Pub Date : 2026-03-01Epub Date: 2025-12-08DOI: 10.1016/j.hpb.2025.12.016
Sini Takala , Hanna Koppatz , Arno Nordin , Ville Sallinen
Background
Few population-based studies exist for gallbladder cancer (GBC). This study explored incidence, diagnostics, treatment, and survival of patients with GBC in a national cohort.
Methods
Patients with GBC during 2006–2019 in Finland were included from Finnish Cancer Registry with manual patient data verification.
Results
GBC was diagnosed in 1183 patients. Overall incidence was 1.56:100,000 and it decreased over time (from 1.81 to 1.35, p < 0.001). For detailed analysis, 1016 patients were included. The proportion of patients with T2–T3 increased (from 46 % to 65 %; p < 0.001) and T4 decreased (from 35 % to 18 %; p < 0.001). Similarly, the proportion of patients with stage IVA decreased (from 10 % to 4 %, p = 0.002) and stage II increased (from 12 % to 20 %, p = 0.006). In total, 185 (18 %) patients underwent curative-intent surgery with a 92 % R0 resection rate. The proportion of curative-intent surgery increased (from 15 % to 23 %, p = 0.013), as well as use of adjuvant (from 19 % to 54 %, p < 0.001) and systemic chemotherapy (from 31.4 % to 42.1 %, p = 0.014). Median overall survival was 7 months and 5-year overall survival 14 %, which improved during the study period (from 12 % to 14 %, p = 0.007).
Conclusion
The incidence of GBC decreased, and overall survival improved, likely due to increased surgical and oncological treatments.
{"title":"Epidemiology and treatment outcomes of gallbladder cancer in Finland – a nationwide study","authors":"Sini Takala , Hanna Koppatz , Arno Nordin , Ville Sallinen","doi":"10.1016/j.hpb.2025.12.016","DOIUrl":"10.1016/j.hpb.2025.12.016","url":null,"abstract":"<div><h3>Background</h3><div>Few population-based studies exist for gallbladder cancer (GBC). This study explored incidence, diagnostics, treatment, and survival of patients with GBC in a national cohort.</div></div><div><h3>Methods</h3><div>Patients with GBC during 2006–2019 in Finland were included from Finnish Cancer Registry with manual patient data verification.</div></div><div><h3>Results</h3><div>GBC was diagnosed in 1183 patients. Overall incidence was 1.56:100,000 and it decreased over time (from 1.81 to 1.35, <em>p</em> < 0.001). For detailed analysis, 1016 patients were included. The proportion of patients with T2–T3 increased (from 46 % to 65 %; <em>p</em> < 0.001) and T4 decreased (from 35 % to 18 %; <em>p</em> < 0.001). Similarly, the proportion of patients with stage IVA decreased (from 10 % to 4 %, <em>p</em> = 0.002) and stage II increased (from 12 % to 20 %, <em>p</em> = 0.006). In total, 185 (18 %) patients underwent curative-intent surgery with a 92 % R0 resection rate. The proportion of curative-intent surgery increased (from 15 % to 23 %, <em>p</em> = 0.013), as well as use of adjuvant (from 19 % to 54 %, <em>p</em> < 0.001) and systemic chemotherapy (from 31.4 % to 42.1 %, <em>p</em> = 0.014). Median overall survival was 7 months and 5-year overall survival 14 %, which improved during the study period (from 12 % to 14 %, <em>p</em> = 0.007).</div></div><div><h3>Conclusion</h3><div>The incidence of GBC decreased, and overall survival improved, likely due to increased surgical and oncological treatments.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 3","pages":"Pages 436-445"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-12-15DOI: 10.1016/j.hpb.2025.12.019
Wangxin Zhou , Shengwei Ji , Chunjie Zhang , Baoqing Liu , Hong Hong , Maowei Pei
Background
The optimal timing of laparoscopic cholecystectomy (LC) in mild acute biliary pancreatitis (MABP) remains debated. This study compared early (within 72 h) versus delayed LC outcomes.
Methods
A randomized trial at Zhejiang Hospital assigned 120 MABP patients to early or delayed LC. Demographics, complications, operative outcomes, and hospital stay were analyzed.
