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Safety of high-carbohydrate fluid diet 2 h versus overnight fasting before non-emergency endoscopic retrograde cholangiopancreatography:A single-blind,multicenter,randomized controlled trial

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Chinese Medical Journal 2024年第12期137卷 1437-1446页

作者： Wenbo Meng Joseph W.Leung Zhenyu Wang Qiyong Li Leida Zhang Kai Zhang Xuefeng Wang Meng Wang Qi Wang Yingmei Shao Jijun Zhang Ping Yue Lei Zhang Kexiang Zhu Xiaoliang Zhu Hui Zhang Senlin Hou Kailin Cai Hao Sun Ping Xue Wei Liu Haiping Wang Li Zhang Songming Ding Zhiqing Yang Ming Zhang Hao Weng QingyuanWu Bendong Chen Tiemin Jiang Yingkai Wang Lichao Zhang Ke Wu Xue Yang Zilong Wen Chun Liu LongMiao Zhengfeng Wang Jiajia Li Xiaowen Yan Fangzhao Wang Lingen Zhang Mingzhen Bai Ningning Mi XianzhuoZhang Wence Zhou Jinqiu Yuan Azumi Suzuki Kiyohito Tanaka Jiankang Liu Ula Nur Elisabete Weiderpass Xun Li Department of General surgery The First Hospital of Lanzhou UniversityLanzhouGansu 730000China Key Laboratory of Biological Therapy and Regenerative Medicine Transformation Gansu Province LanzhouGansu 730000China Division of Gastroenterology and Hepatology UC Davis Medical CenterSacramentoCA 95816USA Department of Minimally Invasive surgery Tianjin Nankai HospitalTianjin 300100China Division of hepatobiliary and Pancreatic surgery Department of SurgeryShulan(Hangzhou)Hospital Affiliated to Zhejiang Shuren UniversityHangzhouZhejiang 310000China Department of hepatobiliary surgery Southwest HospitalArmy Medical UniversityChongqing 400000China hepatobiliary surgery Department Shandong Provincial Third HospitalJinanShandong 250000China Department of General surgery Xinhua HospitalAffiliated to Shanghai Jiao Tong University School of MedicineShanghai Key Laboratory of Biliary Tract Disease ResearchShanghai 200000China Department of hepatobiliary and Pancreatic surgery The First Hospital of Jilin UniversityChangchunJilin 130000China Department of hepatobiliary surgery The General Hospital of Ningxia Medical UniversityYinchuanNingxia 750000China Department of hepatobiliary&Hydatid Digestive and Vascular Surgery CenterXinjiang Key Laboratory of Echinococcosis and Liver Surgery ResearchThe First Affiliated Hospital of Xinjiang Medical UniversityUrumqiXinjiang 830000China Department of hepatobiliary and Pancreatic surgery The First Hospital of Shanxi Medical UniversityTaiyuanShanxi 030000China Department of General surgery The Second Hospital of Lanzhou UniversityLanzhouGansu 730000China Department of Biliopancreatic Endoscopic surgery The Second Hospital of Hebei Medical UniversityShijiazhuangHebei 050000China Gastrointestinal surgery Department Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430000China Department of hepatobiliary surgery The First Affiliated Hospital of Xi’an Jiaotong UniversityXi’anShaanxi 710000China Depart

Background:Although overnight fasting is recommended prior to endoscopic retrograde cholangiopancreatography(ERCP),the benefits and safety of high-carbohydrate fluid diet(CFD)intake 2 h before ERCP remain *** study aimed to analyze whether high-CFD intake 2 h before ERCP can be safe and accelerate patients’***:This prospective,multicenter,randomized controlled trial involved 15 tertiary ERCP centers.A total of 1330 patients were randomized into CFD group(n=665)and fasting group(n=665).The CFD group received 400 mL of maltodextrin orally 2 h before ERCP,while the control group abstained from food/water overnight(>6 h)before *** ERCP procedures were performed using deep sedation with intravenous *** investigators were blinded but not the *** primary outcomes included postoperative fatigue and abdominal pain score,and the secondary outcomes included complications and changes in metabolic *** outcomes were analyzed according to a modified intention-to-treat ***:The post-ERCP fatigue scores were significantly lower at 4 h(4.1±2.6 vs.4.8±2.8,t=4.23,P3.4±2.4,t=7.94,P37])and positive urine ketone levels(7.7%[39/509]vs.15.4%[82/533],χ^(2)=15.13,P3/634]vs.4.0%[26/658],χ^(2)=3.99,P=0.046)but not pancreatitis(5.5%[35/634]vs.6.5%[43/658],χ^(2)=0.59,P=0.444).Subgroup analysis revealed that CFD reduced the incidence of complications in patients with native papilla(odds ratio[OR]:0.61,95%CI:0.39-0.95,P=0.028)in the multivariable ***:Ingesting 400 mL of CFD 2 h before ERCP is safe,with a reduction in post-ERCP fatigue,

