Hepatobiliary Pancreat Dis Int

	2024 Vol. 23 No. 1
	Published: 2024-02-15


	Pages 1-110
	EDITORIAL REVIEW ARTICLES ORIGINAL ARTICLES/Liver ORIGINAL ARTICLES/Biliary ORIGINAL ARTICLES/Pancreas CLINICAL IMAGE LETTERS TO THE EDITOR

EDITORIAL

	1	Huang HK, Li YM, Xu CF
		Pre-MASLD: Should it be defined separately? ^Hot!
		Nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases, yet it has not received sufficient attention [1] . Over the past two decades, the overall global prevalence of NAFLD has risen from 25% to 37% [2] . The disease burden of NAFLD is fueled by the epidemic of obesity and diabetes [3] . It is estimated that more than half of patients with diabetes have NAFLD, and nearly one-third have nonalcoholic steatohepatitis, a progressive stage of the disease [4] . NAFLD is a major risk factor for end-stage liver disease, including liver cirrhosis and hepatocellular carcinoma [5] . In recent years, the etiology of hepatocellular carcinoma has shown a shift from viral to nonviral factors, especially NAFLD. The prevalence of NAFLD-related hepatocellular carcinoma has tripled in the last decade in Asia [6] . NAFLD is not a condition with effects limited to the liver but rather a multisystem disease [7] . NAFLD is a driver of kidney disease, with a hazard ratio of 1.41 for incident chronic kidney disease [8] . The risk of cardiovascular disease is 1.64 times higher in patients with NAFLD and 2.58 times higher in those with severe NAFLD [9] . Patients with NAFLD are also at higher risk of all-cause mortality, cardiovascular mortality, and liver-related mortality, which are increased with the histological progression of NAFLD [10] .
		Hepatobiliary Pancreat Dis Int. 2024; 23(1): 1-3 . [Abstract] ( 118 ) [HTML 1KB] [PDF 0KB] ( 134 )

REVIEW ARTICLES

	4	Sheng JY, Meng ZF, Li Q, Yang YS
		Recent advances in promising drugs for primary prevention of gastroesophageal variceal bleeding with cirrhotic portal hypertension
		Background: Gastroesophageal variceal bleeding is one of the most severe complications of patients with cirrhosis. Although primary prevention drugs, including non-selective β-blockers, have effectively reduced the incidence of bleeding, their efficacy is limited due to side effects and related contraindications. With recent advances in precision medicine, precise drug treatment provides better treatment efficacy. Data sources: Literature search was conducted in PubMed, MEDLINE and Web of Science for relevant articles published up to May 2022. Information on clinical trials was obtained from https://clinicaltrials.gov/ and http://www.chictr.org.cn/. Results: The in-depth understanding of the pathogenesis and advances of portal hypertension has enabled the discovery of multiple molecular targets for promising drugs. According to the site of action, these drugs could be classified into four classes: intrahepatic, extrahepatic, both intrahepatic and extrahepatic targets and others. All these classes of drugs offer advantages over traditional treatments in prevention of gastroesophageal variceal bleeding in patients with cirrhotic portal hypertension. Conclusions: This review classified and summarized the promising drugs, which prevent gastroesophageal variceal bleeding by targeting specific markers of pathogenesis of portal hypertension, demonstrating the significance of using the precision medicine strategy to discover and develop promising drugs for the primary prevention of gastroesophageal variceal bleeding in patients with cirrhotic portal hypertension.
		Hepatobiliary Pancreat Dis Int. 2024; 23(1): 4-13 . [Abstract] ( 112 ) [HTML 1KB] [PDF 0KB] ( 260 )

