Journal of Hepato‐Biliary‐Pancreatic Sciences最新文献

{"title":"A questionnaire survey to explore the current treatment policies adopted for patients with advanced hepatocellular carcinoma at board-certified HPB training institutions in Japan: A JSHBPS project study 2023, Part 1","authors":"Junichi Shindoh,&nbsp;Masaru Matsumura,&nbsp;Satoshi Okubo,&nbsp;Takuma Okada,&nbsp;Masaji Hashimoto,&nbsp;Masafumi Nakamura,&nbsp;Masayuki Ohtsuka","doi":"10.1002/jhbp.12139","DOIUrl":"10.1002/jhbp.12139","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To clarify the views of expert hepatobiliary surgeons on the management of advanced hepatocellular carcinoma (HCC) in real-world clinical practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A questionnaire survey was conducted of Japanese board-certified HPB training centers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 100 centers responded to the survey. For solitary large (&gt;10 cm) lesions, 77% of the respondents selected upfront surgery, while an increasing number of respondents selected combined therapy with atezolizumab + bevacizumab as the treatment of first choice as the number of lesions increased. In regard to the treatment of patients with vascular invasion, the proportion of respondents who selected systemic therapy with the intent to “potential conversion” surgery increased according to the extent of tumor thrombosis, while only a limited number of respondents excluded these groups of patients from potential surgical indications. As for the initial treatment for extrahepatic spread, consideration of systemic conversion therapy was the most commonly selected option, while upfront surgery was frequently selected for right adrenal metastasis (50%) and solitary hilar node involvement (35%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The present survey clarified the current clinical approaches for the treatment of advanced HCC at HPB training centers. Future analysis, including survival outcomes, would offer important insights into the optimal management of advanced HCC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"32 5","pages":"360-373"},"PeriodicalIF":3.2,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649138","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-intervention for malignant hilar biliary obstruction after metallic stent placement using a novel flexible tapered endoscopic sheath cannula","authors":"Kazuya Koizumi,&nbsp;Karen Kimura,&nbsp;Jun Kubota","doi":"10.1002/jhbp.12132","DOIUrl":"10.1002/jhbp.12132","url":null,"abstract":"<p>In this case video, Koizumi and colleagues demonstrate how a flexible tapered endoscopic sheath cannula facilitates re-intervention for malignant hilar biliary obstruction after placement of multiple metallic stents. By deforming within prior stents, the sheath enables smoother passage and successful stent placement, providing a potential solution for difficult cases.\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":"32 6","pages":"e24-e25"},"PeriodicalIF":3.2,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649166","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":"Annual report of Japanese biliary tract cancer registry from 2021: Focus on the rate of R0 resection, postoperative complications, and site of lymph node metastasis","authors":"Hiroyuki Kato,&nbsp;Akihiko Horiguchi,&nbsp;Takao Ohtsuka,&nbsp;Atsushi Nanashima,&nbsp;Michiaki Unno,&nbsp;Toshifumi Wakai,&nbsp;Fumihiko Miura,&nbsp;Hiroyuki Isayama,&nbsp;Yoshiki Hirooka,&nbsp;Taku Aoki,&nbsp;Hiroyuki Yamamoto,&nbsp;Ichiro Yasuda,&nbsp;Itaru Endo","doi":"10.1002/jhbp.12129","DOIUrl":"10.1002/jhbp.12129","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aimed to clarify the current treatment status for biliary tract cancers based on data from the National Clinical Database (NCD) in Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Total 3895 cases of biliary tract cancers registered in the NCD during 2021 were included. We identified the rates of resection, R0 resection, postoperative complications, and incidences of lymph node metastasis for gallbladder carcinoma, perihilar cholangiocarcinoma, distal bile duct carcinoma, and ampullary carcinoma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The number of biliary tract cancers registered in the NCD during 2021 was 3895 (1775 in extrahepatic bile duct carcinoma, 1422 in gallbladder carcinoma, and 698 in ampullary carcinoma). In gallbladder carcinoma, the resection (89.59%) and R0 resection rates (87.99%) were favorable, and the complication rate (6.05%) was lower than that of others. However, the postoperative complication rate could be higher in T3–T4 cases and when extrahepatic bile duct resection