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Hepatobiliary & pancreatic Diseases International 2022年第3期21卷 295-298页

作者： Zhe Yang Jing-Qi Sun Shuo Wang Li Zhuang Shu-Sen Zheng Department of Hepatobiliary and pancreatic surgery Department of Liver TransplantationShulan(Hangzhou)HospitalZhejiang Shuren University School of MedicineHangzhou 310022China division of Hepatobiliary pancreatic surgery First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China

To the Editor:Downstaging therapy has been confirmed to help patients whose tumors are beyond the liver transplantation (LT) criteria to gain the opportunity for LT with long-term *** et al.[1] recently demonstrated that patients with hepatocellular carcinoma (HCC) beyond the Hangzhou criteria on initial diagnosis without extra hepatic metastasis or vascular invasion have comparative outcomes with those matching Milan criteria after LT if these patients are successfully downstaged to the Hangzhou criteria[1].However,whether the downstaging therapy prolongs the survival time of those with portal vein tumor thrombosis (PVTT) is not *** study was to add some data in this field.

关键词： staging hepatocellular invasion

Feasibility of gallbladder preservation during robotic left hepatectomy:A retrospective comparative study

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Laparoscopic, Endoscopic and Robotic surgery 2022年第3期5卷 100-105页

作者： Kit-Fai Lee Andrew KY.Fung Hon-Ting Lok Janet WC.Kung Eugene YJ.Lo Charing CN.Chong John Wong Kelvin KC.Ng division of Hepatobiliary and pancreatic surgery Department of SurgeryPrince of Wales HospitalThe Chinese University of Hong KongHong KongChina

Objective:Traditionally,gallbladder is routinely removed during left hepatectomy even if there is no gallbladder ***,adverse consequence after cholecystectomy,though rare,still occa-sionally *** study aims to evaluate the feasibility of gallbladder preservation during robotic left ***:All consecutive robotic left hepatectomy cases between December 2010 and January 2022 in Prince of Wales Hospital,the Chinese University of Hong Kong were retrieved from a prospectively collected *** gallbladder was preserved by moving the liver transection line just away from the gallbladder *** were divided into two groups:gallbladder preservation(GBP)and non-gallbladder preservation(NGBP).Operative results and long-term outcomes were compared between these two ***:There were 11 cases in the GBP group and 25 cases in the NGBP *** two groups were comparable in terms of the patient demographics and disease *** was no operative *** was no difference between the two groups in operative time(GBP 270 min *** 332 min,p=0.132),blood loss(GBP 50 mL *** 150 mL,p=0.115)or complication rate(GBP 27.3%*** 24.0%,p>0.999).There was also no difference in 5-year overall *** the GBP group,no patient developed specific symptoms or complications related to the preserved ***-up ultrasound or computed tomography revealed a normal appearance of the preserved gallbladders except in one patient who developed a 3-mm gallbladder *** the other hand,one(4%)patient in the NGBP group developed troublesome diarrhoea after ***:Gallbladder preservation is safe and feasible during robotic left *** preserved gallbladder does not lead to any symptoms,while postcholecystectomy diarrhoea can be avoided.

关键词： Robotic left hepatectomy Gallbladder preservation Cholecystectomy

Konjac glucomannan enhances 5-FU-induced cytotoxicity of hepatocellular carcinoma cells via TLR4/PERK/CHOP signaling to induce endoplasmic reticulum stress

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Oncology Research 2022年第4期30卷 201-210页

作者： YONGKANG SHI JUN MA KE CHEN BIN CHEN Department of General surgery Cancer CenterDivision of Gastrointestinal and Pancreatic SurgeryZhejiang Provincial People’s HospitalAffiliated People’s HospitalHangzhou Medical CollegeHangzhou310011China

