Annals of hepato-biliary-pancreatic surgery最新文献

{"title":"Perioperative red blood cell transfusion in gallbladder cancer surgery: Trends and determinants from nationwide data.","authors":"Junghyun Yoon, Seonju Kim, Sunghee Hong, Yun Kyung Jung, Dongho Choi, Boyoung Park","doi":"10.14701/ahbps.25-130","DOIUrl":"https://doi.org/10.14701/ahbps.25-130","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Gallbladder and biliary tract cancers (GBCs) are rare malignancies with poor prognoses, and surgical resection remains the only curative intervention. This study examined perioperative red blood cell (RBC) transfusion patterns among GBC patients in Korea and explored clinical and sociodemographic determinants associated with transfusion.</p><p><strong>Methods: </strong>Utilizing National Health Insurance Service (NHIS) data from 2012 to 2020, we identified 20,564 patients with GBC. Associations between perioperative RBC transfusion and various sociodemographic and clinical characteristics were assessed. Trends in transfusion rates were analyzed using the average annual percentage change (AAPC).</p><p><strong>Results: </strong>Of the cohort, 6,795 (33.0%) received perioperative RBC transfusions, with a mean age of 70.1 years. Increased likelihood of transfusion was observed among females, individuals with low income, and those residing outside metropolitan areas. Treatment in non-tertiary hospitals, higher Charlson comorbidity index, undergoing multiple surgical procedures, and the presence of extrahepatic cholangiocarcinoma were significantly correlated with transfusion. The transfusion rate declined from 38.4% in 2012 to 29.9% in 2020 (AAPC = -3.2, 95% confidence interval [95% CI]: -3.7, -2.8), with consistent reductions observed across all age groups and a marked decrease for cholecystectomy (AAPC = -7.2, 95% CI: -9.4, -5.0).</p><p><strong>Conclusions: </strong>Perioperative RBC transfusion rates in patients with GBC have declined over the past decade. Nevertheless, women, patients with lower income, and those managed at non-tertiary hospitals continue to receive transfusions at higher rates.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple bilobar liver metastases from uveal melanoma: What is the limit for surgical resection?","authors":"Gennaro Mazzarella, Samer Diab, Alice La Franca, Ecoline Tribillon, Olivier Soubrane","doi":"10.14701/ahbps.25-131","DOIUrl":"https://doi.org/10.14701/ahbps.25-131","url":null,"abstract":"<p><p>The primary clinical factor influencing survival in uveal melanoma (UM) is the onset of liver metastases. Managing uveal melanoma liver metastases (UMLM) remains difficult, as conventional systemic therapies infrequently yield durable responses and are linked with poor outcomes. Nonetheless, liver surgery continues to be the preferred strategy for improving prognosis in patients with potentially resectable metastases. Additionally, under certain conditions, debulking of the tumor has demonstrated effectiveness in delaying hepatic metastatic disease progression when it is technically achievable. This report describes our surgical approach to bilobar liver metastases from UM with hepatic vein infiltration, emphasizing both surgical techniques and outcomes, and explores the potential for maximal tumor reduction in UMLM following an extended disease-free interval between primary UM treatment and liver metastasis detection.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of preoperative biliary drainage on postoperative complications and mortality in patients with different degrees of obstructive jaundice undergoing pancreaticoduodenectomy.","authors":"Qingsong Guo, Jian Wan, Yan Huang, Dongzhi Wang, Qiyang Chen, Chenhao Wu, Xiangjun Fan, Peng Wang, Yuhua Lu","doi":"10.14701/ahbps.25-123","DOIUrl":"https://doi.org/10.14701/ahbps.25-123","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>The role of preoperative biliary drainage (PBD) in improving perioperative outcomes for patients with obstructive jaundice remains controversial. This retrospective study aims to evaluate the impact of PBD in patients with varying severities of jaundice and to identify optimal strategies to minimize complications and mortality following pancreaticoduodenectomy (PD).