was performed concomitantly. Lymph node metastasis was frequently seen in 12.60% at the No. 13a lymph node. In perihilar cholangiocarcinoma, the R0 resection (69.82%) and complication rates (16.75%) were significantly lower and higher, respectively. In distal cholangiocarcinoma and ampullary carcinoma, metastasis was observed in approximately 2% and 10% of the dissected No. 16b1 para-aortic lymph nodes, respectively. In conclusion, although short-term surgical outcomes for biliary tract cancers in Japan might be acceptable, the significantly lower R0 resection and higher complication rates of perihilar cholangiocarcinomas indicate additional challenges for surgeons in the future and should continue to be monitored by the Japanese Society of Hepatobiliary and Pancreatic Surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"32 5","pages":"339-349"},"PeriodicalIF":3.2,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649141","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":"Robotic distal pancreatectomy using a novel surgical robot platform “hinotori™” (with video)","authors":"Takao Ide,&nbsp;Noriyuki Egawa,&nbsp;Kotaro Ito,&nbsp;Tomokazu Tanaka,&nbsp;Hirokazu Noshiro","doi":"10.1002/jhbp.12137","DOIUrl":"10.1002/jhbp.12137","url":null,"abstract":"<p>With accompanying video, Ide and colleagues report their first clinical experience using the new Japanese surgical robot hinotori™ for robotic distal pancreatectomy, with favorable short-term surgical results. Their findings suggest that the hinotori™ surgical robot provides a feasible and reproducible surgical procedure for safe and effective robotic distal pancreatectomy.\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":"32 6","pages":"415-417"},"PeriodicalIF":3.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhbp.12137","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615566","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":"Letter to the editor for “A retrospective comparative study of percutaneous transhepatic gallbladder drainage versus endoscopic gallbladder stenting on the clinical course of acute cholecystitis: A propensity score matching analysis using a Nationwide inpatient database in Japan”","authors":"Amogh Verma,&nbsp;Shubham Kumar,&nbsp;Ranjana Sah","doi":"10.1002/jhbp.12131","DOIUrl":"10.1002/jhbp.12131","url":null,"abstract":"","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"32 5","pages":"e20-e21"},"PeriodicalIF":3.2,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586035","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 method to prevent severe postoperative pancreatic fistula caused by lipolysis","authors":"Naoto Nakamura,&nbsp;Kazuyuki Nagai,&nbsp;Akihiro Kaneda,&nbsp;Akitada Yogo,&nbsp;Yosuke Kasai,&nbsp;Takayuki Anazawa,&nbsp;Yuichiro Uchida,&nbsp;Toshihiko Masui,&nbsp;Yasuhiko Tabata,&nbsp;Etsuro Hatano","doi":"10.1002/jhbp.12128","DOIUrl":"10.1002/jhbp.12128","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although several prophylactic strategies have been developed for postoperative pancreatic fistula (POPF), research on its severe form is few. Recently, it has been reported that severe POPF can be caused by intraabdominal lipolysis. This study aimed to establish a rat model of severe POPF by combining pancreatic juice leakage and lipolysis and to develop a prophylactic strategy for POPF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Sprague–Dawley rats were subjected to pancreatic transection to induce pancreatic juice leakage (PT group). Autologous fat tissue was thermally treated to prepare a fat solution, which was intraperitoneally administered to the rats in the PT group (PT + F group). A water-solubilized lipase inhibitor (cetilistat) was administered intraperitoneally to the rats in the PT + F group. A polyethylene glycol-based hydrogel (PEG-HG) formulation of water-solubilized cetilistat was equally administered. Ascitic and serum biochemical tests, including free fatty acids (FFA) levels, macroscopic or microscopic examinations, and survival analyses, were performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the PT + F group, significantly elevated ascitic and serum FFA levels and serum inflammatory cytokine levels were observed 24 h postoperatively (<i>p</i> &lt; .001), and the survival rate was significantly exacerbated (<i>p</i> &lt; .0001). Intraperitoneal administration of water-solubilized cetilistat resulted in reduced inflammation and improved outcomes. Although PEG hydrogel itself did not improve blood parameters or survival outcomes, the incorporation of water-solubilized cetilistat into the PEG-HG enabled similar improvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Intraperitoneal administration of water-solubilized cetilistat prevented severe inflammation and multiple failures associated with severe POPF. The incorporation of water-solubilized cetilistat into the PEG-HG is a promising delivery system for clinical application.