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Cytokine profiles in patients receiving antioxidant therapy within the ANTICIPATE trial

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World Journal of Gastroenterology 2013年第25期19卷 4001-4006页

作者： Nehal Shah Ajith K Siriwardena Hepato-pancreato-biliary surgery Unit Manchester Royal Infirmary

AIM: To measure a broad profile of pro-and anti-inflammatory cytokines in patients with clinically proven chronic pancreatitis (CP) taking either antioxidant therapy or placebo as part of the larger ANTICIPATE study. METHODS: Patients with chronic pancreatitis were recruited to the ANTICIPATE study following informed consent and were randomised to intervention with either antox version 1.2-based antioxidant therapy or placebo. After a separate ethics committee amendment a subgroup of 7 patients from either arm of the study were selected for additional analysis of cytokines. Cytokines were measured at baseline and after 6 mo of either antox therapy or placebo by biochip array and enzyme-linked immunosorbent assay. RESULTS: Antioxidant therapy and placebo groups were well-matched in terms of age, gender, aetiology of CP, opiate use and disease duration. Baseline antioxidant levels were similar in patients allocated to the antioxidant group as compared to the group al- located to placebo. After 6 mo of antioxidant therapythere was significant elevation in vitamin C levels in the intervention group: 17.6 μg/mL (12.8-29.3 μg/mL) compared to 4.8 μg/mL (1.6-9.1 μg/mL) in placebo (P < 0.001; 95%CI: 9.0-20.2) with similar trends in selenium levels. There was no elevation in a broad array of pro-and anti-inflammatory cytokines in the antioxidant group compared to placebo [interleukin (IL)-1B, IL-4, IL-6, IL-10, tumor necrosis factor-α] either at baseline or after 6 mo of antioxidant therapy. CONCLUSION: Cytokine levels were low at baseline and at 6 mo despite a significant elevation in plasma antioxidants. In patients with CP, with opiate-dependent abdominal pain, circulating cytokine levels are low suggesting that pain in this disease is not simply a manifestation of inflammation.

关键词： Chronic pancreatitis Antioxidant therapy Cytokine

Robotic resection of duodenal gastrointestinal stromal tumour:Preliminary experience from a single centre

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World Journal of Gastrointestinal Oncology 2021年第7期13卷 706-715页

作者： Zhi-Peng Zhou Xiang-Long Tan Zhi-Ming Zhao Yuan-Xing Gao Yu-Yao Song Yu-Ze Jia Cheng-Gang Li department of Hepato-pancreato-biliary surgery Chinese PLA General HospitalBeijing 100853China

BACKGROUND Experience in minimally invasive surgery in the treatment of duodenal gastrointestinal stromal tumors(DGISTs)is accumulating,but there is no consensus on the choice of surgical *** To summarize the technique and feasibility of robotic resection of *** The perioperative and demographic outcomes of a consecutive series of patients who underwent robotic resection and open resection of DGISTs between May 1,2010 and May 1,2020 were retrospectively *** patients were divided into the open surgery group and the robotic surgery ***(PD)or limited resection was performed based on the location of the tumour and the distance between the tumour and duodenal ***,sex,tumour location,tumour size,operation time(OT),estimated blood loss(EBL),postoperative hospital stay(PHS),tumour mitosis,postoperative risk classification,postoperative recurrence and recurrence-free survival were compared between the two *** Of the 28 patients included,19 were male and 9 were female aged 51.3±13.1 *** resection was performed in 17 patients,and PD was performed in 11 *** patients underwent open surgery,and 17 patients underwent robotic *** patients in the robotic surgery group underwent conversion to open *** the tumours were R0 resected,and there was no significant difference in age,sex,tumour size,operation mode,PHS,tumour mitosis,incidence of postoperative complications,risk classification,postoperative targeted drug therapy or postoperative recurrence between the two groups(P>0.05).OT and EBL in the robotic group were significantly different to those in the open surgery group(Psurgery group and the robotic surgery group(P>0.05).CONCLUSION Robotic resection is safe and feasible for patients with DGI

关键词： Gastrointestinal stromal tumor Duodenum Pancreaticoduodenectomy Limited resection Robotic resection

