Journal of Hepato‐Biliary‐Pancreatic Sciences最新文献

{"title":"Visceral Adipose Tissue as an Independent Predictor of Severe Post-ERCP Pancreatitis: A Multicenter Retrospective Cohort Study","authors":"Shinya Uemura,&nbsp;Takuji Iwashita,&nbsp;Takuya Koizumi,&nbsp;Yosuke Ohashi,&nbsp;Shota Iwata,&nbsp;Akinori Maruta,&nbsp;Keisuke Iwata,&nbsp;Masahito Shimizu","doi":"10.1002/jhbp.70158","DOIUrl":"10.1002/jhbp.70158","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Acute pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP), known as post-ERCP pancreatitis (PEP), is a major adverse event. Although risk factors for PEP incidence have been widely studied, factors associated with severe PEP remain unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To identify risk factors, including body composition, associated with severe PEP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study was conducted in patients who underwent ERCP at two tertiary care centers in Japan between January 2013 and October 2021. PEP severity was defined according to the American Society of Gastrointestinal Endoscopy Workshop criteria (2010). Patients were divided into mild and moderate-to-severe groups. Body composition parameters, including skeletal muscle index, subcutaneous adipose tissue, and visceral adipose tissue (VAT), were assessed using CT. Multivariate analysis was performed to identify factors associated with severe PEP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 3087 patients who underwent ERCP for biliary disease, 85 (2.75%) developed PEP. VAT was significantly higher in the severe than mild group (132.7 vs. 80.1 cm², <i>p</i> &lt; 0.01). VAT &gt; 95 cm² was the only independent risk factor for severe PEP (OR 2.79, <i>p</i> = 0.04).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>VAT may be associated with severe PEP. ERCP should be performed with awareness of the increased risk of severe PEP in patients with high visceral adiposity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"33 10","pages":"795-803"},"PeriodicalIF":2.5,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhbp.70158","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578994","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}

{"title":"Clinical Impact of Early Positive Drain Culture on Outcomes and Management After Pancreaticoduodenectomy","authors":"Hayato Baba,&nbsp;Sho Kiritani,&nbsp;Brian Hayama,&nbsp;Kosuke Kobayashi,&nbsp;Atsushi Oba,&nbsp;Yoshihiro Ono,&nbsp;Takafumi Sato,&nbsp;Hiromichi Ito,&nbsp;Yosuke Inoue,&nbsp;Yu Takahashi","doi":"10.1002/jhbp.70143","DOIUrl":"10.1002/jhbp.70143","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Early drain fluid contamination after pancreaticoduodenectomy (PD) may predict postoperative complications. We investigated the significance of positive drain cultures on postoperative day 1 (POD1).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed 637 consecutive patients undergoing PD between 2020 and 2024. Patients were divided into POD1 drain culture–positive (PDC) and negative (NDC) groups to assess risk factors and outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>PDC was identified in 87 patients (14%). In 73% of PDC cases, organisms isolated from POD1 drain cultures matched those from intraoperative bile cultures. Multivariate analysis identified high BMI, biliary tract cancer, soft pancreas, and preoperative biliary drainage as independent risk factors for PDC. Compared with the NDC group, the PDC group had higher rates of Clavien-Dindo grade ≥ IIIa complications (40% vs. 15%), clinically relevant postoperative pancreatic fistula (51% vs. 20%), and postpancreatectomy hemorrhage (9% vs. 3%), as well as longer hospital stay (26 vs. 20 days) (all <i>p</i> &lt; 0.01). Even among patients with a hard pancreas, PDC was associated with increased major complications (41% vs. 12%, <i>p</i> = 0.004). Among PDC patients, early administration of susceptible antibiotics by POD3 was associated with fewer major complications (25% vs. 62%, <i>p</i> = 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Positive POD1 drain cultures predict major complications after PD. Early culture-guided antibiotic therapy may reduce postoperative morbidity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"33 10","pages":"769-778"},"PeriodicalIF":2.5,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148283904","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":"Reply to the Letter","authors":"Junichi Shindoh","doi":"10.1002/jhbp.70144","DOIUrl":"10.1002/jhbp.70144","url":null,"abstract":"","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"33 10","pages":"e92-e93"},"PeriodicalIF":2.5,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148283971","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":"Novel Use of a Superslim Percutaneous Cholangioscope With Irrigation for Intrahepatic Stone Removal in the Right Posterior Segment.","authors":"Tomohiro Kaketani, Kazumasa Nagai, Noriyuki Hirakawa, Ryosuke Tonozuka, Shuntaro Mukai, Takao Itoi","doi":"10.1002/jhbp.70200","DOIUrl":"https://doi.org/10.1002/jhbp.70200","url":null,"abstract":"","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227994","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":"Re: Stump Ischemia Is a Possible Risk Factor for Late-Onset Pancreatic Fistula After Distal Pancreatectomy.","authors":"Gharbi