Annals of hepato-biliary-pancreatic surgery最新文献

{"title":"Left hepatectomy for chronic biopsy-induced intrahepatic arterioportal fistula with aneurysmal degeneration.","authors":"Evangelia Florou, Michail Pizanias, Pauline Kane, Parthi Srinivasan, Andreas Prachalias","doi":"10.14701/ahbps.26-061","DOIUrl":"https://doi.org/10.14701/ahbps.26-061","url":null,"abstract":"<p><p>Arterioportal fistula (APF) is a rare complication of percutaneous liver biopsy. While most biopsy-induced shunts are asymptomatic and resolve on their own, persistent high-flow lesions can lead to progressive vascular remodeling, creating significant management challenges. A 49-year-old woman presented 17 years after undergoing a percutaneous liver biopsy, complaining of a pulsatile epigastric mass. Computed tomography revealed a large aneurysmal intrahepatic APF involving the middle hepatic artery and left portal vein. Due to the complexity of the anatomy and concerns about portal perfusion, endovascular embolization was not pursued. Instead, the patient underwent a formal left hepatectomy, which effectively controlled the fistulous area. Histopathological examination confirmed chronic arterialization of portal venous structures, accompanied by fibromyxoid intimal thickening, consistent with long-standing high-flow shunting. This case illustrates the delayed progression of biopsy-induced APF and emphasizes that hepatic resection is a definitive and safe option for anatomically complex lesions when embolization is not feasible. Careful preoperative mapping of arterial inflow and portal venous outflow is essential for effective operative planning and safe resection in complex APFs.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790647","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":"Persistently elevated serum gamma-glutamyl transferase is associated with pancreatic cyst development: A sex-stratified propensity score matched multicenter cohort study.","authors":"Arkadeep Dhali, Rick Maity, Fayaz Khan, Jyotirmoy Biswas, Sukanta Ray","doi":"10.14701/ahbps.26-030","DOIUrl":"https://doi.org/10.14701/ahbps.26-030","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Elevated gamma-glutamyl transferase (GGT) levels have been linked to various malignancies, yet their relationship with pancreatic cyst development remains largely unexplored. This study aimed to investigate the association between persistently elevated serum GGT levels and pancreatic cyst formation.</p><p><strong>Methods: </strong>This retrospective cohort study utilized data from TriNetX. Adult patients were categorized by sex into high and low GGT cohorts based on quartile values (males: ≥ 57 U/L vs. ≤ 23 U/L; females: ≥ 26 U/L vs. ≤ 14 U/L). Patients were required to have sustained GGT measurements at three different time points. The primary outcomes included pancreatic cyst development, all-cause mortality, and hospitalization over a three-year follow-up period.</p><p><strong>Results: </strong>Pancreatic cyst development occurred in 0.4% of the high GGT group compared to 0.2% in the low GGT group for both sexes. Males with elevated GGT had a hazard ratio (HR) of 1.924 (95% confidence interval [CI] 1.223-3.025, <i>p</i> = 0.004) for pancreatic cyst formation, while females exhibited a HR of 1.957 (95% CI 1.108-3.455, <i>p</i> = 0.018). All-cause mortality was higher in the high GGT groups (males: HR 2.670, 95% CI 2.452-2.908; females: HR 3.372, 95% CI 2.892-3.931). Hospitalization rates were also elevated (males: HR 1.546; females: HR 1.551).</p><p><strong>Conclusions: </strong>Persistently elevated serum GGT levels were associated with an approximately two-fold increase in the hazard of pancreatic cyst diagnosis in both sexes. However, the absolute event rate was low, and the outcome was identified through diagnostic coding without imaging or pathological confirmation.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790580","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":"Comparison of the Rex-recess approach with the standard approach in left lateral sectionectomy of the liver.","authors":"Mohamad Younis Bhat, Sadaf Ali, Akashdeep Singh Sohi, Tarun Yadav","doi":"10.14701/ahbps.25-257","DOIUrl":"https://doi.org/10.14701/ahbps.25-257","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Left lateral sectionectomy (LLS) is a commonly performed liver resection. The Rex-recess technique, an extrahepatic Glissonian approach through the umbilical fissure, provides earlier extrahepatic vascular control, potentially resulting in safer and faster resections. However, comparative data between these approaches is limited. This study aims to compare the Rex-recess technique with the standard technique for LLS regarding operative parameters, intraoperative blood loss, and postoperative outcomes.