关键词： Endoscopic retrograde cholangiopancreatography ERCP Carbohydrate Fasting Safety Complications Enhanced recovery after surgery Randomized controlled trial

Surgically treating a rare and asymptomatic intraductal papillary neoplasm of the bile duct:A case report

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World Journal of Clinical Cases 2024年第2期12卷 367-373页

作者： Shen-Zhen Zhu Zhao-Feng Gao Xiao-Rong Liu Xiao-Guang Wang Fei Chen Department of General surgery Jiaxing Second HospitalJiaxing 314000Zhejiang ProvinceChina Department of hepatobiliary surgery Jiaxing Second HospitalJiaxing 314000Zhejiang ProvinceChina

BACKGROUND Intraductal papillary neoplasms of the bile duct(IPNBs)are rare and characterized by papillary growth within the bile duct *** is similar to obstructive biliary *** this report,we present an unexpected case of asymptomatic IPNB and consolidate our findings with the relevant literature to augment our understanding of this *** relevant literature contributes to a more comprehensive understanding of the *** SUMMARY A 66-year-old Chinese male patient was admitted to our hospital for surgical intervention after gallstones were discovered during a routine physical *** imaging revealed a lesion on the left side of the liver,which raised the suspicion of IPNB.A laparoscopic left hemihepatectomy was performed,and subsequent histopathological examination confirmed the diagnosis of *** the 3-mo postoperative follow-up,the patient reported good recovery and no *** can manifest both latently and *** surgical resection is the most effective treatment for *** Hepatic and biliary masses,should be considered to diagnose *** surgery and vigilant follow-up are crucial in determining prognosis.

关键词： Intraductal papillary neoplasm of the bile duct Tumor Surgical treatment Prognosis Case report

Resveratrol inhibits pancreatic cancer proliferation and metastasis by depleting senescent tumor-associated fibroblasts

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World Journal of Gastrointestinal Oncology 2024年第9期16卷 3980-3993页

作者： He Jiang Guo-Tai Wang Zheng Wang Qing-Yong Ma Zhen-Hua Ma Department of hepatobiliary surgery The First Affiliated HospitalXi’an Jiaotong UniversityXi’an 710061Shaanxi ProvinceChina Department of hepatobiliary surgery Affiliated Hospital of Shaanxi University of Chinese MedicineXianyang 712000Shaanxi ProvinceChina

BACKGROUND Pancreatic cancer,a formidable gastrointestinal neoplasm,is characterized by its insidious onset,rapid progression,and resistance to treatment,which often lead to a grim *** the complex pathogenesis of pancreatic cancer is well recognized,recent attention has focused on the oncogenic roles of senescent tumor-associated ***,their precise role in pancreatic cancer remains *** is a natural polyphenol known for its multifaceted biological actions,including antioxidative and neuroprotective properties,as well as its potential to inhibit tumor proliferation and *** current investigation builds on prior research and reveals the remarkable ability of resveratrol to inhibit pancreatic cancer proliferation and *** To explore the potential of resveratrol in inhibiting pancreatic cancer by targeting senescent tumor-associated *** Immunofluorescence staining of pancreatic cancer tissues revealed prominent coexpression ofα-SMA and ***-1 expression was determined using *** were treated with the senescence-inducing factors known as ***-term growth assays confirmed that 3CKs significantly decreased the CAF growth *** blotting was conducted to assess the expression levels of p16 and *** was performed to assess LaminB1 *** real-time polymerase chain reaction was used to measure the levels of several senescence-associated secretory phenotype factors,including IL-4,IL-6,IL-8,IL-13,MMP-2,MMP-9,CXCL1,and CXCL12.A scratch assay was used to assess the migratory capacity of the cells,whereas Transwell assays were used to evaluate their invasive *** Specifically,we identified the presence of senescent tumor-associated fibroblasts within pancreatic cancer tissues,linking their abundance to cancer ***,Resveratrol effectively eradicated these fibroblasts and hindered their senescence,which co

