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Editorial on“Short-and long-term outcomes after hemihepatectomy for perihilar cholangiocarcinoma:does left or right side matter?”

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Hepatobiliary Surgery and Nutrition 2022年第3期11卷 470-472页

作者： Christian Benzing johann pratschke Moritz Schmelzle Department of Surgery Campus Charité Mitte/Campus Virchow-KlinikumExperimental Surgery and Regenerative MedicineCharité-Universitätsmedizin BerlinBerlinGermany

Perihilar cholangiocarcinoma(PHC)is a malignant tumor known for its aggressive tumor biology(1).The only curative therapeutic approach is major hepatectomy with extrahepatic bile duct ***,these procedures are associated with a very high postoperative mortality of up to 20%(1,2).And even after successful surgical tumor resection,tumor recurrence occurs in the course of many patients resulting in low overall survival(OS)rates(3).

关键词： hepatectomy mortality tumor

Identification and treatment of biliary complications after liver transplantation:more relevant than ever

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Hepatobiliary Surgery and Nutrition 2022年第3期11卷 443-445页

作者： Simon Moosburner johann pratschke Nathanael Raschzok Department of Surgery Campus CharitéMitte/Campus Virchow-KlinikumExperimental SurgeryCharité-Universitätsmedizin BerlinFreie Universität BerlinHumboldt-Universität zu Berlin and Berlin Institute of HealthBerlinGermany BIH CharitéClinician Scientist Program Berlin Institute of Health(BIH)BerlinGermany

Liver transplantation remains the treatment of choice for patients with end-stage liver *** the increasing demand for liver transplantation,the spectrum of potential grafts has been widened and includes now not only regular grafts from donation after brain death(DBD)but also organs from donation after cardiac death(DCD),split liver and living donor grafts,as well as so-called“marginal grafts”from donors with extended criteria such as significant steatosis hepatis or older age(1).These grafts are associated with higher rates of early allograft dysfunction and primary non-function-which stresses the healthcare system with increased length of hospital stay for patients and higher costs(2,3).Moreover,marginal grafts are at risk for biliary complications such as anastomotic and non-anastomotic strictures as well as biliary leakages,which is caused by more severe ischemia reperfusion injury and in consequence reduced micro perfusion of the biliary tract(4).

关键词： liver organs death treatment

Enterolithiasis-associated ileus in Crohn's disease

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World Journal of Gastroenterology 2012年第42期18卷 6160-6163页

作者： Alexander Perathoner Pamela Kogler Christian Denecke johann pratschke Reinhold Kafka-Ritsch Matthias Zitt Department of Visceral Transplant and Thoracic SurgeryCenter of Operative MedicineMedical University of Innsbruck6020 InnsbruckAustria

Stasis of the flow of the intestinal contents,ingested material and unfavorable composition of the chylus can lead to the formation of enteroliths inside the *** represents a rare disorder of the gastrointestinal tract that can be associated with intermittent abdominal pain or more serious complications such as bleeding or *** in Crohn' s disease represents an extremely rare condition and usually occurs only in patients with a long symptomatic history of Crohn's *** report an unusual case of enterolithiasis-related intestinal obstruction in a young male patient with Crohn's disease(A2L3B1 Montreal Classification for Crohn's disease 2005) undergoing emergency laparotomy and ileocoecal *** addition,we present an overview of the relevant characteristics of enterolithiasis on the basis of the corresponding literature.

关键词： Crohn's disease Enterolithiasis Ileus Inflammatory bowel disease Obstruction

Risk factors for bile leakage after hepatectomy

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Hepatobiliary & Pancreatic Diseases International 2016年第1期15卷 12-13页

作者： Benjamin Struecker Andreas Andreou Igor M Sauer johann pratschke Daniel Seehofer General Visceraland Transplantation SurgeryCharité-Universitaetsmedizin BerlinCampus Virchow Clinic

In the current issue, Panaro et al presented a retro- spective single-center study on 411 hepatectomies for benign and malignant liver tumors. After exclusion of hilar cholangiocarcinomas and hepatectomies with simultaneous biliary or pancreatic resection, risk factors for postoperative bile leakage were analyzed. Progress in preoperative assessment （e.g. modern imaging studies, liver function tests）, liver preconditioning （e.g. portal vein embolization）, improving perioperative care, and advances in surgical techniques （e.g. two stage hepatec- tomies, liver partition with portal vein ligation for staged hepatectomy） enable curative resections even for advanced hepatic malignancies with reasonable mortality rates and constantly improving oncological outcomes.

