Hepatobiliary Pancreat Dis Int

	2022 Vol. 21 No. 1
	Published: 2022-02-15


	Pages 1-102
	EDITORIAL REVIEW ARTICLES ORIGINAL ARTICLES/Liver ORIGINAL ARTICLES/Biliary ORIGINAL ARTICLES/Pancreas LETTERS TO THE EDITOR GUIDELINES VIEWPOINTS

EDITORIAL

	1	Kalthoff H
		How open is the therapeutic horizon for pancreatic cancer patients? ^Hot!
		In the nineties of the last century, it was typical for an article about pancreatic cancer to start with an introductory remark, that this malignancy is a very desperate one and that surgery is the only curative option. But it was also obvious that surgery was not really curative and most importantly, not feasible in the majority of cases. In the last two decades, we observed a dramatic increase in research on pancreatic cancer (e.g. more than 65000 articles mentioning pancreatic cancer in PubMed only in the last decade), and clearly, there is scientific progress. This accounts for (i) genetically defined subtypes (for an overview on the various studies [1]), for (ii) precursor lesions like pancreatic intraepithelial neoplasias (PanINs), intraductal papillary mucinous neoplasm (IPMN) and acinar-ductal metaplasia (ADM) [2], for (iii) comprehensive characterization of the tumor microenvironment [3], for (iv) animal models – both genetically engineered mouse models (GEMMs) and xenotransplant systems [4], for (v) complex in vitro systems like spheroids, organoids, complex co-cultures, chip-based 3D-models [5], and for (vi) the impact of the microbiome [6] as well as for (vii) the metabolic implications [7] and finally, for (viii) the biomarker field which has shown progress beyond the tumor marker carbohydrate antigen 19-9 (CA19-9) [8].
		Hepatobiliary Pancreat Dis Int. 2022; 21(1): 1-3 . [Abstract] ( 161 ) [HTML 1KB] [PDF 0KB] ( 173 )

	4	Malhotra P, Palanisamy R, Falasca M
		Targeting pancreatic ductal adenocarcinoma: New therapeutic options for the ongoing battle
		Pancreatic ductal adenocarcinoma (PDAC), the most commonly reported form of pancreatic cancer, is a lethal malignancy that contributes to the global cancer burden with high morbidity and mortality [1]. It has a poor 5-year survival mainly because PDAC poses a significant diagnostic challenge, has a high metastatic rate at diagnosis and is stubbornly resistant to therapy [2].
		Hepatobiliary Pancreat Dis Int. 2022; 21(1): 4-6 . [Abstract] ( 103 ) [HTML 1KB] [PDF 0KB] ( 161 )

GUIDELINES

	7	Bai JG, Wang Y, Zhang Y, Lv Y; Scientific Committee of the Third International Conference of Magnetic Surgery
		Expert consensus on the application of the magnetic anchoring and traction technique in thoracoscopic and laparoscopic surgery
		The mutual interference between surgical instruments in thoracoscopic and laparoscopic surgery and the effective exposure of the surgical field are important factors affecting surgical op- erability [1]. Magnetic anchoring and traction is one of the core techniques of magnetic surgery, which uses magnetic materials to generate force through indirect contact to achieve traction expo- sure of the target organs [2] (Fig. 1). The magnetic anchoring and traction system comprises an internal and an external magnetic component. The external magnetic component is usually a per- manent magnet, and the internal magnetic component includes an internal magnet and a tissue clip. This system requires fewer trocars, reduces surgical trauma, and improves surgical operability [3]. At present, the magnetic anchoring and traction technique has been applied in many fields including general surgery [ 3–10 ], gynecology [10,11], urology [ 12–14], and thoracic surgery [15]. We formed the following consensus on the indications, contraindi- cations, surgical skills, notes, and complication management for the clinical application of the magnetic anchoring and traction technique.
		Hepatobiliary Pancreat Dis Int. 2022; 21(1): 7-9 . [Abstract] ( 156 ) [HTML 1KB] [PDF 0KB] ( 171 )

