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hepatobiliary & Pancreatic Diseases International 2024年第2期23卷 117-122页

作者： Xin Yang Lu Lu Wen-Wei Zhu Yi-Feng Tao Cong-Huan Shen Jin-Hong Chen Zheng-Xin Wang Lun-Xiu Qin hepatobiliary surgery and Liver Transplantation Centers Department of General SurgeryHuashan Hospital&Cancer Metastasis InstituteFudan UniversityShanghai 200040China

Hepatectomy is still the major curative treatment for patients with liver ***,it is still a big challenge to remove the tumors in the central posterior area,especially if their location involves the retrohepatic inferior vena cava and hepatic *** vivo liver resection and auto-transplantation(ELRA),a hybrid technique of the traditional liver resection and transplantation,has brought new hope to these patients and therefore becomes a valid alternative to liver *** to its technical difficulty,ELRA is still concentrated in a few hepatobiliary centers that have experienced surgeons in both liver resection and liver *** efficacy and safety of this technique has already been demonstrated in the treatment of benign liver diseases,especially in the advanced alveolar ***,the application of ELRA for liver malignances has gained more ***,standardization of clinical practice norms and international consensus are still *** prognostic impact in these oncologic patients also needs further *** this review,we summarized the principles and recent progresses on ELRA.

关键词： Ex vivo liver resection Liver auto-transplantation Oncology Liver malignancies

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

The application of real-time indocyanine green fluorescence cholangiography in laparoscopic living donor left lateral sectionectomy

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hepatobiliary surgery and Nutrition 2024年第4期13卷 575-585,I0001页

作者： Lu Lu Wen-Wei Zhu Cong-Huan Shen Yi-Feng Tao Zheng-Xin Wang Jin-Hong Chen Lun-Xiu Qin hepatobiliary surgery Center Department of General SurgeryHuashan HospitalFudan UniversityShanghaiChina Liver Transplantation Center Department of General SurgeryHuashan HospitalFudan UniversityShanghaiChina

Background:The judgment of the division point of the bile duct has always been one of the difficulties of laparoscopic left lateral sectionectomy(LLLS).The purpose of this study was to assess the effects of indocyanine green(ICG)fluorescence cholangiography during LLLS on the occurrence of biliary complications in both donors and *** optimal dose and injection time of ICG were also ***:This is a retrospective cohort *** October 2016 to December 2022,the clinical data of 103 donors who underwent LLLS and relevant recipients were retrospectively *** to whether ICG fluorescence cholangiography was used,they were divided into a non-ICG group(n=46)and an ICG group(n=57).Biliary complications were observed and the optimal dose and injection time of ICG were ***:Three donors in the non-ICG group suffered from bile *** grafts had multiple bile duct openings and biliary complications were observed in the relevant recipients who received these grafts in the non-ICG *** recipients had bile leakage,and the other two had biliary *** was no biliary complications both in donors and recipients in the ICG *** fluorescence intensity of the liver was 108.1±17.6 at a dose of 0.004 mg/kg 90 minutes after injection,significantly weaker than that at 0.05 mg/kg 30 minutes(200.3±17.6,P=0.001)and 90 minutes after injection(140.2±15.4,P=0.001).The fluorescence intensity contrast value at a dose of 0.004 mg/kg was stronger than that at 0.05 mg/kg,both measured 90 minutes after injection(0.098±0.032 vs.0.078±0.022,P=0.021).Conclusions:ICG fluorescence cholangiography is safe and feasible in *** reduces biliary complications in both donors and *** optimal ICG dose was 0.004 mg/kg,and 90 minutes after injection was the best observation *** fluorescence cholangiography is recommended for routine use in LLLS.

关键词： Laparoscopic living donor hepatectomy(LLDH) living donor liver transplantation(LDLT) real-time indocyanine green fluorescence cholangiography(real-time ICG fluorescence cholangiography)

Surgical techniques to prevent delayed gastric emptying after pancreaticoduodenectomy

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hepatobiliary & Pancreatic Diseases International 2024年第5期23卷 449-457页

作者： Peng Duan Lu Sun Kai Kou Xin-Rui Li Ping Zhang department of hepatobiliary and Pancreatic surgery General Surgery Centerthe First Hospital of Jilin UniversityChangchun 130021China department of Dental Implantology Hospital of StomatologyJilin UniversityChangchun 130021China