</p><p><strong>Methods: </strong>This retrospective cohort study included 48 consecutive adult patients who underwent open LLS at a tertiary hepatobiliary centre between January 2021 and November 2025. Patients were categorized based on the surgical technique used: standard technique (n = 25) and Rex-recess technique (n = 23). Primary outcomes assessed included operative time, blood loss, transfusion requirements, and postoperative complications. Secondary outcomes focused on selected early postoperative recovery parameters.</p><p><strong>Results: </strong>Baseline demographics were comparable between groups. The Rex-recess technique significantly reduced operative time (90 ± 17.1 minutes vs. 162 ± 27.2 minutes; <i>p</i> < 0.0001) and intraoperative blood loss (80 ± 42.3 mL vs. 250 ± 67.2 mL; <i>p</i> < 0.0001).Other postoperative outcomes, including complication rates and length of hospital stay, were comparable between the two groups.</p><p><strong>Conclusions: </strong>The Rex-recess approach appears to be a feasible and anatomically sound technique for LLS, offering advantages in operative efficiency, such as reduced operative time and blood loss. However, due to the retrospective design and non-randomized allocation, these findings should be interpreted with caution. Further prospective studies are needed to validate these results.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790504","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":"Indirect comparison of perioperative outcomes between open, laparoscopic, and robotic pancreaticoduodenectomy: Systematic review and network meta-analysis.","authors":"Janghun Han, Woohyung Lee, Jung Bok Lee, Taemin Kim, Mirang Lee, Minkyu Sung, Kwang Pyo Hong, Seung Jae Lee, Ki Byung Song, Jae Hoon Lee, Dae Wook Hwang, Song Cheol Kim","doi":"10.14701/ahbps.26-015","DOIUrl":"https://doi.org/10.14701/ahbps.26-015","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Pancreaticoduodenectomy (PD) is the standard treatment for periampullary tumors, but it is technically challenging. Evidence directly comparing open, laparoscopic, robotic, and hybrid approaches is limited. This study conducts a network meta-analysis (NMA) to compare the perioperative and oncologic outcomes of open PD (OPD), laparoscopic PD (LPD), robotic PD (RPD), and hybrid PD.</p><p><strong>Methods: </strong>We searched PubMed, EMBASE, and the Cochrane Library for studies published between January 1994 and August 2024. We included randomized controlled trials and comparative observational studies that evaluated at least two PD approaches. Perioperative outcomes were the primary endpoints, while oncologic safety served as a secondary endpoint. A random-effects NMA was performed, establishing treatment hierarchies through ranking probabilities (PROSPERO ID: CRD420250365864).</p><p><strong>Results: </strong>A total of 78 studies were included (5 randomized and 73 retrospective). RPD was associated with lower blood loss compared to OPD (mean difference [MD], -163.85 mL) and LPD (MD, -84.14 mL). Hospital stays were also shorter for RPD compared to OPD (MD, -2.50 days) and LPD (MD, -1.88 days). In contrast, OPD was the most time-efficient approach compared to LPD (MD, -77.61 minutes) and RPD (MD, -73.30 minutes). Mortality rates, severe complications, clinically relevant postoperative pancreatic fistula rates, and reoperation rates were comparable across all surgical approaches. In terms of oncologic safety, lymph node yield and R0 resection rates were similar for all modalities.</p><p><strong>Conclusions: </strong>While OPD is the most time-efficient approach, RPD provides significant advantages in reducing intraoperative blood loss and shortening hospital stays compared to both LPD and OPD.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790544","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":"Rapid, intense pericholedochal fibrosis after preoperative biliary drainage: A prospective histologic study in pancreatoduodenectomy specimens.","authors":"Offir Ben-Ishay, Aharon Dick, Edmond Sabo, Eylon Lahat, Yoram Kluger","doi":"10.14701/ahbps.26-065","DOIUrl":"https://doi.org/10.14701/ahbps.26-065","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Preoperative biliary drainage (PBD) is commonly used prior to pancreatoduodenectomy (PD), but its histologic effects on the extrahepatic bile duct are not well understood in humans. This study aimed to prospectively measure pericholedochal fibrosis (PCF) in PD specimens after plastic biliary stenting to assess its extent and clinical significance.