REVIEW ARTICLES

	10	Bai RL, Wang NY, Zhao LL, Zhang YF, Cui JW
		Diverse and precision therapies open new horizons for patients with advanced pancreatic ductal adenocarcinoma ^Hot!
		Pancreatic ductal adenocarcinoma (PDAC) is a common cause of cancer-related death, and most patients are with advanced disease when diagnosed. At present, despite a variety of treatments have been developed for PDAC, few effective treatment options are available; on the other hand, PDAC shows significant resistance to chemoradiotherapy, targeted therapy, and immunotherapy due to its heterogeneous genetic profile, molecular signaling pathways, and complex tumor immune microenvironment. Nevertheless, over the past decades, there have been many new advances in the key theory and understanding of the intrinsic mechanisms and complexity of molecular biology and molecular immunology in pancreatic cancer, based on which more and more diverse new means and reasonable combination strategies for PDAC treatment have been developed and preliminary breakthroughs have been made. With the continuous exploration, from surgical local treatment to comprehensive medical management, the research-diagnosis-management system of pancreatic cancer is improving. This review focused on the variety of treatments for advanced PDAC, including traditional chemotherapy, targeted therapy, immunotherapy, microenvironment matrix regulation as well as the treatment targeting epigenetics, metabolism and cancer stem cells. We pointed out the current research bottlenecks and future exploration directions.
		Hepatobiliary Pancreat Dis Int. 2022; 21(1): 10-24 . [Abstract] ( 174 ) [HTML 1KB] [PDF 0KB] ( 155 )

ORIGINAL ARTICLES/Liver

	25	Brichard M, Iesari S, Lerut J, Reding R, Goffette P, Coubeau L
		Meso-Rex bypass for the management of extrahepatic portal vein obstruction in adults (with video) ^Hot!
		Background: Extrahepatic portal vein obstruction (EHPVO) results in severe portal hypertension (PHT) leading to severely compromised quality of life. Often, pharmacological and endoscopic management is unable to solve this problem. Restoring hepatic portal flow using meso-Rex bypass (MRB) may solve it. This procedure, uncommon in adult patients, is considered the treatment of choice for EHPVO in children. Methods: From 1997 to 2018, 8 male and 6 female adults, with a median age of 51 years (range 22–66) underwent MRB procedure for EHPVO at the University Hospitals Saint-Luc in Brussels, Belgium. Symptoms of PHT were life altering in all but one patient and consisted of repetitive gastro-intestinal bleedings, sepsis due to portal biliopathy, and/or severe abdominal discomfort. The surgical technique consisted in interposition of a free venous graft or of a prosthetic graft between the superior mesenteric vein and the Rex recess of the left portal vein. Results: Median operative time was 500 min (range 300–730). Median follow-up duration was 22 months (range 2–169). One patient died due to hemorrhagic shock following percutaneous transluminal interven- tion for early graft thrombosis. Major morbidity, defined as Clavien-Dindo score ≥III, was 35.7% (5/14). Shunt patency at last follow-up was 64.3% (9/14): 85.7% (6/7) of pure venous grafts and only 42.9% (3/7) of prosthetic graft. Symptom relief was achieved in 85.7% (12/14) who became asymptomatic after MRB. Conclusions: Adult EHPVO represents a difficult clinical condition that leads to severely compromised quality of life and possible life-threatening complications. In such patients, MRB represents the only and last resort to restore physiological portal vein flow. Although successful in a majority of patients, this procedure is associated with major morbidity and mortality and should be done in tertiary centers experienced with vascular liver surgery to get the best results.
		Hepatobiliary Pancreat Dis Int. 2022; 21(1): 25-32 . [Abstract] ( 205 ) [HTML 1KB] [PDF 0KB] ( 174 )

