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Acute suppurative terminal cholangitis:Clinical characteristics of a new subtype of acute cholangitis

Hepatobiliary & pancreatic diseases International 2024年第3期23卷 293-299页

作者： Rong-Tao Zhu Ye Li Chi-Xian Zhang Wei-Jie Wang Ruo-Peng Liang Jian Li Kai Bai Yu-Ling Sun Department of Hepatobiliary and pancreatic Surgery the First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052China Zhengzhou Key Laboratory of Hepatobiliary and pancreatic diseases Zhengzhou 450052China Institute of Hepatobiliary and pancreatic diseases Zhengzhou UniversityZhengzhou 450052China Department of Pathology the First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052China

Background:Acute suppurative terminal cholangitis(ASTC)is rarer than acute obstructive cholangitis and is not well *** explore this subtype of acute cholangitis,we described our clinical experience with ***:We performed a retrospective review of patients with ASTC admitted to our center from September 2014 to August *** analyzed their clinical characteristics,including etiology,clinical manifestations,imaging features,treatment and ***:A total of 32 ASTC patients were included in the *** majority of the patients had a history of biliary operations,and clinical manifestations were occult and *** positive rate of bacterial culture was 46.9%.All the patients had typical imaging features on computed tomography and magnetic resonance *** with effective antibiotics was provided as soon as diagnosis was *** treatment,most patients had a good *** levels of total bilirubin,aspartate aminotransferase,procalcitonin and gamma-glutamyltransferase were the characteristics of critically ill patients and were associated with relatively poor ***:Our results demonstrated that ASTC should be recognized as a new subtype of acute cholangitis,and that earlier diagnosis and more personalized treatments are needed.

关键词： Acute suppurative terminal cholangitis Acute cholangitis Gram-negative bacterial infections Diagnosis Treatment

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Utility of plasma D-dimer for diagnosis of venous thromboembolism after hepatectomy

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World Journal of Clinical Cases 2024年第2期12卷 276-284页

作者： Taiichiro Miyake Hiroaki Yanagimoto Daisuke Tsugawa Masayuki Akita Riki Asakura Keisuke Arai Toshihiko Yoshida Shinichi So Jun Ishida Takeshi Urade Yoshihide Nanno Kenji Fukushima Hidetoshi Gon Shohei Komatsu Sadaki Asari Hirochika Toyama Masahiro Kido Tetsuo Ajiki Takumi Fukumoto Division of Hepato-biliary-pancreatic Surgery Department of SurgeryKobe University Graduate School of MedicineKobe 650-0017HyogoJapan

BACKGROUND Venous thromboembolism(VTE)is a potentially fatal complication of *** use of postoperative prophylactic anticoagulation in patients who have undergone hepatectomy is controversial because of the risk of postoperative ***,we hypothesized that monitoring plasma D-dimer could be useful in the early diagnosis of VTE after *** To evaluate the utility of monitoring plasma D-dimer levels in the early diagnosis of VTE after *** The medical records of patients who underwent hepatectomy at our institution between January 2017 and December 2020 were retrospectively *** were divided into two groups according to whether or not they developed VTE after hepatectomy,as diagnosed by contrast-enhanced computed tomography and/or ultrasonography of the lower *** factors,including demographic data and perioperative D-dimer values,were compared between the two *** operating characteristic curve analysis was performed to determine the D-dimer cutoff *** and multivariate analyses were performed using logistic regression analysis to identify significant *** In total,234 patients who underwent hepatectomy were,of whom(5.6%)were diagnosed with VTE following hepatectomy.A comparison between the two groups showed significant differences in operative time(529 vs 403 min,P=0.0274)and blood loss(530 vs 138 mL,P=0.0067).The D-dimer levels on postoperative days(POD)1,3,5,7 were significantly higher in the VTE group than in the non-VTE *** the multivariate analysis,intraoperative blood loss of>275 mL[odds ratio(OR)=5.32,95%confidence interval(CI):1.05-27.0,P=0.044]and plasma D-dimer levels on POD 5≥21μg/mL(OR=10.1,95%CI:2.04-50.1,P=0.0046)were independent risk factors for VTE after *** Monitoring of plasma D-dimer levels after hepatectomy is useful for early diagnosis of VTE and may avoid routine prophylactic anticoagulation in the

关键词： Hepatectomy Malignant tumor Postoperative complication D-dimer Early diagnosis Venous thromboembolism

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Quality of life after pancreatic surgery

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World Journal of Gastroenterology 2024年第8期30卷 943-955页

作者： Shi-Zhen Li Ting-Ting Zhen Yi Wu Min Wang Ting-Ting Qin Hang Zhang Ren-Yi Qin Department of biliary-pancreatic Surgery Affiliated Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030Hubei ProvinceChina