</p><p><strong>Methods: </strong>Consecutive patients undergoing PD were divided into two groups: those who received PBD (n = 22) and non-drained controls (n = 24). Patients who had neoadjuvant chemotherapy were excluded to focus on stent-related effects. Common bile duct (CBD) specimens were analyzed using standardized Masson's trichrome staining. Digital morphometry quantified CBD dimensions, collagen area, and collagen density. Histologic markers were correlated with stent dwell time and surgical outcomes.</p><p><strong>Results: </strong>PBD was linked to a substantial increase in PCF. Stented ducts showed significantly greater wall thickness (6,554 vs. 499 μm; <i>p</i> < 0.001), total collagen area (<i>p</i> < 0.001), and collagen density (<i>p</i> < 0.001) compared to controls. Fibrosis developed rapidly, becoming clearly evident by day 6, with no significant correlation between collagen burden and stent dwell time (median 10 days). Despite these pronounced histologic changes, operative time (230 vs. 230 minutes; <i>p</i> = 0.98) and postoperative complication rates did not differ significantly between the groups.</p><p><strong>Conclusions: </strong>Short-term PBD with plastic stents causes rapid, intense, and persistent PCF that stabilizes soon after stent placement. Although this fibrotic response did not negatively impact surgical outcomes at a high-volume center, the findings underscore the significant tissue remodeling triggered by stenting and advocate for the careful use of PBD.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790664","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":"Subtotal cholecystectomy as a bailout strategy in difficult cholecystectomy: Outcomes and patient selection criteria.","authors":"İbrahim Halil Öcal, Sinan Hatipoğlu","doi":"10.14701/ahbps.26-049","DOIUrl":"https://doi.org/10.14701/ahbps.26-049","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Subtotal cholecystectomy is a salvage procedure when critical safety margins cannot be achieved in difficult cases. This study evaluated the impact of surgical approach and technique on short- and long-term outcomes.</p><p><strong>Methods: </strong>A retrospective review of 101 patients who underwent subtotal cholecystectomy between January 2010 and November 2024 was conducted. Patients were grouped by approach: laparoscopic (n = 42), open (n = 31), and conversion (n = 28). Techniques were classified as fenestrating or reconstituting. Complications were assessed using the Clavien-Dindo classification. Logistic regression identified risk factors, and Cox regression evaluated long-term outcomes. Intention-to-treat analysis was performed.</p><p><strong>Results: </strong>The mean follow-up was 6.7 years. Morbidity was lower in the laparoscopic group (9.5%) than in the open group (45.2%) (<i>p</i> < 0.001). However, after adjustment for age, American Society of Anesthesiologists score, and emergency status, surgical approach was not an independent risk factor (adjusted odds ratio 1.54, <i>p</i> = 0.214). No significant differences were observed between fenestrating and reconstituting techniques. Five-year complication-free survival was 92.9% in the laparoscopic group and 74.2% in the open group (<i>p</i> = 0.018). No stone recurrence was observed.</p><p><strong>Conclusions: </strong>Subtotal cholecystectomy is a safe option in complex cases. Outcome differences are likely related to patient selection rather than technique. Technique selection should be based on intraoperative findings.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700845","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":"Impact of three-dimensional hepatic models on oncological outcomes and survival after hepatectomy: Prognostic factor analysis in a retrospective cohort.","authors":"María Victoria Vieiro Medina, Laura Alonso Murillo, Carlos Ernesto García Vasquez, Victor Nieto Barros, Marta de la Fuente Bartolomé, Fernando Neria, Santos Francisco Jiménez de Los Galanes Marchán","doi":"10.14701/ahbps.25-250","DOIUrl":"https://doi.org/10.14701/ahbps.25-250","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Three-dimensional (3D) modeling is increasingly used in hepatobiliary surgery to enhance anatomical understanding and operative planning. However, its impact on oncologic outcomes remains uncertain. This study evaluated whether preoperative 3D liver models influence resection margin status and survival after hepatectomy for malignant disease.