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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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Relationship between portal hypertension and liver stiffness measurements in the treatment of hepatocellular carcinoma from the surgeon’s point of view in the Baveno VII era

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hepatobiliary surgery and Nutrition 2024年第1期13卷 150-153页

作者： Nobuyuki Takemura Norihiro Kokudo hepato-biliary pancreatic surgery division Department of SurgeryNational Center for Global Health and MedicineShinjyuku-kuTokyoJapan

hepatocellular carcinoma(HCC)is the third leading cause of cancer-related deaths worldwide(1).It often arises from the backgrounds of damaged liver due to viral hepatitis,alcoholic,or non-alcoholic liver *** the proportion of patients with HCC of non-hepatitis B and C origins has increased in recent years,hepatitis B and C viruses still cause more than half of all carcinogenesis in patients with HCC(2).Patients with HCC often develop portal hypertension(PHT)from cirrhosis due to the deterioration of the background liver,which proves to be the greatest obstacle to various types of treatments for HCC.

关键词： hepatocellular carcinoma(HCC) portal hypertension(PHT) Baveno VII hepatectomy clinically significant portal hypertension(CSPH)

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Update on the Diagnosis and Treatment of Combined hepatocellular Cholangiocarcinoma

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Journal of Clinical and Translational hepatology 2024年第2期12卷 210-217页

作者： Kai-Jian Chu Yoshikuni Kawaguchi Han Wang Xiao-Qing Jiang Kiyoshi Hasegawa biliary Surgical Department No.1 Eastern Hepatobiliary Surgical HospitalThe Naval Medical UniversityShanghaiChina hepato-biliary-pancreatic surgery division Department of SurgeryGraduate School of MedicineThe University of TokyoTokyoJapan Department of Pathology Eastern Hepatobiliary Surgical HospitalThe Naval Medical UniversityShanghaiChina

Combined hepatocellular-cholangiocarcinoma(cHCC-CCA)is a unique type of liver tumor that contains both hepatocellular carcinoma and cholangiocarcinoma components within a single *** fifth edition of the World Health Organization classification provides a definition and diagnostic criteria for ***,the heterogeneous histomorphology and presentation resulting from variation of the proportion of each component poses challenges for clinical diagnosis and treatment.A diagnosis of cHCC-CCA may be suggested by the synchronous elevation of serum tumor markers for hepatocellular carcinoma and cholangiocarcinoma,a mixed enhancement pattern on imaging,and a discrepancy between the elevation of tumor marker and the imaging enhancement *** examination using hematoxylin and eosin staining is considered the gold standard for diagnosing cHCC-CCA,and comprehensive examination of resection or biopsy specimens is crucial for an accurate ***,there is no standard treatment for cHCC-CCA,and surgery is the *** hepatectomy with lymphadenectomy is among the recommended surgical *** role of liver transplantation in the management of cHCC-CCA is still *** chemoembolization may be effective for unresectable cHCC-CCA,particularly for hypervascular ***,the available evidence does not support systemic therapy for advanced *** prognosis of cHCC-CCA is generally poor,and there is no established staging *** research is needed to better understand the histogenesis and clinical management of *** review provides an overview of the current literature on cHCC-CCA with a focus on its clinical characteristics,pathological diagnosis,and management.

关键词： Combined hepatocellular-cholangiocarcinoma Clinical characteristics Imaging characteristics Pathological diagnosis Treatment

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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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Quality of life after pancreatic surgery

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World Journal of Gastroenterology 2024年第8期30卷 943-955页

作者： Shi-Zhen Li Ting-Ting Zhen Yi Wu Min Wang Ting-Ting Qin Hang Zhang Ren-Yi Qin Department of biliary-pancreatic surgery Affiliated Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030Hubei ProvinceChina

BACKGROUND pancreatic surgery is challenging owing to the anatomical characteristics of the *** attention has been paid to changes in quality of life(QOL)after pancreatic *** To summarize and analyze current research results on QOL after pancreatic *** A systematic search of the literature available on PubMed and EMBASE was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses *** studies were identified by screening the references of retrieved *** on patients’QOL after pancreatic surgery published after January 1,2012,were *** included prospective and retrospective studies on patients'QOL after several types of pancreatic *** results of these primary studies were summarized *** A total of 45 articles were included in the study,of which 13 were related to pancreaticoduodenectomy(PD),seven to duodenum-preserving pancreatic head resection(DPPHR),nine to distal pancreatectomy(DP),two to central pancre-atectomy(CP),and 14 to total pancreatectomy(TP).Some studies showed that 3-6 months were needed for QOL recovery after PD,whereas others showed that 6-12 months was more *** TP and PD had similar influences on QOL,patients needed longer to recover to preoperative or baseline levels after *** QOL was better after DPPHR than ***,the superiority of the QOL between patients who underwent CP and PD remains *** decrease in exocrine and endocrine functions postoperatively was the main factor affecting the *** invasive surgery could improve patients’QOL in the early Core Tip:This review summarizes and analyzes current research results on quality of life(QOL)after pancreatic *** article covers the discussion and analysis of the QOL of various pancreatic *** kind of surgical procedure has better QOL is *** long-term benefits on QOL of minimally invasive su

关键词： Quality of life pancreaticoduodenectomy Duodenum-preserving pancreatic head resection Distal pancreatectomy Central pancreatectomy Total pancreatectomy

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TRIANGLE operation,combined with adequate adjuvant chemotherapy,can improve the prognosis of pancreatic head cancer:A retrospective study

