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Undifferentiated high-grade pleomorphic sarcoma of the common bile duct:A case report and review of literature

World Journal of Gastrointestinal Oncology 2024年第5期16卷 2253-2260页

作者： Li-Ping Zheng Wen-Yan Shen Chun-Dong Hu Chun-Hua Wang Xu-Jian Chen Jing Wang Yi-Yu Shen department of General surgery The Second Affiliated Hospital of Jiaxing UniversityJiaxing 314000Zhejiang ProvinceChina department of Pathology The Second Affiliated Hospital of Jiaxing UniversityJiaxing 314000Zhejiang ProvinceChina

BACKGROUND Undifferentiated pleomorphic sarcoma(UPS)is a rare malignant mesenchymal tumor with a poor *** mainly occurs in the extremities,trunk,head and neck,and retroperitoneum *** to the lack of specific clinical manifestations and imaging features,UPS diagnosis mainly depends on pathological and immunohistochemical examinations for exclusive *** we report an extremely rare case of high-grade UPS in the common bile duct(CBD).There are limited available data on such *** SUMMARY A 70-year-old woman was admitted to our department with yellow eyes and urine accompanied by upper abdominal distending pain for 2 *** laboratory data suggested significantly elevated hepatorenal function *** imaging data revealed calculous cholecystitis,intrahepatic and extrahepatic bile duct dilation with extrahepatic bile duct calculi,and a space-occupying lesion at the distal *** endoscopic biliary stenting and symptomatic support therapy,CBD exploration and biopsy were *** frozen section indicated malignant spindle cell tumor of the CBD mass,and further radical pancreaticoduodenectomy was ***,the neoplasm was diagnosed as a high-grade UPS combined with the light-microscopic morphology and immunohistochemical *** This extremely rare case highlighted the need for increasing physicians'vigilance,reducing the odds of misdiagnosis,and providing appropriate treatment strategies.

关键词： Undifferentiated pleomorphic sarcoma Soft tissue sarcoma Common bile duct Extrahepatic bile duct Immunohistochemistry Case report

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Unveiling hidden outcomes in malignant gastric outlet obstruction research–insights from a"Pancreas 2000"review

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World Journal of Gastrointestinal Endoscopy 2024年第8期16卷 451-461页

作者： Filipe Vilas-Boas Giacomo Emanuele Maria Rizzo Charles De Ponthaud Stuart Robinson Sebastien Gaujoux Gabriele Capurso Giuseppe Vanella Bahadır Bozkırlı department of Gastroenterology São João University HospitalPorto 4200Portugal Endoscopy Service Department of Diagnostic and Therapeutic ServicesScientific Institute for ResearchHospitalization and Healthcare-The Mediterranean Institute for Transplantation and Highly Specialized TherapiesPalermo 90127SiciliaItaly department of Digestive Hepato-Biliary and Pancreatic Surgery and Liver TransplantationAP-HP Pitié-SalpêtriereSorbonne UniversitéParis 75013Île-de-FranceFrance department of Hepatobiliary Pancreatic and Transplant SurgeryFreeman HospitalNewcastle NE77DNNewcastle upon TyneUnited Kingdom Division of Pancreato-biliary Endoscopy and Endosonography Pancreas Translational and Clinical Research CenterIRCCS San Raffaele Scientific InstituteVita-Salute San Raffaele UniversityMilano 20132Italy department of General surgery HPB-UnitAcıbadem Maslak HospitalIstanbul 34398Türkiye

Malignant gastric outlet obstruction(mGOO)is a major condition affecting patients with periampullary tumors,including pancreatic *** current treatment options include surgical gastroenterostomy,endoscopic stenting and more recently EUS-guided *** studies comparing the outcomes of the three procedures focus on technical success,clinical success and ***“occult”outcomes relevant to the patient’s viewpoints and perspective may ultimately impact on cancer-related and overall survival,such as body mass composition,nutritional biomarkers,chemotherapy tolerance and patient-reported quality of *** aim of this review is to provide an overview of potential key outcomes that should be explored in future comparative research around mGOO treatment options.

