Hepatobiliary & Pancreatic Diseases International最新文献

{"title":"A rare case of emphysematous liver abscess.","authors":"Yi-Heng Jiang, Wei Yu, Lin-Yan Zeng, Lan-Juan Li","doi":"10.1016/j.hbpd.2026.04.005","DOIUrl":"https://doi.org/10.1016/j.hbpd.2026.04.005","url":null,"abstract":"","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789575","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":"Proximal splenic artery ligation improves liver reperfusion, mitigates graft injury and decreases complications after liver transplantation.","authors":"Zhao-Yi Wu, Neng-Sheng Fu, Yu-Jun Ji, Ying Tan, Di Jiang, Yu-Jun Zhang, Lei-Da Zhang, Cheng-Cheng Zhang","doi":"10.1016/j.hbpd.2026.04.004","DOIUrl":"https://doi.org/10.1016/j.hbpd.2026.04.004","url":null,"abstract":"<p><strong>Background: </strong>Graft restoration after liver transplantation (LT) critically depends on adequate hepatic arterial blood flow. Splenic artery ligation (SAL) demonstrates flow-enhancing effects, though its safety and efficacy require evaluation.</p><p><strong>Methods: </strong>A total of 294 LT recipients were stratified into LT without proximal SAL (non-SAL group, n = 262) and LT with proximal SAL (SAL group, n = 32) groups. A 30-minute warm ischemia rat LT model was established, with rats randomized into the control and SAL groups. Biological samples were collected from control and SAL groups on post-LT days 1, 3, and 7 (n = 5 per time point).</p><p><strong>Results: </strong>Splenic computed tomography scan showed 25% SAL recipients had splenic infarction volume > 20% in 1 month, with significantly reduced infarction in 6 months post-LT [post-LT 1 month splenic infarction volume 20%-50% group, 25.11% (1-month) vs. 0.017% (6-month), P < 0.001; post-LT 1 month splenic infarction volume > 50% group, 60.41% (1-month) vs. 24.38% (6-month), P = 0.018]. The SAL group demonstrated significantly smaller spleen size at both 1-month (785 cm³) and 6-month (651 cm³) versus pre-LT (1064 cm³, both P < 0.001) and decreased early allograft dysfunction (9.4% vs. 31.0%, P = 0.039) and non-anastomotic biliary stricture incidence (6.2% vs. 25.9%, P = 0.046) compared with the non-SAL group. Proximal SAL did not result in abscess formation or pancreatitis. Consistent with clinical observations, the rat SAL group developed splenic infarction without abscess formation. Ultrasound showed 1.21-fold higher hepatic arterial flow velocity in SAL group (525 vs. 433 mm/s, P < 0.001), with unchanged portal vein flow (147 vs. 142 mm/s, P = 0.664). Laser speckle imaging showed 67% higher hepatic arterial flow in the SAL group (1535 vs. 915 PU, P < 0.001). The SAL group manifested significant graft restoration and continuous biliary tree structures; histopathological analysis showed milder epithelial damage, reduced inflammation and proinflammatory cytokines, and diminished ductular reaction (all P < 0.05 compared with non-SAL group).</p><p><strong>Conclusions: </strong>Proximal SAL improved hepatic artery blood supply, ameliorated graft injury and decreased complications in LT.</p>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789761","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":"Exosomal hnRNPA2B1 suppresses irinotecan-induced ferroptosis in pancreatic cancer.","authors":"Xu-Lin Zhou, Wei Liu, Xiao-Chun Sun, Tian Li, Yong-Min Yan, Da-Wei Cui, Xiang Wang, Min Xu","doi":"10.1016/j.hbpd.2026.04.002","DOIUrl":"https://doi.org/10.1016/j.hbpd.2026.04.002","url":null,"abstract":"<p><strong>Background: </strong>Irinotecan is a commonly used chemotherapeutic drug for pancreatic cancer (PC), but its specific mechanism of inducing cell death is yet to be elucidated. Exosomes are key mediators of intercellular communication and are involved in tumorigenesis. This study aimed to investigate whether irinotecan-induced ferroptosis can inhibit PC progression, and to explore the mechanism of exosomes derived from PC cells reverse irinotecan-induced ferroptosis.</p><p><strong>Methods: </strong>Exosomes were isolated from cells via polymer precipitation method. CCK8 assay and colony formation assay were used to test the proliferation of PC cells. Wound-healing assay and Transwell migration assay were used to test the migration of PC cells. Ferroptosis in cells was detected by analysis of malondialdehyde, glutathione, Fe²⁺ and reactive oxygen species concentrations. Transmission electron microscopy was used to observe the morphology of intracellular mitochondria. Related proteins were detected by Western blot.