</p><p><strong>Methods: </strong>In this retrospective case-control study, 59 patients undergoing hepatic resection for malignancy between May 2018 and May 2023 were included. Patients were managed either with patient-specific 3D models (n = 31) or conventional imaging (n = 28). Predictors of R0 resection were analyzed using logistic regression, and overall survival (OS) and disease-free survival (DFS) were assessed using Cox proportional hazards models.</p><p><strong>Results: </strong>R0 resection was achieved in 79.7% of patients, with no significant difference between groups (77.4% vs. 82.1%; <i>p</i> = 0.865). Bilobar tumor distributionadjusted odds ratio [OR] 0.05, 95% confidence interval [CI] 0.00-0.76; <i>p</i> = 0.039) and a higher albumin-bilirubin score (adjusted OR 0.06, 95% CI 0.00-0.46; <i>p</i> = 0.029) were independently associated with lower odds of achieving R0 resection. In multivariable analysis, the use of 3D models was independently linked to improved 2-year DFS (adjusted hazard ratio 0.47, 95% CI 0.24-0.92; <i>p</i> = 0.028). Tumor type affected recurrence rates, with hepatocellular carcinoma and other tumors showing a lower risk of recurrence compared to colorectal liver metastases. No significant differences in OS were found.</p><p><strong>Conclusions: </strong>Preoperative 3D modeling was not associated with higher R0 resection rates but was independently associated with improved 2-year DFS. Given the retrospective design and potential residual confounding, these findings should be interpreted cautiously and considered hypothesis-generating pending prospective validation.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678853","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":"Laparoscopic versus open partial hepatectomy for hepatocellular carcinoma in F4 cirrhosis: A propensity score-matched study of perioperative safety.","authors":"Hiroaki Sugita, Shinichi Nakanuma, Tomokazu Tokoro, Ryohei Takei, Mitsuyoshi Okazaki, Kaichiro Kato, Satoshi Takada, Isamu Makino, Shintaro Yagi","doi":"10.14701/ahbps.26-046","DOIUrl":"https://doi.org/10.14701/ahbps.26-046","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Patients with hepatocellular carcinoma (HCC) and histologically confirmed F4 cirrhosis often have limited hepatic reserve, making major hepatectomy difficult. Although laparoscopic liver resection is increasingly performed, its perioperative safety in this setting remains unclear. This study compared laparoscopic and open partial hepatectomy in these patients using propensity score matching (PSM).</p><p><strong>Methods: </strong>Among 298 patients who underwent hepatectomy for HCC between 2006 and 2023, 112 with histologically confirmed F4 cirrhosis who underwent partial hepatectomy were included (laparoscopic, n = 60; open, n = 52). PSM was performed using previous liver resection, difficulty score, tumor size, tumor number, and platelet count, yielding 32 matched pairs. Outcomes included operative time, blood loss, transfusion requirements, complications, hospital stay, posthepatectomy liver failure (PHLF), R0 resection rate, and 30-day mortality.</p><p><strong>Results: </strong>After matching, intraoperative blood loss was significantly lower in the laparoscopic group than in the open group (50 mL vs. 295 mL, <i>p</i> < 0.001). Operative time, transfusion rate, complication rate, R0 resection rate, and 30-day mortality were comparable between groups. Hospital stay was significantly shorter in the laparoscopic group (13 vs. 22 days, <i>p</i> < 0.001). Grade A PHLF occurred in one patient in the open group, with no significant between-group difference.</p><p><strong>Conclusions: </strong>In patients with HCC and histologically confirmed F4 cirrhosis, laparoscopic partial hepatectomy was associated with less blood loss and shorter hospital stay than open surgery, without increasing perioperative morbidity. It may be a safe option in carefully selected patients undergoing limited liver resection.