	14	de la Pinta C
		Stereotactic body radiotherapy in pancreatic adenocarcinoma ^Hot!
		Background: Stereotactic body radiotherapy (SBRT) in pancreatic cancer allows high delivery of radiation doses on tumors without affecting surrounding tissue. This review aimed at the SBRT application in the treatment of pancreatic cancer. Data sources: We retrieved articles published in MEDLINE/PubMed from January 2017 to December 2022. Keywords used in the search included: “pancreatic adenocarcinoma”OR “pancreatic cancer”AND “stereo- tactic ablative radiotherapy (SABR)”OR“stereotactic body radiotherapy (SBRT)”OR“chemoradiotherapy (CRT)”. English language articles with information on technical characteristics, doses and fractionation, indications, recurrence patterns, local control and toxicities of SBRT in pancreatic tumors were included. All articles were assessed for validity and relevant content. Results: Optimal doses and fractionation have not yet been defined. However, SBRT could be the standard treatment in patients with pancreatic adenocarcinoma in addition to CRT. Furthermore, the combination of SBRT with chemotherapy may have additive or synergic effect on pancreatic adenocarcinoma. Conclusions: SBRT is an effective modality for patients with pancreatic cancer, supported by clinical practice guidelines as it has demonstrated good tolerance and good disease control. SBRT opens a possibility of improving outcomes for these patients, both in neoadjuvant treatment and with radical intent.
		Hepatobiliary Pancreat Dis Int. 2024; 23(1): 14-19 . [Abstract] ( 130 ) [HTML 1KB] [PDF 0KB] ( 85 )

ORIGINAL ARTICLES/Liver

	20	Gioia S, De Santis A, d’Amati G, Nardelli S, Spagnoli A, Di Rocco A, Ridola L, Riggio O
		Application of ultrasonography-elastography score to suspect porto-sinusoidal vascular disease in patients with portal vein thrombosis
		Background: Porto-sinusoidal vascular disease (PSVD) and portal vein thrombosis (PVT) are causes of portal hypertension characterized respectively by an intrahepatic and a pre-hepatic obstacle to the flow in the portal system. As PVT may be a consequence of PSVD, in PVT patients at presentation, a pre-existing PSVD should be suspected. In these patients the identification of an underlying PSVD would have rele- vant implication regarding follow-up and therapeutic management, but it could be challenging. In this setting ultrasonography may be valuable in differential diagnosis. The aim of the study was to use ultrasonography to identify parameters to discriminate between PSVD and “pure”PVT and then to suspect PVT secondary to a pre-existing PSVD. Methods: Fifty-three patients with histologically proven PSVD and forty-eight patients affected by chronic PVT were enrolled and submitted to abdominal ultrasonography with elastography by acoustic radiation force impulse (ARFI). Results: ARFI was higher and superior mesenteric vein (SMV) diameter was wider in PSVD patients than in PVT patients. Thus, a prognostic score was obtained as linear combinations of the two parameters with a good discrimination capacity between PSVD and PVT (the area under the curve = 0.780; 95% confidence interval: 0.690-0.869). Conclusions: A score based on ARFI and SMV diameter may be useful to suspect an underlying PSVD in patients with PVT and to identify a subgroup of patients to be submitted to liver biopsy.
		Hepatobiliary Pancreat Dis Int. 2024; 23(1): 20-24 . [Abstract] ( 108 ) [HTML 1KB] [PDF 0KB] ( 76 )

	25	Bao HL, Chen CZ, Ren CZ, Sun KY, Liu H, Song SH, Fu ZR
		Polydatin ameliorates hepatic ischemia-reperfusion injury by modulating macrophage polarization ^Hot!
		Background: Polydatin, a glucoside of resveratrol, has shown protective effects against various diseases. However, little is known about its effect on hepatic ischemia-reperfusion (I/R) injury. This study aimed to elucidate whether polydatin protects liver against I/R-induced injury and to explore the underlying mechanism. Methods: After gavage feeding polydatin once daily for a week, mice underwent a partial hepatic I/R procedure. Serum alanine aminotransferase (ALT)/aspartate aminotransferase (AST), hematoxylin-eosin (H&E) and TdT-mediated dUTP nick-end labeling (TUNEL) staining were used to evaluate liver injury. The severity related to the inflammatory response and reactive oxygen species (ROS) production was also investigated. Furthermore, immunofluorescence and Western blotting were used to detect macrophage polarization and the NF-κB signaling pathway in macrophages. Results: Compared with the I/R group, polydatin pretreatment significantly attenuated I/R-induced liver damage and apoptosis. The oxidative stress marker (dihydroethidium fluorescence, malondialdehyde, superoxide dismutase and glutathione peroxidase) and I/R related inflammatory cytokines (interleukin-1β, interleukin-10 and tumor necrosis factor-α) were significantly suppressed after polydatin treatment. In addition, the result of immunofluorescence indicated that polydatin reduced the polarization of macrophages toward M1 macrophages both in vivo and in vitro. Western blotting showed that polydatin inhibited the pro-inflammatory function of RAW264.7 via down-regulating the NF-κB signaling pathway. Conclusions: Polydatin protects the liver from I/R injury by remodeling macrophage polarization via NF- κB signaling.
		Hepatobiliary Pancreat Dis Int. 2024; 23(1): 25-34 . [Abstract] ( 181 ) [HTML 1KB] [PDF 0KB] ( 108 )