</p><p><strong>Results: </strong>Irinotecan could inhibit the proliferation of PC cells, decrease the expression of the ferroptosis-negative regulators glutathione peroxidase 4 and cystine transporter solute carrier family 7 member 11, and increase the intracellular concentrations of Fe²⁺ and ferroptosis metabolites. However, exosomes derived from PC cells inhibit irinotecan-induced ferroptosis and diminish the anti-tumor effect, whereas this effect was significantly reduced following the knockdown of hnRNPA2B1.</p><p><strong>Conclusions: </strong>These findings indicated that exosomal hnRNPA2B1 could inhibit irinotecan-induced ferroptosis of PC, which strongly regulated the progression and drug resistance of PC.</p>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789801","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":"Is the 0.80% graft-to-recipient weight threshold still relevant in modern adult living donor liver transplantation?","authors":"Dimitri A Raptis, Leen Alshibi, Sami A Kareem, Sultan Aljudaibi, Massimo Malago, Dieter C Broering","doi":"10.1016/j.hbpd.2026.04.003","DOIUrl":"https://doi.org/10.1016/j.hbpd.2026.04.003","url":null,"abstract":"<p><p>The graft-to-recipient weight ratio (GRWR) threshold of 0.80% has long been used to guide graft selection in adult living donor liver transplantation (LDLT) as a pragmatic surrogate for graft adequacy. However, expanding use of donor-sparing left liver grafts and advances in perioperative management have challenged the universality of this cutoff. This review re-examines the relevance of the 0.80% GRWR threshold in modern adult LDLT, focusing on the evolving pathophysiology of small-for-size syndrome, the role of portal hyperperfusion and secondary hepatic arterial hypoperfusion mediated through the hepatic arterial buffer response, and the clinical impact of hemodynamic monitoring and inflow modulation. We summarized surgical and pharmacologic strategies to optimize portal and arterial inflow and proposed practical hemodynamic targets (e.g., portal venous flow < 5 mL/min per gram graft and portal venous pressure < 20 mmHg with preserved hepatic arterial inflow). To provide real-world context, the authors integrated original data from their institutional left-graft LDLT cohort (n = 202, median GRWR 0.72%, range 0.39%-1.48%), including recipients with GRWR < 0.80% (n = 59, 29.2%) and < 0.60% (n = 32, 15.8%). Small-for-size syndrome occurred in 56.9% of recipients. GRWR < 0.80% was not associated with the incidence of small-for-size syndrome (44.2% vs. 57.4%, P = 0.110) or in-hospital mortality (9.4% vs. 5.6%, P = 0.563), and long-term survival was comparable across GRWR groups when portal inflow was controlled and hepatic arterial perfusion preserved. Overall, GRWR remains useful for risk stratification but should not function as an absolute cutoff, rather a physiology-driven, hemodynamic-guided strategy may better define graft adequacy in modern adult LDLT.</p>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789834","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":"Machine learning-driven prognostication in liver transplantation: A tacrolimus intrapatient variability enhanced predictive model.","authors":"Yao-Xing Ren, Yan Wang, Jun-Xi Xiang, Da-Wei Han, He-Zhao Zhang, Xu-Feng Zhang, Rui Zhang, Fu-Min Wang","doi":"10.1016/j.hbpd.2026.04.001","DOIUrl":"https://doi.org/10.1016/j.hbpd.2026.04.001","url":null,"abstract":"<p><strong>Background: </strong>Accurately predicting long-term survival after liver transplantation (LT) remains a major clinical challenge. Tacrolimus intrapatient variability (Tac-IPV) has emerged as a potential prognostic marker, yet its integration into clinical decision-making remains limited.</p><p><strong>Methods: </strong>This retrospective study analyzed 381 adult LT recipients from two centers: 288 from the First Affiliated Hospital of Xi'an Jiaotong University (2015-2019) and 93 from the First Hospital of Shanxi Medical University (2020-2023). We developed a novel composite index, the Liver Transplantation Prognosis Predictor (LTPP), which integrates Tac-IPV (coefficient of variation), total bilirubin, and donor age using a Euclidean norm-based fusion method. The prognostic value of LTPP was evaluated through survival analysis and compared with conventional scores (model for end-stage liver disease and Child-Pugh scores). In addition, a random forest model was developed and externally validated to predict post-transplant survival.