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

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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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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Impact of neoadjuvant multimodal therapy in the setting of locally advanced hepatocellular carcinoma

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World Journal of Gastroenterology 2024年第28期30卷 3452-3455页

作者： Daniele Ferraro Federica Falaschi Luca Nazzaro Giovanni Vennarecci hepato-biliary and Liver Transplant Centre Department of General Surgery and Woman’s HealthAORN Antonio CardarelliNaples 80131Italy

Immunotherapy and the implementation of more aggressive treatment schemes for locally advanced hepatocellular carcinomas have expanded the boundaries of curative *** of these advancements,patients who were once consid... 详细信息

关键词： hepatocellular carcinoma Immunotherapy Radioembolization Chemoembolization Liver transplantation Liver resection

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Robotic versus laparoscopic surgery for sporadic benign insulinoma:Short-and long-term outcomes

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hepatobiliary & Pancreatic Diseases International 2024年第4期23卷 399-405页

作者： Zhu-Zeng Yin Yuan-Xing Gao Zhi-Ming Zhao Ming-Gen Hu Wen-Bo Tang Rong Liu Faculty of hepato-Pancreato-biliary surgery The First Medical CenterChinese PLA General HospitalBeijing 100853China Institute of hepatobiliary surgery of Chinese PLA Beijing 100853China Key Laboratory of Digital hepatobiliary surgery of Chinese PLA Beijing 100853China

Background:Minimally invasive surgery is the optimal treatment for *** present study aimed to compare short-and long-term outcomes of laparoscopic and robotic surgery for sporadic benign ***:A retrospective analysis of patients who underwent laparoscopic or robotic surgery for insulinoma at our center between September 2007 and December 2019 was *** demographic,perioperative and postoperative follow-up results were compared between the laparoscopic and robotic ***:A total of 85 patients were enrolled,including 36 with laparoscopic approach and 49 with robotic *** was the preferred surgical ***-nine patients(69.4%)underwent enucleation;among them,26 and 33 patients underwent laparoscopic and robotic surgery,*** enucleation had a lower conversion rate to laparotomy(0 vs.19.2%,P=0.013),shorter operative time(102.0 vs.145.5 min,P=0.008)and shorter postoperative hospital stay(6.0 vs.8.5 d,P=0.002)than laparoscopic *** were no differences between the groups in terms of intraoperative blood loss,the rates of postoperative pancreatic fistula and *** a median follow-up of 65 months,two patients in the laparoscopic group developed a functional recurrence and none of the patients in the robotic group had a ***:Robotic enucleation can reduce the conversion rate to laparotomy and shorten operative time,which might lead to a reduction in postoperative hospital stay.

关键词： Robotic surgical procedures Laparoscopy Insulinoma Enucleation Pancreatectomy

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Development and validation of a nomogram model for predicting the risk of gallstone recurrence after gallbladder-preserving surgery

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hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 288-292页

作者： Peng Liu Yong-Wei Chen Che Liu Yin-Tao Wu Wen-Chao Zhao Jian-Yong Zhu Yang An Nian-Xin Xia Faculty of hepato-Pancreato-biliary surgery the First Medical CenterChinese PLA General HospitalBeijing 100853China Institute of hepatobiliary surgery of Chinese PLA Beijing 100853China Key Laboratory of Digital Hepetobiliary surgery of Chinese PLA Beijing 100853China

Background:The high incidence of gallstone recurrence was a major concern for laparoscopic gallbladderpreserving *** study aimed to investigate the risk factors for gallstone recurrence after gallbladder-preserving surgery and to establish an individualized nomogram model to predict the risk of gallstone ***:The clinicopathological and follow-up data of 183 patients who were initially diagnosed with gallstones and treated with gallbladder-preserving surgery at our hospital from January 2012 to January 2019 were retrospectively *** independent predictive factors for gallstone recurrence following gallbladder-preserving surgery were identified by multivariate logistic regression analysis.A nomogram model for the prediction of gallstone recurrence was constructed based on the selected *** C-index,receiver operating characteristic(ROC)curve and calibration curve were used to evaluate the predictive power of the nomogram model for gallstone ***:During the follow-up period,a total of 65 patients experienced gallstone recurrence,and the recurrence rate was 35.5%.Multivariate logistic regression analysis revealed that the course of gallstones>2 years[odds ratio(OR)=2.567,95%confidence interval(CI):1.270-5.187,P=0.009],symptomatic gallstones(OR=2.589,95%CI:1.059-6.329,P=0.037),multiple gallstones(OR=2.436,95%CI:1.133-5.237,P=0.023),history of acute cholecystitis(OR=2.778,95%CI:1.178-6.549,P=0.020)and a greasy diet(OR=2.319,95%CI:1.186-4.535,P=0.014)were independent risk factors for gallstone recurrence after gallbladder-preserving surgery.A nomogram model for predicting the recurrence of gallstones was established based on the above five *** results showed that the C-index of the nomogram model was 0.692,suggesting it was valuable to predict gallstone ***,the calibration curve showed good consistency between the predicted probability and actual ***:The nomogram model for

