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International consensus guidelines on robotic pancreatic surgery in 2023

Hepatobiliary Surgery and Nutrition 2024年第1期13卷 89-104页

作者： Rong Liu mohammed Abu Hilal marc G.Besselink Thilo Hackert Chinnusamy Palanivelu Yupei Zhao Jin He Ugo Boggi Jin-Young Jang Fabrizio Panaro Brian K.P.Goh mikhail Efanov Yuichi Nagakawa Hong-Jin Kim Xiaoyu yin Zhim.ng Zhao yi-m.ng shyr Shridhar Iyer Eli Kakiashvili Ho-Seong Han Jae Hoon Lee Roland Croner marco Vito marino Arun Prasad Wei Wang Songqing He Kehu Yang Qu Liu Zizheng Wang m.ngyang Li Shuai Xu Kongyuan Wei Zhaoda Deng Yuze Jia Tess m.E.van Ramshorst Faculty of Hepatopancreatobiliary Surgery The First Medical Center of Chinese People’s Liberation Army(PLA)General HospitalBeijingChina Department of Surgery Poliambulanza Foundation HospitalBresciaItaly Department of Surgery University Hospital Southampton NHS Foundation TrustSouthamptonUK Amsterdam UmC location University of AmsterdamDepartment of SurgeryAmsterdamThe Netherlands Cancer Center Amsterdam AmsterdamThe Netherlands Department of General Visceral and Thoracic SurgeryUniversity Hospital Hamburg-EppendorfHamburgGermany Department of minimal Invasive Hernia Surgery GEM Hospital and Research CentreChennaiTamil NaduIndia Department of General Surgery Peking Union Medical College Hospital BeijingBeijingChina Department of Surgery Johns Hopkins University School of MedicineBaltimoreMDUSA Division of General and Transplant Surgery University of PisaPisaItaly Department of Surgery Seoul National University HospitalSeoul National University College of MedicineSeoulKorea Department of Surgery/Division of HBP Surgery&Transplantation University of MontpellierMontpellierFrance Department of Hepatopancreatobiliary and Transplant Surgery Singapore General Hospital and National Cancer Centre SingaporeSingaporeSingapore Department of Hepato-Pancreato-Biliary Surgery Moscow Clinical Scientific CenterMoscowRussia Department of Gastrointestinal and Pediatric Surgery Tokyo Medical UniversityShinjukuTokyoJapan Department of Surgery Yeungnam University College of MedicineDaeguKorea Department of Pancreato-Biliary Surgery The First Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina 18 Division of Hepatobiliary Pancreatic Surgery and Liver TransplantationNational University HospitalSingaporeSingapore Department of Surgery Galilee Medical CenterNahariyaIsrael Department of Surgery Seoul National University Bundang HospitalSeoul National University College of MedicineSeongnam-siKorea Division of Hepato-Biliary and Pancreatic Surgery Department of SurgeryAsan Medical Cente

Background:With the rapid development of robotic surgery,especially for the abdominal surgery,robotic pancreatic surgery(RPS)has been applied increasingly around the ***,evidence-based guidelines regarding its application,safety,and efficacy are still *** harvest robust evidence and comprehensive clinical practice,this study aims to develop international guidelines on the use of ***:World Health Organization(WHO)Handbook for Guideline Development,GRADE Grid method,Delphi vote,and the AGREE-II instrument were used to establish the Guideline Steering Group,Guideline Development Group,and Guideline Secretary Group,formulate 19 clinical questions,develop the recommendations,and draft the *** online meetings were held on 04/12/2020,30/11/2021,and 25/01/2022 to vote on the recommendations and get advice and suggestions from all involved *** the experts focusing on minimally invasive surgery from America,Europe and Oceania made great contributions to this consensus ***:After a systematic literature review 176 studies were included,19 questions were addressed and 14 recommendations were developed through the expert assessment and comprehensive judgment of the quality and credibility of the ***:The international RPS guidelines can guide current practice for surgeons,patients,medical societies,hospital administrators,and related social *** randomized trials are required to determine the added value of RPS as compared to open and laparoscopic surgery.