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World Journal of Gastrointestinal Oncology 2024年第5期16卷 1773-1786页

作者： Jia-Hao Chen Li-Yong Zhu Zhi-Wei Cai Xiao Hu Abousalam Abdoulkader Ahmed Jie-Qiong Ge Xiao-Yan Tang Chun-Jing Li Yun-Long Pu Chong-Yi Jiang Department of hepato-biliary-pancreatic surgery Huadong Hospital Affiliated to Fudan UniversityShanghai 200040China Shanghai Key Laboratory of Clinical Geriatric Medicine Fudan UniversityShanghai 200040China Department of Nursing Huadong Hospital Affiliated to Fudan UniversityShanghai 200040China

BACKGROUND The TRIANGLE operation involves the removal of all tissues within the triangle bounded by the portal vein-superior mesenteric vein,celiac axis-common hepatic artery,and superior mesenteric artery to improve patient *** previously promising in patients with locally advanced pancreatic ductal adenocarcinoma(PDAC),data are limited regarding the long-term oncological outcomes of the TRIANGLE operation among resectable PDAC patients undergoing pancreaticoduodenectomy(PD).AIM To evaluate the safety of the TRIANGLE operation during PD and the prognosis in patients with resectable *** This retrospective cohort study included patients who underwent PD for pancreatic head cancer between January 2017 and April 2023,with or without the TRIANGLE *** were divided into the PD_(TRIANGLE)and PD_(non-TRIANGLE)*** and survival outcomes were compared between the two *** adjuvant chemotherapy was defined as adjuvant chemotherapy≥6 *** The PD_(TRIANGLE)and PD_(non-TRIANGLE) groups included 52 and 55 patients,*** were no significant differences in the baseline characteristics or perioperative indexes between the two ***,the recurrence rate was lower in the PD_(TRIANGLE) group than in the PD_(non-TRIANGLE) group(48.1%vs 81.8%,P<0.001),and the local recurrence rate of PDAC decreased from 37.8%to 16.0%.Multivariate Cox regression analysis revealed that PD_(TRIANGLE)(HR=0.424;95%CI:0.256-0.702;P=0.001),adequate adjuvant chemotherapy≥6 months(HR=0.370;95%CI:0.222-0.618;P<0.001)and margin status(HR=2.255;95%CI:1.252-4.064;P=0.007)were found to be independent factors for the recurrence *** The TRIANGLE operation is safe for PDAC patients undergoing ***,it reduces the local recurrence rate of PDAC and may improve survival in patients who receive adequate adjuvant chemotherapy.

关键词： TRIANGLE operation pancreatic ductal adenocarcinoma Heidelberg triangle Adjuvant chemotherapy Prognosis pancreaticoduodenectomy

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ABHD17C represses apoptosis and pyroptosis in hepatocellular carcinoma cells

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BIOCELL 2024年第9期48卷 1299-1310页

作者： LINPEI WANG JIAWEI WANG CHUNFENG SHI WEI WANG JIAN WU division of hepatobiliary and pancreatic surgery Department of SurgeryThe First Affiliated HospitalZhejiang University School of MedicineHangzhou310030China Department of hepatobiliary and pancreatic surgery The Second Affiliated Hospital of Fujian Medical UniversityQuanzhou362000China

Background:Alpha/beta hydrolase domain-containing protein 17C(ABHD17C)is a depalmitoylation enzyme that removes the S-palmitoylation of targeted *** hepatocellular carcinoma(HCC)cells SNU449 and Hep3B use ABHD17C as an oncogene;however,the exact mechanism of this action is yet ***:The expression of ABHD17C in liver cancer tissues was analyzed by bioinformatics,and the expression of ABHD17C in clinical liver cancer tissues and adjacent normal tissues was ***,the proliferative viability of HCC cells after overexpression or knockdown of ABHD17C was examined,and pyroptosis and apoptosis proteins were ***:ABHD17C was overexpressed in human HCC tissues as well as numerous HCC cell *** of ABHD17C caused reduced viability,cell cycle arrest,and defective invasion and migration in HCC cells,while overexpression of ABHD17C exhibited the opposite ***,we discovered that the knockdown of ABHD17C resulted in enhanced apoptotic and pyroptotic phenotypes of HCC cells,whereas overexpression of ABHD17C attenuated such ***:It suggests that ABHD17C contributes to HCC carcinogenesis,making it a promising target for medication treatment.

关键词： ABHD17C hepatocellular carcinoma Apoptosis Pyroptosis

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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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Achieving laparoscopic anatomic resection for hepatocellular carcinoma by fluorescence guided positive staining of hepatic cone unit

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hepatobiliary & pancreatic Diseases International 2024年第4期23卷 406-411页

作者： Jun-Fang Deng Chuan-Hui Peng Yu Zhang Xiao-Feng Xu Rong-Liang Tong Zheng-Long Zhai Di-Yu Chen Cheng Zhang Li-Ming Wu Jian Wu division of hepatobiliary pancreatic surgery the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China

Laparoscopic anatomical liver resection has been increasingly reported worldwide,but how to demarcate the resection planes is technically challenging[1].Positive staining technique with intraoperative indocyanine green(ICG)-fluorescence imaging has been introduced as an effective tool for real-time intraoperative guidance[2].Liver anatomy is ***,liver is composed of 9 segments,each is composed of two to three subsegments,and each subsegment contains several hepatic cone units.A hepatic cone unit is dominated by a tertiary or quaternary hepatic pedicles[3].

关键词： hepatic resection anatomy

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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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