	35	Miao LL,Wang JW, Liu HH, Gao S, Fan YC,Wang K
		Hypomethylation of glycine dehydrogenase promoter in peripheral blood mononuclear cells is a new diagnostic marker of hepatitis B virus-associated hepatocellular carcinoma
		Background: Glycine dehydrogenase (GLDC) plays an important role in the initiation and proliferation of several human cancers. In this study, we aimed to detect the methylation status of GLDC promoter and its diagnostic value for hepatitis B virus-associated hepatocellular carcinoma (HBV-HCC). Methods: We enrolled 197 patients, 111 with HBV-HCC, 51 with chronic hepatitis B (CHB), and 35 healthy controls (HCs). The methylation status of GLDC promoter in peripheral mononuclear cells (PBMCs) was identified by methylation specific polymerase chain reaction (MSP). The mRNA expression was examined using real-time quantitative polymerase chain reaction (qPCR). Results: The methylation frequency of the GLDC promoter was significantly lower in HBV-HCC patients (27.0%) compared to that in CHB patients (68.6%) and HCs (74.3%) ( P < 0.001). The methylated group had lower alanine aminotransferase level ( P = 0.035) and lower rates of tumor node metastasis (TNM) III/IV ( P = 0.043) and T3/T4 ( P = 0.026). TNM stage was identified to be an independent factor for GLDC promoter methylation. GLDC mRNA levels in CHB patients and HCs were significantly lower than those in HBV-HCC patients ( P = 0.022 and P < 0.001, respectively). GLDC mRNA levels were significantly higher in HBV-HCC patients with unmethylated GLDC promoters than those with methylated GLDC promoters ( P = 0.003). The diagnostic accuracy of alpha-fetoprotein (AFP) combined with GLDC promoter methy- lation for HBV-HCC was improved compared with that of AFP alone (AUC: 0.782 vs. 0.630, P < 0.001). In addition, GLDC promoter methylation was an independent predictor for overall survival of HBV-HCC patients ( P = 0.038). Conclusions: The methylation frequency of GLDC promoter was lower in PBMCs from HBV-HCC patients than that from patients with CHB and HCs. The combination of AFP and GLDC promoter hypomethylation significantly improved the diagnostic accuracy of HBV-HCC.
		Hepatobiliary Pancreat Dis Int. 2024; 23(1): 35-42 . [Abstract] ( 94 ) [HTML 1KB] [PDF 0KB] ( 91 )