关键词： Robotic surgery guidelines pancreatectomy pancreaticoduodenectomy distal pancreatectomy(DP)

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A comparative study of pancreas transplantation between type 1 and 2 diabetes mellitus

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Hepatobiliary Surgery and Nutrition 2021年第4期10卷 443-453页

作者： Bor-Shiuan shyr Bor-Uei shyr Shih-Chin Chen Che-Chuan Loong yi-m.ng shyr Shin-E Wang Division of General Surgery Department of SurgeryTaipei Veterans General Hospitaland National Yang Ming UniversityTaipei Division of Transplant Surgery Department of SurgeryTaipei Veterans General Hospitaland National Yang Ming UniversityTaipei

Background:Pancreas transplantation remains the best long-term treatment option to achieve physiological euglycemia and insulin independence in patients with labile diabetes mellitus(Dm).It is widely accepted as an optimal procedure for type 1 Dm(T1Dm),but its application in type 2 Dm(T2Dm)is not unanimously ***:In total,146 diabetes patients undergoing pancreas transplantation were included in this *** data and outcomes were compared between the T1Dm and T2Dm ***:majority(93%)of the pancreas transplantations in T2Dm were for uremic *** occurred in 106(73%)patients,including 70(48%)with early complications before discharge and 79(54%)with late complications during follow-up ***,rejection of pancreas graft occurred in 37(25%)*** rejection rate in T2Dm recipients was significantly lower than that in *** short-and long-term outcomes for endocrine function in terms of fasting blood sugar and hemoglobin A1c levels and graft survival rates are comparable between the T2Dm and T1Dm ***:T2Dm is not inferior to T1Dm after pancreas transplantation in terms of surgical risks,immunological and endocrine outcomes,and graft survival ***,pancreas transplantation could be an effective option to treat selected uremic T2Dm patients without significant insulin resistance.

关键词： Type 2 diabetes mellitus(T2Dm) pancreas transplantation

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Influence of iron on the severity of hepatic fibrosis in patients with chronic hepatitis C

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World Journal of Gastroenterology 2006年第30期12卷 4897-4901页

作者： Tsung-Jung Lin Li-ying Liao shyr-yi Lin Chih-Lin Lin Ting-An Chang Department of Gastroenterology Ren-Ai Branch Taipei City Hospital TaipeiTaiwan China Graduate Institute of medical Sciences Taipei Medical University Taipei Taiwan China Department of Pathology Ren-Ai Branch Taipei City Hospital Taipei Taiwan China

AIm： To evaluate the association am.ng hepatic fibrosis, serum iron indices, and hepatic iron stores in patients with Chronic Hepatitis C （CHC）. mETHODS： Thirty-two CHC patients were included in our study. The histological degree of fibrosis and inflammation activity was assessed according to the metavir system. The serum iron indices including ferritin, iron and transferrin saturation were measured. Hepatic iron deposition was graded by Perls＇ stain. RESULTS： The CHC patients with severe hepatic fibrosis （n = 16） were significantly older than CHC patients with mild fibrosis （n = 16）（P = 0.024）. The serum iron indices, increased serum iron store and positive hepatic iron stain were not significantly different between the two groups. In multivariate logistic regression analysis, the age at biopsy was an independent predictor of severe hepatic fibrosis （Odds ratio = 1.312; P = 0.035）. The positive hepatic iron stain was significantly associated with the values of alanine aminotransferase （ALT）（P = 0.017）, ferritin （P = 0.008）, serum iron （P = 0.019） and transferrin saturation （P = 0.003）. The ferritin level showed significant correlation with the value ofALT （r = 0.531; P = 0.003）, iron （r = 0.467; P = 0.011） and transferrin saturation （r = 0.556; P = 0.002）. CONCLUSION： Our findings suggest that the severity of hepatitis C virus （HCV）-related liver injury is associated with patient age at biopsy. Both serum iron indices and hepatic iron deposition show correlation with serum indices of chronic liver disease but are not related to grade and stage of liver histology.

