Journal of Hepato‐Biliary‐Pancreatic Sciences最新文献

{"title":"Reply to the Letter by Rani Kassir et al.","authors":"Ryuji Okubo, Masaki Nio","doi":"10.1002/jhbp.70132","DOIUrl":"10.1002/jhbp.70132","url":null,"abstract":"","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"33 9","pages":"e77-e78"},"PeriodicalIF":2.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147982139","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":"Gastroduodenal Fistula Following Endoscopic Ultrasound-Guided Gallbladder Drainage Using a Double-Pigtail Plastic Stent","authors":"Tatsuki Hirai,&nbsp;Tsuyoshi Takeda,&nbsp;Takashi Sasaki","doi":"10.1002/jhbp.70147","DOIUrl":"10.1002/jhbp.70147","url":null,"abstract":"<p>Hirai and colleagues reported delayed gastroduodenal fistula formation 6 months after EUS-guided gallbladder drainage with a double-pigtail plastic stent. Persistent stent pressure from gallbladder contraction may cause bowel injury even with double-pigtail stents. Careful stent selection and positioning, together with regular imaging follow-up, may reduce injury and detect delayed complications.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"33 9","pages":"e73-e74"},"PeriodicalIF":2.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301974","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":"Postoperative Steroids in Biliary Atresia: Are Current Recommendations Evidence-Based?","authors":"Rani Kassir,&nbsp;Rémi Dubois,&nbsp;Guillaume Rossignol","doi":"10.1002/jhbp.70131","DOIUrl":"10.1002/jhbp.70131","url":null,"abstract":"","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"33 9","pages":"e75-e76"},"PeriodicalIF":2.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147941551","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":"Middle Pancreatectomy for Low-Grade Malignancies: Superior Long-Term Glucose Tolerance Preservation Over Distal Pancreatectomy","authors":"Atsuro Fujinaga,&nbsp;Minoru Esaki,&nbsp;Kei Kitamura,&nbsp;Ryosuke Umino,&nbsp;Takahiro Mizui,&nbsp;Akinori Miyata,&nbsp;Satoshi Nara","doi":"10.1002/jhbp.70121","DOIUrl":"10.1002/jhbp.70121","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study compared outcomes of middle pancreatectomy (MP) and distal pancreatectomy (DP), focusing on long-term glucose tolerance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed 282 patients who underwent MP (<i>n</i> = 69) or DP (<i>n</i> = 213) for low-grade malignant tumors from 2000 to 2020. Surgical outcomes, HbA1c levels, prevalence of diabetes mellitus (DM), and escalation of antidiabetic medication were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>MP was associated with longer operation time (312 vs. 245 min, <i>p</i> &lt; 0.001) and higher pancreatic fistula rate (64% vs. 47%, <i>p</i> = 0.018). Among 248 patients with 3-year follow-up, MP showed lower HbA1c levels (5.9% vs. 6.3%, <i>p</i> &lt; 0.001), lower incidence of new-onset DM (3% vs. 30%, <i>p</i> &lt; 0.001), and fewer cases of increased antidiabetic medication use (8% vs. 24%, <i>p</i> = 0.005). Insulin therapy was newly required in 1 MP case versus 18 DP cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite higher morbidity, MP demonstrated superior preservation of long-term glucose tolerance compared with DP. These findings suggest that MP is a valuable parenchyma-preserving option for patients with low-grade malignant pancreatic tumors, particularly those at increased risk of postoperative DM, although careful consideration of surgical risks is required.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"33 9","pages":"712-719"},"PeriodicalIF":2.