关键词： Gallstone Gallbladder-preserving surgery Recurrence Risk factors Nomogram

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Post-operative morbidity after neoadjuvant chemotherapy and resection for gallbladder cancer: A national surgical quality improvement program analysis

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World Journal of Gastrointestinal surgery 2024年第1期16卷 95-102页

作者： Minha Kim Stephanie Stroever Krist Aploks Alexander Ostapenko Xiang Da Dong Ramanathan Seshadri Department of General surgery Danbury HospitalDanburyCT 06810United States Department of Research and Innovation Nuvance HealthDanburyCT 06810United States division of Surgical Oncology/hepato-Pancreato-biliary surgery Danbury HospitalDanburyCT 06810United States

BACKGROUND Gallbladder cancer is the most common malignancy of the biliary ***-adjuvant chemotherapy(NACT)has improved overall survival by enabling R0 ***,there is no consensus of guidelines for neoadjuvant therapy in gallbladder *** investigations continue to analyze the regimen and benefit of NACT for ongoing care of gallbladder cancer patients,we examined American College of Surgeons National Surgical Quality Improvement Program(NSQIP)database to determine if there was higher morbidity among the neo-adjuvant group within the 30-day post-operative *** hypothesized patients who underwent NACT were more likely to have higher post-operative *** To investigate the 30-day post-operative morbidity outcomes between patients who received NACT and underwent surgery and patients who only had *** A retrospective analysis of the targeted hepatectomy NSQIP data between 2015 and 2019 was performed to determine if NACT in gallbladder cancer increased the risk for post-operative morbidity(bile leak,infection rate,rate of converting to open surgery,etc.)compared to the group who only had *** calculate the odds ratio for the primary and secondary outcomes,a crude logistic regression was *** Of the 452 patients,52 patients received NACT prior to *** were no statistically significant differences in the odds of morbidity between the two groups,including bile leak[odds ratio(OR),0.69;95%confidence interval(95%CI):0.16-2.10;P=0.55],superficial wound infection(OR,0.58;95%CI:0.03-3.02;P=0.61),and organ space wound infection(OR,0.63;95%CI:0.18-1.63;P=0.61).CONCLUSION There was no significant difference in the risk of 30-day post-operative morbidity between the NACT and surgery group and the surgery only group.

关键词： Gallbladder cancer Neoadjuvant chemotherapy Radical cholecystectomy National surgery Quality Improvement Program Postoperative outcome

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Role of ablation therapy in conjunction with surgical resection for neuroendocrine tumors involving the liver

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World Journal of Gastrointestinal surgery 2024年第3期16卷 768-776页

作者： Alexander Ostapenko Stephanie Stroever Lud Eyasu Minha Kim Krist Aploks Xiang Da Dong Ramanathan Seshadri Department of General surgery Danbury HospitalDanburyCT 06810United States Department of Research and Innovation Nuvance HealthDanburyCT 06810United States division of Surgical Oncology/hepato-Pancreato-biliary surgery Danbury HospitalDanburyCT 06810United States

BACKGROUND Resection of hepatic metastasis from neuroendocrine tumors(NETs)improves quality of life and prolongs 5-year *** can be utilized with surgery to achieve complete *** several studies report long-term out-comes for patients undergoing ablation,none have explored perioperative effects of ablation in patients with metastatic *** To determine if intra-operative ablation during hepatectomy increases risk of ad-verse outcomes such as surgical site infections(SSIs),bleeding,and bile *** A retrospective analysis of the hepatectomy National Surgical Quality Impro-vement Program database from 2015-2019 was performed to determine the odds of SSIs,bile leaks,or bleeding in patients undergoing intraoperative ablation when compared to hepatectomy *** Of the 966 patients included in the study,298(30.9%)underwent ablation during *** were 78(11.7%)patients with SSIs in the hepatectomy alone group and 39(13.1%)patients with a SSIs in the hepatectomy with ablation *** leak occurred in 41(6.2%)and 14(4.8%)patients in the two groups,respec-tively;bleeding occurred in 117(17.5%)and 33(11.1%),*** con-trolling for confounding variables,ablation did not increase risk of SSI(P=0.63),bile leak(P=0.34)or bleeding(P=0.07)when compared to patients undergoing resection alone on multivariate *** Intraoperative ablation with hepatic resection for NETs is safe in the perioperative period without significant increased risk of infection,bleeding,or bile *** should utilize this modality when appropriate to a-chieve optimal disease control and outcomes.

