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

Correction to "Outcomes of patients with initially unresectable pancreatic cancer who underwent conversion surgery after FOLFIRINOX or gemcitabine plus nab-paclitaxel chemotherapy: A multicenter retrospective cohort study (PC-CURE-1)". 更正“最初不可切除的胰腺癌患者在FOLFIRINOX或吉西他滨加nab-紫杉醇化疗后接受转换手术的结果：一项多中心回顾性队列研究（PC-CURE-1）”。

IF 3.2 3区医学

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2025-01-08 DOI: 10.1002/jhbp.12096

引用次数: 0

Efficacy of mapping biopsy using a novel sheath system for the histological diagnosis of superficial ductal spread in distal cholangiocarcinoma: A retrospective multicenter study. 一项回顾性多中心研究：使用一种新型鞘系统对远端胆管癌浅表导管扩散的组织学诊断进行活检的有效性。

IF 3.2 3区医学

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2025-01-08 DOI: 10.1002/jhbp.12103

Mitsuru Okuno, Keisuke Iwata, Tsuyoshi Mukai, Takuji Iwashita, Takuji Tanaka, Akinori Maruta, Keisuke Kawashima, Ichiro Yasuda, Hisataka Moriwaki, Masahito Shimizu

{"title":"Efficacy of mapping biopsy using a novel sheath system for the histological diagnosis of superficial ductal spread in distal cholangiocarcinoma: A retrospective multicenter study.","authors":"Mitsuru Okuno, Keisuke Iwata, Tsuyoshi Mukai, Takuji Iwashita, Takuji Tanaka, Akinori Maruta, Keisuke Kawashima, Ichiro Yasuda, Hisataka Moriwaki, Masahito Shimizu","doi":"10.1002/jhbp.12103","DOIUrl":"https://doi.org/10.1002/jhbp.12103","url":null,"abstract":"Background: Mapping biopsy (MB) can evaluate superficial ductal spread (SDS) through the histopathological diagnosis of cholangiocarcinoma, enabling the selection of an appropriate surgical procedure. This retrospective study evaluated the efficacy of MB using a novel sheath system in distal cholangiocarcinoma (dCCA) cases.Methods: A total of 199 cholangiocarcinoma cases underwent preoperative diagnosis. Among them, 40, 21, and 26 cases underwent direct, sheath, and peroral cholangioscopy (POCS) MB, respectively, for dCCA. Each group was compared regarding their technical success rate and the diagnostic accuracy for SDS.Results: Although all cases achieved technical success, the median procedure time of POCS (48-min) tended to be longer than direct (33-min) and sheath MB (30-min) (p overall = .092). Diagnostic specificity and accuracy were significantly higher in the sheath group (95.2%, 95.2%) compared to the direct (71.0%, 70.0%) and POCS (60.9%, 57.7%) MB groups (p overall = .019 and .0094). Multivariate analysis revealed that the sheath MB group was an independent significant factor for the accurate margin diagnosis (OR 0.11; 95% CI: 0.01-0.86, p = .0358).Conclusions: The sheath MB method provided the most accurate histopathological diagnosis of SDS in dCCA. To obtain a larger tissue sample and avoid tumor cell contamination, sheath MB is worth performing to assess the accuracy of the preoperative SDS diagnosis.","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950003","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

Subcutaneous adipose tissue radiodensity as a predictor of poor prognosis in advanced biliary tract cancer. 皮下脂肪组织放射密度作为晚期胆道癌预后不良的预测因子。

IF 3.2 3区医学

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2025-01-08 DOI: 10.1002/jhbp.12105

Ryo Sugiura, Yasuyuki Kawamoto, Masaki Kuwatani, Kazumichi Kawakubo, Kazuaki Harada, Masatsugu Ohara, Hiroki Yonemura, Shunichiro Nozawa, Naoya Sakamoto