</p><p><strong>Methods: </strong>This retrospective clinical study included 240 patients with obstructive jaundice who underwent PD. Patients were categorized into severe Jaundice group (SJ group) and moderate Jaundice group (MJ group). Preoperative, intraoperative, and postoperative clinical data were compared based on whether PBD was performed. Additionally, the association between PBD duration and postoperative complications and mortality after PD was assessed.</p><p><strong>Results: </strong>Among 115 patients in the SJ group, 94 received PBD, whereas 46 of the 125 patients in the MJ group received PBD. In the SJ-PBD group, the rate of postoperative bile leakage was significantly lower compared with the direct surgery group; however, overall complication rates did not differ. In the MJ-PBD group, the incidence of incision-related complications increased significantly, with no notable reduction in overall postoperative complications. Patients who underwent PBD for at least 10 days experienced lower rates of severe complications (Clavien-Dindo grade ≥ 3) than patients with PBD duration less than 10 days (14.3% vs. 25.5%, <i>p</i> = 0.012).</p><p><strong>Conclusions: </strong>PBD should be considered in obstructive jaundiced patients with total bilirubin > 256 μmol/L, particularly those presenting with systemic functional impairment. A minimum PBD duration of 10 days appears beneficial for reducing the risk of serious postoperative complications and mortality.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Updates on incidence, mortality and survival of liver cancer using Korea central cancer registry database: 1999-2022.","authors":"Sung Yeon Hong, Mee Joo Kang, Eun Hye Park, E Hwa Yun, Hye-Jin Kim, Bong-Wan Kim, Kyu-Won Jung","doi":"10.14701/ahbps.25-150","DOIUrl":"https://doi.org/10.14701/ahbps.25-150","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Liver cancer (LC) remains a major contributor to morbidity and mortality globally. This study seeks to provide updated insights into the epidemiological trends of LC in South Korea by examining changes in incidence, mortality, and survival rates between 1999 and 2022, with the goal of guiding public health interventions and informing clinical decision-making.</p><p><strong>Methods: </strong>This retrospective cohort study utilized data from Korea Central Cancer Registry (KCCR) for primary LC cases, classified as code C22 according to the International Classification of Diseases, tenth version (ICD-10), diagnosed from 1999 to 2022. Crude rates and age-standardized rates (ASRs) were determined. Additionally, subgroup analyses were conducted separately for hepatocellular carcinoma (HCC, C22.0) and intrahepatic cholangiocarcinoma (IHCC, C22.1).</p><p><strong>Results: </strong>Between 1999 and 2022, both the incidence and mortality rates of HCC showed marked decreases. The annual percent change of ASR for incidence and mortality was -2.99% and -4.89%, respectively. There was a notable rise in 5-year survival rates for HCC, especially among patients with localized-stage disease. Conversely, IHCC incidence stabilized and mortality rates showed minimal change. Although patients with localized IHCC achieved significantly higher survival rates following surgical resection, only a small proportion of IHCC cases were diagnosed at a localized stage (22.4%).</p><p><strong>Conclusions: </strong>Analysis of LC trends in Korea reveals a persistent reduction in incidence and significant improvements in early detection and survival rates for HCC. Despite these gains, IHCC continues to pose clinical difficulties, underscoring the need for further studies to enhance early diagnosis.