Lassad","doi":"10.1002/jhbp.70205","DOIUrl":"https://doi.org/10.1002/jhbp.70205","url":null,"abstract":"","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224270","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":"Reply to the Letter to the Editor Regarding \"Independent Prognostic Value of Natural Tooth Count Versus Posterior Teeth Occlusion in Resected Pancreatic Cancer\".","authors":"Kenichiro Uemura, Kaoru Seo","doi":"10.1002/jhbp.70202","DOIUrl":"https://doi.org/10.1002/jhbp.70202","url":null,"abstract":"","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194741","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":"Reply to the Letter to the Editor Regarding \"Re: Stump Ischemia Is a Possible Risk Factor for Late-Onset Pancreatic Fistula After Distal Pancreatectomy\".","authors":"Shigeaki Kurihara, Takeaki Ishizawa","doi":"10.1002/jhbp.70203","DOIUrl":"https://doi.org/10.1002/jhbp.70203","url":null,"abstract":"","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182469","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 Extrahepatic Bile Duct Resection as a Parenchyma-Preserving Alternative in Bismuth I-II Perihilar Cholangiocarcinoma: A Comparative Single-Center Analysis.","authors":"Eriselda Keshi, Simon Moosburner, Florian Siemund, Nils Haep, Thomas Malinka, Uli Fehrenbach, Wenzel Schöning, Johann Pratschke, Felix Krenzien","doi":"10.1002/jhbp.70198","DOIUrl":"https://doi.org/10.1002/jhbp.70198","url":null,"abstract":"<p><strong>Introduction: </strong>Perihilar cholangiocarcinoma (pCCA) is an aggressive biliary malignancy usually requiring major hepatectomy, which carries substantial morbidity and mortality. In selected patients with Bismuth-Corlette Type I-II tumors, isolated extrahepatic bile duct resection (EH) may represent a parenchyma-preserving alternative. However, comparative outcome data remain limited. This study evaluated perioperative and long-term outcomes following EH and major hepatectomy (MH).</p><p><strong>Methods: </strong>Of 305 consecutive patients undergoing surgery for perihilar cholangiocarcinoma between 2010 and 2024, 49 with the uncommon Bismuth-Corlette Type I-II disease met the inclusion criteria and underwent either major hepatectomy (n = 26) or extrahepatic bile duct resection (n = 23) with lymphadenectomy. Surgical selection was based on liver function, comorbidities, and tumor extent. Perioperative outcomes and overall survival were compared.</p><p><strong>Results: </strong>EH patients were older (p = 0.01) and had more hepatic comorbidities (21.7% vs. 0%, p = 0.010). MH was associated with more severe complications (p = 0.013). R0 resection rates were similar (p = 0.88). One-, three-, and five-year overall survival did not differ significantly (EH: 82%, 47%, 24%; MH: 72%, 47%, 27%; p = 0.472).</p><p><strong>Conclusion: </strong>MH remains the standard treatment for medically fit patients with pCCA. In carefully selected, high-risk patients with anatomically limited Bismuth-Corlette Type I-II tumors, isolated EH may provide lower perioperative morbidity while achieving acceptable long-term outcomes.</p>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166249","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 Impact of the C-Reactive Protein-Albumin-Lymphocyte (CALLY) Index in Patients With Hepatocellular Carcinoma Undergoing Living Donor Liver Transplantation.","authors":"Junya Mita, Shinji Itoh, Takeo Toshima, Shohei Yoshiya, Takashi Motomura, Kyohei Yugawa, Norifumi Iseda, Tomoharu Yoshizumi","doi":"10.1002/jhbp.70207","DOIUrl":"https://doi.org/10.1002/jhbp.70207","url":null,"abstract":"<p><strong>Background: </strong>The C-reactive protein-albumin-lymphocyte (CALLY) index reflects systemic inflammation, nutritional status, and immune competence. However, its prognostic significance in patients undergoing living donor liver transplantation (LDLT) for hepatocellular carcinoma (HCC) remains unclear.</p><p><strong>Methods: </strong>We retrospectively analyzed 239 patients with HCC who underwent LDLT. Prognostic performance, clinicopathological associations, and post-transplant outcomes were evaluated using Cox regression, competing-risk analysis, and internal validation.</p><p><strong>Results: </strong>The 5-year area under the curve for the CALLY index was 0.65 (95% confidence interval [CI], 0.53-0.77). Low CALLY was associated with worse overall survival (p = 0.0134) and higher 1-year mortality (12.7% vs. 4.0%, p = 0.0153). In multivariable analysis, low CALLY was associated with higher mortality (hazard ratio, 2.17; 95% CI, 1.20-3.93; p = 0.0099). Adding CALLY to the clinical model increased the apparent C-index from 0.513 to 0.612 (ΔC-index, 0.099; p = 0.042), although calibration was similar. CALLY was not associated with HCC recurrence, whereas elevated PIVKA-II was.</p><p><strong>Conclusion: </strong>Low CALLY was associated with higher mortality after LDLT for HCC and appears to reflect recipient condition rather than recurrence risk. It may be useful for preoperative risk assessment.</p>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167265","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":"Letter to the Editor. Re: Independent Prognostic Value of Natural Tooth Count Versus Posterior Teeth Occlusion in Resected Pancreatic Cancer: Methodological Concerns.","authors":"Gharbi Lassad","doi":"10.1002/jhbp.70204","DOIUrl":"https://doi.org/10.1002/jhbp.70204","url":null,"abstract":"","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166831","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}