{"title":"Subcutaneous adipose tissue radiodensity as a predictor of poor prognosis in advanced biliary tract cancer.","authors":"Ryo Sugiura, Yasuyuki Kawamoto, Masaki Kuwatani, Kazumichi Kawakubo, Kazuaki Harada, Masatsugu Ohara, Hiroki Yonemura, Shunichiro Nozawa, Naoya Sakamoto","doi":"10.1002/jhbp.12105","DOIUrl":"https://doi.org/10.1002/jhbp.12105","url":null,"abstract":"Background: High subcutaneous adipose tissue radiodensity (SATr), an indirect surrogate marker of adipose tissue quality, was associated with poor prognosis in various cancers. The present study aimed to assess the association of SATr with survival outcomes in patients with advanced biliary tract cancer (BTC).Methods: This retrospective, single-center study included patients with unresectable or recurrent BTC who underwent chemotherapy/chemoradiotherapy. Overall survival (OS) and progression-free survival (PFS) were assessed using the log-rank test and the Cox proportional hazards model according to the SATr status.Results: The study cohort included 234 patients, including 38 and 196 patients with high and non-high SATr, respectively. The median OS durations were 10.5 and 17.4 months (HR = 1.72, 95% CI: 1.19-2.49, p < .01) and the median PFS durations were 4.9 and 8.0 months (HR = 1.52, 95% CI: 1.05-2.20, p = .03) in patients with high and non-high SATr, respectively. By multivariate analysis, high SATr, neutrophil/lymphocyte ratio >5, modified Glasgow prognostic score 1-2, and serum carcinoembryonic antigen >5.0 ng/mL were predictors for OS (HR, 1.66, 2.42, 2.00, and 1.56, respectively; p < .05). By multivariate analysis, metastatic disease status, high SATr, neutrophil/lymphocyte ratio >5, and modified Glasgow prognostic score 1-2 were independent risk factors for worse PFS (HR, 1.56, 1.56, 1.81, and 1.57, respectively; p < .05).Conclusions: High SATr was associated with risk of tumor progression and poor prognosis in patients with advanced BTC treated by palliative chemotherapy/chemoradiotherapy.","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950127","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

An updated review about the possibility of surveillance strategy in non-resected mucinous cystic neoplasms. 关于未切除的粘液囊性肿瘤监测策略的可能性的最新综述。

IF 3.2 3区医学

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2025-01-03 DOI: 10.1002/jhbp.12106

Won-Gun Yun, Jin-Young Jang

{"title":"An updated review about the possibility of surveillance strategy in non-resected mucinous cystic neoplasms.","authors":"Won-Gun Yun, Jin-Young Jang","doi":"10.1002/jhbp.12106","DOIUrl":"https://doi.org/10.1002/jhbp.12106","url":null,"abstract":"After the World Health Organization established a precise definition of mucinous cystic neoplasm (MCN) in 2000, based on the presence of ovarian-type stroma, its clinical features became more apparent. Surgery for MCN, which primarily affects middle-aged women with long life expectancies, is likely to negatively impact the patient's quality of life. Although recent studies have reported a low proportion of advanced neoplasia among resected MCN (≤15%), many clinicians still recommend surgery for patients with presumed MCN without considering risk stratification for advanced neoplasia. Recent studies have demonstrated that, when appropriate patient groups are established based on high-risk characteristics, there is no difference in long-term prognosis between a surveillance strategy and surgery. Additionally, while most guidelines do not recommend post-resection surveillance for MCN, research indicates that surveillance of non-resected MCN is more cost-effective than surgery when considering the expenses of post-pancreatectomy diabetic care. It is time to carefully consider a surveillance strategy, despite the significant misdiagnosis rates associated with MCN diagnosis based solely on imaging without histology.","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927341","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 sex and body mass index in liver transplantation for acute-on-chronic liver failure. 性别和体重指数对急性和慢性肝衰竭肝移植的影响。

IF 3.2 3区医学

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2024-12-27 DOI: 10.1002/jhbp.12100

Miho Akabane, Yuki Imaoka, Toshihiro Nakayama, Carlos O Esquivel, Kazunari Sasaki

{"title":"The impact of sex and body mass index in liver transplantation for acute-on-chronic liver failure.","authors":"Miho Akabane, Yuki Imaoka, Toshihiro Nakayama, Carlos O Esquivel, Kazunari Sasaki","doi":"10.1002/jhbp.12100","DOIUrl":"https://doi.org/10.1002/jhbp.12100","url":null,"abstract":"Background/purpose: There have been no studies evaluating how body mass index (BMI) impacts on waitlist and post-liver transplant (LT) mortality in acute-on-chronic liver failure (ACLF) by sex. We aimed to determine these impacts using the United Network for Organ Sharing (UNOS) database.Methods: Adults listed for LT with estimated ACLF (Est-ACLF) (2005-2023) were identified and subdivided by sex and BMI (high/middle/low). Competing-risk analyses evaluated impacts on waitlist mortality. Kaplan-Meier analyses assessed post-LT survival. Multivariable Cox regression identified risk factors.Results: Of 37 251 Est-ACLF patients, 14 534 (39.0%) were female. Females had higher 90-day waitlist mortality than males (subhazard ratio [sHR]: 1.20, p < .01). High/low BMI patients had higher mortality than middle (sHR: 1.08/1.11, p < .01). In females, high BMI was associated with higher mortality than low (sHR: 1.10, p = .02); in males, low BMI was associated with higher mortality than high/middle (sHR: 1.16/1.16 vs. high/middle, p < .01). Multivariable analyses showed in females, high BMI was a significant risk factor for waitlist mortality (sHR:1.21, p < .01), while low was not; in males, high/low BMI was significant, with low having higher sHR (1.17) than high (1.09). Post-LT survival showed no significant difference in females; in males, low BMI showed worse post-3-/5-year-LT survival (p < .01). Multivariable Cox regression showed for females, neither low nor high BMI was significant for post-LT survival; for males, low BMI was significant for 1-/3-/5-year-LT survival (HR: 1.30/1.30/1.22, p < .01).Conclusions: Our analysis of BMI's impact on LT outcomes in ACLF by sex enables risk stratification and provides a basis for adjusting BMI.","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895455","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

