using Cox proportional hazards models. Subgroup analyses were performed by surgical type.Results: A total of 26 175 patients were included, and 36.1% received transfusion. After matching, mortality remained higher in the transfusion group (63.3% vs. 52.4%, p < 0.0001). Adjusted hazard ratios (aHRs) remained elevated across follow-ups: 45 days, 9.9 (95% CI, 1.0-96.1); 6 months, 3.0 (1.9-4.8); and 5 years, 1.4 (1.3-1.6). Subgroup analyses showed increased short- and long-term mortality risk in pancreaticoduodenectomy, with an overall aHR of 1.4 (1.2-1.6). In contrast, no long-term mortality risk was observed in distal pancreatectomy.Conclusions: Perioperative transfusion was associated with increased mortality after pancreatic surgery. These findings indicate the need for prudent transfusion practices and patient blood management strategies tailored to the surgical type to minimize transfusion-related risks.","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773598","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

Impact of Preoperative Factors of Dialysis Patients Who Underwent Pancreaticoduodenectomy on Postoperative Complications, 30-Day and Operative Mortality: Analysis Using the Japanese National Clinical Database. 胰十二指肠切除术透析患者术前因素对术后并发症、30天及手术死亡率的影响：基于日本国家临床数据库的分析

IF 2.8 3区医学

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2026-04-19 DOI: 10.1002/jhbp.70102

Michinori Matsumoto, Hiroyuki Yamamoto, Toru Ikegami, Kyoko Yamamoto, Ken Shirabe, Yoshihiro Kakeji, Atsushi Nanashima, Itaru Endo, Masafumi Nakamura, Masayuki Ohtsuka

{"title":"Impact of Preoperative Factors of Dialysis Patients Who Underwent Pancreaticoduodenectomy on Postoperative Complications, 30-Day and Operative Mortality: Analysis Using the Japanese National Clinical Database.","authors":"Michinori Matsumoto, Hiroyuki Yamamoto, Toru Ikegami, Kyoko Yamamoto, Ken Shirabe, Yoshihiro Kakeji, Atsushi Nanashima, Itaru Endo, Masafumi Nakamura, Masayuki Ohtsuka","doi":"10.1002/jhbp.70102","DOIUrl":"https://doi.org/10.1002/jhbp.70102","url":null,"abstract":"Background: Pancreaticoduodenectomy (PD) in dialysis patients is rare but carries a high risk of complications and mortality. This study aimed to identify preoperative factors associated with severe postoperative complications and mortality.Methods: Using the Japanese National Clinical Database, 329 dialysis patients undergoing PD between 2016 and 2020 were retrospectively analyzed. Multivariable penalized logistic regression identified preoperative risk factors for Clavien-Dindo classification (CDC) grade ≥ 4 complications, 30-day mortality, operative mortality, postoperative sepsis, and postoperative pancreatic fistula (POPF) (grade B or C).Results: CDC grade ≥ 4 complications, 30-day mortality, and operative mortality occurred in 10.3%, 5.5%, and 11.2%, respectively. Diet- or oral medication-treated diabetes (Odds ratio 5.19, 95% confidence interval 1.19-22.66) and insulin-treated diabetes (7.50, 1.61-34.93) independently predicted 30-day mortality. Serum albumin levels < 3.0 g/dL independently predicted operative mortality (2.72, 1.05-7.02), while cardiovascular disease showed a borderline association (2.15, 0.95-4.85). Elevated CRP was significantly associated with postoperative sepsis (2.47, 1.07-5.67), and pancreatic cancer was associated with a lower risk of POPF (grade B or C) (0.59, 0.37-0.94).Conclusions: Dialysis patients undergoing PD face perioperative risks. Early mortality is driven by acute metabolic and infectious vulnerability, whereas operative mortality reflects diminished physiologic reserve related to malnutrition and cardiovascular comorbidity.","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723019","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

Timing of Adjuvant S-1 Chemotherapy and Survival After Pancreatectomy for Pancreatic Cancer: An Ancillary Analysis of the JASPAC 01 Trial. 胰腺癌切除术后辅助S-1化疗的时机与生存：JASPAC 01试验的辅助分析

IF 2.8 3区医学

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2026-04-17 DOI: 10.1002/jhbp.70117

Dongha Lee, Yukiyasu Okamura, Yoshihide Nanno, Takuya Mizumoto, Jun Ishida, Naoto Gotohda, Hirochika Toyama, Akira Fukutomi, Narikazu Boku, Katsuhiko Uesaka