5-Fluorouracil(5-FU)is a commonly used chemotherapeutic agent for various ***,the drug resistance developed by tumor cells hinders the therapeutic *** glucomannan(KGM)is indicated to sensitize 5-FU-resistant hepatocellular carcinoma(HCC)cells to *** our study,we found that KGM or 5-FU treatment alone did not affect the malignant cell behaviors and endoplasmic reticulum(ER)stress of 5-FU-resistant HCC cells or HepG2/5-FU and Bel-7402/5-FU cells,while cotreatment with KGM and 5-FU significantly facilitated HCC cell apoptosis and ER stress and suppressed cell proliferation potential and migration ***,we explored the underlying mechanism by which KGM induces 5-FU cytotoxicity in HCC *** found that Toll-like receptor 4(TLR4)was downregulated in KGM-and 5-FU-treated HCC ***4 overexpression reversed the KGM and 5-FU cotreatment-induced inhibition of the malignant behaviors of 5-FU-resistant HCC ***,KGM enhanced 5-FU-induced ER stress by inhibiting TLR4 to activate PERK/ATF4/CHOP *** mouse models were established using HepG2/5-FU cells,and KGM was demonstrated to reverse 5-FU resistance in HCC tumors in vivo by suppressing TLR4 to enhance ER stress and activate PERK/ATF4/CHOP *** conclusion,KGM combined with 5-FU treatment significantly promoted apoptosis and reduced cell proliferation,migration and ER stress in 5-FU-resistant HCC cells compared with KGM or 5-FU treatment alone by downregulating TLR4 to activate PERK/ATF4/CHOP signaling.

关键词： Konjac glucomannan 5-FU Hepatocellular carcinoma Drug resistance

Artificial intelligence in the diagnosis and management of colorectal cancer liver metastases

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World Journal of Gastroenterology 2022年第1期28卷 108-122页

作者： Gianluca Rompianesi Francesca Pegoraro Carlo DL Ceresa Roberto Montalti Roberto Ivan Troisi division of Hepato-Bilio-pancreatic Minimally Invasive and Robotic SurgeryDepartment of Clinical Medicine and SurgeryFederico II University HospitalNaples 80125Italy Department of Hepato-Pancreato-Biliary surgery Oxford University Hospitals NHS Foundation TrustOxford OX39ESUnited Kingdom division of Hepato-Bilio-pancreatic Minimally Invasive and Robotic SurgeryDepartment of Public HealthFederico II University HospitalNaples 80125Italy

Colorectal cancer(CRC)is the third most common malignancy worldwide,with approximately 50%of patients developing colorectal cancer liver metastasis(CRLM)during the follow-up *** of CRLM is best achieved via a multidisciplinary approach and the diagnostic and therapeutic decision-making process is *** order to optimize patients’survival and quality of life,there are several unsolved challenges which must be *** primarily include a timely diagnosis and the identification of reliable prognostic ***,to allow optimal treatment options,a precision-medicine,personalized approach is *** widespread digitalization of healthcare generates a vast amount of data and together with accessible high-performance computing,artificial intelligence(AI)technologies can be *** increasing diagnostic accuracy,reducing timings and costs,the application of AI could help mitigate the current shortcomings in CRLM *** this review we explore the available evidence of the possible role of AI in all phases of the CRLM natural *** analysis and convolutional neural networks(CNN)which combine computed tomography(CT)images with clinical data have been developed to predict CRLM development in CRC *** models have also proven themselves to perform similarly or better than expert radiologists in detecting CRLM on CT and magnetic resonance scans or identifying them from the noninvasive analysis of patients’exhaled *** application of AI and machine learning(ML)in diagnosing CRLM has also been extended to histopathological examination in order to rapidly and accurately identify CRLM tissue and its different histopathological growth *** and CNN have shown good accuracy in predicting response to chemotherapy,early local tumor progression after ablation treatment,and patient survival after surgical treatment or *** the initial enthusiasm and the accumulating evidence,AI technologies’role i

关键词： Colorectal cancer Liver metastases Artificial intelligence Machine learning Deep learning Neural networks Radiomics

Application of biocompatible custom ceria nanoparticles in improving the quality of liver grafts for transplantation

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Nano Research 2023年第4期16卷 5176-5188页