Association between phosphorus-to-calcium ratio at ICU admission and all-cause mortality in acute pancreatitis: Insights from the MIMIC-IV database. ICU入院时磷钙比与急性胰腺炎全因死亡率之间的关系：来自MIMIC-IV数据库的见解

IF 3.2 3区医学

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2024-12-23 DOI: 10.1002/jhbp.12094

Yimin Han, Fan Chen, Wanzhen Wei, Jiahui Zeng, Yiqun Song, Zheng Wang, Fang Cao, Yaochun Wang, Kedong Xu, Zhenhua Ma

{"title":"Association between phosphorus-to-calcium ratio at ICU admission and all-cause mortality in acute pancreatitis: Insights from the MIMIC-IV database.","authors":"Yimin Han, Fan Chen, Wanzhen Wei, Jiahui Zeng, Yiqun Song, Zheng Wang, Fang Cao, Yaochun Wang, Kedong Xu, Zhenhua Ma","doi":"10.1002/jhbp.12094","DOIUrl":"https://doi.org/10.1002/jhbp.12094","url":null,"abstract":"Background: Serum phosphorus and serum calcium are important electrolytes in the body. The relationship between them and acute pancreatitis (AP) has been previously discussed. However, the results seem to lack credibility due to the neglect of mutual influence between them. Thus, a comprehensive indicator is needed.Methods: In this study, AP patients with intensive care unit (ICU) treatment were extracted from Medical Information Mart for Intensive Care (MIMIC) database. The outcomes included in-hospital mortality and ICU mortality. Kaplan-Meier survival analysis, Cox proportional hazard regression model and restricted cubic spline were employed to investigate the association between the phosphorus-to-calcium ratio (PCR) index and clinical outcomes.Results: A total of 719 AP patients (57.2% male) were enrolled. The in-hospital and ICU mortality were 11.4% and 7.5%, respectively. After adjusting for confounders, Cox proportional hazard analysis indicated patients with a higher PCR index had a significant association with in-hospital mortality (adjusted hazard ratio, 2.88; 95% confidence interval, 1.34-6.19; p = .007). Restricted cubic splines revealed that a progressively increasing risk of all-cause mortality was associated with an elevated PCR index.Conclusion: The PCR index has a strong correlation with in-hospital and ICU all-cause mortality in AP, which provides a reference for clinical decision-making.","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877319","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 safety and feasibility of robotic pancreaticoduodenectomy: A multicenter retrospective assessment of 425 patients in Japan. 机器人胰十二指肠切除术的安全性和可行性：日本425例患者的多中心回顾性评估。

IF 3.2 3区医学

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2024-12-23 DOI: 10.1002/jhbp.12101

So Nakamura, Kohei Nakata, Yuichi Nagakawa, Shingo Kozono, Go Wakabayashi, Taiga Wakabayashi, Ichiro Uyama, Takeshi Takahara, Yutaka Takeda, Yoshiaki Ohmura, Saiho Ko, Ayumi Nishioka, Sho Kiritani, Yosuke Inoue, Tomohiko Adachi, Susumu Eguchi, Mamoru Morimoto, Yoichi Matsuo, Hiroshi Kurahara, Takao Ohtsuka, Masafumi Nakamura