关键词： Malignant gastric outlet obstruction Endoscopic ultrasound-guided gastroenterostomy Patient-reported outcomes Body composition Nutrition Quality of life

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Endoscopic-ultrasound-guided biliary drainage with placement of electrocautery-enhanced lumen-apposing metal stent for palliation of malignant biliary obstruction:Updated meta-analysis

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World Journal of Gastrointestinal surgery 2024年第3期16卷 907-920页

作者： Zu-Xiang Peng Fang-Fang Chen Wen Tang Xu Zeng Hong-Juan Du Ru-Xian Pi Hong-Ming Liu Xiao-Xiao Lu department of Hepatobiliary surgery Daping HospitalArmy Medical UniversityChongqing 400042China department of Oncology Chongqing General HospitalChongqing UniversityChongqing 401147China department of Gastroenterology and Hepatobiliary surgery People’s Hospital of Fenggang CountyGuizhou 564200Guizhou ProvinceChina Hepatobiliary and Pancreatic Tumor Center Chongqing University Cancer HospitalChongqing 400030China

BACKGROUND Endoscopic ultrasound-guided biliary drainage using electrocautery-enhanced(ECE)delivery of lumen-apposing metal stent(LAMS)is gradually being re-cognized as a viable palliative technique for malignant biliary obstruction after endoscopic retrograde cholangiopancreatography(ERCP)***,most of the studies that have assessed its efficacy and safety were small and *** meta-analyses of six or fewer studies that were published 2 years ago were therefore underpowered to yield convincing *** To update the efficacy and safety of ECE-LAMS for treatment of biliary ob-struction after ERCP *** We searched PubMed,EMBASE,and Scopus databases from the inception of the ECE technique to May 13,*** outcome measure was pooled technical success rate,and secondary outcomes were pooled rates of clinical success,re-intervention,and adverse ***-analysis was performed using a random-effects model following Freeman-Tukey double-arcsine transformation in R soft-ware(version 4.1.3).RESULTS Fourteen eligible studies involving 620 participants were ultimately *** pooled rate of technical success was 96.7%,and clinical success was 91.0%.Adverse events were reported in 17.5%of *** reinter-vention rate was 7.3%.Subgroup analyses showed results were generally *** ECE-LAMS has favorable success with acceptable adverse events in relieving biliary obstruction when ERCP is *** consistency of results across most subgroups suggested that this is a generalizable approach.

关键词： biliary obstruction biliary drainage Electrocautery-enhanced lumen-apposing metal stents Endoscopic ultrasound Endoscopic retrograde cholangiopancreatography failure

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Liver transplantation as an alternative for the treatment of intrahepatic cholangiocarcinoma: Past, present, and future directions

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Hepatobiliary & Pancreatic Diseases International 2024年第2期23卷 129-138页

作者： Sudha Kodali Ashton A Connor Souhail Thabet Elizabeth W Brombosz R Mark Ghobrial Sherrie and Alan Conover Center for Liver Disease and Transplantation Houston Methodist HospitalHoustonTX 77030USA JC Walter Jr Transplant Center Houston Methodist HospitalHoustonTX 77030USA department of Medicine Weill Cornell Medical CollegeNew YorkNYUSA department of surgery Houston Methodist HospitalHoustonTX 77030USA department of surgery Weill Cornell Medical CollegeNew YorkNYUSA School of Medicine New Giza UniversityGizaEgypt

Intrahepatic cholangiocarcinoma(iCCA)is a rare biliary tract cancer with high mortality *** resection of the iCCA lesion is the first choice of treatment,with good prognosis after margin-negative ***,only 12%-40% of patients are eligible for resection at presentation due to cirrhosis,portal hypertension,or large tumor *** transplantation(LT)offers margin-negative iCCA extirpation for patients with unresectable ***,iCCA was a contraindication for LT until size-based selection criteria were introduced to identify patients with satisfied post-LT *** studies have shown that tumor biology-based selection can yield high post-LT survival in patients with locally advanced *** selection criterion is the tumor response to neoadjuvant *** with response to neoadjuvant therapy have better outcomes after LT compared with those without tumor response to neoadjuvant *** index that helps predict the treatment outcome is the *** survival outcomes have also opened the door for living donor LT for *** undergoing LT for iCCA now have statistically similar survival rates as patients undergoing *** combination of surgery and locoregional and systemic therapies improves the prognosis of iCCA patients.