</p><p><strong>Results: </strong>In three-fold cross-validation, the random forest model demonstrated robust predictive performance for 1-, 2-, and 3-year survival (area under the receiver operating characteristic curve: 0.76, 0.73, and 0.68 in internal validation; 0.71, 0.74, and 0.70 in external validation). Survival analysis showed that LTPP significantly outperformed model for end-stage liver disease and Child-Pugh scores in risk stratification (log-rank P < 0.0001), establishing it as a reliable prognostic indicator.</p><p><strong>Conclusions: </strong>This study introduces LTPP, a clinically accessible composite index incorporating Tac-IPV. Compared to existing scoring systems, LTPP provides superior prognostic accuracy for long-term survival following LT, offering a promising tool for individualized post-transplant management.</p>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718975","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":"Editorial: Breaking barriers in transplantation.","authors":"Jan P Lerut, Samuele Iesari","doi":"10.1016/j.hbpd.2026.03.004","DOIUrl":"https://doi.org/10.1016/j.hbpd.2026.03.004","url":null,"abstract":"","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147619263","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 surgery in liver transplantation: Current status and perspectives from living and deceased donor settings.","authors":"Cristiano Guidetti, Roberta Odorizzi, Barbara Catellani, Paolo Magistri, Stefano Di Sandro, Gian Piero Guerrini, Fabrizio Di Benedetto","doi":"10.1016/j.hbpd.2026.03.003","DOIUrl":"https://doi.org/10.1016/j.hbpd.2026.03.003","url":null,"abstract":"<p><strong>Background: </strong>Robotic surgery has progressively expanded its role in hepatopancreatobiliary surgery, and its application to liver transplantation represents one of the most advanced developments in minimally invasive surgery. However, the clinical value, indications, and limitations of robotic approaches in liver transplantation remain incompletely defined.</p><p><strong>Data sources: </strong>This narrative and critical review summarized the available literature on robotic surgery in liver transplantation, focusing on three distinct settings: robotic living donor hepatectomy (RLDH), robotic living donor liver transplantation (RLDLT), and robotic deceased donor liver transplantation (RDDLT). Published clinical series, observational studies, and selected expert guidance were analyzed to evaluate technical feasibility, patient selection, perioperative outcomes, and learning curve considerations.</p><p><strong>Results: </strong>RLDH has been shown to be feasible and safe in carefully selected donors when performed in high-volume centers, with donor outcomes comparable to laparoscopic and open approaches. RLDLT in recipients represents a further level of technical complexity; limited single-center experiences suggest favorable short-term postoperative outcomes without compromising early graft function, although these results are highly dependent on patient selection and institutional expertise. RDDLT remains confined to a small number of pioneering centers, with evidence limited to small case series demonstrating technical feasibility and encouraging short-term outcomes.</p><p><strong>Conclusions: </strong>Robotic surgery in liver transplantation is a promising and evolving field. Current evidence supports its use in highly selected patients and specialized centers, while broader adoption will require further validation and standardization.</p>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596323","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":"Clinicopathological features and prognosis of dual-phenotype hepatocellular carcinoma after curative hepatectomy: A propensity score matching analysis.","authors":"Tai-Feng Zhu, Zi-Yue Huang, Xiao-Kun Chen, Cheng-Pei Zhu, Shun-Da Du, Xin-Ting Sang, Yong-Chang Zheng, Hai-Tao Zhao","doi":"10.1016/j.hbpd.2026.03.002","DOIUrl":"https://doi.org/10.1016/j.hbpd.2026.03.002","url":null,"abstract":"<p><strong>Background: </strong>Dual-phenotype hepatocellular carcinoma (DPHCC) is a recently defined subtype of hepatocellular carcinoma (HCC) characterized by the simultaneous hepatocellular and biliary epithelial marker expression. This study aimed to elucidate the clinicopathological features of DPHCC following curative liver resection and its relationship with prognosis.