{"title":"The safety and feasibility of robotic pancreaticoduodenectomy: A multicenter retrospective assessment of 425 patients in Japan.","authors":"So Nakamura, Kohei Nakata, Yuichi Nagakawa, Shingo Kozono, Go Wakabayashi, Taiga Wakabayashi, Ichiro Uyama, Takeshi Takahara, Yutaka Takeda, Yoshiaki Ohmura, Saiho Ko, Ayumi Nishioka, Sho Kiritani, Yosuke Inoue, Tomohiko Adachi, Susumu Eguchi, Mamoru Morimoto, Yoichi Matsuo, Hiroshi Kurahara, Takao Ohtsuka, Masafumi Nakamura","doi":"10.1002/jhbp.12101","DOIUrl":"https://doi.org/10.1002/jhbp.12101","url":null,"abstract":"Background/purpose: The Japanese public health insurance system has recently covered robotic pancreaticoduodenectomy (RPD). This study aimed to review the results of RPD during the introductory period and elucidate its safety and feasibility in Japan.Methods: Consecutive data of 425 patients who underwent RPD were retrospectively collected from 10 high-volume centers in Japan between April 2020 and September 2022. The primary endpoints were the rates of conversion to open surgery and completion of minimally invasive surgery (MIS), defined as the use of a totally robotic operation or combined robotic and laparoscopic procedures. Secondary endpoints were operative time, blood loss, complication rate, and 30- and 90-day mortality rates.Results: Study comprised 222 males and 203 females, with a median age of 70 (p10-p90; 50-81) years. The conversion to open surgery and completion rates of MIS were 3.8% (16 patients) and 91.1% (387 patients), respectively. The median operative time was 617 min (p10-p90; 456-834 min), and the median volume of blood loss was 160 g (p10-p90; 30-558 g). The complication rate (Clavien-Dindo classification grade ≥ IIIa) was 20.5%. The 30- and 90-day mortality rates were 0.2% and 0.5%, respectively.Conclusions: Our results indicate that RPD can be introduced successfully and is a promising approach for pancreaticoduodenectomy.","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877322","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

Utility and safety of endoscopic papillary balloon dilation with small-incision sphincterotomy for small bile duct stones: A randomized controlled trial. 内镜下乳头状球囊扩张联合小切口括约肌切开术治疗小胆管结石的有效性和安全性：一项随机对照试验。

IF 3.2 3区医学

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2024-12-11 DOI: 10.1002/jhbp.12097

Yuki Ishida, Takeshi Hisa, Ryusuke Matsumoto, Shigeru Nishiyama, Akiharu Kudo, Takahiro Yamada, Shozo Osera, Akihisa Tomori, Hideki Fukushima

{"title":"Utility and safety of endoscopic papillary balloon dilation with small-incision sphincterotomy for small bile duct stones: A randomized controlled trial.","authors":"Yuki Ishida, Takeshi Hisa, Ryusuke Matsumoto, Shigeru Nishiyama, Akiharu Kudo, Takahiro Yamada, Shozo Osera, Akihisa Tomori, Hideki Fukushima","doi":"10.1002/jhbp.12097","DOIUrl":"https://doi.org/10.1002/jhbp.12097","url":null,"abstract":"Background: Endoscopic sphincterotomy (ES) for bile duct stones (BDS) can cause basket impaction with stone, complicating the procedure. In this study, we evaluated the utility and safety of small incision ES combined with endoscopic papillary balloon dilation (sES + EPBD) (balloon dilated up to the stone size), compared with ES alone for BDS <12 mm.Methods: The primary endpoint was the frequency of mechanical lithotripsy (ML), indicating the risk of basket impaction with stone; however, the secondary endpoints were procedure time, successful stone removal, and early adverse events.Results: A total of 100 patients were randomized into the ES and sES + EPBD groups (n = 50 for each). Significantly fewer cases required ML (20.0% vs. 4.0%, p = .028) in the sES + EPBD group. The maximum short-axis diameter of the stones in all patients requiring ML in the ES group ranged from 8 to 11 mm. The median procedure time was significantly shorter (18.5 min vs. 17 min, p = .047) in the sES + EPBD group. Both groups showed similar frequencies of successful stone removal in one session (88.0% vs. 98.0%, p = .112) and early adverse events (4.0% vs. 2.0%, p = .62).Conclusion: In cases of small BDS, sES + EPBD exhibits a low frequency of ML, which shortens procedure time and prevents basket impaction with stones.","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813192","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

It is time for reform: Results from a questionnaire survey on the current status of next generation HBP surgeons in Japan 是改革的时候了：日本下一代HBP外科医生现状问卷调查结果。

IF 3.2 3区医学

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2024-12-10 DOI: 10.1002/jhbp.12092