关键词： Liver transplantation Cholangiocarcinoma Hepatectomy Transplant oncology Liver neoplasm

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Management of hilar cholangiocarcinoma in the North of England: Pathology, treatment, and outcome

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World Journal of Gastroenterology 2005年第48期11卷 7625-7630页

作者： SD Mansfield O Barakat RM Charnley BC Jaques CB O'Suilleabhain PJ Atherton D Manas department of Hepato-Pancreatico-biliary surgery

AIM: To assess the management and outcome of hilar cholangiocarcinoma (Klatskin tumor) in a single tertiary referral ***: The notes of all patients with a diagnosis of hilar cholangiocarcinoma referred to our unit for over an 8-year period were identified and retrospectively reviewed. Presentation, management and outcome were ***: Seventy-five patients were identified. The median age was 64 years (range 34-84 years). Male to female ratio was 1:1. Eighty-nine percent of patients presented with jaundice. Most patients referred were under Bismuth classification 3a, 3b or 4. Seventy patients required biliary drainage, 65 patients required 152percutaneous drainage procedures, and 25 had other complications. Forty-one patients had 51 endoscopic drainage procedures performed (15 failed). Of these,36 subsequently required percutaneous drainage. The median number of drainage procedures for all patients was three, 18 patients underwent resection (24%), nine had major complications and three died *** 5-year survival rate was 4.2% for all patients, 21%for resected patients and 0% for those who did not undergo resection (P = 0.0021). The median number of admissions after diagnosis in resected patients was two and three in non-resected patients (P＜0.05).Twelve patients had external-beam radiotherapy, seven brachytherapy, and eight chemotherapy. There was no significant benefit in terms of survival (P = 0.46) or hospital ***: Resection increases survival but carries the risk of significant morbidity and *** biliary drainage is almost always necessary and endoscopic drainage should be avoided if possible.

关键词： Hilar cholangiocarcinoma Pathology Treatment Outcome England

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Natural history of asymptomatic gallbladder stones in clinic without beds:A long-term prognosis over 10 years

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World Journal of Clinical Cases 2024年第1期12卷 42-50页

作者： Yuji Sakai Toshio Tsuyuguchi Hiroshi Ohyama Junichiro Kumagai Takashi Kaiho Masayuki Ohtsuka Naoya Kato Tadao Sakai department of Gastroenterology Sakai ClinicKimistu 299-1162Japan department of Gastroenterology Graduate School of MedicineChiba UniversityChiba 260-8677Japan department of Gastroenterology Chiba Prefectural Sawara HospitalChiba Prefectural Sawara HospitalSawara 287-0003Japan department of Gastroenterology Kimitsu Central HospitalKisarazu 292-8535Japan department of surgery Kimitsu Central HospitalKisarazu 292-8535Japan department of General surgery Graduate School of MedicineChiba UniversityChiba 260-8677Japan

BACKGROUND Several studies have explored the long-term prognosis of patients with asymp-tomatic gallbladder *** reports were primarily conducted in facilities equipped with beds for addressing symptomatic *** To report the long-term prognosis of patients with asymptomatic gallbladder stones in clinics without bed *** We investigated the prognoses of 237 patients diagnosed with asymptomatic gallbladder stones in clinics without beds between March 2010 and October *** symptoms developed,patients were transferred to hospitals where appropriate treatment was *** investigated the asymptomatic and survival periods during the *** Among the 237 patients,214(90.3%)remained asymptomatic,with a mean asymptomatic period of 3898.9279±46.871 d(50-4111 d,10.7 years on average).biliary complications developed in 23 patients(9.7%),with a mean survival period of 4010.0285±31.2788 d(53-4112 d,10.9 years on average).No patient died of biliary *** The long-term prognosis of asymptomatic gallbladder stones in clinics without beds was *** the condition became symptomatic,the patients were transferred to hospitals with beds that could address it;thus,no deaths related to biliary complications were *** finding suggests that follow-up care in clinics without beds is possible.