	43	Zhang QQ, Chen Q, Cao P, Shi CX, Zhang LY, Wang LW, Gong ZJ
		AGK2 pre-treatment protects against thioacetamide-induced acute liver failure via regulating the MFN2-PERK axis and ferroptosis signaling pathway
		Background: Acute liver failure (ALF) is an unpredictable and life-threatening critical illness. The pathological characteristic of ALF is massive necrosis of hepatocytes and lots of inflammatory cells infiltration which may lead to multiple organ failure. Methods: Animals were divided into 3 groups, normal, thioacetamide (TAA, ALF model) and TAA + AGK2. Cultured L02 cells were divided into 5 groups, normal, TAA, TAA + mitofusin 2 (MFN2)-siRNA, TAA + AGK2, and TAA + AGK2 + MFN2-siRNA groups. The liver histology was evaluated with hematoxylin and eosin staining, inositol-requiring enzyme 1 (IRE1), activating transcription factor 6 β(ATF6 β), protein kinase R (PKR)-like endoplasmic reticulum kinase (PERK) and phosphorylated-PERK (p-PERK). C/EBP ho- mologous protein (CHOP), reactive oxygen species (ROS), MFN2 and glutathione peroxidase 4 (GPX4) were measured with Western blotting, and cell viability and liver chemistry were also measured. Mitochondria- associated endoplasmic reticulum membranes (MAMs) were measured by immunofluorescence. Results: The liver tissue in the ALF group had massive inflammatory cell infiltration and hepatocytes necrosis, which were reduced by AGK2 pre-treatment. In comparison to the normal group, apoptosis rate and levels of IRE1, ATF6 β, p-PERK, CHOP, ROS and Fe2 + in the TAA-induced ALF model group were sig- nificantly increased, which were decreased by AGK2 pre-treatment. The levels of MFN2 and GPX4 were decreased in TAA-induced mice compared with the normal group, which were enhanced by AGK2 pre- treatment. Compared with the TAA-induced L02 cell, apoptosis rate and levels of IRE1, ATF6 β, p-PERK, CHOP, ROS and Fe2 + were further increased and levels of MFN2 and GPX4 were decreased in the MFN2- siRNA group. AGK2 pre-treatment decreased the apoptosis rate and levels of IRE1, ATF6 β, p-PERK, CHOP, ROS and Fe2 + and enhanced the protein expression of MFN2 and GPX4 in MFN2-siRNA treated L02 cell. Immunofluorescence observation showed that level of MAMs was promoted in the AGK2 pre-treatment group when compared with the TAA-induced group in both mice and L02 cells. Conclusions: The data suggested that AGK2 pre-treatment had hepatoprotective role in TAA-induced ALF via upregulating the expression of MFN2 and then inhibiting PERK and ferroptosis pathway in ALF.
		Hepatobiliary Pancreat Dis Int. 2024; 23(1): 43-51 . [Abstract] ( 98 ) [HTML 1KB] [PDF 0KB] ( 448 )

	52	Zhang L, He S, Guan H, Zhao Y, Zhang D
		Circulating RNA ZFR promotes hepatocellular carcinoma cell proliferation and epithelial-mesenchymal transition process through miR-624-3p/WEE1 axis
		Background: Hepatocellular carcinoma (HCC), the most common type of primary liver cancer, is the fourth leading cause of cancer-related deaths worldwide. Previous evidence shows that the expression of circulating RNA ZFR (circZFR) is upregulated in HCC tissues. However, the molecular mechanism of circZFR in HCC is unclear. Methods: Quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) was employed to detect the expression of circZFR, microRNA-624-3p (miR-624-3p) and WEE1 in HCC tissues and cells. RNase R assay and actinomycin D treatment assay were used to analyze the characteristics of circZFR. For functional analysis, the capacities of colony formation, cell proliferation, cell apoptosis, migration and invasion were assessed by colony formation assay, 5-ethynyl-2-deoxyuridine (EdU) assay, flow cytometry assay and transwell assay. Western blot was used to examine the protein levels of WEE1 and epithelial-mesenchymal transition (EMT)-related proteins. The interactions between miR-624-3p and circZFR or WEE1 were validated by dual-luciferase reporter assay and RNA immunoprecipitation (RIP) assay. Xenograft models were established to determine the role of circZFR in vivo. Results: circZFR and WEE1 were upregulated, while miR-624-3p expression was reduced in HCC tissues and cells. circZFR could sponge miR-624-3p, and WEE1 was a downstream gene of miR-624-3p. Knock-down of circZFR significantly reduced the malignant behaviors of HCC and that co-transfection with miR- 624-3p inhibitor restored this change. Overexpression of WEE1 abolished the inhibitory effect of miR- 624-3p mimic on HCC cells. Mechanistically, circZFR acted as a competitive endogenous RNA (ceRNA) to regulate WEE1 expression by targeting miR-624-3p. Furthermore, in vivo studies have illustrated that circZFR knockdown inhibited tumor growth. Conclusions: circZFR knockdown reduced HCC cell proliferation, migration and invasion and promoted apoptosis by regulating the miR-624-3p/WEE1 axis, suggesting that the circZFR/miR-624-3p/WEE1 axis might be a potential target for HCC treatment.
		Hepatobiliary Pancreat Dis Int. 2024; 23(1): 52-63 . [Abstract] ( 88 ) [HTML 1KB] [PDF 0KB] ( 98 )