Yukiko Kosai-Fujimoto, Tomoaki Yoh, Takanobu Hara, Saori Umezawa, Aya Maekawa, Yasuko Matsuo, Norihiro Ishii, Hiroko Okinaga, Itaru Endo, Masayuki Ohtsuka, Susumu Eguchi, Ken Shirabe

{"title":"It is time for reform: Results from a questionnaire survey on the current status of next generation HBP surgeons in Japan","authors":"Yukiko Kosai-Fujimoto, Tomoaki Yoh, Takanobu Hara, Saori Umezawa, Aya Maekawa, Yasuko Matsuo, Norihiro Ishii, Hiroko Okinaga, Itaru Endo, Masayuki Ohtsuka, Susumu Eguchi, Ken Shirabe","doi":"10.1002/jhbp.12092","DOIUrl":"10.1002/jhbp.12092","url":null,"abstract":"A questionnaire survey was designed and performed to assess the current status of “next generation” hepatobiliary and pancreatic (HBP) surgeons regarding surgical training, career, recruiting, and work-life balance in Japan. Using a valid email address, a questionnaire was sent to members of the Japanese Society of Hepato-Biliary-Pancreatic Surgeons (JSHBPS) who were under 45 years old. The questionnaire comprised 50 questions across the following four sections: (i) board certification of JSHBPS, (ii) research activity and overseas study, (iii) recruiting, and (iv) work-life balance. A questionnaire survey was sent to 1735 HBP surgeons and responses were received from 303 members (17.5%). In a survey with 303 respondents, over 45.9% were above 41 years old, 93.7% were male, and 91.0% were affiliated with university surgery departments. About 25.1% were JSHBPS board-certified, while 72.7% of uncertified doctors aspired for the certification. Research activity was deemed crucial by 74.9%. Recruitment targeting postgraduate years 1–5 was recommended, with the technical difficulty of surgery being the main reason for choosing HBP. Regarding work-life balance, excessive work and classical work style were regarded as a hindrance to the sustainability of working practices. This survey highlighted that next generation HBP surgeons are highly motivated to acquire advanced surgical skills and recognize the importance of research experience. However, they are facing long working hours and insufficient training opportunities. Fundamental reforms, such as revising the training curriculum, improving work styles, and enhancing recruitment, are necessary steps forward to ensure the sustainability of HBP surgery in Japan.","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"32 1","pages":"17-25"},"PeriodicalIF":3.2,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801086","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

Usefulness of simplified comprehensive geriatric assessment as a pre-ERCP screening for the elderly. 简化综合老年病评估作为老年人ercp前筛查的有效性。

IF 3.2 3区医学

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2024-12-06 DOI: 10.1002/jhbp.12093

Shuzo Nomura, Kei Saito, Mariko Fujisawa, Mai Kitahara, Noriyuki Kuniyoshi, Hiroo Imazu, Hirofumi Kogure

{"title":"Usefulness of simplified comprehensive geriatric assessment as a pre-ERCP screening for the elderly.","authors":"Shuzo Nomura, Kei Saito, Mariko Fujisawa, Mai Kitahara, Noriyuki Kuniyoshi, Hiroo Imazu, Hirofumi Kogure","doi":"10.1002/jhbp.12093","DOIUrl":"https://doi.org/10.1002/jhbp.12093","url":null,"abstract":"Background: Endoscopic retrograde cholangiopancreatography (ERCP) is often performed in elderly patients for stone removal and biliary drainage following common bile duct stones or malignant biliary obstruction. Safety in ERCP should be considered in elderly patients due to complications and decreased activities of daily living (ADL), but there are no adequate pretest evaluation criteria. In recent years, the usefulness of the comprehensive geriatric assessment (CGA) for planning treatment and predicting prognosis has been reported.Methods: We retrospectively analyzed consecutive patients who underwent ERCP at our institution between October 2021 and June 2023. The relationship between CGA and ERCP outcomes was examined by dividing CGA scores into three groups (Group A; score 0, Group B; score 1-4, Group C; score 5-7) among patients 65 years of age and older. Risk factors for prolonged hospitalization were identified using univariate and multivariate analysis.Results: Of the 388 patients, 290 were 65 or older with a CGA score. The median length of hospital stay was significantly longer in the higher CGA7 scores group (5 vs. 8 vs. 15 days, p < .01). There was no significant difference in the rate of adverse events (p = .54) and median total procedure time (p = .35). In univariate and multivariate analysis, higher CGA score groups were significant risk factors for a prolonged hospital stay.Conclusions: CGA appears to be a valuable tool for preadmission screening in elderly patients undergoing ERCP.","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785949","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