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773595","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":"Comparison of Nanoliposomal Irinotecan Plus Fluorouracil/Leucovorin and S-1, Irinotecan, and Oxaliplatin as Second-Line Chemotherapy After Gemcitabine Plus Nab-Paclitaxel for Unresectable Pancreatic Cancer","authors":"Masahiro Itonaga,&nbsp;Reiko Ashida,&nbsp;Takashi Tamura,&nbsp;Yasunobu Yamashita,&nbsp;Yuki Kawaji,&nbsp;Takahiro Shishimoto,&nbsp;Hiromu Morishita,&nbsp;Keisuke Hanada,&nbsp;Fumiyoshi Kojima,&nbsp;Masayuki Kitano","doi":"10.1002/jhbp.70122","DOIUrl":"10.1002/jhbp.70122","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The optimal second-line chemotherapy after gemcitabine plus nab-paclitaxel (GnP) for unresectable pancreatic cancer (PC) remains unclear. This study compared the efficacy and safety of nanoliposomal irinotecan plus fluorouracil/leucovorin (NFF) and S-1, irinotecan, and oxaliplatin (S-IROX) after GnP failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center retrospective cohort study included patients with unresectable PC refractory to GnP who received NFF or S-IROX between July 2020 and June 2024. Progression-free survival (PFS), overall survival (OS), tumor response, and adverse events were evaluated. Prognostic factors were also assessed with subgroup analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy-nine patients were analyzed (NFF, <i>n</i> = 55; S-IROX, <i>n</i> = 24). Median PFS was significantly longer with S-IROX than with NFF (6.29 vs. 3.45 months; <i>p</i> = 0.048), and the overall response rate was higher (29% vs. 9%; <i>p</i> = 0.038). Median OS did not differ significantly (12.81 vs. 10.64 months; <i>p</i> = 0.170). The incidence of grade ≥ 3 adverse events was comparable. Multivariate analysis identified S-IROX, modified Glasgow Prognostic Score (mGPS) 0, and CA19-9 &lt; 373 IU/L as independent predictors of longer PFS, while mGPS 0 and CA19-9 &lt; 373 IU/L were associated with longer OS. Subgroup analyses showed favorable outcomes with S-IROX in locally advanced disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>S-IROX may be an effective and safe second-line option after GnP, particularly for locally advanced PC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"33 9","pages":"701-711"},"PeriodicalIF":2.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773580","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: Clinical and Radiological Predictive Features for High-Grade and Invasive Carcinoma in Intraductal Papillary Mucinous Neoplasms: A Systematic Review","authors":"Camila Hidalgo Salinas,&nbsp;Joseph R. Habib","doi":"10.1002/jhbp.70133","DOIUrl":"10.1002/jhbp.70133","url":null,"abstract":"","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"33 9","pages":"e81-e82"},"PeriodicalIF":2.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148016113","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":"Feasibility of Surgical Resection for Advanced Gallbladder Carcinoma Based on Preoperative Clinical T Stagings: A Multicenter Retrospective Analysis (SNOW-22-05)","authors":"Asayo Kato,&nbsp;Takashi Mizuno,&nbsp;Teiichi Sugiura,&nbsp;Hiromichi Ito,&nbsp;Yoji Kishi,&nbsp;Takehiro Noji,&nbsp;Yuta Abe,&nbsp;Shimpei Otsuka,&nbsp;Kimitaka Tanaka,&nbsp;Yu Takahashi,&nbsp;Masayuki Tanaka,&nbsp;Tomoki Ebata,&nbsp;Satoshi Hirano","doi":"10.1002/jhbp.70149","DOIUrl":"10.1002/jhbp.70149","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Purpose</h3>\u0000 \u0000 <p>Surgical resection remains the only potentially curative treatment for advanced gallbladder cancer (GBC). However, preoperative diagnosis and staging are often challenging, and the indication for extended resection remains controversial. This study evaluated the feasibility of upfront resection for advanced GBC based on clinical T (cT) staging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients radiologically diagnosed with cT3 or cT4 GBC at six Japanese centers between 2010 and 2022 were retrospectively analyzed. Resection rate, benign lesions, perioperative outcomes, and overall survival (OS) were compared between the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 300 patients (cT3, <i>n</i> = 182; cT4, <i>n</i> = 118), 260 (87%) underwent resection. Benign lesions were identified