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Surgical techniques to prevent delayed gastric emptying after pancreaticoduodenectomy

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

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Preoperative prognostic nutritional index predicts long-term outcomes of patients with ampullary adenocarcinoma after curative pancreatoduodenectomy

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World Journal of Gastrointestinal surgery 2024年第5期16卷 1291-1300页

作者： Chong-Yuan Sun Xiao-Jie Zhang Zheng Li He Fei Ze-Feng Li Dong-Bing Zhao Department of pancreatic and gastric Surgical Oncology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China

BACKGROUND The prognostic nutritional index(PNI),a marker of immune-nutrition balance,has predictive value for the survival and prognosis of patients with various *** To explore the clinical significance of the preoperative PNI on the prognosis of ampullary adenocarcinoma(AC)patients who underwent curative *** The data concerning 233 patients diagnosed with ACs were extracted and analyzed at our institution from January 1998 to December *** patients were categorized into low and high PNI groups based on the cutoff value determined by receiver operating characteristic curve *** compared disease-free survival(DFS)and overall survival(OS)between these groups and assessed prognostic factors through univariate and multivariate *** The optimal cutoff value for the PNI was established at *** with a PNI≥45.3 were categorized into the PNI-high group,while those with a PNI<45.3 were assigned to the PNI-low *** within the PNI-low group tended to be of advanced age and exhibited higher levels of aspartate transaminase and total bilirubin and a lower creatinine level than were those in the PNI-high *** 5-year OS rates for patients with a PNI≥45.3 and a PNI<45.3 were 61.8%and 43.4%,respectively,while the 5-year DFS rates were 53.5%and 38.3%,*** in the PNI-low group had shorter OS(P=0.006)and DFS(P=0.012).In addition,multivariate analysis revealed that the PNI,pathological T stage and pathological N stage were found to be independent prognostic factors for both OS and *** The PNI is a straightforward and valuable marker for predicting long-term survival after *** PNI should be incorporated into the standard assessment of patients with AC.

关键词： Ampullary carcinoma Prognostic nutritional index Prognosis pancreaticoduodenectomy

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Investigation and analysis of the status of cancer health popularization in China,2023

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World Journal of Clinical Oncology 2024年第10期15卷 1269-1279页

作者： Hai-Tao Hu Yu-Juan Jiang Xin-Xin Shao Yi-Ming Lu Yan-Tao Tian Quan Xu Department of pancreatic and gastric surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China

BACKGROUND Cancer presents a significant public health challenge in China,necessitating broad collaboration across *** Chinese government has articulated a goal to increase the overall five-year survival rate for cancer by 15%by *** this objective requires not only advances in medical technology,but also an im-provement in the dissemination of knowledge pertaining to cancer prevention and *** To provide a comprehensive understanding of the status of cancer prevention and level of popularization in China in *** From January 2023 to May 2023,online questionnaires were distributed to 3000 participants,including medical personnel,patients with cancer,their families,and the general *** were 2711 valid responses,covering the entire *** A total of 1020 medical personnel and 1691 patients with cancer,their family members,and the general public participated in the *** medical personnel,93.2%had popularized cancer *** addressed topics included cancer prevention(85.9%)and cancer screening(77.8%).Primary challenges included time constraints(73.9%),insufficient personnel and material support(66.7%),and uncertainty as to where to begin(49.3%).Among patients with cancer,their family members,and the general public,93.4%reported reading or watching cancer science popularization materials and 56.9%expressed a desire for deeper *** most sought-after topics in cancer science popularization included cancer screening(80.2%)and cancer prevention(75.8%).The greatest challenge encountered in accessing cancer health popularization was an abundance of misinformation(67.5%).CONCLUSION Most clinical doctors,patients,family,and the general public wish to participate in cancer ***,improvement in the quality of content in cancer prevention and treatment education is required.

关键词： Cancer health popularization Patient education Science popularization Cancer prevention

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Relationship between Helicobacter pylori infection and colorectal polyp/colorectal cancer

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World Journal of Gastrointestinal surgery 2024年第4期16卷 1008-1016页

作者： Ying Liu Ding-Quan Yang Jun-Nan Jiang Yan Jiao Department of General surgery The Affiliated Hospital to Changchun University of Chinese MedicineChangchun 130021Jilin ProvinceChina Department of Gastrointestinal and Colorectal surgery China-Japan Union Hospital of Jilin UniversityChangchun 130033Jilin ProvinceChina Department of Hepatobiliary and pancreatic surgery General Surgery CenterThe First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina

Helicobacter pylori(***)plays an important role in the development of gastric cancer,although its association to colorectal polyp(CP)or colorectal cancer(CRC)is *** this issue of World Journal of Gastrointestinal surgery,Zhang et al investigated the risk factors for *** infection after colon polyp ***,the researchers used R software to create a prediction model for *** infection based on their *** editorial gives an overview of the association between *** and CP/CRC,including the clinical significance of *** as an independent risk factor for CP/CRC,the underlying processes of ***-associated carcinogenesis,and the possible risk factors and identification of ***.

