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Association between intra-pancreatic fat deposition and diseases of the exocrine pancreas: A narrative review

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World Journal of Gastroenterology 2025年第2期31卷 27-41页

作者： Jing Ye Jian-Guo Wang Rong-Qiang Liu Qiao Shi Wei-Xing Wang department of General surgery Renmin Hospital of Wuhan UniversityWuhan 430060Hubei ProvinceChina department of pancreatic surgery Renmin Hospital of Wuhan UniversityWuhan 430060Hubei ProvinceChina

Intrapancreatic fat deposition(IPFD)has garnered increasing attention in recent *** prevalence of IPFD is relatively high and associated with factors such as obesity,age,and ***,the pathophysiological mechanisms underlying IPFD remain unclear,with several potential contributing factors,including oxida-tive stress,alterations in the gut microbiota,and hormonal *** was found to be highly correlated with the occurrence and prognosis of exocrine pan-creatic *** imaging techniques remain the primary diagnostic approach for IPFD,an expanding array of biomarkers and clinical scoring systems have been identified for screening ***,effective treatments for IPFD are not available;however,existing medications,such as glucagon-like peptide-1 receptor agonists,and new therapeutic approaches explored in animal models have shown considerable potential for managing this *** paper reviews the pathogenesis of IPFD,its association with exocrine pancreatic disea-ses,and recent advancements in its diagnosis and treatment,emphasizing the significant clinical relevance of IPFD.

关键词： Intrapancreatic fat deposition pancreatic steatosis Nonalcoholic fatty pancreas disease Pancreatitis pancreatic cancer

Targeted gene sequencing and bioinformatics analysis of patients with gallbladder neuroendocrine carcinoma:A case report

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World Journal of Gastrointestinal Oncology 2025年第1期17卷 239-251页

作者： Yun-Chuan Yang Zhi-Tao Chen Da-Long Wan Hui Tang Mu-Lin Liu department of Medical College Jinan UniversityGuangzhou 510000Guangdong ProvinceChina department of General surgery The First Affiliated Hospital of Bengbu Medical UniversityBengbu 233000Anhui ProvinceChina department of Hepatobiliary surgery Shulan(Hangzhou)Hospital Affiliated to Zhejiang Shuren University Shulan International Medical CollegeHangzhou 310022Zhejiang ProvinceChina department of Hepatobiliary and pancreatic surgery The First Affiliated HospitalCollege of MedicineZhejiang UniversityHangzhou 310003Zhejiang ProvinceChina department of Pathology The First Affiliated Hospital of Medical School of Zhejiang UniversityHangzhou 310000Zhejiang ProvinceChina

BACKGROUND Gallbladder neuroendocrine carcinoma(NEC)represents a subtype of gallbladder malignancies characterized by a low incidence,aggressive nature,and poor *** its clinical severity,the genetic alterations,mechanisms,and signaling pathways underlying gallbladder NEC remain *** SUMMARY This case study presents a rare instance of primary gallbladder NEC in a 73-year-old female patient,who underwent a radical cholecystectomy with hepatic hilar lymphadenectomy and resection of liver segments IV-B and *** gene sequencing and bioinformatics analysis tools,including STRING,GeneMANIA,Metascape,TRRUST,Sangerbox,cBioPortal and GSCA,were used to analyze the biological functions and features of mutated genes in gallbladder *** mutations(APC,ARID2,IFNA6,KEAP1,RB1,SMAD4,TP53,BTK,GATA1,GNAS,and PRDM3)were identified,and the tumor mutation burden was determined to be 9.52 muts/Mb via targeted gene sequencing.A protein-protein interaction network showed significant interactions among the twelve mutated *** Ontology and Kyoto Encyclopedia of Genes and Genomes analyses were used to assess mutation functions and *** results revealed 40 tumor-related pathways.A key regulatory factor for gallbladder NEC-related genes was identified,and its biological functions and features were compared with those of gallbladder *** Gallbladder NEC requires standardized *** with other gallbladder carcinomas revealed clinical phenotypes,molecular alterations,functional characteristics,and enriched pathways.