	33	Guo XY, Xia YL, Li ZY, Li R, Fan Y, Yao WM, Liu F
		Fas -670 A/G polymorphism predicts prognosis of hepatocellular carcinoma after curative resection in Chinese Han population
		Background: Apoptosis, also called programmed cell death, is a genetically controlled process against hyperproliferation and malignancy. The Fas-Fas ligand (FasL) system is considered a major pathway for apoptosis in cells and tissues. Thus, this study aimed to investigate whether single nucleotide polymor- phisms (SNPs) in Fas and FasL gene may have effects on the recurrence and survival of patients with hepatocellular carcinoma (HCC) after curative hepatectomy. Methods: We investigated the relationship between Fas rs1800682, rs2234767 and FasL rs763110 polymorphisms and recurrence-free survival (RFS) as well as overall survival (OS) in 117 Chinese Han patients with HCC who underwent hepatectomy. Results: In Kaplan-Meier survival analysis, only Fas rs1800682 (-670 A/G) was associated with RFS and OS. Compared with AA genotype, the AG/GG genotype was significantly associated with better RFS ( P = 0.008) and OS ( P = 0.020). Moreover, multivariate Cox regression analysis showed that Fas rs1800682 remained as a significant independent predictor of RFS for HCC patients with hepatectomy [AG/GG vs. AA: adjusted hazard ratio = 0.464, 95% confidence interval: 0.275–0.782, P = 0.004], but was not an independent predictor of OS ( P = 0.395). Conclusions: This study demonstrated that Fas -670 G allele may play a protective role in the recurrence and survival of HCC patients with hepatectomy. Furthermore, Fas rs1800682 polymorphism might be a promising biomarker for HCC patients after hepatectomy.
		Hepatobiliary Pancreat Dis Int. 2022; 21(1): 33-40 . [Abstract] ( 136 ) [HTML 1KB] [PDF 0KB] ( 246 )

	41	Zhang QJ,Li DZ, Lin BY, Geng L, Yang Z, Zheng SS
		SNHG16 promotes hepatocellular carcinoma development via activating ECM receptor interaction pathway
		Background: Accumulating data have suggested that long non-coding RNAs (lncRNAs) play important roles in regulating tumor cell growth. This study was designed to investigate the role of SNHG16 in hep- atocellular carcinoma (HCC). Methods: SNHG16 expression was detected with real-time polymerase chain reaction (PCR). The cut- off value of SNHG16 for tumor-free survival (TFS) was determined with receiver operating characteristic curve analysis. Small interfering RNA was used to inhibit the expression of SNHG16 in HCC cell lines. The biologic behavior of HCC cell was determined with cell viability assay and Transwell assay in vitro. The potential predictive value of SNHG16 on prognosis was analyzed by Kaplan-Meier curves and Cox proportional hazards regression model. Results: SNHG16 expression was upregulated in tumor tissues and HCC cell lines. High expression of SNHG16 was associated with tumor recurrence and poor prognosis after surgery. Multivariate analysis revealed that SNHG16 was an independent prognostic factor for poor recurrence-free survival. Moreover, inhibition of SNHG16 in HepG2, Hep3B, and BEL-7402 cells significantly reduced cell invasiveness and proliferation. Mechanistic analyses indicated that the ECM-receptor interaction pathway was remarkably activated by SNHG16. Conclusions: SNHG16 might be a promising biomarker for predicting tumor recurrence in HCC patients after surgery and a potential therapeutic target for HCC.
		Hepatobiliary Pancreat Dis Int. 2022; 21(1): 41-49 . [Abstract] ( 114 ) [HTML 1KB] [PDF 0KB] ( 142 )