作者： Yinbiao Qiao Jianhui Li Suchen Bian Chenyue Zhan Jia Luo Li Jiang Haoyu Li Hao Wu Cheng Zhang Shusen Zheng Haiyang Xie Penghong Song division of Hepatobiliary and pancreatic surgery Department of SurgeryThe First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China National Health Commission(NHC)Key Laboratory of Combined Multi-organ Transplantation Hangzhou 310003China Department of Hepatobiliary and pancreatic surgery Department of Liver TransplantationShulan(Hangzhou)HospitalZhejiang Shuren University School of MedicineHangzhou 310015China The Organ Repair and Regeneration Medicine Institute of Hangzhou Hangzhou 310003China

Liver transplantation(LT),an ultimate and vital method for treating end-stage liver disease,is often accompanied by ischemiareperfusion injury(IRI)resulting from warm or cold ischemia of the donor *** protection techniques are used to improve the quality of liver grafts(from retrieval to implantation).Reactive oxygen species(ROS)cause oxidative stress,which is considered a crucial factor in IRI after *** antioxidants capable of scavenging ROS alleviate IRI in multiple types of organs and *** this study,we synthesized ceria nanoparticles(NPs)with antioxidant properties using a pyrolysis method and covered them with phospholipid-polyethylene glycol to improve their biocompatibility in *** investigated the potential organprotective effect of ceria NPs and the underlying *** NPs promoted liver function recovery after LT by attenuating IRI in liver grafts in *** protective effect of ceria NPs on liver grafts was investigated by applying hypothermic oxygenated machine perfusion ex *** NPs attenuated hypoxia reoxygenation-or H_(2)O_(2)-induced hepatocyte injury by enhancing mitochondrial activity and ROS scavenging in *** effects may be associated with the activation of the nuclear factor erythroid-derived 2-related factor 2(Nrf2)/Kelch-like ECH-associated protein 1(Keap1)/heme oxygenase 1(HO-1)signaling *** conclusion,ceria NPs may serve as a promising antioxidant agent for the treatment of hepatic IRI after LT.

关键词： ceria nanoparticles liver transplantation hypothermic oxygenated machine perfusion(HOPE) ischemia-reperfusion injury(IRI) antioxidant

The effect of SphK1/S1P signaling pathway on hepatic sinus microcirculation in rats with hepatic ischemia-reperfusion injury

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Hepatobiliary & pancreatic Diseases International 2022年第1期21卷 94-98页

作者： Li-Ming Jin Yuan-Xing Liu Jian Cheng Lin Zhou Hai-Yang Xie Xiao-Wen Feng Hui Li Yan Shen Xiao Xu Shu-Sen Zheng division of Hepatobiliary and pancreatic surgery Department of SurgeryFirst Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China NHC Key Laboratory of Combined Multi-organ Transplantation Hangzhou 310003China Department of General surgery Hepatobiliary and Pancreatic Surgery and Minimally Invasive SurgeryZhejiang Provincial People’s HospitalAffiliated People’s Hospital of Hangzhou Medical CollegeHangzhou 310014China

To the Editor:Hepatic ischemia-reperfusion(I/R)injury is the component of liver injury related to liver transplantation and liver surgery[1-3].The hepatic sinus microcirculation injury is a central part of hep-atic I/R injury,which eventually leads to hepatocyte *** process is closely associated with the participation of liver non-parenchymal cells such as Kuffer cells,hepatic stellate cells,liver sinusoidal endothelial cells(LSECs),and cytokines.

关键词： hepatic ischemia microcirculation

Gallbladder Burkitt's lymphoma mimicking gallbladder cancer:A case report

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World Journal of Gastroenterology 2022年第6期28卷 675-682页

作者： Kiyotaka Hosoda Akira Shimizu Koji Kubota Tsuyoshi Notake Hikaru Hayashi Koya Yasukawa Kentaro Umemura Atsushi Kamachi Takamune Goto Hidenori Tomida Shiori Yamazaki Yuri Narusawa Naoko Asano Takeshi Uehara Yuji Soejima division of Gastroenterological Hepato-Biliary-PancreaticTransplantation and Pediatric SurgeryDepartment of SurgeryShinshu University School of MedicineMatsumoto 390-8621Japan Department of Laboratory Medicine Shinshu University School of MedicineMatsumoto 390-8621Japan