关键词： Chronic hepatitis C Hepatitis C virus Hepatic iron Serum iron Hepatic fibrosis

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Intraluminal versus infiltrating gallbladder carcinoma:Clinical presentation,ultrasound and computed tomography

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World Journal of Gastroenterology 2009年第45期15卷 5662-5668页

作者： Tze-Yu Lee Sheung-Fat Ko Chung-Cheng Huang Shu-Hang ng Jiun-Lung Liang Hsuan-ying Huang min-Chi Chen shyr-m.ng Sheen-Chen Department of Radiology Chang Gung University College of Medicine Chang Gung Memorial Hospital-Kaohsiung Medical Center Kaohsiung Hsien 833 Taiwan China Department of Pathology Chang Gung University College of Medicine Chang Gung Memorial Hospital-Kaohsiung Medical Center Kaohsiung Hsien 833 Taiwan China Public Health and Biostatistics Consulting Center Chang Gung University College of Medicine Chang Gung Memorial Hospital-Kaohsiung Medical Center Kaohsiung Hsien 833 Taiwan China Department of Surgery Chang Gung University College of Medicine Chang Gung Memorial Hospital-Kaohsiung Medical Center Kaohsiung Hsien 833 Taiwan China

AIm： To compare clinical presentation and ultrasound （US） and computed tomography （CT） sensitivity between intraluminal and infiltrating gallbladder carcinoma （GBCA）. mETHODS： This retrospective study evaluated 65 cases of GBCA that were categorized morphologically into the intraluminaI-GBCA （n = 37） and infiltrating-GBCA （n = 28） groups. The clinical and laboratory findings, presence of gallstones, gallbladder size, T-staging, nodal status, sensitivity of preoperative US and CT studies, and outcome were compared between the two groups. RESULTS： There were no significant differences between the two groups with respect to female predominance, presence of abdominal pain, serum aminotransferases level, T2-T4 staging, and regional metastatic nodes. Compared with the patients with intraluminaI-GBCA, those with infiltrating-GBCA were significantly older （65.49 ± 1.51 years vs 73.07 ± 1.90 years）, had a higher frequency of jaundice （3/37 patients vs 13/28 patients） and fever （3/37 patients vs 10/28 patients）, higher alkaline phosphatase （119.36 ± 87.80 IU/L vs 220.68 ± 164.84 IU/L） and total bilirubin （1.74 ± 2.87 mg/L vs 3.50 ± 3.51 mg/L） levels, higher frequency of gallstones （12/37 patients vs 22/28 patients）, smaller gallbladder size （length, 7.47± 1.70 cm vs 6.47 ± 1.83 cm; width, 4.21 ± 1.43 cm vs 2.67 ± 0.93 cm）, and greater proportion of patients with 〈 12 mo survival （16/37 patients vs 18/28 patients）. The sensitivity for diagnosing intraluminal- GBCA with and without gallstones was 63.6% and 91.3% by US, and 80% and 100% by CT, respectively. The sensitivity for diagnosing infiltrating-GBCA with and without gallstones was 12.5% and 25% by US, and 71.4% and 75% by c-r, respectively. CONCLUSION： In elderly women exhibiting small gallbladder and gallstones on US, especially those with jaundice, fever, high alkaline phosphatase and bilirubin levels, CT may reveal concurrent infiltrating-GBCA.

关键词： Gallbladder neoplasms Carcinoma Ultrasound Computed tomography

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Balthazar computed tomography severity index is superior to Ranson criteria and APACHE Ⅱ scoring system in predicting acute pancreatitis outcome

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World Journal of Gastroenterology 2005年第38期11卷 6049-6052页

作者： Ting-Kai Leung Chi-m.ng Lee shyr-yi Lin Hsin-Chi Chen Hung-Jung Wang Li-Kuo Shen Ya-Yen Chen Department of Diagnostic Radiology Taipei Medical University Hospital Taipei TaiwanChina Department of Internal medicine Taipei Medical University Hospital Taipei Taiwan China