关键词： Resveratrol Pancreatic Cancer Proliferation Metastasis Senescent Fibroblasts

Diagnosis and treatment experience of atypical hepatic cystic echinococcosis type 1 at a tertiary center in China

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World Journal of Gastroenterology 2024年第5期30卷 462-470页

作者： Yu-Peng Li Jie Zhang Zhi-De Li Chao Ma Guang-Lei Tian Yuan Meng Xiong Chen Zhi-Gang Ma Department of hepatobiliary surgery People's Hospital of Xinjiang Uygur Autonomous RegionUrumqi 830000Xinjiang Uygur Autonomous RegionChina

BACKGROUND Some hydatid cysts of cystic echinococcosis type 1(CE1)lack well-defined cyst walls or distinctive endocysts,making them difficult to differentiate from simple hepatic *** To investigate the diagnostic methods for atypical hepatic CE1 and the clinical efficacy of laparoscopic *** The clinical data of 93 patients who had a history of visiting endemic areas of CE and were diagnosed with cystic liver lesions for the first time at the People's hospital of Xinjiang Uygur Autonomous Region(China)from January 2018 to September 2023 were retrospectively *** diagnoses were made based on findings from serum immunoglobulin tests for echinococcosis,routine abdominal ultrasound,high-frequency ultrasound,abdominal computed tomography(CT)scan,and *** to the treatments,these patients underwent reexaminations at the outpatient clinic until October *** evaluations included the diagnostic precision of diverse examinations,the efficacy of surgical approaches,and the incidence of CE *** All 93 patients were diagnosed with simple hepatic cysts by conventional abdominal ultrasound and abdominal CT *** them,16 patients were preoperatively diagnosed with atypical CE1,and 77 were diagnosed with simple hepatic cysts by high-frequency *** the 16 patients preoperatively diagnosed with atypical CE1 underwent laparoscopy,of whom 14 patients were intraoperatively confirmed to have CE1,which was consistent with the postoperative pathological diagnosis,one patient was diagnosed with a mesothelial cyst of the liver,and the other was diagnosed with a hepatic cyst combined with local *** the 77 patients who were preoperatively diagnosed with simple hepatic cysts,4 received aspiration sclerotherapy of hepatic cysts,and 19 received laparoscopic *** patients were intraoperatively diagnosed with simple hepatic *** the followup period,none of the 14 patients with CE1 expe

关键词： Hepatic echinococcosis Hepatic cystic echinococcosis type 1 Hepatic cyst Color Doppler ultrasound Laparoscopy

Pancreatic giant malignancy simulating a gastrointestinal stromal tumor

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hepatobiliary & Pancreatic Diseases International 2024年第4期23卷 431-433页

作者： Ben-Jie Liu Chen-Hui Jin Yan-Lun Guo Zhi-Gang Ke Jun-Jun Huang Lin-Ping Cao Department of hepatobiliary surgery Department of General SurgeryPujiang Branch of the First Affiliated HospitalZhejiang University School of MedicineJinhua 322200China Department of Pathology Pujiang Branch of the First Affiliated HospitalZhejiang University School of MedicineJinhua 322200China Department of hepatobiliary and Pancreatic surgery the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China

Pancreatic acinar cell carcinoma(PACC)is a rare malignant tumor of pancreatic epithelial cells,which produces pancreatic exocrine *** originates from acinar cells and terminal branches of the pancreatic ducts in the exocrine tissue of the *** accounts for 1%−2%of pancreatic exocrine tumors[1].Herein,we present an elderly woman with PACC who recovered after effective laparoscopic *** tumor was located on the left side of the abdomen;imaging suggested that it was a gastrointestinal stromal tumor of the gastric wall origin,infiltrating the tail of the pancreas and omentum,while postoperative pathology suggested PACC.