</p><p><strong>Methods: </strong>We analyzed 1493 patients with HCC who underwent curative liver resection at the Peking Union Medical College Hospital from January 2013 to December 2023. All patients were divided into two groups according to immunohistochemical marker expression, with 487 and 1006 cases in the DPHCC and non-DPHCC groups, respectively. Propensity score matching was performed to reduce the deviation caused by baseline characteristics.</p><p><strong>Results: </strong>After 1:2 matching (DPHCC/non-DPHCC group = 453/771), patients were comparable regarding all baseline characteristics. Compared to patients with non-DPHCC, those with DPHCC were significantly associated with poorer differentiation, microvascular invasion, satellite nodules, and bile duct tumor thrombus (P < 0.05). Patients with DPHCC also exhibited significantly worse recurrence-free survival (P = 0.009) and overall survival (P = 0.021). Furthermore, multivariate analysis revealed that DPHCC was an independent risk factor for recurrence-free survival (HR = 1.28, 95% CI: 1.05-1.52, P = 0.019) and overall survival (HR = 1.33, 95% CI: 1.15-1.51, P = 0.023).</p><p><strong>Conclusions: </strong>DPHCC, a newly proposed subtype of HCC, is associated with poorer clinicopathological features and adverse prognosis, providing important clinical guidance.</p>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494301","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":"Non-physiological renoportal anastomosis during liver transplantation in a patient with Yerdel grade 4 portal vein thrombosis.","authors":"Ming-Zheng Chen, Sui Shen, Kai-Wun Chang, Zi-Xuan Feng, Nan Ye, Li Zhuang, Shu-Sen Zheng, Zhe Yang","doi":"10.1016/j.hbpd.2026.03.001","DOIUrl":"https://doi.org/10.1016/j.hbpd.2026.03.001","url":null,"abstract":"","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147492242","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":"Interleukin-22 in acute pancreatitis: Balancing damage and repair.","authors":"Serge Chooklin, Serhii Chuklin","doi":"10.1016/j.hbpd.2026.02.003","DOIUrl":"https://doi.org/10.1016/j.hbpd.2026.02.003","url":null,"abstract":"<p><strong>Background: </strong>Acute pancreatitis (AP) is a severe inflammatory disorder characterized by the premature activation of digestive enzymes, acinar cell injury, and systemic complications. Interleukin-22 (IL-22), a member of the IL-10 cytokine family, has increasingly been recognized as a critical mediator at the intersection of immune regulation and epithelial protection. Experimental evidence indicates that IL-22 exerts both protective and pathogenic effects depending on disease stage and immune context.</p><p><strong>Data sources: </strong>This review synthesized findings from experimental and clinical studies investigating the role of IL-22 in AP. Literature encompassing murine models, in vitro experiments, and patient cohorts, was analyzed, with emphasis on signaling mechanisms, tissue-protective versus pathogenic functions, and the translational potential of IL-22 as both a therapeutic target and a biomarker.</p><p><strong>Results: </strong>IL-22 safeguards acinar cells through signal transducer and activator of transcription 3 and AKT/mTOR signaling, suppresses excessive autophagy, and promotes the expression of anti-apoptotic proteins (Bcl-2, Bcl-xL). It strengthens intestinal barrier integrity via Reg-IIIβ/γ induction, reduces lung injury by limiting neutrophilic inflammation, and shows hepatoprotective and renoprotective properties. Elevated serum IL-22 levels in patients with severe AP correlate with gastrointestinal failure and systemic complications, supporting its utility as a biomarker. Nonetheless, IL-22 exhibits dual roles: in mild AP, it can exacerbate necrosis, while chronic activity has been linked to fibrosis and tumorigenesis. Regulation by IL-22 binding protein (IL-22BP) is essential for maintaining homeostasis. Preclinical nanotherapeutic strategies have improved IL-22 delivery and stability.</p><p><strong>Conclusions: </strong>IL-22 constitutes both a promising therapeutic candidate and a potential biomarker in AP. Recombinant IL-22 and advanced delivery systems can reduce complications in severe disease, while IL-22 measurement could improve prognostic stratification. However, key challenges remain concerning safety, optimal therapeutic windows, and long-term risks. Large-scale clinical trials are required to establish IL-22 as a cornerstone of precision medicine in AP.</p>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322591","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}