Results
There were no differences in baseline demographics, overall complication rates (10 % vs. 8.3 %; P = 0.752), intraoperative blood loss (33.93 ± 17.68 mL vs. 37.08 ± 30.97 mL; P = 0.593) or conversion to open surgery rate (3.3 % vs. 5.0 %; P = 1.00) between the two groups. There were no recurrent biliary events, postoperative readmissions, reoperations, or deaths in either group; However, the early LC group demonstrated significant advantages in intraoperative adhesions (80 % vs. 93.3 %; P < 0.05), procedure time (61.87 ± 12.54 vs. 66.77 ± 12.11 min, P < 0.05) and the length of hospital stay (5 days vs. 7 days, P < 0.05).
Conclusion
For patients with MABP, early LC performed within 72 h of admission significantly reduces hospital length of stay and procedure time, without increasing perioperative complication rates or measures of procedural difficulty.
背景：轻度急性胆源性胰腺炎（MABP）的腹腔镜胆囊切除术（LC）的最佳时机仍有争议。本研究比较了早期（72小时内）和延迟LC的结果。方法：浙江医院的一项随机试验将120例MABP患者分配到早期或延迟LC。分析了人口统计学、并发症、手术结果和住院时间。结果：两组患者在基线人口统计学、总并发症发生率（10%对8.3%,P = 0.752）、术中出血量（33.93±17.68 mL对37.08±30.97 mL, P = 0.593）和中转开腹率（3.3%对5.0%,P = 1.00）方面均无差异。两组患者均无胆道事件复发、术后再入院、再手术或死亡；早期LC组在术中粘连（80% vs. 93.3%, P < 0.05）、手术时间（61.87±12.54 vs. 66.77±12.11 min, P < 0.05）、住院时间（5天vs. 7天，P < 0.05）方面均有显著优势。结论：对于MABP患者，在入院后72小时内进行早期LC可显著缩短住院时间和手术时间，且不增加围手术期并发症发生率或手术难度。
{"title":"Randomized controlled trial of early versus late cholecystectomy in patients with mild acute pancreatitis","authors":"Wangxin Zhou , Shengwei Ji , Chunjie Zhang , Baoqing Liu , Hong Hong , Maowei Pei","doi":"10.1016/j.hpb.2025.12.019","DOIUrl":"10.1016/j.hpb.2025.12.019","url":null,"abstract":"<div><h3>Background</h3><div>The optimal timing of laparoscopic cholecystectomy (LC) in mild acute biliary pancreatitis (MABP) remains debated. This study compared early (within 72 h) versus delayed LC outcomes.</div></div><div><h3>Methods</h3><div>A randomized trial at Zhejiang Hospital assigned 120 MABP patients to early or delayed LC. Demographics, complications, operative outcomes, and hospital stay were analyzed.</div></div><div><h3>Results</h3><div>There were no differences in baseline demographics, overall complication rates (10 % vs. 8.3 %; <em>P</em> = 0.752), intraoperative blood loss (33.93 ± 17.68 mL vs. 37.08 ± 30.97 mL; <em>P</em> = 0.593) or conversion to open surgery rate (3.3 % vs. 5.0 %; <em>P</em> = 1.00) between the two groups. There were no recurrent biliary events, postoperative readmissions, reoperations, or deaths in either group; However, the early LC group demonstrated significant advantages in intraoperative adhesions (80 % vs. 93.3 %; <em>P</em> < 0.05), procedure time (61.87 ± 12.54 vs. 66.77 ± 12.11 min, <em>P</em> < 0.05) and the length of hospital stay (5 days vs. 7 days, <em>P</em> < 0.05).</div></div><div><h3>Conclusion</h3><div>For patients with MABP, early LC performed within 72 h of admission significantly reduces hospital length of stay and procedure time, without increasing perioperative complication rates or measures of procedural difficulty.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 3","pages":"Pages 296-302"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145889158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-12-05DOI: 10.1016/j.hpb.2025.12.012
Jeska A. Fritzsche , Esmée Smit , Cyriel Y. Ponsioen , Otto M. van Delden , Frederike Dijk , Joris I. Erdmann , Paul Fockens , Arantza Fariña Sarasqueta , Geert Kazemier , Heinz-Josef Klümpen , Anne Uyterlinde , Roy L.J. van Wanrooij , Mattheus C.B. Wielenga , IJsbrand A.J. Zijlstra , Joanne Verheij , Rogier P. Voermans
Background
Although biliary brush cytology has a high specificity (95–100 %), the sensitivity is poor (41–67 %). This study aimed to evaluate whether the use of an optimized protocol for brush cytology improves the results in patients with suspected perihilar or intrahepatic cholangiocarcinoma (pCCA/iCCA).