关键词： Gallbladder neuroendocrine carcinoma Targeted-gene sequencing Bioinformatics analysis case report Immunocytochemistry Case report

Mononuclear phagocyte system in hepatitis C virus infection

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World Journal of Gastroenterology 2018年第44期24卷 4962-4973页

作者： Yu Yang Zheng--Kun Tu Xing--Kai Liu Ping Zhang department of hepatobiliaryand pancreatic surgery The First Hospital of Jilin University Institute of Translational Medicine The FirstHospital of Jilin University

The mononuclear phagocyte system （MPS）, which con-sists of monocytes, dendritic cells （DCs）, and macro-phages, plays a vital role in the innate immune defense against pathogens. Hepatitis C virus （HCV） is effcient in evading the host immunity, thereby facilitating its devel-opment into chronic infection. Chronic HCV infection is the leading cause of end-stage liver diseases, liver cirrhosis, and hepatocellular carcinoma. Acquired im-mune response was regarded as the key factor to era-dicate HCV. However, innate immunity can regulate the acquired immune response. Innate immunity-derived cytokines shape the adaptive immunity by regulating T-cell differentiation, which determines the outcome of acute HCV infection. Inhibition of HCV-specific T-cell responses is one of the most important strategies for im-mune system evasion. It is meaningful to illustrate the role of innate immune response in HCV infection. With the MPS being the important factor in innate immunity, therefore, understanding the role of the MPS in HCV infection will shed light on the pathophysiology of chronic HCV infection. In this review, we outline the impact of HCV infection on the MPS and cytokine production. We discuss how HCV is detected by the MPS and describe the function and impairment of MPS components in HCV infection.

关键词： Mononuclear phagocyte system Hepatitis C virus Monocyte Dendritic cell Macrophage

Integration of perioperative features and intragraft TCF7L2 expression to predict lipid metabolic disorder in liver transplant recipients

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Science China Life Sciences 2025年第01期 297-299页

作者： Junbin Zhou Rongli Wei Guanghan Fan Zhengxing Lian Xuanyu Zhang Linsong Tang Zhetuo Qi Haiyang Xie Shusen Zheng Qiang Wei Xiao Xu department of Hepatobiliary and pancreatic surgery People's Hospital of LishuiAffiliated Lishui Hospital of Wenzhou Medical UniversityThe First Affiliated Hospital of Lishui University NHFPC Key Laboratory of Combined Multi-Organ Transplantation Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province Department of Hepatobiliary and Pancreatic SurgeryHangzhou First People's Hospital department of Hepatobiliary and pancreatic surgery The First Affiliated HospitalZhejiang University School of Medicine department of Urology The Second Affiliated HospitalZhejiang University School of Medicine department of Hepatobiliary and pancreatic surgery Department of Liver TransplantationShulan (Hangzhou) Hospital Hangzhou Medical College Zhejiang University School of Medicine

Dear Editor, Liver transplantation(LT) is the only curative therapy for patients with endstage liver disease(He et al., 2023; Ling et al., 2022). Post-transplant hypertriglyceridemia(PTHT), which has an incidence of up to 32.8% in 6 months after LT, is one of the major post-transplant complications(Toshima et al., 2020).

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Inhibition of pancreatic stellate cell activity by adipose-derived stem cells

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Hepatobiliary & pancreatic Diseases International 2015年第2期14卷 215-221页

作者： Fu-Xiang Yu Long-Feng Su Chun-Lei Dai Yang Wang Yin-Yan Teng Jun-Hui Fu Qi-Yu Zhang Yin-He Tang department of Hepatobiliary and pancreatic surgery FirstAffiliatedHospital WenzhouMedicalCollege department of Hepatobiliary and pancreatic surgery FirstAffiliatedHospitalWenzhouMedicalCollege