ORIGINAL ARTICLES/Biliary

	50	Sbeit W, Kadah A, Simaan M, Shahin A, Khoury T
		Predictors of recurrent bile duct stone after clearance by endoscopic retrograde cholangiopancreatography: A case-control study
		Background: Recurrent common bile duct (CBD) stone is a long-term sequalae among patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) with CBD stone extraction. Data regarding risk factors for recurrent CBD stone are scarce. We aimed to identify predictors of recurrent CBD stone. Methods: We performed a retrospective case-controlled study from January 2010 to December 2019. Inclusion criteria included patients who had recurrent CBD stone at least 6 months after the index ERCP, in which complete stone extraction was performed and normal cholangiogram was obtained. Overall, 457 patients were included. Forty-two patients (9.2%) had recurrent CBD stone, and 415 patients (90.8%) did not have recurrent CBD stone. Results: In univariate analysis, male sex [odds ratio (OR) = 0.49, P = 0.033] was a protective factor, while endoscopic stone extraction by basket vs. balloon (OR = 2.55, P = 0.005), older age (OR = 1.03, P = 0.003), number of CBD stones (OR = 1.99, P = 0.037), size of CBD stone (OR = 4.06, P = 0.003) and mechanical lithotripsy (OR = 9.22, P = 0.004) were risk factors for recurrent CBD stone. In multivariate logistic regression analysis, mechanical lithotripsy [OR = 9.73, 95% confidence interval (CI): 1.69–55.89, P = 0.010], basket clearance vs. combined basket and balloon (OR = 18.25, 95% CI: 1.05–318.35, P = 0.046) and older age (OR = 1.02, 95% CI: 1.00–1.05, P = 0.023) were risk factors, and male sex (OR = 0.39, 95% CI: 0.19–0.81, P = 0.012) was a protective factor. Conclusions: We identified modifiable and non-modifiable risk factors for recurrent CBD stone. Taking into consideration those factors might aid in minimizing the CBD stone recurrence risk.
		Hepatobiliary Pancreat Dis Int. 2022; 21(1): 50-55 . [Abstract] ( 130 ) [HTML 1KB] [PDF 0KB] ( 153 )

	56	Vedachalam S, Jalil S, Krishna SG, Porter K, Li N, Kelly SG, Conteh L, Mumtaz K
		Call for action: Increased healthcare utilization with growing use of percutaneous cholecystectomy tube over initial cholecystectomy in cirrhotics
		Background: Acute calculous cholecystitis (ACC) is frequently seen in cirrhotics, with some being poor candidates for initial cholecystectomy. Instead, these patients may undergo percutaneous cholecystostomy tube (PCT) placement. We studied the healthcare utilization and predictors of cholecystectomy and PCT in patients with ACC. Methods: The National Database was queried to study all cirrhotics and non-cirrhotics with ACC between 2010–2014 who underwent initial PCT (with or without follow-up cholecystectomy) or cholecystectomy. Cirrhotic patients were divided into compensated and decompensated cirrhosis. Independent predictors and outcomes of initial PCT and failure to undergo subsequent cholecystectomy were studied. Results: Out of 919 189 patients with ACC, 13 283 (1.4%) had cirrhosis. Among cirrhotics, cholecystectomy was performed in 12 790 (96.3%) and PCT in the remaining 493 (3.7%). PCT was more frequent in cirrhotics (3.7%) than in non-cirrhotics (1.4%). Multivariate analyses showed increased early readmissions [odds ratio (OR) = 2.12, 95% confidence interval (CI): 1.43–3.13, P < 0.001], length of stay (effect ratio = 1.39, 95% CI: 1.20–1.61, P < 0.001), calendar-year hospital cost (effect ratio = 1.34, 95% CI: 1.28–1.39, P < 0.001) and calendar-year mortality (hazard ratio = 1.89, 95% CI: 1.07–3.29, P = 0.030) in cirrhotics undergoing initial PCT compared to cholecystectomy. Decompensated cirrhosis (OR = 2.25, 95% CI: 1.67–3.03, P < 0.001) had the highest odds of getting initial PCT. Cirrhosis, regardless of compensated (OR = 0.56, 95% CI: 0.34–0.90, P = 0.020) or decompensated (OR = 0.28, 95% CI: 0.14–0.59, P < 0.001), reduced the chances of getting a subsequent cholecystectomy. Conclusions: Cirrhotic patients undergo fewer cholecystectomy incurring initial PCT instead. Moreover, the rates of follow-up cholecystectomy are lower in cirrhotics. Increased healthcare utilization is seen with initial PCT amongst cirrhotic patients. This situation reflects suboptimal management of ACC in cirrhotics and a call for action.
		Hepatobiliary Pancreat Dis Int. 2022; 21(1): 56-62 . [Abstract] ( 121 ) [HTML 1KB] [PDF 0KB] ( 254 )