{"title":"Timing of Adjuvant S-1 Chemotherapy and Survival After Pancreatectomy for Pancreatic Cancer: An Ancillary Analysis of the JASPAC 01 Trial.","authors":"Dongha Lee, Yukiyasu Okamura, Yoshihide Nanno, Takuya Mizumoto, Jun Ishida, Naoto Gotohda, Hirochika Toyama, Akira Fukutomi, Narikazu Boku, Katsuhiko Uesaka","doi":"10.1002/jhbp.70117","DOIUrl":"https://doi.org/10.1002/jhbp.70117","url":null,"abstract":"Background: Relationship between timing of initiating adjuvant chemotherapy (AC) and clinical outcomes after surgery for pancreatic cancer remains controversial.Methods: In this ancillary analysis of the JASPAC 01 trial, 187 patients were classified according to the interval between surgery and chemotherapy initiation to Early (< 6 weeks, n = 45), Standard (6-8 weeks, n = 70), and Delayed (> 8 weeks, n = 72). Overall survival (OS) and relapse-free survival (RFS) were analyzed.Results: Baseline characteristics were comparable among three groups. The Standard group showed significantly longer OS than the Early group (median, 66 vs. 37 months; HR 0.61, 95% CI 0.38-0.99; p = 0.041), and relatively longer OS compared with the Delayed group (median, 45 months; HR 0.68, 95% CI 0.44-1.05; p = 0.077). RFS was longer in the Standard group (median, 46 months) compared with the Early group (20 months; HR 0.61, 95% CI 0.38-0.99; p = 0.040) and the Delayed group (20 months; HR 0.59, 95% CI 0.39-0.89; p = 0.011). Multivariate analysis identified operative procedure, R1 resection, lymph node metastasis, and nonstandard initiation (< 6 or > 8 weeks) as independent adverse prognostic factors.Conclusions: Initiation of S-1 AC at 6-8 weeks after pancreatectomy was associated with favorable survival outcomes.","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716885","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

Safety and Outcomes of Laparoscopic Common Bile Duct Exploration in Elderly Patients: A Retrospective Comparative Cohort Study From a High-Volume Specialist Centre. 老年患者腹腔镜胆总管探查的安全性和结果：来自高容量专科中心的回顾性比较队列研究。

IF 2.8 3区医学

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2026-04-08 DOI: 10.1002/jhbp.70112

Matthew Brazkiewicz, Javed Latif, Robyn Anderson, Imran Bhatti, Altaf Awan

{"title":"Safety and Outcomes of Laparoscopic Common Bile Duct Exploration in Elderly Patients: A Retrospective Comparative Cohort Study From a High-Volume Specialist Centre.","authors":"Matthew Brazkiewicz, Javed Latif, Robyn Anderson, Imran Bhatti, Altaf Awan","doi":"10.1002/jhbp.70112","DOIUrl":"https://doi.org/10.1002/jhbp.70112","url":null,"abstract":"Background: Laparoscopic common bile duct exploration (LCBDE) treats choledocholithiasis whilst avoiding morbidity associated with endoscopic retrograde cholangiopancreatography (ERCP). This study compared outcomes of LCBDE in patients aged < 70 years and ≥ 70 years at a high-volume specialist center.Methods: A retrospective analysis of a prospectively maintained database was performed for patients undergoing LCBDE between January 2011 and September 2024. Patients were stratified by age (< 70 vs. ≥ 70 years). Primary outcome was complete bile duct clearance. Secondary outcomes included operative time, length of stay (LOS), 30-day morbidity (Clavien-Dindo), conversion to open surgery, readmission, and retained stones. Statistical analyses used Mann-Whitney U and χ2 or Fisher's exact tests.Results: Four hundred and ninety-four patients underwent LCBDE (375 < 70 years; 119 ≥ 70 years). Elderly patients had higher ASA grades and Charlson Comorbidity Index scores (p < 0.001). Complete ductal clearance was achieved in 99.5% of younger and 100% of elderly patients (p = 0.20). Conversion to open surgery occurred in six patients. No perioperative mortality was observed. Median LOS was longer in elderly patients (3 vs. 2 days; p < 0.001). Thirty-day morbidity did not differ significantly between groups.Conclusion: LCBDE is a safe and effective treatment for choledocholithiasis in selected elderly patients when performed in specialist centers.","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639028","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