Radiofrequency ablation vs hepatic resection for solitary colorectal liver metastasis:A meta-analysis

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World Journal of Gastroenterology 2011年第36期17卷 4143-4148页

作者： Yun-Zi Wu Bin Li Tao Wang Shuang-Jia Wang Yan-Ming Zhou department of Hepato-biliary-pancreato-Vascular surgery the First Affiliated Hospital of Xiamen UniversityXiamen 361003Fujian ProvinceChina

AIM:To evaluate the comparative therapeutic efficacy of radiofrequency ablation (RFA) and hepatic resection (HR) for solitary colorectal liver metastases (CLM).METHODS:A literature search was performed to identify comparative studies reporting outcomes for both RFA and HR for solitary *** odds ratios (OR) with 95% confidence intervals (95% CI) were calculated using either the fixed effects model or random effects ***:Seven nonrandomized controlled trials studies were included in this *** studies included a total of 847 patients:273 treated with RFA and 574 treated with *** 5 years overall survival rates in the HR group were significantly better than those in the RFA group (OR:0.41,95% CI:0.22-0.90,P=0.008).RFA had a higher rate of local intrahe-patic recurrence compared to HR (OR:4.89,95% CI:1.73-13.87,P=0.003).No differences were found between the two groups with respect to postoperative morbidity and ***:HR was superior to RFA in the treatment of patients with solitary ***,the findings have to be carefully interpreted due to the lower level of evidence.

关键词： Hepatic resection Colorectal liver metastases Radiofrequency ablation Efficacy Meta-analysis

Natural orifice transluminal endoscopic surgery in pancreatic diseases

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World Journal of Gastroenterology 2010年第31期16卷 3859-3864页

作者： Sonja Gillen Jrg Kleeff Michael Kranzfelder Shailesh V Shrikhande Helmut Friess Hubertus Feussner department of surgery Tech-nische Universitt München department of Gastrointestinal and Hepato-pancreato-biliary surgery Tata Memorial Hospital

Natural orifice transluminal endoscopic surgery (NOTES) is a surgical technique that has received considerable interest in recent years. Although minimal access surgery has increasingly replaced traditional open abdominal surgical approaches for a wide spectrum of indications, in pancreatic diseases its widespread use is limited to few indications because of the challenging and demanding nature of major pancreatic operations. Nonetheless, there have been attempts in animal models as well as in the clinical setting to perform diag- nostic and resectional NOTES for pancreatic diseases. Here, we review and comment upon the available data regarding currently analyzed and performed pancreatic NOTES procedures. Potential indications for NOTES include peritoneoscopy, cyst drainage, and necrosectomy, palliative procedures such as gastroenterostomy, as well as resections such as distal pancreatectomy or enucleation. These procedures have already been shown to be technically feasible in several studies in animal models and a few clinical trials. In conclusion, NOTES is a rapidly developing concept/technique that could potentially become an integral part of the armamentarium dealing with surgical approaches to pancreatic diseases.

关键词： Natural orifice transluminal endoscopic surgery Pancreatic disease Chronic pancreatitis Pancreatic resection Pancreatic drainage

Evaluation of the short-term outcomes of robotic-assisted radical resection for perihilar cholangiocarcinoma:a propensity-scored matching analysis

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Gastroenterology Report 2023年第1期11卷 254-259页

作者： Xi-Tai Huang Jin-Zhao Xie Jian-Peng Cai Wei Chen Liu-Hua Chen Li-Jian Liang Xiao-Yu Yin department of pancreato-biliary surgery The First Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdongP.R.China