in 21 (8%) patients. Compared with cT3, cT4 tumors had higher rates of extended resection (75% vs. 40%, <i>p</i> &lt; 0.001), exploratory laparotomy (24% vs. 7%, <i>p</i> &lt; 0.001), and postoperative complications (59% vs. 29%, <i>p</i> &lt; 0.001). Postoperative mortality tended to be higher in cT4 patients (7% vs. 3%, <i>p</i> = 0.197), and median OS was significantly shorter (22 vs. 44 months, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Clinical T staging helps guide treatment planning for advanced GBC. Upfront resection is feasible for cT3 GBC, whereas cT4 disease is associated with extensive surgery and poor outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"33 9","pages":"690-700"},"PeriodicalIF":2.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391009","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":"Utility of the Iwate Difficulty Scoring System for the Stratification of Laparoscopic Right Hepatectomies: An International Multicenter Study","authors":"Motokazu Sugimoto,&nbsp;Yun Zhao,&nbsp;Naoto Gotohda,&nbsp;Hwee-Leong Tan,&nbsp;Ye-Xin Koh,&nbsp;Davit L. Aghayan,&nbsp;Cheng Yao,&nbsp;Takeashi Ishizawa,&nbsp;Francesca Ratti,&nbsp;Wanguang Zhang,&nbsp;Olivier Scatton,&nbsp;Fabricio Ferreira Coelho,&nbsp;Safi Dokmak,&nbsp;Vincenzo Mazzaferro,&nbsp;Adrian K. H. Chiow,&nbsp;Iswanto Sucandy,&nbsp;Arpad Ivanecz,&nbsp;Sung-Hoon Choi,&nbsp;Jae Hoon Lee,&nbsp;Mikel Prieto,&nbsp;Marco Vivarelli,&nbsp;Felice Giuliante,&nbsp;Andrea Ruzzenente,&nbsp;Chee-Chien Yong,&nbsp;Mengqiu Yin,&nbsp;Constantino Fondevila,&nbsp;Mikhail Efanov,&nbsp;Zenichi Morise,&nbsp;Fabrizio Di Benedetto,&nbsp;Raffaele Brustia,&nbsp;Raffaele Dalla Valle,&nbsp;Ugo Boggi,&nbsp;David Geller,&nbsp;Andrea Belli,&nbsp;Riccardo Memeo,&nbsp;Kiyoshi Hasegawa,&nbsp;Roland S. Croner,&nbsp;Salvatore Gruttadauria,&nbsp;Jason Hawksworth,&nbsp;James O. Park,&nbsp;Fernando Rotellar,&nbsp;Gi-Hong Choi,&nbsp;Ricardo Robles-Campos,&nbsp;Xiaoying Wang,&nbsp;Robert P. Sutcliffe,&nbsp;Johann Pratschke,&nbsp;Chung-Ngai Tang,&nbsp;Charing C. N. Chong,&nbsp;Mathieu D'Hondt,&nbsp;Kazuteru Monden,&nbsp;Santiago Lopez-Ben,&nbsp;T. Peter Kingham,&nbsp;Alessandro Ferrero,&nbsp;Giuseppe Maria Ettorre,&nbsp;Daniel Cherqui,&nbsp;Xiao Liang,&nbsp;Rutger-Jan Swijnenburg,&nbsp;Go Wakabayashi,&nbsp;Roberto I. Troisi,&nbsp;Tan-To Cheung,&nbsp;Atsushi Sugioka,&nbsp;Masaki Ueno,&nbsp;Gaetan-Romain Joliat,&nbsp;Moritz Schmelzle,&nbsp;Etsuro Hatano,&nbsp;Alejandro Mejia,&nbsp;Marco V. Marino,&nbsp;Umberto Cillo,&nbsp;Chengzhan Zhu,&nbsp;Zha Yong,&nbsp;Guillaume Millet,&nbsp;Guido Torzilli,&nbsp;Decai Yu,&nbsp;Tran Cong Duy Long,&nbsp;Yufu Peng,&nbsp;Yonggang Wei,&nbsp;Rong Liu,&nbsp;Ho-Seong Han,&nbsp;Olivier Soubrane,&nbsp;David Fuks,&nbsp;Kuo-Hsin Chen,&nbsp;Mohammad Abu Hilal,&nbsp;Luca Aldrighetti,&nbsp;Bjørn Edwin,&nbsp;Brian K. P. Goh,&nbsp;International Robotic and Laparoscopic Liver Resection Study Group Investigators","doi":"10.1002/jhbp.70127","DOIUrl":"10.1002/jhbp.70127","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Laparoscopic right hepatectomy (L-RH) is a technically complex procedure, characterized by diverse tumor presentations and anatomical variations. While the Iwate Difficulty Scoring System (I-DSS) is widely utilized to assess technical difficulty in laparoscopic liver resections, its predictive value for surgical outcomes in L-RH remains unclear. This study aimed to evaluate the clinical utility of the I-DSS specifically in the context of L-RH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This international, multicenter study included 1732 patients who underwent L-RH at 78 centers between 2005 and 2023. Baseline clinicopathological characteristics and surgical outcomes were collected and analyzed based on I-DSS grades. Multivariable analyses were performed to adjust for potential confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients were categorized into three I-DSS grades: intermediate (<i>n</i> = 