BACKGROUND pancreatic surgery is challenging owing to the anatomical characteristics of the *** attention has been paid to changes in quality of life(QOL)after pancreatic *** To summarize and analyze current research results on QOL after pancreatic *** A systematic search of the literature available on PubMed and EMBASE was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses *** studies were identified by screening the references of retrieved *** on patients’QOL after pancreatic surgery published after January 1,2012,were *** included prospective and retrospective studies on patients'QOL after several types of pancreatic *** results of these primary studies were summarized *** A total of 45 articles were included in the study,of which 13 were related to pancreaticoduodenectomy(PD),seven to duodenum-preserving pancreatic head resection(DPPHR),nine to distal pancreatectomy(DP),two to central pancre-atectomy(CP),and 14 to total pancreatectomy(TP).Some studies showed that 3-6 months were needed for QOL recovery after PD,whereas others showed that 6-12 months was more *** TP and PD had similar influences on QOL,patients needed longer to recover to preoperative or baseline levels after *** QOL was better after DPPHR than ***,the superiority of the QOL between patients who underwent CP and PD remains *** decrease in exocrine and endocrine functions postoperatively was the main factor affecting the *** invasive surgery could improve patients’QOL in the early Core Tip:This review summarizes and analyzes current research results on quality of life(QOL)after pancreatic *** article covers the discussion and analysis of the QOL of various pancreatic *** kind of surgical procedure has better QOL is *** long-term benefits on QOL of minimally invasive su

关键词： Quality of life pancreaticoduodenectomy Duodenum-preserving pancreatic head resection Distal pancreatectomy Central pancreatectomy Total pancreatectomy

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Cholangiocarcinoma combined with biliary obstruction:an exosomal circRNA signature for diagnosis and early recurrence monitoring

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Signal Transduction and Targeted Therapy 2024年第6期9卷 2642-2654页

作者： Ningyuan Wen Dingzhong Peng Xianze Xiong Geng Liu Guilin Nie Yaoqun Wang Jianrong Xu Shaofeng Wang Sishu Yang Yuan Tian Bei Li Jiong Lu Nansheng Cheng Division of biliary Surgery Department of General SurgeryWest China HospitalSichuan UniversityChengduSichuanChina Research Center for biliary diseases West China HospitalSichuan UniversityChengduSichuanChina

Cholangiocarcinoma(CCA)is a highly malignant biliary tract cancer with currently suboptimal diagnostic and prognostic *** present a novel system to monitor CCA using exosomal circular RNA(circRNA)via serum and biliary liquid biopsies.A pilot cohort consisting of patients with CCA-induced biliary obstruction(CCA-BO,n=5)and benign biliary obstruction(BBO,n=5)was used to identify CCA-derived exosomal circRNAs through microarray *** was followed by a discovery cohort(n=20)to further reveal a CCA-specific circRNA complex(hsa-circ-0000367,hsa-circ-0021647,and hsa-circ-0000288)in both bile and serum *** vitro and in vivo studies revealed the three circRNAs as promoters of CCA *** and prognostic models were established and verified by two independent cohorts(training cohort,n=184;validation cohort,n=105).An interpreter-free diagnostic model disclosed the diagnostic power of biliary exosomal circRNA signature(Bile-DS,AUROC=0.947,RR=6.05)and serum exosomal circRNA signature(Serum-DS,AUROC=0.861,RR=4.04)compared with conventional CA19-9(AUROC=0.759,RR=2.08).A prognostic model of CCA undergoing curative-intent surgery was established by calculating early recurrence score,verified with bile samples(Bile-ERS,C-index=0.783)and serum samples(Serum-ERS,C-index=0.782).These models,combined with other prognostic factors revealed by COX-PH model,enabled the establishment of nomograms for recurrence monitoring of *** study demonstrates that the exosomal triple-circRNA panel identified in both bile and serum samples serves as a novel diagnostic and prognostic tool for the clinical management of CCA.

关键词： biliary diagnosis Serum

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Relationship between portal hypertension and liver stiffness measurements in the treatment of hepatocellular carcinoma from the surgeon’s point of view in the Baveno VII era

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Hepatobiliary Surgery and Nutrition 2024年第1期13卷 150-153页

作者： Nobuyuki Takemura Norihiro Kokudo Hepato-biliary pancreatic Surgery Division Department of SurgeryNational Center for Global Health and MedicineShinjyuku-kuTokyoJapan

Hepatocellular carcinoma(HCC)is the third leading cause of cancer-related deaths worldwide(1).It often arises from the backgrounds of damaged liver due to viral hepatitis,alcoholic,or non-alcoholic liver *** the proportion of patients with HCC of non-hepatitis B and C origins has increased in recent years,hepatitis B and C viruses still cause more than half of all carcinogenesis in patients with HCC(2).Patients with HCC often develop portal hypertension(PHT)from cirrhosis due to the deterioration of the background liver,which proves to be the greatest obstacle to various types of treatments for HCC.