关键词： Helicobacter pylori Colorectal polyp Colorectal cancer Risk factor

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pancreatic giant malignancy simulating a gastrointestinal stromal tumor

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Hepatobiliary & pancreatic Diseases International 2024年第4期23卷 431-433页

作者： Ben-Jie Liu Chen-Hui Jin Yan-Lun Guo Zhi-Gang Ke Jun-Jun Huang Lin-Ping Cao Department of Hepatobiliary surgery Department of General SurgeryPujiang Branch of the First Affiliated HospitalZhejiang University School of MedicineJinhua 322200China Department of Pathology Pujiang Branch of the First Affiliated HospitalZhejiang University School of MedicineJinhua 322200China Department of Hepatobiliary and pancreatic surgery the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China

pancreatic acinar cell carcinoma(PACC)is a rare malignant tumor of pancreatic epithelial cells,which produces pancreatic exocrine *** originates from acinar cells and terminal branches of the pancreatic ducts in the exocrine tissue of the *** accounts for 1%−2%of pancreatic exocrine tumors[1].Herein,we present an elderly woman with PACC who recovered after effective laparoscopic *** tumor was located on the left side of the abdomen;imaging suggested that it was a gastrointestinal stromal tumor of the gastric wall origin,infiltrating the tail of the pancreas and omentum,while postoperative pathology suggested PACC.

关键词： pancreatic gastrointestinal pancreas

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Retrospective analysis of surgically treated pT4b gastric cancer with pancreatic head invasion

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World Journal of Clinical Cases 2021年第29期9卷 8718-8728页

作者： Peng Jin Hao Liu Fu-Hai Ma Shuai Ma Yang Li Jian-Ping Xiong Wen-Zhe Kang Hai-Tao Hu Yan-Tao Tian Department of pancreatic and gastric surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China

BACKGROUND For advanced gastric cancer patients with pancreatic head invasion,some studies have suggested that extended multiorgan resections(EMR)improves ***,other reports have shown high rates of morbidity and mortality after *** for T4b gastric cancer remains *** To evaluate the surgical approach for pT4b gastric cancer with pancreatic head *** A total of 144 consecutive patients with gastric cancer with pancreatic head invasion were surgically treated between 2006 and 2016 at the China National Cancer *** cancer was confirmed in 76 patients by postoperative pathology and retrospectively *** patients were divided into the gastrectomy plus en bloc pancreaticoduodenectomy group(GP group)and gastrectomy alone group(GA group)by comparing the clinicopathological features,surgical outcomes,and prognostic factors of these *** There were 24 patients(16.8%)in the GP group who had significantly larger lesions(Pgastric cancer and pancreatic head *** Curative resection of the invaded pancreas should be performed to improve survival in selected *** of t

关键词： gastric cancer T4 R0 resection Prognostic factors Extended multiorgan resection Pancreatectomy

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中国胃癌肝转移患者临床诊疗特征及预后分析:全国多中心队列研究(RECORD研究)

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Science Bulletin 2024年第3期69卷 303-307页

作者：高云鹤郗洪庆商亮唐兆庆卫勃乔治唐云王鑫鑫周静汪学非黄昌明陆俊李国新余江梁延锐季加孚李子禹薛侃梁寒柯彬臧潞何子锐谢少华黄华徐泽宽田艳涛熊建平李佶阳崔秋霞李力卢婷婷宋奇嬴刘诗贺孙益红李乐平陈凛 RECORD研究协作组 Section of gastric surgery Senior Department of General SurgeryThe First Medical CenterChinese PLA General HospitalBeijing 100853China Section of Abdominal Trauma surgery Senior Department of General SurgeryThe First Medical CenterChinese PLA General HospitalBeijing 100853China Institute of General surgery The First Medical CenterChinese PLA General HospitalBeijing 100853China Department of Gastrointestinal surgery Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan 250021China Department of General surgery Fudan University Zhongshan HospitalShanghai 200032China Department of General surgery Fujian Medical University Union HospitalFuzhou 350001China Department of General surgery Nanfang Hospital Affiliated to Southern Medical UniversityGuangzhou 510515China Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education) Gastrointestinal Cancer CenterPeking University Cancer Hospital&InstituteBeijing 100142China Department of gastric Cancer surgery Tianjin Medical University Cancer Institute and HospitalTianjin 300060China Department of General surgery Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghai 200025China Institute of Population Medicine and School of Public Health Fujian Medical UniversityFuzhou 350122China Department of gastric surgery Fudan University Shanghai Cancer CenterShanghai 200032China Department of General surgery Jiangsu Province HospitalNanjing Medical UniversityNanjing 210029China Department of pancreatic and gastric surgery National Cancer CenterNational Clinical Research Center for CancerCancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100029China

Despite surgical improvements and pharmacological advances,management of late-stage gastric cancer patients,especially those with hepatic metastasis remains challenging[1–3].Although nationwide registry data from SEER(Surveillance,Epidemiology,and End Results)[4]and the Nordic database[5]in Western countries have provided epidemiological information for patients with gastric cancer liver metastasis(GCLM),little is known about the detailed clinical characteristics.