Background: Delayed gastric emptying(DGE) is one of the most common complications after pancreaticoduodenectomy(PD). DGE represents impaired gastric motility without significant mechanical obstruction and is associated with an increased length of hospital stay, increased healthcare costs, and a high readmission rate. We reviewed published studies on various technical modifications to reduce the incidence of DGE. Data sources: Studies were identified by searching Pub Med for relevant articles published up to December 2022. The following search terms were used: “pancreaticoduodenectomy”, “pancreaticojejunostomy”, “pancreaticogastrostomy”, “gastric emptying”, “gastroparesis” and “postoperative complications”. The search was limited to English publications. Additional articles were identified by a manual search of references from key articles. Results: In recent years, various surgical procedures and techniques have been explored to reduce the incidence of DGE. Pyloric resection, Billroth II reconstruction, Braun's enteroenterostomy, and antecolic reconstruction may be associated with a decreased incidence of DGE, but more high-powered studies are needed in the future. Neither laparoscopic nor robotic surgery has demonstrated superiority in preventing DGE, and the use of staplers is controversial regarding whether they can reduce the incidence of DGE. Conclusions: Despite many innovations in surgical techniques, there is no surgical procedure that is superior to others to reduce DGE. Further larger prospective randomized studies are needed.

关键词： Pancreaticoduodenectomy Delayed gastric emptying Postoperative complications Surgical techniques

Emerging role of molecular diagnosis and personalized therapy for hepatocellular carcinoma

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iLIVER 2024年第1期3卷 38-44页

作者： Ming-Da Wang Yong-Kang Diao Lan-Qing Yao Zhong-Qi Fan Ke-Chun Wang Han Wu Li-Hui Gu Jia-Hao Xu Chao Li Guo-Yue Lv Tian Yang department of hepatobiliary surgery Eastern Hepatobiliary Surgery HospitalSecond Military Medical University(Navy Medical University)Shanghai 200438China department of hepatobiliary and Pancreatic surgery General Surgery CenterFirst Hospital of Jilin UniversityChangchun 130021China

Hepatocellular carcinoma(HCC)is a prevalent malignancy worldwide,ranking as the sixth most common malignancy and the third leading cause of cancer-related *** diagnosis,limited management options,and its complex etiology contribute to the poor prognosis and high mortality *** advances in understanding the molecular mechanisms of HCC and innovations in high-throughput sequencing technologies have led to the development of molecular diagnostics and personalized therapies for this challenging *** review provides a comprehensive overview of research on the molecular diagnosis and individualized treatment for *** highlight key advances and potential future directions and discuss the application of next-generation sequencing technologies to identify and characterize genetic and epigenetic alterations in HCC *** technologies may aid in the selection of targeted therapies,prediction of treatment response,and monitoring disease ***,we explore the role of liquid biopsy in HCC diagnosis,prognosis prediction,and treatment monitoring,focusing on circulating tumor cells,circulating tumor DNA,and extracellular *** also explore the evolving landscape of personalized therapy for HCC,including targeted therapies against key oncogenic signaling pathways,immune checkpoint inhibitors,tumor-agnostic therapies,and innovative cellbased *** discuss the challenges and opportunities that lie ahead in the quest to improve HCC patient outcomes through the integration of molecular diagnostics and individualized precision *** emphasize the need for multi-interdisciplinary collaboration,refinement of predictive and prognostic biomarkers,and the development of more effective combination strategies for HCC management in the new area of precision medicine.

关键词： Hepatocellular carcinoma Liquid biopsy Diagnosis Immune checkpoint inhibitors Targeted therapy

Efficacy and safety of low-dose cyclophosphamide combined with lenvatinib, pembrolizumab and TACE for unresectable hepatocellular carcinoma:A single-center, prospective,single-arm clinical trial

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Chinese Journal of Cancer Research 2024年第2期36卷 114-123页

作者： Yupeng Ren Yuxuan Li Mingbo Cao Yongchang Tang Feng Yuan Gaoyuan Yang Zhiwei He Zheng Shi Xiaorui Su Zhicheng Yao Meihai Deng department of hepatobiliary surgery the Third Affiliated HospitalSun Yat-sen UniversityGuangzhou 510630China department of general surgery Qilu HospitalShandong UniversityJinan 250012China department of hepatobiliary surgery the First Affiliated Hospital of Guangzhou Medical UniversityGuangzhou 510120China department of hepatobiliary and Pancreatic surgery the Third Affiliated HospitalSun Yat-sen UniversityGuangzhou 510630China