Methods
Patients were prospectively included after changing the protocol (June 2021–June 2023) and compared with a historical cohort (January 2017–May 2021). Changes included different brush processing, addition of next-generation sequencing (NGS), and additional sampling (two brush samples and intraductal biopsies). Primary outcome was the sensitivity and the specificity of the procedure.
Results
A total of 175 patients were evaluated (62 prospective, 113 historical) of which 165 patients had malignant disease (94 %). After implementation of the protocol, the sensitivity was 88.3 % (95%CI, 76.8–94.8 %) versus 50.5 % (95%CI, 40.6–60.3 %) prior to implementation. Sensitivity of only the first brush sample with the optimized processing did also significantly increase (78 %; 95%CI, 65.5–87.5 %). Specificity was 100 % in both groups (2/2 vs 8/8).
Conclusions
A modification in the processing of cytopathology led to a significant improvement in the sensitivity of the first bile duct brush to 78 %. Furthermore, adding NGS increased sensitivity to 83 %, an extra brush sample to 85 %, and intraductal biopsies to 88 %.
{"title":"High sensitivity of biliary brush cytology in patients with suspected perihilar or intrahepatic cholangiocarcinoma: a prospective cohort comparison with historical controls","authors":"Jeska A. Fritzsche , Esmée Smit , Cyriel Y. Ponsioen , Otto M. van Delden , Frederike Dijk , Joris I. Erdmann , Paul Fockens , Arantza Fariña Sarasqueta , Geert Kazemier , Heinz-Josef Klümpen , Anne Uyterlinde , Roy L.J. van Wanrooij , Mattheus C.B. Wielenga , IJsbrand A.J. Zijlstra , Joanne Verheij , Rogier P. Voermans","doi":"10.1016/j.hpb.2025.12.012","DOIUrl":"10.1016/j.hpb.2025.12.012","url":null,"abstract":"<div><h3>Background</h3><div>Although biliary brush cytology has a high specificity (95–100 %), the sensitivity is poor (41–67 %). This study aimed to evaluate whether the use of an optimized protocol for brush cytology improves the results in patients with suspected perihilar or intrahepatic cholangiocarcinoma (pCCA/iCCA).</div></div><div><h3>Methods</h3><div>Patients were prospectively included after changing the protocol (June 2021–June 2023) and compared with a historical cohort (January 2017–May 2021). Changes included different brush processing, addition of next-generation sequencing (NGS), and additional sampling (two brush samples and intraductal biopsies). Primary outcome was the sensitivity and the specificity of the procedure.</div></div><div><h3>Results</h3><div>A total of 175 patients were evaluated (62 prospective, 113 historical) of which 165 patients had malignant disease (94 %). After implementation of the protocol, the sensitivity was 88.3 % (95%CI, 76.8–94.8 %) versus 50.5 % (95%CI, 40.6–60.3 %) prior to implementation. Sensitivity of only the first brush sample with the optimized processing did also significantly increase (78 %; 95%CI, 65.5–87.5 %). Specificity was 100 % in both groups (2/2 vs 8/8).</div></div><div><h3>Conclusions</h3><div>A modification in the processing of cytopathology led to a significant improvement in the sensitivity of the first bile duct brush to 78 %. Furthermore, adding NGS increased sensitivity to 83 %, an extra brush sample to 85 %, and intraductal biopsies to 88 %.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 3","pages":"Pages 399-407"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-12-04DOI: 10.1016/j.hpb.2025.12.005
Brianna Greenberg , Alexandra W. Acher , Razan Habib , Matthew Castelo , Sabrina M. Wang , Rachel Roke , Grace Xu , Kevin Thorpe , Matthew P. Guttman , Julie Hallet , Paul J. Karanicolas
Background
As cancer care increasingly prioritizes patient-centered outcomes, understanding predictors of postoperative quality of life (QOL) is essential. This study aimed to identify preoperative factors associated with early QOL outcomes following oncologic liver resection, using prospectively collected data from a multicenter randomized controlled trial.