BACKGROUND：pancreatic stellate cells（PSCs）play a critical role in the development of pancreatic *** this study we used a novel method to isolate and culture rat PSCs and then investigated the inhibitory effects of adipose-derived stem cells（ADSCs）on activation and proliferation of ***：pancreatic tissue was obtained from SpragueDawley rats for PSCs *** cell cultures were adopted for co-culture of ADSCs and PSCs. PSCs prolifera- tion and apoptosis were determined using CCK-8 and flow cytometry, respectively, a-SMA expressions were analyzed using Western blotting. The levels of cytokines [nerve growth factor （NGF）, interleukin-10 （IL-10） and transforming growth factor-ill （TGF-[31）] in conditioned medium were detected by ELISA. Gene expression （MMP-2, MMP-9 and TIMP-1） was analyzed using qRT-PCR. RESULTS： This method produced 17.6_＋6.5 ~ 103 ceils per gram of the body weight with a purity of 90%-95% and a viability of 92%-97%. Co-culture of PSCs with ADSCs significantly inhib- ited PSCs proliferation and induced PSCs apoptosis. Moreover, a-SMA expression was significantly reduced in PSCs＋ADSCs compared with that in PSC-only cultures, while expression of fibrinolytic proteins （e.g., MMP-2 and MMP-9） was upregulated and anti-fibrinolytic protein （TIMP-1） was downregulated. In addition, NGF expression was up-regulated, but IL-10 and TGF-β1 expressions were down-regulated in the coculture conditioned medium compared with those in the PSC- only culture medium. CONCLUSIONS： This study provided an easy and reliable technique to isolate PSCs. The data demonstrated the inhibitory effects of ADSCs on the activation and proliferation of PSCs in vitro.

关键词： pancreatic stellate cells isolation mesenchymal stem cells pancreatic fibrosis fibrinolytic protein

Pretreatment red blood cell distribution width as a predictive marker for postoperative complications after laparoscopic pancreatoduodenectomy

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World Journal of Gastrointestinal Oncology 2025年第1期17卷 143-157页

作者： Xian-Rang Cao Yin-Long Xu Jia-Wei Chai Kai Zheng Jun-Jie Kong Jun Liu Shun-Zhen Zheng department of Liver Transplantation and Hepatobiliary surgery Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan 250021Shandong ProvinceChina department of Breast and Thyroid surgery Shandong Provincial Maternal and Child Health Care HospitalJinan 250014Shandong ProvinceChina

BACKGROUND Red blood cell distribution width(RDW)is associated with the development and progression of various *** To explore the association between pretreatment RDW and short-term outcomes after laparoscopic pancreatoduodenectomy(LPD).METHODS A total of 804 consecutive patients who underwent LPD at our hospital between March 2017 and November 2021 were retrospectively *** between pretreatment RDW and clinicopathological characteristics and short-term outcomes were *** Patients with higher pretreatment RDW were older,had higher Eastern Cooperative Oncology Group scores and were associated with poorer short-term outcomes than those with normal *** pretreatment RDW was an independent risk factor for postoperative complications(POCs)(hazard ratio=2.973,95%confidence interval:2.032-4.350,Ppancreatic fistula,severe bile leakage and severe *** pretreatment RDW was positively associated with the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio and was negatively associated with albumin and the prognostic nutritional *** Pretreatment RDW was a special parameter for patients who underwent *** was associated with malnutrition,severe inflammatory status and poorer short-term *** could be a surrogate marker for nutritional and inflammatory status in identifying patients who were at high risk of developing POCs after LPD.

关键词： Biomarker Laparoscopic pancreatoduodenectomy Postoperative complication Red blood cell distribution width Short-term outcomes

Diagnosis and Management of Severe Acute Pancreatitis Complicated with Abdominal Compartment Syndrome

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2003年第4期23卷 399-402页

作者：陶京王春友陈立波杨智勇许逸卿熊炯炘周峰 department of pancreatic surgery

Presented in this paper is our experience in the diagnosis and management of abdominal compartment syndrome during severe acute pancreatitis. On the basis of the history of severe acute pancreatitis, after effective fluid resuscitation, if patients developed renal, pulmonary and cardiac insufficiency after abdominal expansion and abdominal wall tension, ACS should be considered. Cystometry could be performed to confirm the diagnosis. Emergency decompressive celiotomy and temporary abdominal closure with a 3 liter sterile plastic bag must be performed. It is also critical to prevent reperfusion syndrome. In 23 cases of ACS, 18 cases received emergency decompressive celiotomy and 5 cases did not. In the former, 3 patients died (16.7 %) while in the later, 4 (80%) died. Total mortality rate was 33.3% (7/21). In 7 death cases, 4 patients developed acute obstructive suppurative cholangitis (AOSC). All the patients who received emergency decompressive celiotomy 5 h after confirmation of ACS survived. The definitive abdominal closure took place mostly 3 to 5 days after emergency decompressive celiotomy, with longest time being 8 days. 6 cases of ACS at infection stage were all attributed to infected necrosis in abdominal cavity and retroperitoneum. ACS could occur in SIRS stage and infection stage during SAP, and has different pathophysiological basis. Early diagnosis, emergency decompressive celiotomy and temporary abdominal closure with a 3L sterile plastic bag are the keys to the management of the condition.