AIm： Acute pancreatitis （AP） is a process with variable involvement of regional tissues or organ systems. multifactorial scales included the Ranson, Acute Physiology and Chronic Health Evaluation （APACHE Ⅱ） systems and Balthazar computed tomography severity index （CTSI）. The purpose of this review study was to assess the accuracy of CTSI, Ranson score, and APACHE II score in course and outcome prediction of AP. mETHODS： We reviewed 121 patients who underwent helical CT within 48 h after onset of symptoms of a first episode of AP between 1999 and 2003. Fourteen inappropriate subjects were excluded; we reviewed the 107 contrastenhanced CT images to calculate the CTSI. We also reviewed their Ranson and APACHE Ⅱ score. In addition, complications, duration of hospitalization, mortality rate, and other pathology history also were our comparison parameters. RESULTS： We classified 85 patients （79%） as having mild AP （CTSI 〈5） and 22 patients （21%） as having severe AP （CTSI ≥5）. In mild group, the mean APACHE II score and Ranson score was 8.6±1.9 and 2.4±1.2, and those of severe group was 10.2±2.1 and 3.1±0.8, respectively. The most common complication was pseudocyst and abscess and it presented in 21 （20%） patients and their CTSI was 5.9±1.4. A CTSI ≥5 significantly correlated with death, complication present, and prolonged length of stay. Patients with a CTSI ≥5 were 15 times to die than those CTSI 〈5, and the prolonged length of stay and complications present were 17 times and 8 times than that in CTSI 〈5, respectively. CONCLUSION： CTSI is a useful tool in assessing the severity and outcome of AP and the CTSI ≥5 is an index in our study. Although Ranson score and APACHE II score also are choices to be the predictors for complications, mortality and the length of stay of AP, the sensitivity of them are lower than CTSI.

关键词： Acute pancreatitis Ranson score APACHE Ⅱ score Balthazar computed tomography severity index

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molecular mechanisms of denbinobin-induced anti-tumorigenesis effect in colon cancer cells

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World Journal of Gastroenterology 2005年第20期11卷 3040-3045页

作者： Kuo-Ching Yang yih-Huei Uen Fat-moon Suk Yu-Chih Liang ying-Jan Wang Yuan-Soon Ho I-Hsuan Li shyr-yi Lin Department of Internal medicine Shin Kong Wu Ho-Su memorial Hospital Taipei Taiwan Department of Internal medicine Taipei Medical University Taipei Taiwan China Department of Surgery Chi-mei Foundational medical Center Yung-Kane City Tainan Taiwan China Department of Internal medicine Taipei medical University Hospital Taipei Taiwan China School of medical Technology Taipei medical University Taipei Taiwan China Department of Environmental and Occupational Health National Cheng Kung University medical College TainanTaiwan China Department of Internal medicine School of medicine Taipei Medical University Taipei Taiwan China Department of Internal medicine School of medicine and Department of Internal medicine Taipei Medical University Hospital Taipei Medical University Taipei Taiwan China

AIm: To explore both the in vitro and in vivo effects of denbinobin against colon cancer cells and clarify its underlying signal pathways. mETHODS: We used COLO 205 cancer cell lines and nude mice xenograft model to study the in vitro and in vivo anti-cancer effects of denbinobin. RESULTS: Denbinobin at concentration of 10-20 μmol/L dose-dependently suppressed COLO 205 cell proliferation by mTT test. Flow cytometry analysis and DNA fragmentation assay revealed that 10-20 μmol/L denbinobin treatment induced COLO 205 cells apoptosis. Western blot analysis showed that caspases 3,8,9 and Bid protein were activated by denbinobin treatment to COLO 205 cells accompanied with cytochrome c and apoptosis-inducing factor (AIF) translocation. Pretreatment of mEK 1 inhibitor (U10126), but not p38 inhibitor (SB203580) and JNK inhibitor (SP600125), reversed denbinobin-induced caspase 8, 9 and Bid activation in COLO 205 cells suggesting that extracellular signal-regulated kinase were involved in the denbinobin-induced apoptosis in COLO 205 cells. Significant regression of tumor up to 68% was further demonstrated in vivo by treating nude mice bearing COLO 205 tumor xenografts with denbinobin 50 mg/kg intraperitoneally. CONCLUSION: Our findings suggest that denbinobin could inhibit colon cancer growth both in vitro and in vivo. Activation of extrinsic and intrinsic apoptotic pathways and AIF were involved in the denbinobin-induced COLO 205 cell apoptosis.