关键词： Gallbladder stone Acute cholangitis Acute cholecystitis Asymptomatic gallbladder stone Symptomatic gallbladder stone

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The switch triggering the invasion process:Lipid metabolism in the metastasis of hepatocellular carcinoma

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Chinese Medical Journal 2024年第11期137卷 1271-1284页

作者： Jiaqian Zhang Zhicheng Zhang Zhangfan Wu Yufei Wang Zerui Zhang Limin Xia department of Gastroenterology Institute of Liver and Gastrointestinal DiseasesHubei Key Laboratory of Hepato-Pancreato-Biliary DiseasesTongji Hospital of Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430030China State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases Xijing Hospital of Digestive DiseasesFourth Military Medical UniversityXi’anShaanxi 710032China

In humans,the liver is a central metabolic organ with a complex and unique histological *** carcinoma(HCC),which is a highly aggressive disease with a poor prognosis,accounts for most cases of primary liver *** an emerging hallmark of cancers,metabolic reprogramming acts as a runaway mechanism that disrupts homeostasis of the affected organs,including the ***,rewiring of the liver metabolic microenvironment,including lipid metabolism,is driven by HCC cells,propelling the phenotypes of HCC cells,including dissemination,invasion,and even metastasis in *** resulting formation of this vicious loop facilitates various malignant behaviors of HCC ***,few articles have comprehensively summarized lipid reprogramming in HCC ***,we have reviewed the general situation of the liver microenvironment and the physiological lipid metabolism in the liver,and highlighted the effects of different aspects of lipid metabolism on HCC metastasis to explore the underlying *** addition,we have recapitulated promising therapeutic strategies targeting lipid metabolism and the effects of lipid metabolic reprogramming on the efficacy of HCC systematical therapy,aiming to offer new perspectives for targeted therapy.

关键词： Hepatocellular carcinoma Invasion Metastasis Lipid metabolism Tumor microenvironment

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Sarcopenia adversely impacts clinical outcomes in patients undergoing pancreaticoduodenectomy: A systematic review and meta-analysis

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World Journal of Gastrointestinal surgery 2024年第6期16卷 1857-1870页

作者： Qi-Hui Zhang Jin-Dong Ma Yan-Min Lu Run-Nan Zhang Zhong-Hua Zhao Ya-Tong Li Qiang-Pu Chen department of Clinical Nutrition Binzhou Medical University HospitalBinzhou 256603Shandong ProvinceChina department of Hepatobiliary surgery Binzhou Medical University HospitalBinzhou 256603Shandong ProvinceChina

BACKGROUND Sarcopenia is a syndrome marked by a gradual and widespread reduction in skeletal muscle mass and strength,as well as a decline in functional ability,which is associated with malnutrition,hormonal changes,chronic inflammation,distur-bance of intestinal flora,and exercise *** is a com-monly employed clinical intervention for conditions such as pancreatic head cancer,ampulla of Vater cancer,and cholangiocarcinoma,among others,with a notably high rate of postoperative *** is frequent in patients undergoing ***,data regarding the effects of sarcopenia in patients undergoing pancreaticoduodenectomy(PD)are both limited and *** PubMed,Cochrane Library,Web of Science,and Embase databases were screened for studies published from the time of database inception to June 2023 that described the effects of sarcopenia on the outcomes and complications of *** researchers independently assessed the quality of the data extracted from the studies that met the inclusion ***-analysis using RevMan 5.3.5 and Stata 14.0 software was *** and funnel plots were used,respectively,to demonstrate the outcomes of the sarcopenia group vs the non-sarcopenia group after PD and to evaluate potential publication *** Sixteen studies encompassing 2381 patients were included in the *** patients in the sarcopenia group(n=833)had higher overall postoperative complication rates[odds ratio(OR)=3.42,95%confidence interval(CI):1.95-5.99,P<0.0001],higher Clavien-Dindo class≥Ⅲ major complication rates(OR=1.41,95%CI:1.04-1.90,P=0.03),higher bacteremia rates(OR=4.46,95%CI:1.42-13.98,P=0.01),higher pneumonia rates(OR=2.10,95%CI:1.34-3.27,P=0.001),higher pancreatic fistula rates(OR=1.42,95%CI:1.12-1.79,P=0.003),longer hospital stays(OR=2.86,95%CI:0.44-5.28,P=0.02),higher mortality rates(OR=3.17,95%CI:1.55-6.50,P=0.002),and worse overall survival(hazard ratio=2.81,95%CI:1.4

关键词： Pancreaticoduodenectomy Sarcopenia Postoperative complications Length of stay Meta-analysis

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Inferior pancreaticoduodenal artery pseudoaneurysm in a patient with calculous cholecystitis: A case report

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World Journal of Clinical Cases 2019年第18期7卷 2851-2856页

作者： Qiao-Dong Xu Song-Gang Gu Jia-Hong Liang Shao-Dong Zheng Zhi-Hua Lin Pei-Dong Zhang Jiang Yan department of biliary-Pancreatic Minimally Invasive surgery The First Affiliated Hospital of Shantou University Medical College

