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Preoperative albumin-bilirubin score and liver resection percentage determine postoperative liver regeneration after partial hepatectomy

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World Journal of Gastroenterology 2024年第14期30卷 2006-2017页

作者： Kazuhiro Takahashi Masahiko Gosho Yoshihiro Miyazaki Hiromitsu Nakahashi Osamu Shimomura Kinji Furuya Manami Doi Yohei Owada Koichi Ogawa Yusuke Ohara Yoshimasa Akashi Tsuyoshi Enomoto Shinji Hashimoto Tatsuya Oda department of gastrointestinal and Hepatobiliary-pancreatic surgery University of TsukubaTsukuba 3058-575IbarakiJapan department of Biostatistics University of TsukubaTsukuba 3058-575IbarakiJapan

BACKGROUND The success of liver resection relies on the ability of the remnant liver to *** of the knowledge regarding the pathophysiological basis of liver regeneration comes from rodent studies,and data on humans are ***,there is limited knowledge about the preoperative factors that influence postoperative *** To quantify postoperative remnant liver volume by the latest volumetric software and investigate perioperative factors that affect posthepatectomy liver *** A total of 268 patients who received partial hepatectomy were *** were grouped into right hepatectomy/trisegmentectomy(RH/Tri),left hepa-tectomy(LH),segmentectomy(Seg),and subsegmentectomy/nonanatomical hepatectomy(Sub/Non)*** regeneration index(RI)and late rege-neration rate were defined as(postoperative liver volume)/[total functional liver volume(TFLV)]×100 and(RI at 6-months-RI at 3-months)/RI at 6-months,*** lower 25th percentile of RI and the higher 25th percentile of late regeneration rate in each group were defined as“low regeneration”and“delayed regeneration”.“Restoration to the original size”was defined as regeneration of the liver volume by more than 90%of the TFLV at 12 months *** The numbers of patients in the RH/Tri,LH,Seg,and Sub/Non groups were 41,53,99 and 75,*** RI plateaued at 3 months in the LH,Seg,and Sub/Non groups,whereas the RI increased until 12 months in the RH/Tri *** to our multivariate analysis,the preoperative albumin-bilirubin(ALBI)score was an independent factor for low regeneration at 3 months[odds ratio(OR)95%CI=2.80(1.17-6.69),P=0.02;per 1.0 up]and 12 months[OR=2.27(1.01-5.09),P=0.04;per 1.0 up].Multivariate analysis revealed that only liver resection percentage[OR=1.03(1.00-1.05),P=0.04]was associated with delayed ***,multivariate analysis demonstrated that the preoperative ALBI score[OR=2.63(1.00-1.05),P=0.02;per 1.

关键词： Liver regeneration Albumin-bilirubin score Liver resection percentage Partial hepatectomy Human Regeneration index

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Unraveling the enigma:A comprehensive review of solid pseudopapillary tumor of the pancreas

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World Journal of gastrointestinal Oncology 2024年第3期16卷 614-629页

作者： Ye-Cheng Xu De-Liang Fu Feng Yang department of pancreatic surgery Pancreatic Disease InstituteHuashan HospitalFudan UniversityShanghai 200040China

Solid pseudopapillary tumor of the pancreas(SPTP)is a rare neoplasm predom-inantly observed in young ***,CTNNB1 mutations,β-catenin nuclear accumulation,and subsequent Wnt-signaling pathway activation are the leading molecular *** preoperative diagnosis often relies on imaging techniques and endoscopic *** resection remains the mainstay *** models,such as the Fudan Prognostic Index,show promise as predictive tools for assessing the prognosis of *** three types of metachronous liver metastasis can be beneficial in tailoring individu-alized treatment and follow-up *** advancements,challenges persist in understanding its etiology,establishing standardized treatments for unresectable or metastatic diseases,and developing a widely recognized grading *** comprehensive review aims to elucidate the enigma by consolidating current knowledge on the epidemiology,clinical presentation,pathology,molecular characteristics,diagnostic methods,treatment options,and prognostic factors.