13), advanced (<i>n</i> = 355), and expert (<i>n</i> = 1364). Unadjusted analysis showed that higher I-DSS grades were associated with shorter operation time and increased morbidity. However, after adjustment for baseline factors, no significant differences were observed across I-DSS grades in terms of intra- and postoperative outcomes, including operation time, blood loss, transfusion, morbidity, mortality, and surgical margin positivity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The I-DSS has limited ability to stratify technical difficulty in L-RH. Future studies should be undertaken to develop a new difficulty classification system tailored specifically to specific procedures such as L-RH.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"33 9","pages":"670-679"},"PeriodicalIF":2.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147930438","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":"Pathophysiology Underlying Manifestation of Pancreaticobiliary Maljunction Throughout Life","authors":"Kenitiro Kaneko,&nbsp;Yasuyuki Fukami,&nbsp;Shoko Kato,&nbsp;Kentaro Shinohara,&nbsp;Takaaki Osawa,&nbsp;Tsuyoshi Sano","doi":"10.1002/jhbp.70110","DOIUrl":"10.1002/jhbp.70110","url":null,"abstract":"<div>\u0000 \u0000 <p>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.</p>\u0000 </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"33 9","pages":"661-669"},"PeriodicalIF":2.5,"publicationDate":"2026-09-22","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}

{"title":"Independent Prognostic Value of Natural Tooth Count Versus Posterior Teeth Occlusion in Resected Pancreatic Cancer","authors":"Kaoru Seo,&nbsp;Kenichiro Uemura,&nbsp;Kenjiro Okada,&nbsp;Hiromi Nishi,&nbsp;Tatsuaki Sumiyoshi,&nbsp;Ryuta Shintakuya,&nbsp;Yoshiaki Murakami,&nbsp;Hiroyuki Kawaguchi,&nbsp;Shinya Takahashi","doi":"10.1002/jhbp.70113","DOIUrl":"10.1002/jhbp.70113","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Purpose</h3>\u0000 \u0000 <p>Prognostic significance of preoperative patient-related factors, including oral health status, in pancreatic ductal adenocarcinoma (PDAC) remains unclear. We evaluated the association between preoperative factors—particularly oral health parameters—and long-term survival after curative PDAC resection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients who underwent radical pancreatectomy for PDAC (2014–2022) were retrospectively analyzed. Preoperative factors, including oral health status (natural tooth count and posterior teeth occlusion), clinical characteristics, and immuno-nutritional markers, were assessed for their association with overall survival (OS). Multivariate models adjusted for established pathological and treatment-related prognostic variables were further analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 343 eligible patients, 339 underwent preoperative dental examinations; 135 had ≤ 20 teeth and 204 had ≥ 21 teeth. Patients with ≤ 20 teeth had significantly poorer OS (median survival: 39.1 vs. 60.7 months, <i>p</i> &lt; 0.001). Posterior teeth occlusion was not associated with OS. In multivariate analysis of preoperative factors, natural tooth count was independently associated with OS (<i>p</i> = 0.003). This association remained significant after adjustment for established prognostic variables (<i>p =</i> 0.016), whereas other immuno-nutritional markers did not emerge as independent prognostic factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Post-PDAC resection, natural tooth count, but not posterior teeth occlusion, is independently associated with OS. Tooth count may reflect long-term host vulnerability and serve as a prognostic marker in PDAC patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"33 9","pages":"720-729"},"PeriodicalIF":2.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhbp.70113","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773633","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}