ORIGINAL ARTICLES/Biliary

	64	Koya Y, Shibata M, Maruno Y, Sakamoto Y, Oe S, Miyagawa K, Honma Y, Harada M
		Low skeletal muscle mass and high visceral adiposity are associated with recurrence of acute cholecystitis after conservative management: A propensity score-matched cohort study
		Background: Recurrent acute cholecystitis (RAC) can occur after non-surgical treatment for acute cholecystitis (AC), and can be more severe in comparison to the first episode of AC. Low skeletal muscle mass or adiposity have various effects in several diseases. We aimed to clarify the relationship between RAC and body parameters. Methods: Patients with AC who were treated at our hospital between January 2011 and March 2022 were enrolled. The psoas muscle mass and adipose tissue area at the third lumbar level were measured using computed tomography at the first episode of AC. The areas were divided by height to obtain the psoas muscle mass index (PMI) and subcutaneous/visceral adipose tissue index (SATI/VATI). According to median VATI, SATI and PMI values by sex, patients were divided into the high and low PMI groups. We performed propensity score matching to eliminate the baseline differences between the high PMI and low PMI groups and analyzed the cumulative incidence and predictors of RAC. Results: The entire cohort was divided into the high PMI ( n = 81) and low PMI ( n = 80) groups. In the propensity score-matched cohort there were 57 patients in each group. In Kaplan–Meier analysis, the low PMI group and the high VATI group had a significantly higher cumulative incidence of RAC than their counterparts (log-rank P = 0.001 and 0.015, respectively). In a multivariate Cox regression analysis, the hazard ratios of low PMI and low VATI for RAC were 5.250 (95% confidence interval 1.083–25.450, P = 0.039) and 0.158 (95% confidence interval: 0.026-0.937, P = 0.042), respectively. Conclusions: Low skeletal muscle mass and high visceral adiposity were independent risk factors for RAC.
		Hepatobiliary Pancreat Dis Int. 2024; 23(1): 64-70 . [Abstract] ( 86 ) [HTML 1KB] [PDF 0KB] ( 279 )

	71	Fugazza A, Colombo M, Kahaleh M, Muthusamy VR, Benjamin B, Laleman W, Barbera C, Fabbri C, Nieto J, Al-Lehibi A,
		The outcomes and safety of patients undergoing endoscopic retrograde cholangiopancreatography combining a single-use cholangioscope and a single-use duodenoscope: A multicenter retrospective international study ^Hot!
		Background: Duodenoscope-related multidrug-resistant organism (MDRO) infections raise concerns. Disposable duodenoscopes have been recently introduced in the market and approved by regulatory agencies with the aim to reduce the risk of endoscopic retrograde cholangiopancreatography (ERCP) associated infections. The aim of this study was to evaluate the outcome of procedures performed with single-use duodenoscopes in patients with clinical indications to single-operator cholangiopancreatoscopy. Methods: This is a multicenter international, retrospective study combining all patients who underwent complex biliopancreatic interventions using the combination of a single-use duodenoscope and a single-use cholangioscope. The primary outcome was technical success defined as ERCP completion for the intended clinical indication. Secondary outcomes were procedural duration, rate of cross-over to reusable duodenoscope, operator-reported satisfaction score (1 to 10) on performance rating of the single-use duodenoscope, and adverse event (AE) rate. Results: A total of 66 patients (26, 39.4% female) were included in the study. ERCP was categorized according to ASGE ERCP grading system as 47 (71.2%) grade 3 and 19 (28.8%) grade 4. The technical success rate was 98.5% (65/66). Procedural duration was 64 (interquartile range 15-189) min, cross-over rate to reusable duodenoscope was 1/66 (1.5%). The satisfaction score of the single-use duodenoscope classified by the operators was 8.6 ±1.3 points. Four patients (6.1%) experienced AEs not directly related to the single-use duodenoscope, namely 2 post-ERCP pancreatitis (PEP), 1 cholangitis and 1 bleeding. Conclusions: Single-use duodenoscope is effective, reliable and safe even in technically challenging procedures with a non-inferiority to reusable duodenoscope, making these devices a viable alternative to standard reusable equipment.
		Hepatobiliary Pancreat Dis Int. 2024; 23(1): 71-76 . [Abstract] ( 142 ) [HTML 1KB] [PDF 0KB] ( 89 )