关键词： Pancreas Solid pseudopapillary tumor β-catenin Endoscopic ultrasound surgery Recurrence Liver metastasis Prognostic prediction

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Mirizzi syndrome:Problems and strategies

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Hepatobiliary & pancreatic Diseases International 2024年第3期23卷 234-240页

作者： Jun Wu Shuang-Yong Cai Xu-Liang Chen Zhi-Tao Chen Shao-Hua Shi department of Hepatobiliary and pancreatic surgery People’s Hospital of Jiulongpo DistrictChongqing 400050China department of Hepatobiliary and pancreatic surgery Shulan(Hangzhou)Hospital Affiliated to Zhejiang Shuren University Shulan International Medical CollegeHangzhou 310003China

Mirizzi syndrome is a serious complication of gallstone *** is caused by the impacted stones in the gallbladder neck or cystic *** of the features of Mirizzi syndrome is severe inflammation or dense fibrosis at the Calot’s *** our clinical practice,bile duct,branches of right hepatic artery and right portal vein clinging to gallbladder infundibulum are often observed due to gallbladder infundibulum adhered to right hepatic *** intraoperative damage of branches of right hepatic artery occurs more easily than that of bile duct,all of which are hidden pitfalls for *** resonance cholangiopancreatography(MRCP)and endoscopic retrograde cholangiopancreatography(ERCP)are the preferable tools for the diagnosis of Mirizzi *** cholecystectomy in Mirizzi syndrome is easy to damage branches of right hepatic artery and bile duct due to gallbladder infundibulum adhered to right hepatic *** cholecystectomy is an easy,safe and definitive approach to Mirizzi *** combined with the application of ERCP,a laparoscopic management of Mirizzi syndrome by well-trained surgeons is feasible and *** objective of this review was to highlight its existing problems:(1)low preoperative diagnostic rate,(2)easy to damage bile duct and branches of right hepatic artery,and(3)high concomitant gallbladder ***,the review aimed to discuss the possible therapeutic strategies:(1)to enhance its preoperative recognition by imaging findings,and(2)to avoid potential pitfalls during surgery.

关键词： Mirizzi syndrome Bile duct injury Artery injury Surgical treatment Subtotal cholecystectomy

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Prognostic significance of grade of malignancy based on histopathological differentiation and Ki-67 in pancreatic ductal adenocarcinoma

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Cancer Biology & Medicine 2024年第5期21卷 416-432页

作者： Yuexiang Liang Guannan Sheng Yu Guo Yiping Zou Hanhan Guo Zhifei Li Shaofei Chang Quan Man Song Gao Jihui Hao department of pancreatic Cancer Tianjin Medical University Cancer Institute&HospitalNational Clinical Research Center for CancerKey Laboratory of Cancer Prevention and TherapyTianjinTianjin’s Clinical Research Center for CancerTianjin 300060China department of gastrointestinal Oncology The First Affiliated Hospital of Hainan Medical UniversityHaikou 570102China department of gastrointestinal pancreatic surgery Shanxi Provincial People’s HospitalTaiyuan 030012China

Objective:Tumor cell malignancy is indicated by histopathological differentiation and cell ***-67,an indicator of cellular proliferation,has been used for tumor grading and classification in breast cancer and neuroendocrine ***,its prognostic significance in pancreatic ductal adenocarcinoma(PDAC)remains ***:Patients who underwent radical pancreatectomy for PDAC were retrospectively enrolled,and relevant prognostic factors were *** of malignancy(GOM),a novel index based on histopathological differentiation and Ki-67,is proposed,and its clinical significance was ***:The optimal threshold for Ki-67 was determined to be 30%.Patients with a Ki-67 expression level>30%rather than≤30%had significantly shorter 5-year overall survival(OS)and recurrence-free survival(RFS).In multivariate analysis,both histopathological differentiation and Ki-67 were identified as independent prognostic factors for OS and *** GOM was used to independently stratify OS and RFS into 3 tiers,regardless of TNM stage and other established prognostic *** tumor-nodemetastasis-GOM stage was used to stratify survival into 5 distinct tiers,and surpassed the predictive performance of TNM stage for OS and ***:Ki-67 is a valuable prognostic indicator for *** of the GOM in the TNM staging system may potentially enhance prognostic accuracy for PDAC.