Single-Arm Robotic Pancreaticoduodenectomy Using the da Vinci SP Surgical System With a Right Posterior Approach and External Traction. 单臂机器人胰十二指肠切除术应用达芬奇SP手术系统右后路外牵引。

IF 2.8 3区医学

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2026-04-07 DOI: 10.1002/jhbp.70111

Hirotaka Fukuoka, Takeshi Takahara, Akihiro Nishimura, Sinichi Taniwaki, Yuichiro Uchida, Hideaki Iwama, Masayuki Kojima, Ichiro Uyama, Koichi Suda

引用次数: 0

Development and Validation of Nomogram Predicting Survival in Resectable Gallbladder Cancer. 预测可切除胆囊癌患者生存的Nomogram预测方法的开发与验证。

IF 2.8 3区医学

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2026-04-07 DOI: 10.1002/jhbp.70114

Shraddha Patkar, Tanvi M Shah, Mufaddal Kazi, Sadhana Kannan, Gurudutt Varty, Vikas Ostwal, Anant Ramaswamy, Prabhat Bhargav, Prajakta Barve, Mahesh Goel

{"title":"Development and Validation of Nomogram Predicting Survival in Resectable Gallbladder Cancer.","authors":"Shraddha Patkar, Tanvi M Shah, Mufaddal Kazi, Sadhana Kannan, Gurudutt Varty, Vikas Ostwal, Anant Ramaswamy, Prabhat Bhargav, Prajakta Barve, Mahesh Goel","doi":"10.1002/jhbp.70114","DOIUrl":"https://doi.org/10.1002/jhbp.70114","url":null,"abstract":"Background: Gallbladder cancers (GBCs) are aggressive tumors with limited improvement in outcomes over decades. Accurate prediction of survival is crucial for tailored treatment and improved outcomes.Objective: To develop a nomogram predicting overall survival (OS) in resectable GBCs.Methods: A retrospective analysis of 1045 patients of resected gallbladder cancer between January 2010 to December 2022 was done. A predictive nomogram was built and was internally validated.Results: The nomogram included age, original T stage, original N stage, and lympho-vascular/perineural invasion, CA 19.9, incidental versus non-incidental GBC, and grade. The Harrell's concordance index for the nomogram was 0.677. The area under the ROC curves for 1-, 3-, and 5-year OS were 72.12, 72.64, and 71.15 respectively. Patients were stratified into low-risk and high-risk groups based on a threshold score of 22.48, with significantly different median OS (not reached vs. 31.4 months, p < 0.001).Conclusions: The developed nomogram demonstrates good discriminative capacity and risk stratification in patients undergoing surgery for GBC and may be utilized for better selection and application of adjuvant treatment strategies, potentially improving outcomes.","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627901","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

Pathophysiology Underlying Manifestation of Pancreaticobiliary Maljunction Throughout Life. 胰胆管畸形终生病理生理基础表现。

IF 2.8 3区医学

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2026-04-02 DOI: 10.1002/jhbp.70110

Kenitiro Kaneko, Yasuyuki Fukami, Shoko Kato, Kentaro Shinohara, Takaaki Osawa, Tsuyoshi Sano

{"title":"Pathophysiology Underlying Manifestation of Pancreaticobiliary Maljunction Throughout Life.","authors":"Kenitiro Kaneko, Yasuyuki Fukami, Shoko Kato, Kentaro Shinohara, Takaaki Osawa, Tsuyoshi Sano","doi":"10.1002/jhbp.70110","DOIUrl":"https://doi.org/10.1002/jhbp.70110","url":null,"abstract":"Pancreaticobiliary maljunction (PBM) is an anomaly in which the bile and pancreatic ducts join outside the area of action of the sphincter. PBM is typically accompanied by choledochal cysts (dilated PBM); however, cases of PBM without biliary dilatation (nondilated PBM) have also been reported. PBM manifests throughout life. The presentation remains unclear due to age-dependent differences in its pathophysiology. PBM symptoms may be attributed to biliary obstruction caused by substances that differ with age: calcium bilirubinate debris in neonates, protein plugs in children, and gallstones in adults. Each substance is associated with PBM types. Debris occurs in dilated PBM with a narrow segment. Plugs are produced by pancreatobiliary reflux in dilated PBM but rarely in nondilated PBM. Bile duct gallstones have been implicated in dilated PBM with a narrow segment, while gallbladder gallstones may be coincident. Pancreatobiliary reflux appears to induce carcinogenesis silently and cause symptoms in the elderly. A large number of adults with PBM are reported to be asymptomatic. In summary, PBM on its own appears to cause no symptoms. However, associated biliary stricture and pancreatobiliary regurgitation produce obstructive substances or cancers, which may lead to symptoms. The substances may vary with the patient's age and PBM types.","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592668","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