关键词： Hepatocellular carcinoma(HCC) portal hypertension(PHT) Baveno VII hepatectomy clinically significant portal hypertension(CSPH)

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Recent advances in promising drugs for primary prevention of gastroesophageal variceal bleeding with cirrhotic portal hypertension

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Hepatobiliary & pancreatic diseases International 2024年第1期23卷 4-13页

作者： Ji-Yao Sheng Zi-Fan Meng Qiao Li Yong-Sheng Yang Department of Hepatobiliary and pancreatic Surgery the Second Hospital of Jilin UniversityChangchun 130041China Jilin Engineering Laboratory for Translational Medicine of Hepatobiliary and pancreatic diseases the Second Hospital of Jilin UniversityChangchun 130041China

Background:Gastroesophageal variceal bleeding is one of the most severe complications of patients with *** primary prevention drugs,including non-selectiveβ-blockers,have effectively reduced the incidence of bleeding,their efficacy is limited due to side effects and related *** recent advances in precision medicine,precise drug treatment provides better treatment *** sources:Literature search was conducted in PubMed,MEDLINE and Web of Science for relevant articles published up to May *** on clinical trials was obtained from https://***/and http://***/.Results:The in-depth understanding of the pathogenesis and advances of portal hypertension has enabled the discovery of multiple molecular targets for promising *** to the site of action,these drugs could be classified into four classes:intrahepatic,extrahepatic,both intrahepatic and extrahepatic targets and *** these classes of drugs offer advantages over traditional treatments in prevention of gastroesophageal variceal bleeding in patients with cirrhotic portal ***:This review classified and summarized the promising drugs,which prevent gastroesophageal variceal bleeding by targeting specific markers of pathogenesis of portal hypertension,demonstrating the significance of using the precision medicine strategy to discover and develop promising drugs for the primary prevention of gastroesophageal variceal bleeding in patients with cirrhotic portal hypertension.

关键词： Cirrhotic portal hypertension Target drug Primary prevention Bleeding

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Is appendoscope a new option for the treatment of acute appendicitis?

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World Journal of Gastroenterology 2024年第28期30卷 3386-3392页

作者： Shu-Jiong Feng Yi-Feng Zhou Jian-Feng Yang Hong-Zhang Shen Guang-Xing Cui Xiao-Feng Zhang Department of Gastroenterology Affiliated Hangzhou First People’s HospitalSchool of MedicineWestlake UniversityHangzhou 310000Zhejiang ProvinceChina Department of Gastroenterology Key Laboratory of Integrated Traditional Chinese and Western Medicine for Biliary and Pancreatic Diseases of Zhejiang ProvinceHangzhou 310000Zhejiang ProvinceChina Department of Gastroenterology Hangzhou Institute of Digestive DiseasesHangzhou 310000Zhejiang ProvinceChina

Acute appendicitis is a common surgical *** is commonly caused by obstruction of the appendiceal lumen due to fecaliths,tumors,or lymphoid *** over a century,appendectomy has been the primary treatment for acute *** Groves performed the first open appendectomy in *** 1983,Kurt Semm completed the first laparoscopic appendectomy,heralding a new era in ***,appendectomy is associated with certain complications and a rate of negative *** have suggested controversy over the impact of appendectomy on the development of inflammatory bowel disease and Parkinson’s disease,but an increasing number of studies indicate a possible positive correlation between appendectomy and colorectal cancer,gallstones,and cardiovascular *** the recognition that the appendix is not a vestigial organ and the advancement of endoscopic technology,Liu proposed the endoscopic retrograde appendicitis *** is an effective minimally invasive alternative for treating uncomplicated acute *** team has developed an appendoscope with a disposable digital imaging system operated through the biopsy channel of a colonoscope and successfully applied it in the treatment of *** article provides an overview of the progress in endoscopic treatment for acute appendicitis and offers a new perspective on the future direction of appendiceal disease treatment.