关键词： Pancreatic gastrointestinal pancreas

Influence of sex on outcomes of liver transplantation for hepatocellular carcinoma:a multicenter cohort study in China

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Cancer Biology & Medicine 2024年第4期21卷 347-362页

作者： Jian Chen Zhe Yang Fengqiang Gao Zhisheng Zhou Junli Chen Di Lu Kai Wang Meihua Sui Zhengxin Wang Wenzhi Guo Guoyue Lyu Haizhi Qi Jinzhen Cai Jiayin Yang Shusen Zheng Xiao Xu Zhejiang University School of Medicine Hangzhou 310030China Institute of Organ Transplantation Zhejiang UniversityHangzhou 310030China Department of hepatobiliary and Pancreatic surgery Shulan Hospital of HangzhouHangzhou 310006China National Center for Healthcare Quality Management in Liver Transplant Hangzhou 310003China Department of General surgery Huashan HospitalFudan UniversityShanghai 200040China Department of hepatobiliary and Pancreatic surgery The First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052China Department of hepatobiliary and Pancreatic surgery The First Hospital of Jilin UniversityChangchun 130021China Department of Liver Transplantation Second Xiangya HospitalCentral South UniversityChangsha 410008China Department of Organ Transplantation Center The Affiliated Hospital of Qingdao UniversityQingdao 266003China Department of Liver surgery and Liver Transplantation Center West China HospitalSichuan UniversityChengdu 610044China NHC Key Laboratory of Combined Multi-organ Transplantation Hangzhou 310003China Department of hepatobiliary and Pancreatic surgery The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China

Objective:Sex-specific differences are observed in various liver diseases,but the influence of sex on the outcomes of hepatocellular carcinoma(HCC)after liver transplantation(LT)remains to be *** study is the first Chinese nationwide investigation of the role of sex in post-LT outcomes in patients with ***:Data for recipients with HCC registered in the China Liver Transplant Registry between January 2015 and December 2020 were *** associations between donor,recipient,or donor-recipient transplant patterns by sex and the post-LT outcomes were studied with propensity score matching(PSM).The survival associated with different sex-based donor-recipient transplant patterns was further ***:Among 3,769 patients enrolled in this study,the 1-,3-,and 5-year overall survival(OS)rates of patients with HCC after LT were 96.1%,86.4%,and 78.5%,respectively,in female recipients,and 95.8%,79.0%,and 70.7%,respectively,in male recipients after PSM(P=0.009).However,the OS was comparable between recipients with female donors and male *** analysis indicated that male recipient sex was a risk factor for post-LT survival(HR=1.381,P=0.046).Among the donor-recipient transplant patterns,the male-male donor-recipient transplant pattern was associated with the poorest post-LT survival(P<0.05).Conclusions:Our findings highlighted that the post-LT outcomes of female recipients were significantly superior to those of male recipients,and the male-male donor-recipient transplant pattern was associated with the poorest post-LT *** from male donors may provide the most benefit to female *** results indicate that sex should be considered as a critical factor in organ allocation.

关键词： Sex liver transplantation hepatocellular carcinoma outcome recipient donor

The role of gut microbiota associated metabolites in digestive disorders

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Engineered Regeneration 2024年第2期5卷 228-246页

作者： Na Li Cheng Zhao Pingnan Zhang Songting Wu Xiaotan Dou Saifei Xu Xiaoqi Zhang Chunyan Peng Ying Xie Shuling Huang Lin Zhou Yonghua Shen Lei Wang Jinglin Wang Chenggong Yu Department of Gastroenterology Nanjing Drum Tower HospitalAffiliated Hospital of Medical SchoolNanjing UniversityNanjing210008China Division of hepatobiliary and Transplantation surgery Department of Gernal SurgeryNanjing Drum Tower HospitalAffiliated Hospital of Medical SchoolNanjing UniversityNanjing210008China