关键词： Risk factors for bile leakage after hepatectomy

Warm HTK donor pretreatment reduces liver injury during static cold storage in experimental rat liver transplantation

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Hepatobiliary & Pancreatic Diseases International 2015年第6期14卷 596-602页

作者： Wenzel Schoening Veeravorn Ariyakhagorn Thomas Schubert Peter Olschewski Andreas Andreou Peter Neuhaus johann pratschke Gero Puhl Allgemein- Visceral- & TransplantationschirurgieCharite Campus Virchow Klinikum General and Vascular Surgery Bumrungrad International Hospital Department of Pathology University of Erlangen

BACKGROUND： Organ shortage has led to an increased number of transplantations from extended criteria donors. These organs are more vulnerable to ischemia-reperfusion injury. Thus, improvement of organ preservation is needed. HTK is a widely used preservation solution for static cold storage in liver transplantation. The present study was to investigate the beneficial effect of warm HTK donor pretreatment on liver preservation.

关键词： experimental liver transplantation static cold storage organ preservation ischemia-reperfusion injury

Influence of the body mass index on postoperative outcome and long-term survival after pancreatic resections in patients with underlying malignancy

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Hepatobiliary Surgery and Nutrition 2019年第3期8卷 201-210页

作者： Philippa Seika Fritz Klein Uwe Pelzer johann pratschke Marcus Bahra Thomas Malinka Department of Surgery Charite Campus Mitte and Charite Campus Virchow KlinikumCharité-Universitatsmedizin BerlinBerlinGermany Department of Hematology/Oncology/Tumorimmunology Campus Virchow KlinikumCharité-Universitatsmedizin BerlinBerlinGermany

Background:While the long-term survival rate among patients with pancreatic and periampullary carcinomas remains low,it can be influenced by various *** purpose of this retrospective study was to investigate the effects of body mass index(BMI)on postoperative complications and patient survival after pancreatic resections for underlying malignancy over a 20-year observation ***:We analyzed 1,384 patients,918 patients with pancreatic ductal adenocarcinoma(PDAC)(66.3%),229 patients with distal cholangiocarcinoma(16.5%),206 ampullary carcinoma patients(14.8%),and 31 duodenal carcinoma patients(2.2%).Patients were classified into four groups(group 130.0)according to their BMI(kg/m2).We analyzed differences in postoperative complications,postoperative length of hospital stays,reoperations,postoperative mortality and survival rate among the ***:Within a mean observation period of 687.7[2–8,500]days,735(53.1%)patients *** were important differences in postoperative complications(group 1,16.2%;group 2,20.3%;group 3,27.2%,group 4,41.6%)with the type of postoperative complications also varying between the *** 1-,5-,10-and 15-year survival rates were 66.4%,25.5%,17.9%,and 12.1%,respectively,with survival rates varying amongst the four ***:Patients with a BMI between 18.5 and 30 show better postoperative outcomes,regarding complications,hospitalization duration,and reoperation rates than underweight or obese ***-term survival depends strongly on postoperative complications while patients with a higher BMI show better long-term survival rates.

关键词： Pancreatic resection body mass index(BMI) outcome long-term survival

An inflammatory subtype of pancreatic ductal adenocarcinoma is associated with poor prognosis and increased perioperative mortality

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Journal of Pancreatology 2019年第3期2卷 107-112页

作者： Benzing Christian Klein Fritz Pelzer Uwe Sinn Marianne pratschke johann Bahra Marcus Campus Charité-Mitte and Campus Virchow Klinikum Charité-Universitätsmedizin BerlinBerlinGermany Department of Hematology Oncology and Tumor ImmunologyCharité-Universitätsmedizin BerlinBerlinGermany

Pancreatic ductal adenocarcinoma(PDAC)is a malignancy characterized by an aggressive tumor *** present analysis seeks to identify and analyze a cohort that meets criteria for"inflammatory"PDAC(IPDAC).All patients who underwent a curative resection for PDAC at our institution between 1989 and 2015 were included in the retrospective *** with histological proven adenocarcinoma and elevated C-reactive protein(CRP)(≥6 mg/L)serum concentrations,but no other suspicion of infection were *** provide a matched control group with normal CRP serum levels from the same patient ***-six(6.8%)of 532 patients meet our criteria for an IPDAC group ***-hospital(30 days)mortality was 13.9%in the IPDAC group vs 0%in the control group(P=.020).Median follow-up was 183.8 months(standard deviation[SD]=53.3,range 14.3-285.4).Median overall survival was 8.5 months(SD=16.8,range 0.3-89.6)in the IPDAC group and 24.8 months(SD=19.4,range 0.7-80.4)in the control group(P=.002).Patients indicating an IPDAC in our cohort had a significantly and clinical meaningful decreased overall survival and a higher perioperative morbidity and mortality.