关键词： Acute appendicitis Endoscopic technology Endoscopic retrograde appendicitis therapy Appendoscope Appendiceal disease treatment

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Immune Regulatory Networks and Therapy of yδT Cells in Liver Cancer:Recent Trends and Advancements

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Journal of Clinical and Translational Hepatology 2024年第3期12卷 287-297页

作者： Kun-Li Yin Kai-Jian Chu Ming Li Yu-Xin Duan Yan-Xi Yu Mei-Qing Kang Da Fu Rui Liao Department of Hepatobiliary Surgery the First Affiliated Hospital of Chongqing Medical UniversityChongqingChina biliary Surgical Department I the Eastern Hepatobiliary Surgical HospitalNaval Medical UniversityShanghaiChina General Surgery Institute of Pancreatic DiseasesRuijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina

The roles of γδ T cells in liver cancer,especially in the poten-tial function of immunotherapy due to their direct cytotoxic effects on tumor cells and secretion of important cytokines and chemokines,have aroused research *** re-view briefly describes the basic characteristics of γδ T cells,focusing on their diverse effects on liver *** particular,different subtypes of γδ T cells have diverse or even opposite effects on liver *** provide a detailed description of the immune regulatory network of γδ T cells in liver can-cer from two aspects:immune components and nonimmune *** interactions between various components in this immune regulatory network are dynamic and pluralis-tic,ultimately determining the biological effects of γδ T cells in liver *** also integrate the current knowledge of γδ T-cell immunotherapy for liver cancer treatment,emphasiz-ing the potential of these cells in liver cancer immunotherapy.

关键词： Liver cancer γδT cells Immunotherapy Tumor microenvironment

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History of chronic gastritis:How our perceptions have changed

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World Journal of Gastroenterology 2024年第13期30卷 1851-1858页

作者： Dmitry Bordin Maria Livzan Department of pancreatic Biliary and Upper GI Tract DiseasesA.S.Loginov Moscow Clinical Scientific CenterMoscow 111123Russia Department of Propaedeutic of Internal diseases and Gastroenterology Russian University of MedicineMoscow 127006Russia Department of Outpatient Therapy and Family Medicine Tver State Medical UniversityTver 170100Russia Department of Internal Medicine and Gastroenterology Omsk State Medical UniversityOmsk 644099Russia

Currently,the diagnostic strategy for chronic gastritis(CG)is aimed not just at fixing the presence of gastric mucosal inflammation,but also at gastric cancer(GC)risk stratification in a particular *** classification approach with the definition of the stage of gastritis determines the need,activities and frequency of dynamic monitoring of a ***,this attitude to the patient suffering from CG was far from *** present publication is a literature review describing the key milestones in the history of CG research,from the description of the first observations of inflammation of the gastric mucosa,assessment of gastritis as a predominantly functional disease,to the advent of endoscopy of the upper digestive tract and diagnostic gastric biopsy,assessment of the role of Helicobacter pylori infection in progression of inflammatory changes to atrophy,intestinal metaplasia,dysplasia and GC.

关键词： Chronic gastritis Intestinal metaplasia Dysplasia Gastric cancer Helicobacter pylori

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Update on the Diagnosis and Treatment of Combined Hepatocellular Cholangiocarcinoma

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Journal of Clinical and Translational Hepatology 2024年第2期12卷 210-217页

作者： Kai-Jian Chu Yoshikuni Kawaguchi Han Wang Xiao-Qing Jiang Kiyoshi Hasegawa biliary Surgical Department No.1 Eastern Hepatobiliary Surgical HospitalThe Naval Medical UniversityShanghaiChina Hepato-biliary-pancreatic Surgery Division Department of SurgeryGraduate School of MedicineThe University of TokyoTokyoJapan Department of Pathology Eastern Hepatobiliary Surgical HospitalThe Naval Medical UniversityShanghaiChina

Combined hepatocellular-cholangiocarcinoma(cHCC-CCA)is a unique type of liver tumor that contains both hepatocellular carcinoma and cholangiocarcinoma components within a single *** fifth edition of the World Health Organization classification provides a definition and diagnostic criteria for ***,the heterogeneous histomorphology and presentation resulting from variation of the proportion of each component poses challenges for clinical diagnosis and treatment.A diagnosis of cHCC-CCA may be suggested by the synchronous elevation of serum tumor markers for hepatocellular carcinoma and cholangiocarcinoma,a mixed enhancement pattern on imaging,and a discrepancy between the elevation of tumor marker and the imaging enhancement *** examination using hematoxylin and eosin staining is considered the gold standard for diagnosing cHCC-CCA,and comprehensive examination of resection or biopsy specimens is crucial for an accurate ***,there is no standard treatment for cHCC-CCA,and surgery is the *** hepatectomy with lymphadenectomy is among the recommended surgical *** role of liver transplantation in the management of cHCC-CCA is still *** chemoembolization may be effective for unresectable cHCC-CCA,particularly for hypervascular ***,the available evidence does not support systemic therapy for advanced *** prognosis of cHCC-CCA is generally poor,and there is no established staging *** research is needed to better understand the histogenesis and clinical management of *** review provides an overview of the current literature on cHCC-CCA with a focus on its clinical characteristics,pathological diagnosis,and management.

关键词： Combined hepatocellular-cholangiocarcinoma Clinical characteristics Imaging characteristics Pathological diagnosis Treatment

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