BACKGROUND Malignant lymphoma is a rare form of gallbladder *** of these malignancies are diffuse large B-cell lymphomas or mucosa-associated lymphoid tissue-type lymphomas;however,Burkitt’s lymphoma of the gallbladder is extremely rare,and only two previous reports are available in the ***,we report a rare case of Burkitt’s lymphoma of the gallbladder mimicking gallbladder *** SUMMARY An 83-year-old man with no abdominal complaints was found to have a gallbladder tumor and periportal lymph node enlargement on computed tomography(CT)performed for hypertension *** laboratory data revealed slightly elevated serum levels of carcinoembryonic antigen and soluble interleukin 2 *** examinations revealed two irregular and contrastenhanced masses extending into the gallbladder lumen,but these did not infiltrate the ***,a periportal lymph node had enlarged to 30 *** on these findings,we diagnosed the patient as having gallbladder adenocarcinoma with lymph node metastasis,which was treated using bile duct resection with gallbladder bed resection and periportal lymph node ***,the patient was finally diagnosed as having Burkitt’s *** the surgical margin was pathologically negative,recurrence was noted at the hepatic radical margin and superior pancreaticoduodenal lymph nodes on positron emission tomography/CT soon after ***,he was referred to a hematologist and started receiving treatment with reduced-dose cyclophosphamide,doxorubicin,vincristine,and *** Burkitt’s lymphoma can occur in the *** can be useful in cases with findings suggestive of gallbladder malignant lymphoma.

关键词： Gallbladder Malignant lymphoma Burkitt’s lymphoma Gallbladder cancer Lymphadenopathy Case report

Indocyanine green fluorescence imaging for spleen preservation in laparoscopic splenic artery aneurysm resection:A case report

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World Journal of Gastrointestinal surgery 2022年第7期14卷 714-719页

作者： Jian Cheng Li-Yang Sun Jie Liu Cheng-Wu Zhang Department of General surgery Cancer CenterDivision of Hepatobiliary and Pancreatic SurgeryZhejiang Provincial People’s Hospital(Affiliated People’s HospitalHangzhou Medical College)Hangzhou 310014Zhejiang ProvinceChina

BACKGROUND Splenic artery aneurysm(SAA)is a rare vascular lesion conventionally treated by resection or interventional *** surgical procedure usually involves splenectomy,and interventional therapy may cause post-embolization *** of the spleen and its function is rarely reported during the management of *** SUMMARY We report a patient with an asymptomatic SAA(3.5 cm in diameter),which was en-bloc resected laparoscopically using indocyanine green(ICG)fluorescence imaging to preserve the spleen and its *** ICG fluorescence imaging for spleen preservation in laparoscopic SAA resection is safe and may be beneficial in avoiding splenectomy and maintaining splenic function.

关键词： Laparoscopic Indocyanine green Fluorescence imaging Splenic artery Aneurysm Spleen-preserving Case report

Older liver grafts from donation after circulatory death are associated with impaired survival and higher incidence of biliary non-anastomotic structure

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Hepatobiliary & pancreatic Diseases International 2023年第6期22卷 577-583页

作者： Tian Shen Shan-Hua Zheng Jun Chen Zhi-Sheng Zhou Meng-Fan Yang Xiang-Yan Liu Jun-Li Chen Shu-Sen Zheng Xiao Xu Department of Hepatobiliary and pancreatic surgery Shulan(Hangzhou)HospitalHangzhou 310022China division of Hepatobiliary pancreatic surgery The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province Department of Hepatobiliary and Pancreatic SurgeryAffiliated Hangzhou First People’s HospitalZhejiang University School of MedicineHangzhou 310006China China Liver Transplant Registry Hangzhou 310003China NHC Key Laboratory of Combined Multi-organ Transplantation Hangzhou 310003China Institute of Organ Transplantation Zhejiang UniversityHangzhou 310003China