Background:The application of robotic-assisted radical resection in perihilar cholangiocarcinoma(pCCA)remains poorly *** study aimed to evaluate the safety and efficacy of robotic-assisted radical resection for pCCA in our ***:Between July 2017 and July 2022,pCCA patients undergoing robotic-assisted and open radical resection at First Affiliated Hospital of Sun Yat-sen University(Guangzhou,China)were *** short-term outcomes were compared by using propensity-scored matching(PSM)***:Eighty-six pCCA patients were *** PSM at a ratio of 1:2,10 and 20 patients were assigned to the roboticassisted and open groups,*** were no significant disparities in the clinicopathological features between the two *** robotic-assisted group had significantly longer operation time(median:548 vs 353 min,P=0.004)and larger total number of lymph nodes examined(median:11 vs 5,P=0.010)than the open *** robotic-assisted group tended to have a lower intraoperative blood loss(median:125 vs 350 mL,P=0.067),blood transfusion rates(30.0%vs 70.0%,P=0.056),and post-operative overall morbidities(30.0%vs 70.0%,P=0.056)than the open group,even though the differences were not statistically *** were no significant differences in the negative resection margin,post-operative major morbidities,or post-operative length-of-stay between the robotic-assisted and open groups(all P>0.05).Conclusions:Robotic-assisted radical resection of pCCA may get a larger total number of lymph nodes examined than open *** robotic-assisted surgery may be a feasible and safe technique for selected pCCA patients.

关键词： robotic-assisted surgery perihilar cholangiocarcinoma biliary reconstruction

Learning curves of resection and reconstruction procedures in robotic-assisted pancreatoduodenectomy by a single surgeon:a retrospective cohort study of 160 consecutive cases

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Gastroenterology Report 2023年第1期11卷 424-432页

作者： Xi-Tai Huang Xi-Yu Wang Jin-Zhao Xie Jian-Peng Cai Wei Chen Liu-Hua Chen Xiao-Yu Yin department of pancreato-biliary surgery The First Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdongP.R.China

Background:Robotic-assisted pancreatoduodenectomy(RPD)has been routinely performed in a few of centers *** study aimed to evaluate the perioperative outcomes and the learning curves of resection and reconstruction procedures in RPD by one single ***:Consecutive patients undergoing RPD by a single surgeon at the First Affiliated Hospital of Sun Yat-sen University(Guangzhou,China)between July 2016 and October 2022 were *** perioperative outcomes and learning curves were retrospectively analysed by using cumulative sum(CUSUM)***:One-hundred and sixty patients were *** to the CUSUM curve,the times of resection and reconstruction procedures were shortened significantly after 30 cases(median,284 vs 195 min;P<0.001)and 45 cases(median,138 vs 120 min;P<0.001),*** estimated intraoperative blood loss(median,100 vs 50 mL;P<0.001)and the incidence of clinically relevant post-operative pancreatic fistula(29.2%vs 12.5%;P=0.035)decreased significantly after 20 and 120 cases,*** were no significant differences in the total number of lymph nodes examined,post-operative major complications,or post-operative length-of-stay between the two ***:Optimization of the resection procedure and the acquisition of visual feedback facilitated the performance of *** was a safe and feasible procedure in the selected patients.

关键词： robotic-assisted surgery pancreatoduodenectomy learning curve outcomes

Neoadjuvant therapy in the treatment of hilar cholangiocarcinoma:Review of the literature

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World Journal of Gastrointestinal surgery 2019年第6期11卷 279-286页

作者： Fabio Frosio Federico Mocchegiani Grazia Conte Enrico Dalla Bona ANDrea Vecchi Daniele Nicolini Marco Vivarelli Unit of Hepato-pancreato-biliary and Transplant surgery Department of Experimental and Clinical Medicine Polytechnic University of Marche

Cholangiocarcinoma(CCA)is a malignant tumor of the biliary system and includes,according to the anatomical classification,intra hepatic CCA(iCCA),hilar CCA(hCCA)and distal CCA(dCCA).Hilar CCA is the most challenging type in terms of diagnosis,treatment and *** is the only treatment possibly providing long-term survival,but only few patients are considered resectable at the time of *** fact,tumor’s extension to segmentary or subsegmentary biliary ducts,along with large lymph node involvement or intrahepatic metastases,precludes the surgical *** achieve R0 margins is mandatory for the disease-free survival and overall *** case of unresectable locally advanced hCCA,radiochemotherapy(RCT)as neoadjuvant treatment demonstrated to be a therapeutic option before either hepatic resection or liver *** liver surgery,RCT is believed to enhance the R0 margins *** patients meeting the Mayo Clinic criteria,RCT prior to orthotopic liver transplant(OLT)has proved to produce acceptable 5-years *** this review,we analyze the current role of neoadjuvant RCT before resection as well as before OLT.