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathologically confirmed complete remission after neoadjuvant chemotherapy in patients with advanced intrapancreatic cholangiocarcinoma following robot-assisted excision of choledochal cyst: A case report.","authors":"In Soo Cho, Milim Kim, Chang Moo Kang","doi":"10.14701/ahbps.25-136","DOIUrl":"https://doi.org/10.14701/ahbps.25-136","url":null,"abstract":"<p><p>The occurrence of cholangiocarcinoma following choledochal cyst excision is a rare clinical entity. In cases with extensive lymphadenopathy, where poor oncologic prognosis is anticipated, immune checkpoint inhibitors have recently shown promise as a therapeutic approach in biliary tract cancer. We describe a case involving successful minimally invasive pylorus-preserving pancreaticoduodenectomy in this unusual patient, following neoadjuvant immune chemotherapy. A 44-year-old female, who had previously undergone bile duct excision for choledochal cyst on November 28, 2022, presented with abdominal pain in July 2024. Imaging revealed an 8-cm mass in the pancreatic head, with multiple metastatic lymph nodes noted in the epigastrium, mesentery, retroperitoneum, and both common iliac chains. Endoscopic ultrasound-guided biopsy identified atypical cells with necrosis suggestive of poorly differentiated carcinoma, but immunohistochemistry did not confirm pancreatic origin. Positron emission tomography-computed tomography revealed absence of additional primary malignancy, though it showed multiple enlarged lymph nodes and findings indicative of possible peritoneal seeding. Considering the patient's prior history of choledochal cyst resection and extensive perihilar lymphadenopathy, a diagnosis of cholangiocarcinoma was favored. Neoadjuvant chemoimmunotherapy with durvalumab, gemcitabine, and cisplatin was administered across 11 cycles. Subsequent imaging demonstrated significant tumor regression, prompting surgical exploration on April 11, 2025. Intraoperatively, extensive adhesions surrounding the hepaticojejunostomy and pancreas were encountered. Pancreaticoduodenectomy was completed utilizing the pre-existing Roux limb for pancreaticojejunostomy. Frozen section analysis of the peritoneum and mesentery was negative for malignancy. Final histopathology confirmed complete remission. This case highlights the potential feasibility and safety of minimally invasive surgery in this rare clinical scenario.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hand grip strength predicts major complications following pancreaticoduodenectomy: A prospective observational study.","authors":"Lohith P, Deeksha Kapoor, Amanjeet Singh, Azhar Perwaiz, Adarsh Chaudhary","doi":"10.14701/ahbps.25-117","DOIUrl":"https://doi.org/10.14701/ahbps.25-117","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Although mortality after pancreaticoduodenectomy (PD) has decreased, morbidity remains high. The Modified Frailty Index (mFI) and hand grip strength (HGS) assessed preoperatively have been shown to predict postoperative morbidity and mortality after PD in retrospective studies. Our study aimed to evaluate the role of mFI and HGS in predicting outcomes following PD.</p><p><strong>Methods: </strong>A prospective observational study conducted from June 2021 to March 2023 enrolled all consecutive patients undergoing PD. Preoperatively, patient characteristics, mFI, and HGS were calculated. Postoperative complications were graded according to the Clavien-Dindo (CD) classification. The statistical association between these complications with high mFI and weak HGS was analyzed.</p><p><strong>Results: </strong>A total of 180 patients were enrolled in the study. Major complications (CD grade ≥ 3) and 90-day mortality occurred in 10.5% and 3.3% of patients, respectively. The proportion of patients with weak HGS was significantly higher among those who developed major complications (14 of 19) compared to those who did not (28 of 161) (<i>p</i> < 0.001). In contrast, high mFI did not reach statistical significance (<i>p</i> = 0.063). Additionally, weak HGS showed a statistically significant association with 90-day mortality (14.3% vs 0%, <i>p</i> < 0.001), hospital stay > 8 days (83.3% vs 24.6%, <i>p</i> < 0.001), 90-day re-admission (19.4% vs 4.3%, <i>p</i> = 0.002), and overall complications (30.7% vs 5.7%, <i>p</i> < 0.001), compared to normal HGS. Weak HGS was a significant predictor of major complications in multivariate analysis (adjusted odds ratio, 11.52; <i>p</i> < 0.0001).</p><p><strong>Conclusions: </strong>HGS is a simple tool used preoperatively to assess functional sarcopenia and has been identified as an independent predictor of major complications following PD.