ORIGINAL ARTICLES/Pancreas

	77	Mao WJ, Zhou J, Zhang GF, Chen FX, Zhang JZ, Li BQ, Ke L, Li WQ
		Early systemic anticoagulation reduces hospital readmission in acute necrotizing pancreatitis patients: A retrospective cohort study
		Background: Early systemic anticoagulation (SAC) is a common practice in acute necrotizing pancreatitis (ANP), and its impact on in-hospital clinical outcomes had been assessed. However, whether it affects long-term outcomes is unknown. This study aimed to evaluate the effect of SAC on 90-day readmission and other long-term outcomes in ANP patients. Methods: During January 2013 and December 2018, ANP patients admitted within 7 days from the on- set of abdominal pain were screened. The primary outcome was 90-day readmission after discharge. Cox proportional-hazards regression model and mediation analysis were used to define the relationship between early SAC and 90-day readmission. Results: A total of 241 ANP patients were enrolled, of whom 143 received early SAC during their hospitalization and 98 did not. Patients who received early SAC experienced a lower incidence of splanchnic venous thrombosis (SVT) [risk ratio (RR) = 0.40, 95% CI: 0.26-0.60, P < 0.01] and lower 90-day read- mission with an RR of 0.61 (95% CI: 0.41-0.91, P = 0.02) than those who did not. For the quality of life, patients who received early SAC had a significantly higher score in the subscale of vitality ( P = 0.03) while the other subscales were all comparable between the two groups. Multivariable Cox regression model showed that early SAC was an independent protective factor for 90-day readmission after adjust- ing for potential confounders with a hazard ratio of 0.57 (95% CI: 0.34-0.96, P = 0.04). Mediation analysis showed that SVT mediated 37.0% of the early SAC-90-day readmission causality. Conclusions: The application of early SAC may reduce the risk of 90-day readmission in the survivors of ANP patients, and reduced SVT incidence might be the primary contributor.
		Hepatobiliary Pancreat Dis Int. 2024; 23(1): 77-82 . [Abstract] ( 92 ) [HTML 1KB] [PDF 0KB] ( 82 )

CLINICAL IMAGE

	83	Vadala di Prampero SF, Panic N, Massidda M, Rocchi C, Rinaldi PM, Malenkovic A, Bulajic M
		Two big orifices in the second duodenal portion: A case of an atypical double papilla
		With the advent of endoscopic retrograde cholangiopancreatography (ERCP) in the early 1970s, anatomic anomalies of the Vaterian system were described endoscopically [1] . Although the occurrence is rare, the common bile duct (CBD) and the pancreatic duct may fail to coalesce during embryologic development. This leads to double major papilla because both ducts open into the duodenum separately [1] . In this way the cranial duct communicates with the CBD, while the caudal orifice communicates with the pancreatic duct [2] .
		Hepatobiliary Pancreat Dis Int. 2024; 23(1): 83-85 . [Abstract] ( 91 ) [HTML 1KB] [PDF 0KB] ( 95 )