Objective: Unresectable hepatocellular carcinoma(uHCC) continues to pose effective treatment options. The objective of this study was to assess the efficacy and safety of combining low-dose cyclophosphamide with lenvatinib, pembrolizumab and transarterial chemoembolization(TACE) for the treatment of ***: From February 2022 to November 2023, a total of 40 patients diagnosed with uHCC were enrolled in this small-dose, single-center, single-arm, prospective study. They received a combined treatment of low-dose cyclophosphamide with lenvatinib, pembrolizumab, and TACE. Study endpoints included progression-free survival(PFS), objective response rate(ORR), and safety assessment. Tumor response was assessed using the modified Response Evaluation Criteria in Solid Tumors(mRECIST), while survival analysis was conducted through KaplanMeier curve analysis for overall survival(OS) and PFS. Adverse events(AEs) were evaluated according to the National Cancer institute Common Terminology Criteria for Adverse Events(version 5.0).Results: A total of 34 patients were included in the study. The median follow-up duration was 11.2 [95% confidence interval(95% CI), 5.3-14.6] months, and the median PFS(mPFS) was 15.5(95% CI, 5.4-NA) *** OS(mOS) was not attained during the study period. The ORR was 55.9%, and the disease control rate(DCR) was 70.6%. AEs were reported in 27(79.4%) patients. The most frequently reported AEs(with an incidence rate >10%) included abnormal liver function(52.9%), abdominal pain(44.1%), abdominal distension and constipation(29.4%), hypertension(20.6%), leukopenia(17.6%), constipation(17.6%), ascites(14.7%), and insomnia(14.7%). Abnormal liver function(14.7%) had the most common grade 3 or higher ***: A combination of low-dose cyclophosphamide with lenvatinib, pembrolizumab, and TACE is safe and effective for u HCC, showcasing a promising therapeutic strategy for managing uHCC.

关键词： Hepatocellular carcinoma lenvatinib low-dose cyclophosphamide pembrolizumab transarterial chemoembolization

Engineered stem cells by emerging biomedical stratagems

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Science Bulletin 2024年第2期69卷 248-279页

作者： Jinglin Wang Xiaoxuan Zhang Hanxu Chen Haozhen Ren Min Zhou Yuanjin Zhao department of Vascular surgery.Nanjing Drum Tower Hospital Affliated Hospital of Medical SchoolNanjing UniversityNanjing 210008China Division of hepatobiliary surgery and Transplantation surgery Department of General SurgeryNanjing Drum Tower HospitalSchool of Biological Science and Medical EngineeringSoutheast UniversityNanjing 210096China Shenzhen Research institute Southeast UniversityShenzhen 518038China

Stem cell therapy holds immense potential as a viable treatment for a widespread range of intractable *** the safety of stem cell transplantation having been demonstrated in numerous clinical trials,various kinds of stem cells are currently utilized in medical *** the achievements,the therapeutic benefits of stem cells for diseases are limited,and the data of clinical researches are *** optimize tthe effectiveness of stem cells,engineering approaches have been developed to enhance their inherent abilities and impart them with new functionalities,paving the way for the next generation of stem cell *** review offers a detailed analysis of engineered stem cells,including their clinical applications and potential for future *** begin by briefly introducing the recent advances in the production of stem cells(induced pluripotent stem cells(ipsCs),embryonic stem cells(ESCs),mesenchymal stem cells(MSCs)and hematopoietic stem cells(HSCs).Furthermore,we present the latest developments of engineered strategies in stem cells,including engineered methods in molecular biology and biomaterial fields,and their application in biomedical ***,we summarize the current obstacles and suggest future prospects for engineered stem cells in clinical translations and biomedical applications.