关键词： Hilar cholangiocarcinoma Klatskin tumor Neoadjuvant treatement Radiotherapy Chemotherapy Hepatic resection Liver transplantation

Validation of a surgical model for posthepatectomy liver failure in rats

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Animal Models and Experimental Medicine 2023年第3期6卷 266-273页

作者： Andrea Lund Michelle Meier Kasper Jarlhelt Andersen Marie Ingemann Pedersen Anders Riegels Knudsen Jakob Kirkegård Frank Viborg Mortensen Aarhus University Hospital Department of Upper Gastrointestinal and Hepato-Pancreato-Biliary SurgeryAarhus NDenmark

Background:The upper limit for liver resections in rats is approximately 90%.In the early postoperative phase,mortality *** aim of the present study was to validate the rat model of 90%partial hepatectomy(PH)as a model of post-hepatectomy liver failure(PHLF).Further,we wanted to test a quantitative scoring system as a detector of lethal outcomes caused by PHLF in ***:Sixty-eight rats were randomized to 90%PH,sham operation,or no ***,block randomization was performed based on time of euthanization:12,24,or 48 h after surgery.A general distress score(GDS)≥10 during the day or≥6 at midnight prompted early euthanization and classification as *** euthanized as planned were classified as *** euthanization,blood and liver tissue were collected,and liver-specific biochemistry was ***:Based on the biochemical results,all animals subjected to 90%PH expe-rienced *** rats were euthanized due to irreversible *** GDS increased for nonsurvivors within 12–18 h after *** mean time for euthaniza-tion was 27 h after ***:Based on the GDS and liver-specific biochemistry,we concluded that the model of 90%PH seems to be a proper model for investigating PHLF in *** a high GDS is associated with increased mortality,the GDS appears to be valuable in detect-ing lethal outcomes caused by PHLF in rats.

关键词： 90%liver resection general distress score liver failure post-hepatectomy liver failure rats

Values of a novel pyroptosis-related genetic signature in predicting outcome and immune status of pancreatic ductal adenocarcinoma

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Gastroenterology Report 2022年第1期10卷 476-489页

作者： Xiang Xu Jia-Hua Liang Jian-Hui Li Qiong-Cong Xu Xiao-Yu Yin department of pancreato-biliary surgery The First Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdongP.R.China

Background Pyroptosis is an emerging form of programmed cell death associated with progression in ***,there are few studies reporting on the association between pancreatic ductal adenocarcinoma(PDAC)and ***,we aimed to construct a pyroptosis-related genetic signature to predict the clinical outcome and immune status in PDAC *** RNA-seq data of 176 PDAC patients from The Cancer Genome Atlas(TCGA)and 167 PDAC patients from the Genotype-Tissue Expression Project were analysed for pyroptosis-related differentially expressed genes(DEGs)between PDAC and normal *** risk signature of DEGs was analysed using the least absolute shrinkage and selection operator(LASSO)Cox regression analysis and its accuracy was validated in the Gene Expression Omnibus(GEO)cohort(n=190).Functional enrichment analyses were performed to explore the mechanisms of the *** immune characteristics were evaluated using single-sample gene set enrichment analysis and ESTIMATE algorithms for each *** A nine-gene risk signature was generated from LASSO Cox regression analysis and classified PDAC patients into either a high-or low-risk group according to the median risk *** high-risk group had significantly shorter overall survival than the low-risk group and it was verified in the external GEO database.A nomogrambased on the risk signature was constructed and showed an ideal prediction *** enrichment analyses revealed that pyroptosis might regulate the tumor immune microenvironment in *** infiltration evaluation suggested that immune status was more activated in the low-risk group than in the high-risk *** The risk signature encompassing nine pyroptosis-related genes may be a prognostic marker for *** might affect the prognosis of PDAC patients via regulating the tumor immune microenvironment.

关键词： pancreatic ductal adenocarcinoma pyroptosis prognosis immune