ORIGINAL ARTICLES/Pancreas

	63	Zhang H, Gao L, Mao WJ, Yang J, Zhou J, Tong ZH, Ke L, Li WQ
		Early versus delayed intervention in necrotizing acute pancreatitis complicated by persistent organ failure
		Background: Current guidelines for the treatment of patients with necrotizing acute pancreatitis (NAP) recommend that invasive intervention for pancreatic necrosis should be deferred to 4 or more weeks from disease onset to allow necrotic collections becoming “walled-off”. However, for patients showing signs of clinical deterioration, especially those with persistent organ failure (POF), it is controversial whether this delayed approach should always be adopted. In this study, we aimed to assess the impact of differently timed intervention on clinical outcomes in a group of NAP patients complicated by POF. Methods: All NAP patients admitted to our hospital from January 2013 to December 2017 were screened for potential inclusion. They were divided into two groups based on the timing of initial intervention (within 4 weeks and beyond 4 weeks). All the data were extracted from a prospectively collected database. Results: Overall, 131 patients were included for analysis. Among them, 100 (76.3%) patients were intervened within 4 weeks and 31 (23.7%) underwent delayed interventions. As for organ failure prior to intervention, the incidences of respiratory failure, renal failure and cardiovascular failure were not significantly different between the two groups ( P > 0.05). The mortality was not significantly different between the two groups (35.0% vs. 32.3%, P = 0.83). The incidences of new-onset multiple organ failure (8.0% vs. 6.5%, P = 1.00), gastrointestinal fistula (29.0% vs. 12.9%, P = 0.10) and bleeding (35.0% vs. 35.5%, P = 1.00), and length of ICU (30.0 vs. 22.0 days, P = 0.61) and hospital stay (42.5 vs. 40.0 days, P = 0.96) were comparable between the two groups. Conclusion: Intervention within 4 weeks did not worsen the clinical outcomes in NAP patients complicated by POF.
		Hepatobiliary Pancreat Dis Int. 2022; 21(1): 63-68 . [Abstract] ( 117 ) [HTML 1KB] [PDF 0KB] ( 132 )

VIEWPOINTS

	69	Liu SS, Wang HY, Sun Y, Zou YW, Ren ZG, Chen XH, Yu ZJ
		Irreversible electroporation plus chemotherapy versus chemotherapy alone as treatments for patients with locally advanced pancreatic cancer
		Pancreatic cancer is a major health problem worldwide, with a high incidence and mortality rate. It is estimated that it has become the sixth leading cause of cancer-related death in China and the fourth leading cause of cancer-related death globally [1]. For patients with locally advanced pancreatic cancer (LAPC), there are no standard treatment options. National Comprehensive Cancer Network (NCCN) guidelines define LAPC as that affecting the superior mesenteric artery (SMA) or the celiac axis (CA) more than 180 ° or nonrepairable infiltration of the superior mesenteric vein (SMV) or portal vein (PV). Although chemotherapy is a treatment option for these patients, the response rates are extremely low and survival benefits are limited [2]. As an emerging local tumor ablation technique, irreversible electroporation (IRE) works by inducing permanent cell membrane porosity through high voltage and microsecond pulses. Because of its lack of thermal effect, it can cause permanent cell death without damaging the surrounding tissues, which is a good option for tumors with large blood vessels, nerves and important tissue structures around the tumors. Additionally, the survival time of patients with LAPC is limited by radiotherapy or chemotherapy alone, and an adjuvant or consolidated local treatment is needed clinically to provide longer local control to relieve pain and possibly improve the survival of LAPC patients. More importantly, IRE allows larger blood vessels to remain intact, and activated antigen-presenting cells can infiltrate lesions and deliver infiltrating tumor fragments to the lymph nodes in place which activates adaptive immune system [3,4].
		Hepatobiliary Pancreat Dis Int. 2022; 21(1): 69-72 . [Abstract] ( 111 ) [HTML 1KB] [PDF 0KB] ( 181 )