关键词： Cholangitis CRP Inflammatory carcinoma PDAC

Tumor–stromal cross-talk modulating the therapeutic response in pancreatic cancer

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Hepatobiliary & Pancreatic Diseases International 2018年第5期17卷 461-472页

作者： Christopher C.M.Neumann Ellen von Horschelmann Anja Reutzel-Selke Elisabeth Seidel Igor Maximilian Sauer johann pratschke Marcus Bahra Rosa Bianca Schmuck Department of Surgery Campus Charité Mitte Campus Virchow-KlinikumExperimental SurgeryCharité-Universitatsmedizin BerlinBerlinGermany Berlin Institute of Health Department of SurgeryCampus CharitéMitte and Campus Virchow-KlinikumAugustenburger Platz 113353 BerlinGermany

Background: Pancreatic ductal adenocarcinoma(PDAC) is a highly malignant solid tumor with a dismal prognosis. The stroma component makes up to 90% of the tumor mass and is thought to be one of the main reasons for the tumor’s high chemoresistance. Cancer associated fibroblasts(CAFs) have previously been identified to be the key stromal players. This is the first time we provide detailed in vitro experiments investigating tumor–stromal interactions when exposed to three well-known chemotherapeutic agents. Methods: Monocultures, indirect and direct co-cultures of two PDAC cell lines(AsPC and Panc-1) and six primary patients derived CAFs were treated with gemcitabine, nab-paclitaxel and the γ-secretaseinhibitor(GSI) DAPT. The cell viability of each component was measured with XTT. Finally, IL-6 concentrations of the supernatants were analyzed. Results: On the contrary to PDAC cell lines, CAF monocultures hardly responded to any treatment which suggested that stroma(CAFs) itself is more resistant to standard chemo-treatments than the epithelial cancer cells. Moreover, only a weak chemotherapeutic response was observed in direct co-cultures of cancer cells with CAFs. A change in the morphology of direct co-cultures was accompanied with the chemoresistance. CAFs were observed to build cage-like structures around agglomerates of tumor cells. High levels of IL-6 were also associated with a reduced response to therapy. Indirect co-cultures make the tumor–stromal interaction more complex. Conclusions: CAFs are highly chemoresistant. Direct cell–cell contact and high levels of IL-6 correlate with a high chemoresistance.

关键词： Pancreatic cancer Tumor microenvironment Cancer associated fibroblasts Cancer–stroma co-culture Atroma targeted therapy

Validation of the Enhanced Recovery after Surgery (ERAS) society recommendations for liver surgery: a prospective, observational study

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Hepatobiliary Surgery and Nutrition 2023年第1期12卷 20-36,I0003-I0006页

作者： Moritz Schmelzle Felix Krenzien Paul Dahlke Alina Krombholz Nora Nevermann Linda Feldbrügge Axel Winter Wenzel Schoning Christian Benzing johann pratschke Jens Neudecker Department of Surgery Campus Charite Mitte and Campus Virchow-KlinikumCharite-Universitatsmedizincorporate member of Freie Universität BerlinHumboldt-Universitat zu BerlinBerlinGermany Berlin Institute of Health(BIH) BerlinGermany

Twenty-three recommendations were summarized by the Enhanced Recovery After Surgery(ERAS)society for liver *** aim was to validate the protocol especially with regard to adherence and the impact on ***:Using the ERAS Interactive Audit System(EIAS),ERAS items were evaluated in patients undergoing liver *** a period of 26 months,304 patients were prospectively enrolled in an observational study(DRKS00017229).Of those,51 patients(non-ERAS)were enrolled before and 253 patients(ERAS)after the implementation of the ERAS *** adherence and complications were compared between the two ***:Overall adherence increased from 45.2%in the non-ERAS group to 62.7%in the ERAS group(P0.05).Overall complications decreased from 41.2%(n=21)in the non-ERAS group to 26.5%(n=67)in the ERAS group(P=0.0423),which was mainly due to the reduction of grade 1-2 complications from 17.6%(n=9)to 7.6%(n=19)(P=0.0322).As for patients undergoing open surgery,implementation of ERAS lead to a reduction of overall complications in patients scheduled for minimally invasive liver surgery(MILS)(P=0.036).Conclusions:Implementation of the ERAS protocol for liver surgery according to the ERAS guidelines of the ERAS Society reduced Clavien-Dindo grade 1-2 complications particularly in patients who underwent *** ERAS guidelines are beneficial for the outcome,while adherence to the various items has not yet been satisfactorily defined.

关键词： Enhanced Recovery After Surgery(ERAS) prehabilitation liver surger