Background:Grafts from older donors after circulatory death were associated with inferior outcome in liver transplants in the *** it has seemed to remain controversial in the last decade,as a result of modified clinical protocols,selected recipients,and advanced technology of organ perfusion and *** present study aimed to examine the impact of older donor age on complications and survival of liver transplant using grafts from donation after circulatory death(DCD).Methods:A total of 944 patients who received DCD liver transplantation from 2015 to 2020 were included and divided into two groups:using graft from older donor(aged≥65 years,n=87)and younger donor(age<65 years,n=857).Propensity score matching(PSM)was applied to eliminate selection ***:A progressively increased proportion of liver transplants with grafts from older donors was observed from 1.68%to 15.44%during the study *** well-balanced older donor(n=79)and younger donor(n=79)were 1:1 *** were significantly more episodes of biliary nonanastomotic stricture(NAS)in the older donor group than the younger donor group[15/79(19.0%)vs.6/79(7.6%);P=0.017].The difference did not reach statistical significance regarding early allograft dysfunction(EAD)and primary non-function(PNF).Older livers had a trend toward inferior 1-,2-,3-year graft and overall survival compared with younger livers,but these differences were not statistically significant(63.1%,57.6%,57.6%vs.76.9%,70.2%,67.7%,P=0.112;64.4%,58.6%,58.6%vs.76.9%,72.2%,72.2%,P=0.064).The only risk factor for poor survival was ABO incompatible transplant(P=0.008)in the older donor *** the subgroup of ABO incompatible cases,it demonstrated a significant difference in the rate of NAS between the older donor group and the younger donor group[6/8(75.0%)vs.3/14(21.4%);P=0.014].Conclusions:Transplants with grafts from older donors(aged≥65 years)after circulatory death are more frequently associated with inferior outcome com

关键词： Older donor Liver transplantation Survival Biliary stricture Donation after circulatory death

Prognosis of hepatocellular carcinoma with bile duct tumor thrombus after R0 resection:a matched study

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Hepatobiliary & pancreatic Diseases International 2016年第6期15卷 626-632页

作者： Ding-Ding Wang Li-Qun Wu Zu-Sen Wang division of Hepatobiliary pancreatic surgery The Affiliated Hospital of Qingdao University

BACKGROUND： Hepatocellular carcinoma （HCC） with bile duct tumor thrombus （BDTT） is rare. The present study aimed to determine post-surgical prognoses in HCC patients with BDTT, as outcomes are currently unclear. METHODS： We compared the prognoses of 110 HCC patients without BDTT （group A） to 22 cases with BDTT （group B）. The two groups were matched in age, gender, tumor etiology, size, number, portal vascular invasion, and TNM stage. Additionally, 28 HCC patients with BDTT were analyzed to identify prognostic risk factors. RESULTS： The 1-, 3-, and 5-year overall survival rates were 90.9%, 66.9%, and 55.9% for group A and 81.8%, 50.0%, and 37.5% for group B, respectively. The median survival time in groups A and B was 68.8 and 31.4 months, respectively （P=0.043）. The patients for group B showed higher levels of serum total bilirubin, alanine aminotransferase and gammaglutamyl transferase, a larger hepatectomy range, and a higher rate of anatomical resection. In subgroup analyses of patients with BDTT who underwent R0 resection, TNM stage Ⅲ-Ⅳ was an independent risk factor for overall survival; these patients had worse prognoses than those with TNM stage Ⅰ-Ⅱ after R0 resection （hazard ratio=6.056, P=0.014）. Besides, univariate and multivariate analyses revealed that non-R0 resection and TNM stage Ⅲ-Ⅳ were independent risk factors for both disease-free survival and overall survival of 28 HCC patients with BDTT. The median overall survival time of patients with BDTT who underwent R0 resection was longer than that of patients who did not undergo R0 resection （31.0 vs 4.0 months, P=0.007）.CONCLUSIONS： R0 resection prolonged survival time in HCC patients with BDTT, although prognosis remains poor. For such patients, R0 resection is an important treatment that determines long-term survival.

关键词： hepatocellular carcinoma bile duct tumor thrombus prognosis recurrence R0 resection