	73	Hori T, Aoyama R, Yamamoto H, Harada H, Yamamoto M, Yamada M, Yazawa T, Zaima M
		Sinistral portal hypertension and distal splenorenal shunt during pancreatic surgery
		Locally advanced pancreatic cancer located in the head or uncinate process ( i.e. , uncus) often invades the confluence of the superior mesenteric vein (SMV), portal vein (PV), and splenic vein (SV) [1,2]. Additionally, chronic pancreatitis easily occludes drainage flow via the SV [3]. These pancreatic diseases force surgeons to perform en bloc resection of the SV. Simple ligation of the remnant SV without venous resection results in sinistral portal hypertension (PH) ( i.e. , left-sided PH), gastrointestinal bleeding, splenic congestion, and hypersplenism over the long term [1,2 ]. Postoperative sinistral PH is considered an intractable complication accompanied by refractory symptoms similar to those of PH due to liver cirrhosis [1,2]. Optimal management of the remnant SV is required during surgery [1,2]; however, intentional venous reconstruction for drainage flow of the SV is still controversial [1,2,4-8 ]. We herein focus on sinistral PH due to occlusion of drainage flow via the SV, present actual characteristics in typical cases of pancreatic cancer and chronic pancreatitis, and discuss a strategic adaptation of the distal splenorenal shunt (DSRS) procedure.
		Hepatobiliary Pancreat Dis Int. 2022; 21(1): 73-75 . [Abstract] ( 138 ) [HTML 1KB] [PDF 0KB] ( 244 )

LETTERS TO THE EDITOR

	76	Gavriilidis P, Hidalgo E, Sutcliffe RP, Roberts KJ
		Terlipressin versus placebo in living donor liver transplantation
		Terlipressin is a long-acting synthetic analogue of vasopressin, demonstrating several potential benefits in the context of living donor liver transplantation (LDLT). During the recipient hepatectomy, terlipressin reduces the portal flow. Consequently, it may mitigate the extent of bowel congestion following portal vein clamping. By decreasing portal hyperperfusion and hypertension, it protects the graft from further injury and improves renal blood flow. All the above described benefits result in decreased morbidity and improved surgical outcomes [1].
		Hepatobiliary Pancreat Dis Int. 2022; 21(1): 76-79 . [Abstract] ( 124 ) [HTML 1KB] [PDF 0KB] ( 151 )

	80	Glinka J, Vanetta C, Pekolj J, Mattera J, de Santibanes E, de Santibanes M
		Liver graft procurement in neurologically deceased donor: Hospital Italiano of Buenos Aires approach
		Liver procurement (LP) from a neurologically deceased donor (NDD) is one of the most important spotlights in liver transplantation (LT) [1,2]. The commonly used approaches include the “rapid” en-bloc dissection, the in vivo normothermic dissection, or a combination of both, according to the preferences and/or the experience of the LP/LT team. A correct LP is essential to achieve optimal results. On the counterpart, defective execution of any of its steps can leave the liver graft unusable and/or cause severe complications in the recipient [3].
		Hepatobiliary Pancreat Dis Int. 2022; 21(1): 80-82 . [Abstract] ( 120 ) [HTML 1KB] [PDF 0KB] ( 162 )

	83	Zhao Y, Liu Y, Zhou L, Zhang XX, Li P, He Q
		Clinical experience of liver transplantation in the treatment of peliosis hepatis
		Peliosis hepatis (PH) is an uncommon benign vascular disorder characterized by widespread blood-filled cysts in the liver. This disease was first described by Wagner in 1861, and because the liver lesions were generally red or blue-purple, it was first named PH by Schoenlack in 1916 [1]. The etiology of PH is not completely clear now, which is mainly related to drug factors, immune factors, and infections. The diagnosis of PH is difficult because of the lack of specific clinical manifestations and imaging features. Pathological biopsy represents the gold standard in diagnosis of PH [2]. The treatment of PH varies from person to person and no consensus has been reached, including the removal of pathogenic factors, hepatic artery embolization, hepatectomy, etc. [3,4]. Liver transplantation (LT) may be the best treatment for PH with fatal complications [5,6]. This study described a rare case of recurrence of PH after LT.
		Hepatobiliary Pancreat Dis Int. 2022; 21(1): 83-85 . [Abstract] ( 121 ) [HTML 1KB] [PDF 0KB] ( 165 )