关键词： Denbinobin Colon cancer Nude mice Apoptosis ERK pathway

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Immu-mela:An open resource for exploring immunotherapy-related multidimensional genomic profiles in melanoma

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Journal of Genetics and Genomics 2021年第5期48卷 361-368页

作者： Jing Yang Shilin Zhao Jing Wang Quanhu Sheng Qi Liu Yu shyr Center for Quantitative Sciences Vanderbilt University Medical CenterNashville TN 37203USA Department of Biostatistics Vanderbilt University Medical CenterNashville TN 37203USA

There are increasing studies aimed to reveal genomic hallmarks predictive of immune checkpoint blockade(ICB)treatment response,which generated a large number of data and provided an unprecedented opportunity to identify response-related features and evaluate their robustness across ***,those valuable data sets are not easily accessible to the research *** take full advantage of existing large-scale immuno-genomic profiles,we developed Immu-mela(http://***/database/Immu-mela/),a multidimensional immuno-genomic portal that provides interactive exploration of associations between ICB responsiveness and multi-omics features in melanoma,including genetic,transcriptomics,immune cells,and single-cell ***-mela also enables integrative analysis of any two genomic *** demonstrated the value of Immu-mela by identifying known and novel genomic features associated with ICB *** addition,Immu-mela allows users to upload their data sets(unrestricted to any cancer types)and co-analyze with existing data to identify and validate signatures of ***-mela reduces barriers between researchers and complex genomic data,facilitating discoveries in cancer immunotherapy.

关键词： Immunotherapy PD-1/PD-L1 blockade CTLA-4 blockade Immune checkpoint multidimensional genomics Biomarker melanoma

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Involvement of fatty acid-CoA ligase 4 in hepatocellular carcinoma growth: Roles of cyclic AmP and p38 mitogen-activated protein kinase

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World Journal of Gastroenterology 2005年第17期11卷 2557-2563页

作者： Yu-Chih Liang Chih-Hsiung Wu Jan-Show Chu Chung-Kwe Wang Ling-Fang Hung ying-Jan Wang Yuan-Soon Ho Jan-Gowth Chang shyr-yi Lin School of medical Technology Taipei medical University TaipeiTaiwanChina Department of Surgery Taipei medical University Hospital Taipei Medical UniversityTaipeiTaiwanChina Department of Pathology School of medicine Taipei Medical UniversityTaipeiTaiwanChina Department of Internal medicine Taipei municipal Jen-Ai Hospital TaipeiTaiwanChina Department of Environmental and Occupational Health National Cheng Kung University medical College TainanTaiwanChina Department of molecular medicine and Laboratory medicine China medical University Hospital TaiwanChina Department of Internal medicine School of medicine Department of Internal medicine Taipei Medical University HospitalTaipei Medical UniversityTaipeiTaiwanChina

AIm: Fatty acid-CoA ligase 4 (FACL4) is an arachidonatepreferring enzyme which has been shown to be up-regulated in human colon cancer tissues and implicated in the colon tumorigenesis. The purpose of this study was to investigatethe role of FACL4 in the human hepatocellular carcinoma (HCC) tumorigenesis and the specific signal pathways involved in this ***: We investigated the expression and regulation of FACL4 in HCC, adjacent non-tumorous liver tissues, and cell ***: In HCC patients, we demonstrated that FACL4 gene expression was markedly elevated in the cancerous tissues than in the adjacent non-cancerous liver *** addition, several human hepatoma cell lines, including Hep3B and HepG2, expressed high levels of FACL4. Stable overex-pression of FACL4 knockdown plasmids (small interfering RNA, siRNA) to Hep3B cells significantly decreased FACL4 expression and subsequently limited the cell proliferation. Treatment of Hep3B cells with 8bromo-cAmP and SB203508 (p38 mAPK inhibitor) significantly suppressed the FACL4 expression. CONCLUSION: FACL4 is involved in the HCC tumorigenesis and both cAmP and p38 mAPK pathways are associated with the regulation of FACL4 in HCC.

关键词： FACL-4 HCC

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Characterization of pancreatic stem cells derived from adult human pancreas ducts by fluorescence activated cell sorting

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World Journal of Gastroenterology 2006年第28期12卷 4529-4535页

作者： Han-Tso Lin Shih-Hwa Chiou Chung-Lan Kao yi-m.ng shyr Chien-Jen Hsu yin-Wen Tarng Larry L-T Ho Ching-Fai Kwok Hung-Hai Ku Department of medical Research and Education Taipei Veterans General HospitalTaipei11217TaiwanChina Department of medical Research and Education Taipei Veterans General Hospitaland Institute of Clinical MedicineNational Yang-Ming UniversityTaipei11221TaiwanChina Department of Physical medicine and Rehabilitation Taipei Veterans General HospitalTaipei11217TaiwanChina Department of Surgery Taipei Veterans General HospitalTaipei11217TaiwanChina Department of Orthopedics Kaohsiung Veterans General Hospital Kaohsiung 81346TaiwanChina Division of Endocrinology and metabolism Department of Internal MedicineTaipei Veterans General HospitalTaipei11217TaiwanChina Institute of Anatomy and Cell Biology National Yang-Ming UniversityTaipeiDepartment of Education and ResearchTaipei City Hospital11221TaiwanChina