关键词： pancreatic ductal adenocarcinoma prognosis Ki-67 differentiation TNM stage

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Colonoscopy plays an important role in detecting colorectal neoplasms in patients with gastric neoplasms

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World Journal of gastrointestinal Oncology 2024年第1期16卷 133-143页

作者： Xu-Rui Liu Ze-Lin Wen Fei Liu Zi-Wei Li Xiao-Yu Liu Wei Zhang Dong Peng department of gastrointestinal surgery The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China department of gastrointestinal surgery Yongchuan Hospital of Chongqing Medical UniversityChongqing 402160China

BACKGROUND Gastric cancer(GC)and colorectal cancer(CRC)are the fifth and third most common cancer worldwide,***,GC is reported to have a potential predictive value for CRC,especially for advanced *** To evaluate the necessity of colonoscopy for gastric neoplasm(GN)*** Four databases,including PubMed,EMBASE,the Cochrane Library,and Ovid,were used to perform the search strategy on May 2,*** prevalence of colorectal neoplasms(CRN)and baseline characteristics were compared between the neoplasm group and the control *** variables are expressed as the mean difference and standard *** of categorical variables in the two groups are expressed as odds ratios(OR)and 95%confidence intervals(95%CIs).Subgroup analysis according to different kinds of GNs was conducted for more in-depth *** results of this study are represented by forest *** bias was evaluated by a funnel *** data analyses were performed by STATA SE 16.0 *** A total of 3018 patients with GNs and 3905 healthy controls(age and sex matched)were enrolled for *** comparing the prevalence of CRNs between the two groups,CRNs were detected significantly more frequently in GN patients than in controls(OR=1.69,95%CI=1.28 to 2.23,I^(2)=85.12%,P=0.00),especially in patients with GC(OR=1.80,95%CI=1.49 to 2.18,I^(2)=25.55%,P<0.1).Moreover,other risk factors including age(OR=1.08,95%CI=1.00 to 1.17,I^(2)=90.13%,P=0.00)and male sex(OR=2.31,95%CI=1.26 to 4.22,I^(2)=87.35%,P=0.00),were related to the prevalence of *** patients in the GN group,body mass index(BMI,OR=0.88,95%CI=0.80 to 0.98,I^(2)=0.00%,P=0.92)and smoking(OR=1.03,95%CI=1.01 to 1.05,I^(2)=0.00%,P=0.57)were protective and risk factors for CRNs,*** Patients are recommended to undergo colonoscopy when diagnosed with GNs,especially GC patients with a low BMI and a history of smoking.

关键词： Gastric neoplasm Gastric cancer Colorectal neoplasm Colonoscopy

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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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Surgical techniques to prevent delayed gastric emptying after pancreaticoduodenectomy

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Hepatobiliary & pancreatic Diseases International 2024年第5期23卷 449-457页

作者： Peng Duan Lu Sun Kai Kou Xin-Rui Li Ping Zhang department of Hepatobiliary and pancreatic surgery General Surgery Centerthe First Hospital of Jilin UniversityChangchun 130021China department of Dental Implantology Hospital of StomatologyJilin UniversityChangchun 130021China