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"32 6","pages":"476-486"},"PeriodicalIF":3.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557066","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":"Integrated gross and microanatomical analysis of the periportal lymphatic system in human liver","authors":"Yuto Mitsuhashi,&nbsp;Hiroshi Shimoda,&nbsp;Kotaro Umemura,&nbsp;Takuji Kagiya,&nbsp;Kentaro Sato,&nbsp;Hirokazu Narita,&nbsp;Tomohiro Chiba,&nbsp;Keinosuke Ishido,&nbsp;Norihisa Kimura,&nbsp;Kenichi Hakamada","doi":"10.1002/jhbp.12127","DOIUrl":"10.1002/jhbp.12127","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although animal studies have indicated that the periportal lymphatic system is an important intrahepatic lymphatic route, detailed human studies are scarce. We studied the lymphatic pathways and dynamics around Glisson's capsule in human livers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed whole-mount immunostaining for the liver using podoplanin and CD-31 to elucidate the lymphatic vessel distribution around the hepatic triad (HT). Next, 5 mL of India ink was injected into the liver parenchyma to observe the lymph fluid dynamics around Glisson's capsule. Lastly, immunohistochemical staining for CCL21, a chemokine important for lymphocyte migration, and its receptor CCR7 was performed to observe the lymphocyte dynamics within Glisson's capsule.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Lymphatic vessels with blind-ended structures were observed around the peripheral HT. These vessels ran longitudinally, forming a network with numerous blind ends around HT. Ink distribution was observed within gaps and capillary lymphatic vessels in Glisson's capsule. These gaps were CCL21-positive, and a concentration gradient was observed toward the capillary lymphatic vessels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The intrahepatic lymphatic fluid enters the capillary lymphatic vessels via the extravascular pathway, and lymphocyte components enter the capillary lymphatic vessels through the CCR7/CCL21 transport system in the extravascular pathway. This is the first study to elucidate the human intrahepatic periportal lymphatic system.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"32 6","pages":"418-428"},"PeriodicalIF":3.2,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhbp.12127","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557065","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":"Mortality and cardiovascular disease after cholecystectomy in type 2 diabetes: A nationwide longitudinal cohort study","authors":"Han Na Jung,&nbsp;Ji Hye Heo,&nbsp;Eun Roh,&nbsp;Kyung-Do Han,&nbsp;Jun Goo Kang,&nbsp;Seong Jin Lee,&nbsp;Sung-Hee Ihm","doi":"10.1002/jhbp.12109","DOIUrl":"10.1002/jhbp.12109","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The long-term effects of cholecystectomy on mortality and cardiovascular disease (CVD) in patients with diabetes have not been evaluated. In the present study, we investigated the longitudinal effects of cholecystectomy on mortality and CVD in a population-based cohort with type 2 diabetes (T2D).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In total, 2 216 930 national health examination participants with T2D, including 19 258 patients with cholecystectomy, were followed up for a median of 7.9 years. The adjusted hazard ratios (aHRs) were calculated for all-cause mortality and CVD (myocardial infarction or ischemic stroke) in the cholecystectomy group compared with the nonoperative controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cholecystectomy group had a significantly higher risk of mortality than controls (aHR 1.10, 95% confidence interval [CI]: 1.06–1.14), which was more pronounced in younger participants (aHR 1.67 [1.38–2.03], 1.22 [1.13–1.31], and 1.05 [1.00–1.10] for those aged &lt;50, 50–64, and ≥65 years) and participants with less advanced diabetes treatment. The risk of CVD was increased with cholecystectomy only in those aged &lt;50 years (aHR 1.24 [1.01–1.52]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Cholecystectomy in patients with T2D is associated with an increased risk of all-cause mortality, particularly in younger patients without diabetes medication. Only patients aged &lt;50 years have a higher risk of developing CVD after cholecystectomy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"32 7","pages":"514-523"},"PeriodicalIF":3.