	86	Citarella F, Vespasiani-Gentilucci U, Crescenzi A, Bianchi A, Virzi V,Tonini G
		Liver involvement in the course of thymoma-associated multiorgan autoimmunity: The first histological description
		Thymoma-associated multiorgan autoimmunity (TAMA) is a rare paraneoplastic syndrome described in patients with thymoma and characterized by multiorgan failure and graft-versus-host disease (GVHD) like pathology affecting the skin, the gastrointestinal tract, and the liver. To date, only 21 cases are reported in literature [1], with some patients presenting gastrointestinal and hepatic manifestations, mainly colitis, diarrhea, and abnormal liver enzymes, but the hepatic involvement has not been histologically characterized yet. In the present study, we describe for the first time that liver involvement in a patient affected by TAMA resembles GVHD.
		Hepatobiliary Pancreat Dis Int. 2022; 21(1): 86-89 . [Abstract] ( 100 ) [HTML 1KB] [PDF 0KB] ( 164 )

	90	Chai ZT, Chen ZH, Zhang XP, Feng JK, Liu ZH, Cheng SQ
		A stable and reliable animal model for hepatocellular carcinoma with portal vein tumor thrombus
		Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide [1,2]. Portal vein tumor thrombus (PVTT) has been demonstrated to be a poor prognostic indicator for HCC [3–5]. However, effective treatment for the condition is still limited. Understanding the insight into the molecular mechanisms behind PVTT development may help to establish a new therapeutic strategy. Animal models which mimic the development of PVTT in humans are necessary to figure out the molecular mechanisms behind PVTT development. Currently, a wide range of animal models have been established for HCC from different angles, including chemically-induced models like diethylnitrosamine, carbon tetrachloride, thioacetamide, and phenobarbital, geneticallyengineered mouse (GEM) models like Wnt/ β-catenin signaling pathway (CTNNB1), telomerase reverse transcriptase (TERT) activation, aflatoxin B1 and HBV infection, and engrafted models [6–8]. However, all the above animal models cannot be used in the study of PVTT, since these models were not able to present all the histological, physiological, and clinical features of human PVTT.
		Hepatobiliary Pancreat Dis Int. 2022; 21(1): 90-93 . [Abstract] ( 124 ) [HTML 1KB] [PDF 0KB] ( 156 )

	94	Jin LM, Liu YX, Cheng J, Zhou L, Xie HY, Feng XW, Li H, Shen Y, Xu X, Zheng SS
		The effect of SphK1/S1P signaling pathway on hepatic sinus microcirculation in rats with hepatic ischemia-reperfusion injury
		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 hepatic I/R injury, which eventually leads to hepatocyte injury. This process is closely associated with the participation of liver nonparenchymal cells such as Kuffer cells, hepatic stellate cells, liver sinusoidal endothelial cells (LSECs), and cytokines. The activated LSECs and ischemic hepatocytes generate oxygen free radicals, promote cell adhesion, hinder hepatic sinus microcirculation, and damage the hepatocytes eventually [4,5]. These in turn inhibit the activation of LSECs, improving hepatic sinus microcirculation during hepatic I/R injury. Recent studies have shown that sphingosine 1-phosphate (S1P), one of the sphingolipid metabolites, has anti-apoptotic, anti-inflammatory properties and counteracts hepatic I/R injury [6,7]. Hence, this study was to investigate the protective mechanisms of LSECs in hepatic I/R injury through SphK1/S1P signaling.
		Hepatobiliary Pancreat Dis Int. 2022; 21(1): 94-98 . [Abstract] ( 113 ) [HTML 1KB] [PDF 0KB] ( 163 )

	99	Zhu NX, Wang XY, Tong T, Xu JH, Yang YY, Tian L
		Primary pancreatic lymphoma diagnosed by endoscopic ultrasound-guided fine needle biopsy
		Primary pancreatic lymphoma (PPL) is extremely rare, accounting for 1% of extra-nodal lymphomas and less than 0.5% of pancreatic masses [1]. Both cytological and histological analyses are required to confirm the diagnosis of PPL. The main treatments include chemotherapy and radiotherapy [2]. Pancreatic resection alone does not improve the survival rate [3]. Hence, it is necessary to differentiate PPL from other malignant tumors before surgery. To date, there is no consensus on the optimal diagnostic approach and most experience is from case reports.
		Hepatobiliary Pancreat Dis Int. 2022; 21(1): 99-102 . [Abstract] ( 109 ) [HTML 1KB] [PDF 0KB] ( 161 )

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