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of <i>Lactococcus lactis</i> D4 on the expression of Ki-67 and liver fibrosis in a rat model of obstructive jaundice.","authors":"Reno Putri Utami, Avit Suchitra, Irwan, Muhammad Iqbal Rivai, Rini Suswita, Ade Sukma","doi":"10.14701/ahbps.25-104","DOIUrl":"https://doi.org/10.14701/ahbps.25-104","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Obstructive jaundice, resulting from bile duct obstruction, is associated with increased morbidity and mortality due to impaired bile flow, dysbiosis of the gut microbiota, enhanced bacterial translocation, and hepatocellular injury. Persistent biliary obstruction can further progress to hepatic fibrosis and ultimately cirrhosis. Probiotics might help modulate microbiota and reduce liver injury. This study investigates the effect of <i>Lactococcus lactis</i> D4 on Ki-67 expression and liver fibrosis in rats with obstructive jaundice.</p><p><strong>Methods: </strong>Fifteen male Wistar rats (10-16 weeks old) were divided into three groups: sham (laparotomy only), BDL (bile duct ligation without treatment), and BDL-LLD4 (BDL followed by <i>L. lactis</i> D4). After 7 days, liver wedge biopsies were taken for Ki-67 immunohistochemical staining and assessment of fibrosis using the METAVIR score.</p><p><strong>Results: </strong>The highest mean Ki-67 expression was observed in the BDL-LLD4 group (14.20 ± 3.35), significantly higher than in the sham (7.60 ± 2.61; <i>p</i> < 0.05) and BDL groups (3.40 ± 1.34; <i>p</i> < 0.01). The Metavir fibrosis score was lower in the BDL-LLD4 group, but not significantly, suggesting reduced liver damage.</p><p><strong>Conclusions: </strong>Administration of <i>L. lactis</i> D4 in an obstructive jaundice model resulted in a significant upregulation of Ki-67 expression and attenuation of liver fibrosis compared to the BDL group. These results suggest that <i>L. lactis</i> D4 exhibits hepatoprotective effects by promoting liver regeneration and suppressing fibrogenesis, thereby supporting its potential as an adjunctive probiotic therapy for liver disease and preventing postoperative liver failure.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and outcomes of pancreato-duodenectomy in portal annular pancreas: A single center experience with a systematic review of the literature.","authors":"Shreeyash Modak, Raviraj Tilloo, Zeeshan Ahmed, Monish Karunakaran, Sanjeev Patil, Mahesh Shetty, Rohit Dama, Pradeep Rebala, Guduru Venkat Rao","doi":"10.14701/ahbps.25-027","DOIUrl":"10.14701/ahbps.25-027","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Portal annular pancreas (PAP) is an anomaly where pancreatic tissue surrounds the portal vein (PV). We present a case series from our institution and a systematic review of PAP patients who underwent pancreatoduodenectomy (PD).</p><p><strong>Methods: </strong>We conducted a retrospective review of patient records from a tertiary referral center, from January 2014 to June 2024, who underwent PD to identify those with PAP. Additionally, a literature search was performed and articles discussing PAP patients who underwent PD were included.</p><p><strong>Results: </strong>The incidence of PAP was 0.4% (7 out of 1,750 PD cases). Of these, three (42.85%) patients developed clinically relevant postoperative pancreatic fistula (CR-POPF). Following the literature review, 34 articles with 57 patients (including our study) were considered. Reconstruction of the dominant stump, which included the main pancreatic duct, was performed using pancreatojejunostomy in 88.88% of cases and pancreatogastrostomy in 11.11% of cases. The non-dominant stump was managed with en-bloc extended resection (ER) of PAP, leftward of the PV, offering a single-cut surface for pancreatojejunostomy (41.51%), by stapling (26.41%) or suturing the stump (16.98%), stump-pancreatogastrostomy (5.66%), and electrocautery (5.66%). CR-POPF rates for ER, suturing and stapling were 22.72%, 37.5%, and 53.85%, respectively (<i>p</i> = 0.12).</p><p><strong>Conclusions: </strong>Preoperative recognition of PAP is crucial to customize surgical procedures to effectively manage the non-dominant stump.