关键词：胃癌肝转移 metastasis cancer

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Mutational landscape of TP53 and CDH1 in gastric cancer

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World Journal of Gastrointestinal surgery 2024年第2期16卷 276-283页

作者： Hong-Qiao Cai Li-Yue Zhang Li-Ming Fu Bin Xu Yan Jiao Department of Hepatobiliary and pancreatic surgery General Surgery CenterThe First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina Department of Critical Care Medicine The First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina Department of Traditional Chinese Medicine The First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina

In this editorial we comment on an article published in a recent issue of the World J Gastrointest Surg.A common gene mutation in gastric cancer(GC)is the TP53 *** a tumor suppressor gene,TP53 is implicated in more than half of all tumor ***53 gene mutations in GC tissue may be related with clinical pathological *** TP53 mutation arose late in the progression of GC and aided in the final switch to ***1 encodes E-cadherin,which is involved in cell-to-cell adhesion,epithelial structure maintenance,cell polarity,differentiation,and intracellular signaling pathway ***1 mutations and functional loss can result in diffuse GC,and CDH1 mutations can serve as independent prognostic indicators for poor *** patients can benefit from genetic counseling and testing for CDH1 *** therapy may assist to postpone the onset and progression of *** investigation of TP53 and CDH1 gene mutations in GC allows for the investigation of the relationship between these two gene mutations,as well as providing some basis for evaluating the prognosis of GC patients.

关键词： TP53 CDH1 gastric cancer Gene mutation Methylation

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Impact of immunotherapy on liver metastasis

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World Journal of Gastrointestinal surgery 2024年第7期16卷 1969-1972页

作者： Zhuo Fu Ming-Wei Wang Ya-Hui Liu Yan Jiao Medical College Inner Mongolia Minzu UniversityTongliao 028000Inner Mongolia Autonomous RegionChina Ministry of Health Key Laboratory of Radiobiology School of Public Health of Jilin UniversityChangchun 130000Jilin ProvinceChina Department of Hepatobiliary and pancreatic surgery General Surgery CenterThe First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina

This editorial discusses the article“Analysis of the impact of immunotherapy efficacy and safety in patients with gastric cancer and liver metastasis”published in the latest edition of the World Journal of Gastrointestinal *** has achieved outstanding success in tumor ***,the presence of liver metastasis(LM)restrains the efficacy of immunotherapy in various tumors,including lung cancer,colorectal cancer,renal cell carcinoma,melanoma,and gastric cancer.A decrease in CD8+T cells and nature killer cells,along with an increase in macrophages and regulatory T cells,was observed in the microenvironment of LM,leading to immunotherapy *** studies are necessary to determine the best strategy for enhancing the effectiveness of immunotherapy in patients with LM.

关键词： Immunotherapy Liver metastasis Tumor microenvironment Resistance T cells

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中国胃癌肝转移患者临床诊疗特征及预后分析:全国多中心队列研究(RECORD研究)（英文）

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Science Bulletin 2024年第3期 303-307页

作者：高云鹤郗洪庆商亮唐兆庆卫勃乔治唐云王鑫鑫周静汪学非黄昌明陆俊李国新余江梁延锐季加孚李子禹薛侃梁寒柯彬臧潞何子锐谢少华黄华徐泽宽田艳涛熊建平李佶阳崔秋霞李力卢婷婷宋奇嬴刘诗贺孙益红李乐平陈凛 RECORD研究协作组 Section of gastric surgery Senior Department of General Surgery The First Medical Center Chinese PLA General Hospital Section of Abdominal Trauma surgery Senior Department of General Surgery The First Medical Center Chinese PLA General Hospital Institute of General surgery The First Medical Center Chinese PLA General Hospital Department of Gastrointestinal surgery Shandong Provincial Hospital Affiliated to Shandong First Medical University Department of General surgery Fudan University Zhongshan Hospital Department of General surgery Fujian Medical University Union Hospital Department of General surgery Nanfang Hospital Affiliated to Southern Medical University Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education) Gastrointestinal Cancer Center Peking University Cancer Hospital & Institute Department of gastric Cancer surgery Tianjin Medical University Cancer Institute and Hospital Department of General surgery Ruijin Hospital Shanghai Jiao Tong University School of Medicine Institute of Population Medicine and School of Public Health Fujian Medical University Department of gastric surgery Fudan University Shanghai Cancer Center Department of General surgery Jiangsu Province Hospital Nanjing Medical University Department of pancreatic and gastric surgery National Cancer Center National Clinical Research Center for Cancer Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College

Despite surgical improvements and pharmacological advances,management of late-stage gastric cancer patients,especially those with hepatic metastasis remains challenging [1-3].Although nationwide registry data from SEER (Surveillance,Epidemiology,and End Results)[4] and the Nordic database [5] in Western countries have provided epidemiological information for patients with gastric cancer liver metastasis (GCLM),little is known about the detailed clinical ***,emerging evidence has indicated that selective implementation of systemic chemotherapy,immune checkpoint inhibitor (ICI) therapy,surgical resection,

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