AIm： To isolate putative pancreatic stem cells （PSCs） from human adult tissues of pancreas duct using serumfree, conditioned medium. The characterization of surface phenotype of these PSCs was analyzed by flow cytometry. The potential for pancreatic lineage and the capability of β-cell differentiation in these PSCs were evaluated as well. mETHODS： By using serum-free medium supplemented with essential growth factors, we attempted to isolate the putative PSCs which has been reported to express nestin and pdx-1. The matrigelTm was employed to evaluate the differential capacity of isolated cells. Dithizone staining, insulin content/secretion measurement, and immunohistochemistry staining were used to monitor the differentiation. Fluorescence activated cell sorting （FACS） was used to detect the phenotypic markers of putative PSCs. RESULTS： A monolayer of spindle-like cells was cultivated. The putative PSCs expressed pdx-1 and nestin. They were also able to differentiate into insulin-, glucagon-, and somatostatin-positive cells. The spectrum of phenotypic markers in PSCs was investigated; a similarity was revealed when using human bone marrow-derived stem cells as the comparative experiment, such as CD29, CD44, CD49, CD50, CD51, CD62E, PDGFR-α, CD73 （SH2）, CD81, CD105（SH3）. CONCLUSION： In this study, we successfully isolated PSCs from adult human pancreatic duct by using serumfree medium. These PSCs not only expressed nestin and pdx-1 but also exhibited markers attributable to mesenchymal stem cells. Although work is needed to elucidate the role of these cells, the application of these PSCs might be therapeutic strategies for diabetes mellitus.

关键词： Putative pancreas stem cell Nestirr, pdx-1 Phenotypic marker

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Effect of ZVAD-fmk on hepatocyte apoptosis after bile duct ligation in rat

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World Journal of Gastroenterology 2005年第15期11卷 2330-2333页

作者： shyr-m.ng Sheen-Chen Hsin-Tsung Ho Wei-Jen Chen Hock-Liew Eng Department of Surgery Department of Laboratory medicine Department of Pathology

AIm: Retention and accumulation of toxic hydrophobic bile salts within hepatocyte may cause hepatocyte toxicity by inducing apoptosis. Apoptosis is a pathway of cell death orchestrated by a family of proteases called caspases. Z-ValAla-Asp (Ome)-fluoromethyl ketone (ZVAD-fmk) is a cellpermeable irreversible inhibitor of caspase. The purpose of this study was to evaluate the possible effect of ZVAD-fmk on hepatocyte apoptosis after bile duct ligation in the ***: male Sprague-Dawley rats, weighing 250-300 g,were randomized to five groups of five rats each. Group 1 underwent common bile duct ligation and simultaneous treatment with ZVAD-fmk (dissolved in dimethylsulfoxide (DmSO)). Group 2 underwent common bile duct ligation and simultaneous treatment with Z-Phe-Ala-fluoromethyl ketone ( ZFA-fmk, dissolved in DmSO). Group 3 underwent sham operation and simultaneous treatment with the same amount of DmSO. Group 4 underwent sham operation and simultaneous treatment with the same amount of normal saline. Group 5 underwent common bile duct ligation without other manipulation. After three days, liver tissue was harvested for histopathologic analysis and measurements of ***: When compared with sham operation, common bile duct ligation significantly increased hepatocyte apoptosis (P= 0.008) and ductular proliferation (P= 0.007).ZVAD-fmk significantly diminished the increased hepatocyte apoptosis and ductular proliferation after common bile duct ligation (P = 0.008 and P = 0.007, respectively). ZFA did not show the same ***: Hepatocyte apoptosis and ductular proliferation significantly increased after common bile duct ligation. ZVAD-fmk effectively diminished the increased hepatocyte apoptosis and ductular proliferation after common bile duct ligation, whereas ZFA-fmk did not.

关键词： Apoptosis Obstructive jaundice ZVAD-fmk ZFA

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