关键词： Stem cells Genetic modification Biomaterials Microfluidics Organ-on-a-chip Bioprinting

HSP110 aggravates ischemia-reperfusion injury after liver transplantation by promoting NF-κB pathway

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hepatobiliary & Pancreatic Diseases International 2024年第4期23卷 344-352页

作者： Qing-Zhi Hu Zhen-Rui Cao Wei-Xiong Zheng Min-Jie Zhao Jun-Hua Gong Cong Chen Zhong-Jun Wu Rui Tao department of hepatobiliary surgery Bishan Hospital of Chongqing Medical UniversityChongqing 402760China department of Cardiothoracic surgery the First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China c department of hepatobiliary surgery the First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China department of hepatobiliary surgery the Second Affiliated Hospital of Chongqing Medical UniversityChongqing 400010China

Background:Ischemia-reperfusion injury(IRI)poses a significant challenge to liver transplantation(LT).The underlying mechanism primarily involves overactivation of the immune *** shock protein 110(HSP110)functions as a molecular chaperone that helps stabilize protein ***:An IRI model was established by performing LT on Sprague-Dawley rats,and HSP110 was silenced using ***-eosin staining,TUNEL,immunohistochemistry,ELISA and liver enzyme analysis were performed to assess IRI following *** blotting and quantitative reverse transcription-polymerase chain reaction were conducted to investigate the pertinent molecular ***:Our findings revealed a significant increase in the expression of HSP110 at both the mRNA and protein levels in the rat liver following LT(P<0.05).However,when rats were injected with siRNAHSP110,IRI subsequent to LT was notably reduced(P<0.05).Additionally,the levels of liver enzymes and inflammatory chemokines in rat serum were significantly reduced(P<0.05).Silencing HSP110 with siRNA resulted in a marked decrease in M1-type polarization of Kupffer cells in the liver and downregulated the NF-κB pathway in the liver(P<0.05).Conclusions:HSP110 in the liver promotes IRI after LT in rats by activating the NF-κB pathway and inducing M1-type polarization of Kupffer *** HSP110 to prevent IRI after LT may represent a promising new approach for the treatment of LT-associated IRI.

关键词： Ischemia-reperfusion injury Liver transplantation Inflammation HSP110 Heat shock proteins NF-κB

Minimally invasive liver resection in metabolic syndrome: insights and future directions

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hepatobiliary surgery and Nutrition 2024年第4期13卷 703-705页

作者： Kechun Wang Yifan Li Jinbo Gong Mingda Wang Tian Yang department of hepatobiliary surgery Eastern Hepatobiliary Surgery HospitalSecond Military Medical University(Naval Medical University)ShanghaiChina department of hepatobiliary surgery Affiliated Hospital of Nantong UniversityNantongChina

Hepatocellular carcinoma(HCC)has emerged as a formidable global health challenge since it ranks the sixth most common malignant tumor and the third most common cause of cancer-related death(1).One of the most important factors in the creation of the increased incidence of HCC is the increasing rate of metabolic syndrome(MS),which is a complex interaction of metabolic abnormalities represented by obesity,insulin resistance,dyslipidemia,and *** was believed that chronic hepatitis B and C were one of the major etiologies of HCC,but additionally,the changed landscape of etiology now points toward MS and its comorbidities,such as non-alcoholic fatty liver disease,as major contributors in promotion of development and progress of HCC(2,3).

关键词： Minimally invasive surgery hepatectomy metabolic syndrome(MS) survival

Human Herpesvirus 6 Infection Complicated by Viral Encephalitis Following Liver Transplantation:A Case Report

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Infectious Microbes & Diseases 2024年第3期6卷 158-161页

作者： Kai Kou Heyu Huang Wei Qiu Yuguo Chen Xiaodong Sun Guoyue Lv general surgery Center Department of Hepatobiliary and Pancreatic SurgeryThe First Hospital of Jilin University:Bethune First Hospital of Jilin UniversityChangchunChina

Human herpesvirus 6(HHV-6)is a significant pathogen following solid organ ***,we report a 64-year-old female with cirrhosis related to nonalcoholic fatty liver disease who underwent orthotopic allogeneic liver transplantation and was ultimately diagnosed with HHV-6 encephalitis through cerebrospinal fluid analysis and *** treatment with daily ganciclovir was initiated according to characteristics indicative of viral encephalitis 3 days before confirmed *** improvement in symptoms was observed,with clearance of HHV-6 from the *** complex diagnosis and management of this case accentuate the possibility of serious consequences of HHV-6 infection in postoperative liver transplant *** must maintain a high index of suspicion for HHV-6 reactivation,especially given its association with immunosuppressive drug *** recognition and initiation of antiviral therapy are paramount,particularly when patients present with fever or psychiatric symptoms,as these may indicate HHV-6 encephalitis.

关键词： human herpesvirus 6 viral encephalitis liver transplantation