	86	Jiang YW, Yu YH, Jiang TA, Tian SY
		Hepatic cystic lesions mimicking liver abscess on imaging: A report of two cases
		Hepatic cystic lesions include congenital dysplasia, inflammatory cystic lesions, neoplastic cystic lesions and parasitic cystic lesions. As different treatment modalities can be chosen for these lesions, differential diagnosis is particularly important [1]. Clinical features or imaging findings of cystic lesions of the liver are typical; for instance, liver abscess often shows thick-walled enhancement on contrast-enhanced CT, with a "target sign" or "double ring sign". Some neoplastic lesions of the liver may mimic liver abscesses on imaging, which can be easily misdiagnosed in clinical practice. Herein we reported two patients diagnosed with liver abscess on imaging without typical clinical features, which were finally confirmed to be a large cell neuroendocrine carcinoma (LCNEC) and a bile duct hamartoma (BDH) by pathology. The clinical data of these two patients are shown in Table 1.
		Hepatobiliary Pancreat Dis Int. 2024; 23(1): 86-89 . [Abstract] ( 91 ) [HTML 1KB] [PDF 0KB] ( 85 )

LETTERS TO THE EDITOR

	90	Ho KKY, She WH, Tsang SHY, Lo KS, Cheung TT
		Post-fontan circulation hepatocellular carcinoma: Open and laparoscopic hepatectomy
		Fontan-associated liver disease shows increasing incidence as advances in pediatric cardiology have prolonged life expectancy in patients with single ventricle congenital heart defects [1]. Their unique physiology and procedure-related sequelae present an increasingly relevant challenge in hepatic surgery. We hereby reported a series of patients suffering from hepatocellular carcinoma (HCC) who successfully underwent open and laparoscopic hepatectomy, and highlighted points on strategies to mitigate the surgical and anesthetic risks in this population.
		Hepatobiliary Pancreat Dis Int. 2024; 23(1): 90-93 . [Abstract] ( 109 ) [HTML 1KB] [PDF 0KB] ( 286 )

	94	Ogura T, Uba Y, Yamamura M, Nishioka N, Nishikawa H
		Endoscopic hemostasis using self-expandable metal stent combined with PuraStatR for patient with high risk of post-endoscopic sphincterotomy bleeding (with video)
		Endoscopic sphincterotomy (EST) is an established technique for removal of bile duct stones and self-expandable metal stent (SEMS) deployment. However, bleeding can be considered an adverse event after EST, particularly for patients with high risk of bleeding such as those on hemodialysis. Among the various techniques reported for obtaining endoscopic hemostasis [1–3] , SEMS deployment is useful in terms of its tamponade effect, but bleeding can occur continuously even following SEMS deployment from the upper edge of the ampulla of Vater. In this situation, coagulation or endoscopic injection of epinephrine can be considered, but this might be complicated by the presence of ulcer formation. A novel hemostatic agent (PuraStatR , 3D Matrix Europe SAS, Caluireet- Cuire, France) has recently become available [4] . Here we describe a case of successful endoscopic hemostasis using SEMS combined with PuraStatR in a patient with high risk of post-EST bleeding.
		Hepatobiliary Pancreat Dis Int. 2024; 23(1): 94-96 . [Abstract] ( 96 ) [HTML 1KB] [PDF 0KB] ( 190 )

	97	Du CL, Wei SY, Chen YH, Chen KJ
		A robust genomic-based prognostic model for the assessment of cancer stemness and survival for patients with hepatocellular carcinoma
		Hepatocellular carcinoma (HCC) is an aggressive malignancy with poor long-term prognosis [1] . Liver cancer stem cell (CSC) can drive the metastasis, drug resistance, and recurrence of HCC [2] . The regulatory mechanisms about liver cancer stemness have been investigated, which encouraged the identification and characterization of novel prognostic and therapeutic strategies for HCC [3] . As genome-wide, high-throughput sequencing became available, some prognostic models have been established based on gene expression profiles associated with HCC stemness [4] . Nevertheless, in most cases, these models were hardly used in clinical practice due to complex algorithm and expensiveness. This study aimed to establish a stable stemness-related clinical prediction model with simplified algorithms based on gene expression profiles. Furthermore, biomolecular experiments were performed to examine the oncogenic functions of stemness-related genes.
		Hepatobiliary Pancreat Dis Int. 2024; 23(1): 97-102 . [Abstract] ( 91 ) [HTML 1KB] [PDF 0KB] ( 279 )