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhbp.12109","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541827","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":"Metabolic response during preoperative chemotherapy can predict prognosis in pancreatic cancer","authors":"Won-Gun Yun,&nbsp;Tae Young Kim,&nbsp;Seulah Park,&nbsp;Youngmin Han,&nbsp;Go-Won Choi,&nbsp;Hye-Sol Jung,&nbsp;Wooil Kwon,&nbsp;Joon Seong Park,&nbsp;Gi Jeong Cheon,&nbsp;Jin-Young Jang","doi":"10.1002/jhbp.12122","DOIUrl":"10.1002/jhbp.12122","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>With the evolving treatment paradigms for pancreatic cancer, there is an increasing need for reliable markers to evaluate the effectiveness of preoperative chemotherapy. Due to the limitations of current indicators, this study aimed to evaluate the prognostic value of metabolic response based on the changes in the maximum standardized uptake value (SUV_max) on fluorine-18-fluorodeoxyglucose positron emission tomography.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 210 patients with pancreatic cancer who underwent post-chemotherapy curative surgery between 2013 and 2022. Using maximally selected rank statistics for survival, the metabolic response was defined as follows: metabolic responder (%ΔSUV_max &gt;75%), metabolic stable disease (15%–75%), and metabolic non-responder (≤15%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among patients, 15.7%, 66.7%, and 11.6% were categorized into the metabolic responder, metabolic stable disease, and metabolic non-responder groups. The metabolic responder group (83.0 months) had longer median overall survival than the metabolic stable disease (51.0 months, <i>p</i> = .013) and metabolic non-responder (32.0 months, <i>p</i> = .002) groups. In addition, being metabolic responders (vs. non-responders) was an independent predictor of low recurrence rates (hazard ratio [95% confidence interval]: 0.46 [0.23–0.91]; <i>p</i> = .026) and achieving pathologic complete response (odds ratio [95% confidence interval]: 13.39 [1.61–300.77]; <i>p</i> = .035).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Metabolic response during preoperative chemotherapy has predictive power for post-resection prognosis and residual tumor status.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"32 5","pages":"393-403"},"PeriodicalIF":3.2,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523264","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 clinical scoring systems for large-duct primary sclerosing cholangitis in Japanese patients","authors":"Koji Takahashi,&nbsp;Ryosuke Horio,&nbsp;Hiroshi Ohyama,&nbsp;Motoyasu Kan,&nbsp;Mayu Ouchi,&nbsp;Hiroki Nagashima,&nbsp;Kohichiroh Okitsu,&nbsp;Izumi Ohno,&nbsp;Naoya Kato","doi":"10.1002/jhbp.12117","DOIUrl":"10.1002/jhbp.12117","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aimed to identify the significant factors associated with liver transplant-free survival time in Japanese patients with large-duct primary sclerosing cholangitis (PSC) by evaluating the association between various parameters and clinical scores at PSC diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center retrospective study investigated factors influencing liver transplant-free survival in Japanese large-duct PSC patients. Univariate analysis using log-rank tests identified significant clinical parameters and scoring systems, which were further analyzed with multivariate Cox proportional hazards models to determine independent predictors of liver transplant-free survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 77 patients with large-duct PSC were included. The univariate analysis identified that age (<i>p</i> &lt; .001), serum albumin level (<i>p</i> = .024), Child-Pugh score (<i>p</i> = .0012), albumin-bilirubin score (<i>p</i> = .0083), Amsterdam-Oxford PSC score (<i>p</i> &lt; .001), and revised Mayo risk score (<i>p</i> &lt; .001) were significant predictors of liver transplant-free survival time. However, the multivariate analysis revealed that only the Amsterdam-Oxford PSC score remained as an independent factor significantly associated with liver transplant-free survival time (hazard ratio: 12.90, 95% confidence interval: 2.78–59.81, <i>p</i> = .0011).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study underscored the importance of utilizing the Amsterdam-Oxford PSC score in clinical practice to assess disease prognosis and guide patient management in Japanese patients with large-duct PSC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"32 5","pages":"385-392"},"PeriodicalIF":3.2,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515571","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}