BACKGROUND Pancreaticoduodenal artery (PDA) aneurysms are extremely rare. The complicated clinical presentations and high incidence of rupture make it difficult to diagnose and treat. PDA pseudoaneurysms often rupture into the gastrointestinal tract and result in life-threatening gastrointestinal hemorrhage. CASE SUMMARY A 69-year-old man was admitted to our hospital due to right upward abdominal pain. A computed tomography (CT) scan demonstrated acute cholecystitis and cholecystolithiasis. Percutaneous gallbladder drainage was performed subsequently. He was discharged after 3 d and readmitted to hospital for cholecystectomy as arranged 1 mo later. A repeat CT scan revealed an emerging enhancing mass between the pancreatic head and the descending duodenum. Then, he suffered hematochezia and hemorrhagic shock suddenly. Emergency percutaneous angiogram was performed and selective catheterization of the superior mesenteric artery demonstrated a pseudoaneurysm in the inferior PDA. Coil embolization was performed and his clinical condition improved quickly after embolization and blood transfusion. He underwent laparoscopic cholecystectomy and was discharged from hospital after surgery under satisfactory conditions. CONCLUSION PDA pseudoaneurysms are uncommon. Acute haemorrhage is a severe complication of pseudoaneurysm with high mortality which clinicians should pay attention to.

关键词： Calculous cholecystitis Inferior pancreaticoduodenal artery pseudoaneurysm Gastrointestinal haemorrhage Coil embolization Case report

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Connective tissue growth factor is overexpressed in human hepatocellular carcinoma and promotes cell invasion and growth

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World Journal of Gastroenterology 2012年第47期18卷 7070-7078页

作者： Ming Xiu Ya-Hui Liu David R Brigstock Fang-Hui He Rui-Juan Zhang Run-Ping Gao department of Hepatic-biliary-Pancreatic Medicine First HospitalJilin University department of Hepatic-biliary-Pancreatic surgery First HospitalJilin University the Research Institute at Nationwide Children's Hospital ColumbusOH 43205United States Division of Pediatric surgery Department of Surgerythe Ohio State UniversityColumbusOH 43205United States

AIM:To determine the expression characteristics of connective tissue growth factor(CTGF/CCN2) in human hepatocellular carcinoma(HCC) in histology and to elucidate the roles of CCN2 on hepatoma cell cycle progression and metastasis in ***:Liver samples from 36 patients(who underwent hepatic resection for the first HCC between 2006 and 2011) and 6 normal individuals were examined for transforming growth factor β1(TGF-β1) or CCN2 mRNA by in situ *** image analysis was performed to measure integrated optimal density of CCN2 mRNA-positive cells in carcinoma foci and the surrounding ***-specific protein-1(FSP-1) and E-cadherin were examined to evaluate the process of epithelial to mesenchymal transition,α-smooth muscle actin and FSP-1 were detected to identify hepatic stellate cells,and CD34 was measured to evaluate the extent of vascularization in liver tissues by immunohistochemical ***2 was assessed for its stimulation of HepG2 cell migration and invasion using commercial kits while flow cytometry was used to determine CCN2 effects on HepG2 ***:In situ hybridization analysis showed that TGF-β1 mRNA was mainly detected in connective tissues and vasculature around carcinoma *** comparison to normal controls,CCN2 mRNA was enhanced 1.9-fold in carcinoma foci(12.36 ± 6.08 vs 6.42 ± 2.35) or 9.4-fold in the surrounding stroma(60.27 ± 28.71 vs 6.42 ± 2.35),with concomitant expression of CCN2 and TGF-β1 mRNA in those ***-mesenchymal transition phenotype related with CCN2 was detected in 12/36(33.3%) of HCC liver samples at the edges between carcinoma foci and *** of HepG2 cells with CCN2(100 ng/mL) resulted in more of the cells transitioning into S phase(23.85 ± 2.35 vs 10.94 ± 0.23),and induced a significant migratory(4.0-fold) and invasive(5.7-fold) ***-β1-induced cell invasion was abrogated by a neutralizing CCN2 antibody showing that CCN2 is a downstream mediator o

关键词： Connective tissue growth factor Hepatocellular carcinoma Hepatoma cell line Migration Invasion

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