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"308-316"},"PeriodicalIF":1.7,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatectomy with arterial resection following neoadjuvant FOLFIRINOX: A single-institution experience.","authors":"Fahim Kanani, Ester Ovdat, Mohammed Younis, Guy Meyerovich, Nir Messer, Alexander Barenboim, Yaacov Goykhman, Nir Lubezky","doi":"10.14701/ahbps.25-108","DOIUrl":"10.14701/ahbps.25-108","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Arterial resection in pancreatic cancer remains controversial. This study evaluates outcomes of pancreatic resection with arterial involvement following neoadjuvant chemotherapy.</p><p><strong>Methods: </strong>Retrospective analysis of 100 pancreatic adenocarcinoma patients undergoing resection after neoadjuvant FOLFIRINOX (2010-2024): 26 with arterial resection (ArP), 39 with portal-venous resection (PoP), and 35 without vascular involvement (NoP). Primary outcomes included perioperative morbidity, mortality, and survival.</p><p><strong>Results: </strong>ArP patients had significantly more stage III disease (73.1% vs 58.9% vs 28.6%, <i>p</i> < 0.001) but achieved acceptable R0 resection rates (76.9% vs 84.6% vs 91.4%, <i>p</i> = 0.04). ArP procedures required longer operative time (386 ± 71 minutes), greater blood loss (1,100 ± 560 mL), and more transfusions (57.7%; all <i>p</i> < 0.001). Major complications (Clavien-Dindo ≥ III) were higher in ArP (26.9% vs 21.6% vs 8.6%, <i>p</i> = 0.03), with extended ICU stays (3.5 ± 1.5 vs 2.0 ± 1.0 vs 1.0 ± 0.5 days). Ninety-day mortality was 0% (ArP), 2.5% (PoP), and 5.7% (NoP) (<i>p</i> = 0.78). Despite shorter disease-free survival in ArP (7.4 vs 9.7 vs 13.2 months, <i>p</i> = 0.01), median overall survival was comparable (ArP: 19.1, PoP: 18.3, NoP: 22.7 months; <i>p</i> = 0.0652).</p><p><strong>Conclusions: </strong>Arterial resection following neoadjuvant therapy in selected pancreatic cancer patients demonstrates acceptable perioperative risk and achieves survival outcomes comparable to less advanced cases. This approach is justified in experienced high-volume centers for appropriately selected patients with favorable response to neoadjuvant therapy, offering potential cure in rare circumstances.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"323-333"},"PeriodicalIF":1.7,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A positive resection margin does not determine long-term survival following colorectal liver metastasis resection.","authors":"Andreas Konstantinou, Sivasanker Masillamany, Ajit Thomas Abraham, Deepak Hariharan, Vincent Sui Kwong Yip, Hemant Mahendrakumar Kocher","doi":"10.14701/ahbps.24-233","DOIUrl":"10.14701/ahbps.24-233","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>This study evaluates whether positive resection margins after colorectal liver metastasis (CRLM) surgery are linked to tumor recurrence and impact long-term survival.</p><p><strong>Methods: </strong>The oncological outcomes of patients undergoing curative resection for CRLM at a single institution were analyzed concerning clinicopathological factors using both univariate and multivariate statistical methods.</p><p><strong>Results: </strong>Among 138 patients who underwent liver resection for CRLM, hepatic tumor recurrence was noted in 70 patients (50.7%), with no significant difference between those with R0 and R1 resections (<i>p</i> = 0.33). Positive resection margins were associated with tumor proximity to major liver vascular structures, while negative margins corresponded more frequently with T4 stage colorectal cancer. Multivariate analysis indicated that R1 margins in CRLM resections do not affect overall or disease-free survival. Nonetheless, the proximity of tumors to major liver vascular structures and R1 margins from initial colorectal cancer resections were significant independent predictors of poorer survival outcomes.</p><p><strong>Conclusions: </strong>With the advent of modern perioperative systemic therapies, both hepatic recurrence and survival outcomes following hepatectomy for colorectal liver metastases seem unaffected by the presence of R1 resection margins.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"252-268"},"PeriodicalIF":1.7,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}