The gut has been a focal point in the research of digestive system *** internal microbiota generates metabolites that function as signaling molecules and substrates,interacting with the intestinal wall and influ-encing host physiology and ***,the gut microbiota and metabolites owe highly diverse types and quantities,posing challenges for quantitative analysis,and monitoring frequent interactions between diges-tive tract metabolites and the intestinal wall remains a ***,research targeting gut microbiota metabolites has elucidated their relevance to digestive *** modulating metabolites such as short-chain fatty acids,bile acids,and lipopolysaccharides,it is possible to intervene in the progression of diseases such as inflammatory bowel disease and non-alcoholic fatty liver ***,research on gut microbiota is advancing,and more work is required to explore the interactions between host,microbes and underlying *** this review,we have revisited the generation of gut microbiota-related metabolites,their impact on diseases,and modes of interaction,emphasizing the significant role of metabolites in digestive system *** is believed that the linkage between gut microbiota and diseases in current research can be established through metabolites,providing a framework and foundation for research in the field of metabolomics and fundamental mechanisms.

关键词： Gut microbial metabolites Digestive disorders Inflammatory bowel disease(IBD) Non-alcoholic fatty liver disease(NAFLD)

Hemoglobin loss method calculates blood loss during pancreaticoduodenectomy and predicts bleeding-related risk factors

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World Journal of Gastrointestinal surgery 2024年第2期16卷 419-428页

作者： Chao Yu Yi-Min Lin Guo-Zhe Xian Department of hepatobiliary surgery Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan 250021Shandong ProvinceChina

BACKGROUND The common clinical method to evaluate blood loss during pancreaticoduoden-ectomy(PD)is visual inspection,but most scholars believe that this method is extremely subjective and ***,there is no accurate,objective me-thod to evaluate the amount of blood loss in PD *** retrospectively analyzed the clinical data of 341 patients who underwent PD in Shandong Provincial hospital from March 2017 to February *** to different surgical methods,they were divided into an open PD(OPD)group and a laparoscopic PD(LPD)*** differences and correlations between the in-traoperative estimation of blood loss(IEBL)obtained by visual inspection and the intraoperative calculation of blood loss(ICBL)obtained using the Hb loss method were ***,IEBL and perioperative calculation of blood loss(PCBL)were compared between the two groups,and single-factor regression analysis was *** There was no statistically significant difference in the preoperative general patient information between the two groups(P>0.05).PD had an ICBL of 743.2(393.0,1173.1)mL and an IEBL of 100.0(50.0,300.0)mL(P312,P3.82-549.62;P=0.017]was an independent risk factor for *** addition,the single-factor analysis of PCBL showed that body mass index(BMI)(95%CI:0.62-76.75;P=0.046)and preoperative total bilirubin>200μmol/L(95%CI:7.09-644.26;P=0.045)were independent risk factors for *** ICBLs of the LPD group and OPD group were 767.7(435.4,1249.0)mL and 663.8(347.7,1138.2)mL,respectively(P>0.05).The IEBL of the LPD group 200.0(50.0,200.0)mL was slightly greater than that of the OPD group 100.0(50.0,300.0)mL(P>0.05).PCBL was greater in the LPD group than the OPD group[1061.6(612.3,1632.3)mL vs 806.1(375.9,1347.6)mL](P<0.05).CONCLUSION The ICBL in patients who underwent PD was greater than

关键词： Pancreaticoduodenectomy Hemoglobin loss Calculated blood loss Estimated blood loss

Hepatic perivascular epithelioid cell tumors:The importance of preoperative diagnosis

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World Journal of Gastroenterology 2024年第13期30卷 1926-1933页

作者： Shuai Yan Jia-Jie Lu Lin Chen Wei-Hua Cai Jin-Zhu Wu Department of Medical School Nantong UniversityNantong 226300Jiangsu ProvinceChina Department of hepatobiliary surgery Affiliated Nantong Hospital 3 of Nantong UniversityNantong 226006Jiangsu ProvinceChina Nantong Institute of Liver Disease Affiliated Nantong Hospital 3 of Nantong UniversityNantong 226006Jiangsu ProvinceChina

Accurate preoperative diagnosis is highly important for the treatment of perivascular epithelioid cell tumors(PEComas)because PEComas are mainly benign tumors and may not require surgical *** analyzing the causes,properties and clinical manifestations of PEComas,we summarize the challenges and solutions in the diagnosis of PEComas.

关键词： Hepatic perivascular epithelioid cell tumors Liver Preoperative diagnosis Angiomyolipomas Mesenchymal tissue-derived tumors