Multicenter Validation Study of the Clinical Diagnostic Criteria for IgG4-Related Sclerosing Cholangitis 2020 in Japan. 日本igg4相关硬化性胆管炎临床诊断标准2020的多中心验证研究

IF 2.8 3区医学

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2026-04-01 Epub Date: 2026-01-07 DOI: 10.1002/jhbp.70056

Itaru Naitoh, Takahiro Nakazawa, Kensuke Kubota, Takayoshi Nishino, Akira Nakamura, Dai Inoue, Takanori Sano, Kazuhiro Kikuta, Yusuke Kurita, Kazuro Chiba, Tsukasa Ikeura, Hiroyuki Matsubayashi, Takuya Ishikawa, Masaki Kuwatani, Terumi Kamisawa, Ichiro Yasuda, Mitsuhiro Kawano, Atsushi Masamune

{"title":"Multicenter Validation Study of the Clinical Diagnostic Criteria for IgG4-Related Sclerosing Cholangitis 2020 in Japan.","authors":"Itaru Naitoh, Takahiro Nakazawa, Kensuke Kubota, Takayoshi Nishino, Akira Nakamura, Dai Inoue, Takanori Sano, Kazuhiro Kikuta, Yusuke Kurita, Kazuro Chiba, Tsukasa Ikeura, Hiroyuki Matsubayashi, Takuya Ishikawa, Masaki Kuwatani, Terumi Kamisawa, Ichiro Yasuda, Mitsuhiro Kawano, Atsushi Masamune","doi":"10.1002/jhbp.70056","DOIUrl":"10.1002/jhbp.70056","url":null,"abstract":"Background: The diagnostic performance of clinical diagnostic criteria for IgG4-related sclerosing cholangitis 2020 (IgG4-SC2020) has not been fully validated since its proposal as a revision of the 2012 criteria (IgG4-SC2012).Methods: We conducted a multicenter validation study to evaluate the diagnostic performance of IgG4-SC2020 using clinical data collected from 1034 patients with IgG4-SC and 447 patients with mimickers, including 143 with pancreatic cancer, 157 with primary sclerosing cholangitis, and 147 with cholangiocarcinoma in Japan.Results: The sensitivity of IgG4-SC2020 was significantly higher than that of IgG4-SC2012 (99.0% vs. 89.1%; p < 0.001). The specificities of both IgG4-SC2020 and IgG4-SC2012 were 100% for pancreatic cancer and cholangiocarcinoma. For primary sclerosing cholangitis, the specificities of IgG4-SC2020 and IgG4-SC2012 were 97.5% and 100%, respectively, with no significant difference (p = 0.123). A total of 113 patients who could not be diagnosed according to the IgG4-SC2012 were successfully diagnosed using IgG4-SC2020. These diagnostic improvements were attributed to the inclusion of MRCP findings (n = 97), the absence of neoplastic cells on histology (n = 15), and the presence of IgG4-related kidney lesions (n = 1).Conclusions: This Japanese multicenter validation study demonstrated that the diagnostic performance of IgG4-SC2020 was superior to that of IgG4-SC2012.Trial registration: UMIN Clinical Trials Registry (UMIN-CTR), UMIN000052984.","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":"294-303"},"PeriodicalIF":2.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13113202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917667","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

Modified Versus Conventional Technique of Endoscopic Ultrasound-Guided Rendezvous to Access the Narrow Bile Duct in Patients With Benign Biliary Diseases With Difficult Bile Duct Cannulation: A Comparative Feasibility Assessment Study. 超声内镜引导下进入狭窄胆道的改良技术与传统技术在胆道插管困难的良性胆道疾病患者中的比较可行性评估研究

IF 2.8 3区医学

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2026-04-01 Epub Date: 2025-12-08 DOI: 10.1002/jhbp.70051

Jahnvi Dhar, Arup Choudhury, Megha Sharma, Sanjay Kumar, Pankaj Gupta, Cherring Tandup, Satish Subbiah Nagaraj, Saroj Kant Sinha, Takeshi Ogura, Jayanta Samanta