关键词： Hepatectomy Neuroendocrine tumor Ablation Bile leaks Bleeding Surgical site infections

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Comprehensive review of hepatocellular carcinoma with portal vein tumor thrombus:State of art and future perspectives

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hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 221-227页

作者： Paschalis Gavriilidis Timothy M Pawlik Daniel Azoulay Department of surgery Colchester General HospitalTurner RoadColchester CO45JLUK Department of surgery The Ohio State Wexner Medical CenterJames Comprehensive Cancer CenterColumbusOHUSA Department of hepato-biliary and Liver Transplantation surgery Paul Brousse University HospitalParis-Saclay UniversityVillejuif 94800France

Background:Despite advances in the diagnosis of patients with hepatocellular carcinoma(HCC),70%-80%of patients are diagnosed with advanced stage *** vein tumor thrombus(PVTT)is among the most ominous signs of advanced stage disease and has been associated with poor survival if *** sources:A systematic search of MEDLINE(PubMed),Embase,Cochrane Library and Database for Systematic Reviews(CDSR),Google Scholar,and National Institute for Health and Clinical Excellence(NICE)databases until December 2022 was conducted using free text and MeSH terms:hepatocellular carcinoma,portal vein tumor thrombus,portal vein thrombosis,vascular invasion,liver and/or hepatic resection,liver transplantation,and systematic ***:Centers of surgical excellence have reported promising results related to the individualized surgical management of portal thrombus versus arterial chemoembolization or systemic *** elements to the individualized surgical management of HCC and portal thrombus include precise classification of the portal vein tumor thrombus,accurate identification of the subgroups of patients who may benefit from resection,as well as meticulous surgical *** review addressed five specific areas:(a)formation of PVTT;(b)classifications of PVTT;(c)controversies related to clinical guidelines;(d)surgical treatments versus non-surgical approaches;and(e)characterization of surgical techniques correlated with classifications of ***:Current evidence from Chinese and Japanese high-volume centers demonstrated that patients with HCC and associated PVTT can be managed with surgical resection with acceptable results.

关键词： Hepatectomy Liver surgery Liver neoplasms Portal vein tumor thrombus

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Beyond surgery:Overcoming postoperative depression in cancer patients

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World Journal of Psychiatry 2024年第7期14卷 1140-1142页

作者： Shao-Ming Song Xiao Wang Hong-Mei Yue Rong Liu The First School of Clinical Medicine Lanzhou UniversityLanzhou 730000Gansu ProvinceChina Faculty of hepato-pancreato-biliary surgery The First Medical Center of PLA General HospitalBeijing 100853China

Depression is a common occurrence among cancer patients,and it significantly impacts their clinical outcomes and quality of life,with a high incidence during anti-tumor treatment or after *** association between surgery and depression is the result of the interaction of various factors,including physio-logical,psychological,and social factors,all of which are intertwined and make patients susceptible to depression after surgical *** depression has a significant negative impact on many aspects of cancer patients,and it requires timely identification and intervention to improve the overall outcome.

关键词： Depression surgery Tumor Anti-tumor therapy

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Routine utilization of machine perfusion in liver transplantation:Ready for prime time?

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World Journal of Gastroenterology 2024年第11期30卷 1488-1493页

作者： Alessandro Parente Keyue Sun Philipp Dutkowski AM James Shapiro Andrea Schlegel Department of surgery Division of TransplantationUniversity of Alberta HospitalEdmonton T6G 2B7Canada Immunity and Inflammation Lerner Research InstituteClevelandOH 44195United States Swiss hepato-Pancreato-biliary Center Department of Visceral and Transplantation SurgeryUniversity Hospital ZurichZurich 8091Switzerland Immunity and Inflammation Digestive Disease and Surgery InstituteClevelandOH 44195United States

The last decade has been notable for increasing high-quality research and dramatic improvement in outcomes with dynamic liver *** evidence from numerous randomized controlled trials has been pooled by meta-analyses,providing the highest available evidence on the protective effect of machine perfusion(MP)over static cold storage in liver transplantation(LT).Based on a protective effect with less complications and improved graft survival,the field has seen a paradigm shift in organ *** editorial focuses on the role of MP in LT and how it could become the new“gold standard”.Strong collaborative efforts are needed to explore its effects on long-term outcomes.

关键词： Liver transplantation Machine perfusion Viability assessment Hypothermic oxygenated perfusion Normothermic machine perfusion

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