Background: Delayed gastric emptying(DGE) is one of the most common complications after pancreaticoduodenectomy(PD). DGE represents impaired gastric motility without significant mechanical obstruction and is associated with an increased length of hospital stay, increased healthcare costs, and a high readmission rate. We reviewed published studies on various technical modifications to reduce the incidence of DGE. Data sources: Studies were identified by searching Pub Med for relevant articles published up to December 2022. The following search terms were used: “pancreaticoduodenectomy”, “pancreaticojejunostomy”, “pancreaticogastrostomy”, “gastric emptying”, “gastroparesis” and “postoperative complications”. The search was limited to English publications. Additional articles were identified by a manual search of references from key articles. Results: In recent years, various surgical procedures and techniques have been explored to reduce the incidence of DGE. Pyloric resection, Billroth II reconstruction, Braun's enteroenterostomy, and antecolic reconstruction may be associated with a decreased incidence of DGE, but more high-powered studies are needed in the future. Neither laparoscopic nor robotic surgery has demonstrated superiority in preventing DGE, and the use of staplers is controversial regarding whether they can reduce the incidence of DGE. Conclusions: Despite many innovations in surgical techniques, there is no surgical procedure that is superior to others to reduce DGE. Further larger prospective randomized studies are needed.

关键词： pancreaticoduodenectomy Delayed gastric emptying Postoperative complications Surgical techniques

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Pylorus-preserving gastrectomy for early gastric cancer

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World Journal of gastrointestinal Oncology 2024年第3期16卷 653-658页

作者： Ke-Kang Sun Yong-You Wu department of gastrointestinal surgery The Affiliated Kunshan Hospital to Jiangsu UniversitySuzhou 215300Jiangsu ProvinceChina department of gastrointestinal surgery The Second Affiliated Hospital of Soochow UniversitySuzhou 215008Jiangsu ProvinceChina

Pylorus-preserving gastrectomy(PPG)has been widely accepted as a function-preserving gastrectomy for middle-third early gastric cancer(EGC)with a distal tumor border at least 4 cm proximal to the *** procedure essentially preserves the function of the pyloric sphincter,which requires to preserve the upper third of the stomach and a pyloric cuff at least 2.5 *** suprapyloric and infrapyloric vessels are usually preserved,as are the hepatic and pyloric branches of the vagus *** with distal gastrectomy,PPG has significant advantages in preventing dumping syndrome,body weight loss and bile reflux *** postoperative complications after PPG have reached an acceptable *** can be considered a safe,effective,and superior choice in EGC,and is expected to be extensively performed in the future.

关键词： Gastric cancer Pylorus-preserving gastrectomy Oncological safety Gastric stasis

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

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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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Predicting the prognosis of hepatic arterial infusion chemotherapy in hepatocellular carcinoma

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World Journal of gastrointestinal Oncology 2024年第6期16卷 2380-2393页

作者： Qi-Feng Wang Zong-Wei Li Hai-Feng Zhou Kun-Zhong Zhu Ya-Jing Wang Ya-Qin Wang Yue-Wei Zhang department of Hepatobiliary pancreatic Center Beijing Tsinghua Changgung Hospital Affiliated to Tsinghua UniversityBeijing 102218China department of Hepatobiliary and pancreatic surgery Qinghai University Affiliated HospitalXining 810000Qinghai ProvinceChina

Hepatic artery infusion chemotherapy(HAIC)has good clinical efficacy in the treatment of advanced hepatocellular carcinoma(HCC);however,its efficacy *** review summarized the ability of various markers to predict the efficacy of HAIC and provided a reference for clinical *** of October 25,2023,51 articles have been retrieved based on keyword predictions and *** eligible articles were selected for inclusion in this *** literature analysis found that methods used to predict the efficacy of HAIC include serological testing,gene testing,and imaging *** above indicators and their combined forms showed excellent predictive effects in retrospective *** review summarized the strategies currently used to predict the efficacy of HAIC in middle and advanced HCC,analyzed each marker's ability to predict HAIC efficacy,and provided a reference for the clinical application of the prediction system.

关键词： Hepatocellular carcinoma Hepatic artery infusion chemotherapy Prediction Prognosis Imaging Biomarkers Genomics

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