{"title":"Modified Versus Conventional Technique of Endoscopic Ultrasound-Guided Rendezvous to Access the Narrow Bile Duct in Patients With Benign Biliary Diseases With Difficult Bile Duct Cannulation: A Comparative Feasibility Assessment Study.","authors":"Jahnvi Dhar, Arup Choudhury, Megha Sharma, Sanjay Kumar, Pankaj Gupta, Cherring Tandup, Satish Subbiah Nagaraj, Saroj Kant Sinha, Takeshi Ogura, Jayanta Samanta","doi":"10.1002/jhbp.70051","DOIUrl":"10.1002/jhbp.70051","url":null,"abstract":"Background: Extrahepatic endoscopic ultrasound-guided rendezvous (EUS-RV) with narrow common bile duct (CBD), as encountered in benign biliary diseases, can be technically challenging. We evaluated its modification (no aspiration, no contrast) in this difficult clinical scenario.Methods: EUS-RV using conventional versus modified technique in patients with benign diseases and narrow CBD (≤ 6 mm) with difficult biliary cannulation (European Society of Gastrointestinal Endoscopy definition) was evaluated. The primary outcome was technical success, and secondary outcomes were overall EUS-RV core time, radiation dose, and adverse events.Results: Overall, 113 patients were evaluated (conventional 49; modified 64). The modified EUS-RV had numerically higher technical success (83.7% vs. 95.3%; p = 0.05), which was significantly higher when the CBD access diameter was ≤ 3 mm (61.1% vs. 96.9%; p = 0.002). Moreover, the modified EUS-RV had shorter total core EUS-RV time (median 10 vs. 6.12 min; p < 0.001) and overall radiation exposure (median 345 vs. 208.93 mGy; p < 0.001), with comparable overall adverse events. On multivariate analysis, the predictors for technical success were the use of the modified technique (aOR: 6.26; p = 0.02) and CBD access diameter (aOR: 5.56; p = 0.04).Conclusions: Modified EUS-RV technique enables efficient and rapid biliary access in cases of narrowed CBD without the need for contrast injection and bile aspiration.","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":"312-321"},"PeriodicalIF":2.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707992","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 Positional Relationship Between the Inferior Right Hepatic and Posterior Portal Veins. 右肝下静脉与门静脉后静脉的位置关系。

IF 2.8 3区医学

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2026-04-01 Epub Date: 2026-01-26 DOI: 10.1002/jhbp.70073

Koetsu Inoue, Fumiaki Watanabe, Ryuji Hasebe, Yasuaki Kimura, Yuki Mizusawa, Hidetoshi Aizawa, Yuhei Endo, Takaharu Kato, Hiroshi Noda, Toshiki Rikiyama

{"title":"The Positional Relationship Between the Inferior Right Hepatic and Posterior Portal Veins.","authors":"Koetsu Inoue, Fumiaki Watanabe, Ryuji Hasebe, Yasuaki Kimura, Yuki Mizusawa, Hidetoshi Aizawa, Yuhei Endo, Takaharu Kato, Hiroshi Noda, Toshiki Rikiyama","doi":"10.1002/jhbp.70073","DOIUrl":"10.1002/jhbp.70073","url":null,"abstract":"Background: In anatomical segment 7 (S7) segmentectomy, the inferior right hepatic vein (IRHV) can be a useful landmark to identify the portal branch of segment 7 (P7); however, the positional relationship between the IRHV and the posterior portal branch has not been investigated.Patients and methods: We reviewed 203 patients who underwent preoperative multi-detector CT at Jichi Saitama Medical Center from 2022 to 2024. We processed 3D images and evaluated the running patterns concerning the IRHV, and the posterior portal vein and the right hepatic vein (RHV). The IRHV was classified as S6 (IRHV running inside S6 only), S7 (IRHV running inside S7 only), or S6/S7 (the vein courses along the intersegmental plane separating P6 and P7).Results: IRHVs were present in 44.8% of patients and were classified as S6 in 11.0%, S7 in 17.6%, and S6/S7 in 71.4%. Among patients with IRHVs, 92.3% had either an IRHV or an RHV running along the intersegmental plane separating P6 and P7, compared with 24.1% of patients without IRHVs (p < 0.01).Conclusions: Most IRHVs were classified as S6/S7. When the IRHV does not serve as a landmark, the RHV may provide an alternative anatomical landmark for identifying P7 during anatomical S7 segmentectomy.","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":"266-274"},"PeriodicalIF":2.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146052451","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