	103	Devane AM, Schammel CMG
		Benign stricture of bilioenteric anastomosis after Whipple with synthetic polypropylene suture
		Biliary stricture formation at the bilioenteric anastomosis is an infrequent complication (2%-3%) after pancreaticoduodenectomy; the average presentation is within 13-14 months (range from 1 month to 9 years) after surgery [1,2]. While the etiology is unknown, development of biliary stricture has shown to be more likely if a bile leak occurs in the postoperative period [3,4] and with younger patients [5]. Furthermore, while the incidence is thought to be the same in patients with benign and malignant diseases, patients with distal cholangiocarcinoma are at higher risk for stricture formation than other periampullary cancers or benign diseases [1]. Interestingly, an evaluation of early biliary complications after pancreaticoduodenectomy revealed that 6/0 sutures were associated with biliary stricture; however, this was thought to be more a reflection of the technical difficulties and biliary injury from performing bilioenteric anastomosis on a small common bile duct [2].
		Hepatobiliary Pancreat Dis Int. 2024; 23(1): 103-105 . [Abstract] ( 90 ) [HTML 1KB] [PDF 0KB] ( 81 )

	106	Zhu WF, Fang S, Qiao JJ
		Pancreatic panniculitis as the first presentation of pancreatic ductal adenocarcinoma
		Pancreatic panniculitis, also known as pancreatic fat necrosis or enzymatic panniculitis, is a rare type of panniculitis that occurs in 0.3%−3% of patients with pancreatic disease such as acute or chronic pancreatitis and pancreatic carcinoma, especially acinar cell carcinoma [ 1 , 2 ]. The clinical manifestations are nonspecific erythema tender nodules, which need to be distinguished from other types of panniculitis. Subcutaneous fat necrosis may present before the diagnosis of pancreatic disease in up to 45% of patients [2] . In addition, nearly half of pancreatic panniculitis is associated with malignancy and is considered a marker of poor prognosis [3] . Therefore, these nodules serve as an early and valuable marker for discovering related pancreatic diseases which leads to skin biopsy, serum pancreatic enzyme, tumor marker detection, and imaging examination. We herein report a case of pancreatic panniculitis in both lower limbs presented in the context of pancreatic ductal adenocarcinoma (PDAC) with distant metastasis, and the skin lesions subsided after FOLFIRINOX (a combination of 5- fluorouracil, leucovorin, irinotecan, and oxaliplatin) chemotherapy.
		Hepatobiliary Pancreat Dis Int. 2024; 23(1): 106-108 . [Abstract] ( 103 ) [HTML 1KB] [PDF 0KB] ( 275 )

	109	Liu XY, Xu YY, Xiang Z, Zheng SS
		Comment on “Robotic surgery and liver transplantation: A single-center experience of 501 robotic donor hepatectomies”
		We read with great interest the article by Schulze et al. entitled “Robotic surgery and liver transplantation: A single-center experience of 501 robotic donor hepatectomies” [1] . It is the first single-center report including over 500 fully robotic donor hepatectomies. For the donors, the overall complication rate was 6.4% ( n = 32). Postoperative self-limiting bleeding (0.4%) and bile leakage from the resection plane (1.8%) were rare, none of which required further action. For recipients, the three-year actual overall recipient survival was 91.4%. Retransplantation rate was low (1.2%) as were the rates of biliary (5.6%) and vascular (4.4%) complications. Through this study, the authors demonstrated that robotic surgery is relatively mature in donor hepatectomies.
		Hepatobiliary Pancreat Dis Int. 2024; 23(1): 109-110 . [Abstract] ( 91 ) [HTML 1KB] [PDF 0KB] ( 441 )

Forgot your password?

Enter your e-mail address to receive an e-mail with your account information.

Submission Guidance

Top cited articles

- Most Cited Hepatobiliary & Pancreatic Diseases International Articles

- Most Downloaded Hepatobiliary & Pancreatic Diseases International Articles

more>>

Top downloaded articles

more>>

Services

Web feed

hbpdint@126.com

hbpdje@zju.edu.cn

Copyright © Official Publication of First Affiliated Hospital
Official Publication of First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
浙ICP备05050873号-1