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678808","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":"Does modified Blumgart pancreatojejunostomy compared with original Blumgart pancreatojejunostomy decrease the rate of clinically relevant postoperative pancreatic fistula? A single-center propensity score-matched analysis.","authors":"Fernando Revoredo Rego, Gustavo Reaño Paredes, Fritz Kometter Barrios, Tongbo Wang, Guillermo Herrera Chávez, Luis Villanueva Alegre, Jorge Tang Sing, Mónica Uribe León, Wuilber Ludeña Hurtado, José Arenas Gamio, Sheyla Alfaro Ita, Vanessa Bermúdez Alfaro, Liliana Fonseca Cavero, Félix Carrasco Mascaro, Italo Landeo Aliaga, Samy Castillo Flores, José de Vinatea de Cárdenas","doi":"10.14701/ahbps.26-044","DOIUrl":"https://doi.org/10.14701/ahbps.26-044","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>The most common cause of morbidity following pancreatoduodenectomy (PD) is the clinically relevant postoperative pancreatic fistula (CR-POPF). There is currently no universally accepted technique for pancreato-enteric anastomosis. This study aims to compare the Blumgart technique (B-PJ) with the modified Blumgart technique (mB-PJ).</p><p><strong>Methods: </strong>This is a retrospective study involving patients who underwent PD between January 2011 and December 2021. The primary endpoint was to compare the incidence of CR-POPF. Secondary endpoints included major morbidity, length of postoperative stay, rates of reoperation, hospital readmission, postoperative mortality, and predictors of CR-POPF. Propensity score matching (PSM) was employed to minimize potential selection bias.</p><p><strong>Results: </strong>The study included 292 patients. After PSM, the incidence of CR-POPF was not significantly different between B-PJ and mB-PJ (18.9% vs. 15.8%, <i>p</i> = 0.566). No statistical differences were observed in the secondary endpoints. Independent predictors of CR-POPF included preoperative cholangitis (odds ratio [OR]: 4.906, 95% confidence interval [CI]: 1.440-16.713, <i>p</i> = 0.011), soft pancreas (OR: 4.259, 95% CI: 1.043-17.376, <i>p</i> = 0.043), and main pancreatic duct size ≤ 3 mm (OR: 5.229, 95% CI: 1.865-14.656, <i>p</i> = 0.002).</p><p><strong>Conclusions: </strong>This study did not demonstrate that mB-PJ is superior to B-PJ in reducing the incidence of CR-POPF. Factors such as soft pancreas, main pancreatic duct size, and preoperative cholangitis are identified as independent risk factors for CR-POPF.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678828","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":"Assessment of liver regeneration in living donor liver transplantation recipients using computed tomography volumetry-an institutional experience.","authors":"Sanket Solanki, Abhishek Jayant, Kishan Singh Rawat, Sri Aurobindo Prasad Das, Samiran Nundy, Naimish N Mehta","doi":"10.14701/ahbps.26-005","DOIUrl":"https://doi.org/10.14701/ahbps.26-005","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Early liver graft regeneration after living donor liver transplantation (LDLT) is critical for patient outcomes, yet prospective volumetric data from Indian recipients remain limited. This study quantifies early graft regeneration and identifies predictors using computed tomography (CT) volumetry.</p><p><strong>Methods: </strong>In this prospective single-center study, 34 consecutive adult LDLT recipients underwent CT volumetry on postoperative days 7 and 30.</p><p><strong>Results: </strong>Mean baseline graft volume was 607.9 ± 137.9 cm³, increasing to 957.3 ± 175.7 cm³ at day 7 (+62%, <i>p</i> < 0.001) and 1,293.4 ± 247.0 cm³ at day 30 (+111%, <i>p</i> < 0.001), achieving 93% ± 22.7% of predicted standard liver volume (SLV). Multivariate analysis identified recipient body mass index (BMI) (β = 29.4 cm³/kg/m², 95% CI 14.4-44.4, <i>p</i> < 0.001) and graft-to-recipient-weight ratio (GRWR) (β = 435.9 cm³ per unit, 95% CI 95-777, <i>p</i> = 0.015) as independent predictors of day-30 graft volume (adjusted R² = 0.349). Left-lobe grafts showed higher proportional growth than right-lobe grafts (174% ± 41% vs. 103% ± 34%, <i>p</i> < 0.001) with comparable absolute volumes (<i>p</i> = 0.56). Younger recipients (19-41 years) demonstrated greater regeneration than older recipients (56-64 years; 160% ± 32% vs. 109% ± 38%, <i>p</i> = 0.01). Mild macrosteatosis (< 30%) did not impair regeneration.</p><p><strong>Conclusions: </strong>Liver graft regeneration in this Indian LDLT cohort was rapid, with near-complete SLV restoration by 30 days. BMI and GRWR independently predicted volumetric recovery, supporting personalized graft selection and the expanded use of left-lobe grafts.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635323","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}