关键词： severe acute pancreatitis syndrome diagnosis treatment

Clinical significance of variant hepatic artery in pancreatic resection:A comprehensive review

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World Journal of Gastroenterology 2022年第19期28卷 2057-2075页

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

The anatomical structure of the pancreaticoduodenal region is complex and closely related to the surrounding vessels.A variant of the hepatic artery,which is not a rare finding during pancreatic surgery,is prone to intraoperative *** injury to the hepatic artery may affect liver perfusion,resulting in necrosis,liver abscess,and even liver *** preoperative identification of hepatic artery variations,detailed planning of the surgical approach,careful intraoperative dissection,and proper management of the damaged artery are important for preventing hepatic ***,despite the potential risks,planned artery resection has become acceptable in carefully selected *** reconstruction is sometimes essential to prevent postoperative ischemic complications and can be performed using various *** complexity of procedures such as pancreatectomy with en bloc celiac axis resection may be mitigated by the presence of an aberrant right hepatic artery or a common hepatic artery originating from the superior mesenteric ***,we comprehensively reviewed the anatomical basis of hepatic artery variation,its incidence,and its effect on the surgical and oncological outcomes after pancreatic *** addition,we provide recommendations for the prevention and management of hepatic artery injury and liver ***,the hepatic artery variant may not worsen surgical and oncological outcomes if it is accurately identified pre-operatively and appropriately managed intraoperatively.

关键词： Hepatic artery Pancreatectomy pancreaticoduodenectomy Arterial reconstruction Celiac axis resection Outcome Prognosis

Preoperative evaluation of pancreatic ductal adenocarcinoma with synchronous liver metastasis: Diagnosis and assessment of unresectability

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World Journal of Gastroenterology 2016年第45期22卷 10024-10037页

作者： Hao-Jun Shi Chen Jin De-Liang Fu department of pancreatic surgery Pancreatic Disease Institute Huashan Hospital Fudan University

AIM To identify predictors for synchronous liver metastasis from resectable pancreatic ductal adenocarcinoma(PDAC) and assess unresectability of synchronous liver *** Retrospective records of PDAC patients with synchronous liver metastasis who underwent simultaneous resections of primary PDAC and synchronous liver metastasis, or palliative surgical bypass, were collected from 2007 to 2015. A series of pre-operative clinical parameters, including tumor markers and inflammation-based indices, were analyzed by logistic regression to figure out predictive factors and assess unresectability of synchronous liver metastasis. Cox regression was used to identify prognostic factors in liver-metastasized PDAC patients after surgery, with intention to validate their conformance to the indications of simultaneous resections and palliative surgical bypass. Survival of patients from different groups were analyzed by the Kaplan-Meier method. Intra- and post-operative courses were compared, including complications. PDAC patients with no distant metastases who underwent curative resection served as the control *** CA125 > 38 U/mL(OR = 12.397, 95%CI: 5.468-28.105, P 62 U/mL(OR = 5.181, 95%CI: 1.612-16.665, P = 0.006) and age > 62 years(OR = 3.921, 95%CI: 1.217-12.632, P = 0.022) correlated with unresectability of synchronous liver metastasis, both of which also indicated a worse long-term outcome of liver-metastasized PDAC patients after surgery. After the simultaneous resections, patients with postoperatively elevated serum CA125 levels had shorter survival than those with post-operatively reduced serum CA125 levels(7.7 mo vs 16.3 mo, P = 0.013). The survival of liver-metastasized PDAC patients who underwent the simultaneous resections was similar to that of non-metastasized PDAC patients who underwent cu

关键词： CA125 pancreatic ductal adenocarcinoma Liver metastasis Unresectability Prognosis