Methods
This was a secondary analysis of the Hemorrhage During Liver Resection: Tranexamic Acid (HeLiX) trial (NCT02261415), conducted across 11 tertiary centers in Canada and the USA. Patients undergoing liver resection for malignancy completed the EORTC QLQ-C30 questionnaire preoperatively and at postoperative day (POD) 30. Multivariable regression was used to identify preoperative clinical and demographic predictors of clinically meaningful QOL changes across five domains. Inverse probability weighting addressed potential bias from missing data.
Results
Of 863 eligible patients, 796 completed baseline and 588 completed POD30 QOL assessments. Lower preoperative QOL was consistently associated with worse postoperative scores. Major and multivisceral resections predicted clinically meaningful declines in physical, role, and global functioning. Female sex, cardiovascular comorbidities, and smoking were also associated with decline. Prior liver resection and biliary or vascular reconstruction were linked to better physical function at POD30.
Conclusion
Preoperative factors significantly influence early postoperative QOL. These findings support personalized risk counseling and proactive recovery planning in liver cancer surgery.
{"title":"Predictors of quality-of-life following liver resection for malignancy","authors":"Brianna Greenberg , Alexandra W. Acher , Razan Habib , Matthew Castelo , Sabrina M. Wang , Rachel Roke , Grace Xu , Kevin Thorpe , Matthew P. Guttman , Julie Hallet , Paul J. Karanicolas","doi":"10.1016/j.hpb.2025.12.005","DOIUrl":"10.1016/j.hpb.2025.12.005","url":null,"abstract":"<div><h3>Background</h3><div>As cancer care increasingly prioritizes patient-centered outcomes, understanding predictors of postoperative quality of life (QOL) is essential. This study aimed to identify preoperative factors associated with early QOL outcomes following oncologic liver resection, using prospectively collected data from a multicenter randomized controlled trial.</div></div><div><h3>Methods</h3><div>This was a secondary analysis of the Hemorrhage During Liver Resection: Tranexamic Acid (HeLiX) trial (NCT02261415), conducted across 11 tertiary centers in Canada and the USA. Patients undergoing liver resection for malignancy completed the EORTC QLQ-C30 questionnaire preoperatively and at postoperative day (POD) 30. Multivariable regression was used to identify preoperative clinical and demographic predictors of clinically meaningful QOL changes across five domains. Inverse probability weighting addressed potential bias from missing data.</div></div><div><h3>Results</h3><div>Of 863 eligible patients, 796 completed baseline and 588 completed POD30 QOL assessments. Lower preoperative QOL was consistently associated with worse postoperative scores. Major and multivisceral resections predicted clinically meaningful declines in physical, role, and global functioning. Female sex, cardiovascular comorbidities, and smoking were also associated with decline. Prior liver resection and biliary or vascular reconstruction were linked to better physical function at POD30.</div></div><div><h3>Conclusion</h3><div>Preoperative factors significantly influence early postoperative QOL. These findings support personalized risk counseling and proactive recovery planning in liver cancer surgery.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 3","pages":"Pages 333-341"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-12-06DOI: 10.1016/j.hpb.2025.12.008
Sander R.W.J. Martens , Mike van Dooren , Jarmila van der Bilt , Marieke T. de Boer , Djamila Boerma , Philip Bos , Andries E. Braat , Steve M.M. de Castro , Bartholomeus J.G.A. Corten , Freek Daams , Joris I. Erdmann , Floris Ferenschild , Ansje S. Fortuin , Anna van Geloven , Erik van der Hoeven , Rutger Klicks , Flip M. Kruyt , Barbara S. Langenhoff , Mike S.L. Liem , Philip V.M. Linsen , Philip R. de Reuver
Background
Patients with gallbladder polyps (GPs) are frequently subject to surveillance or cholecystectomy due to a risk of malignancy. As most GPs prove to be benign, potential overtreatment may impact quality of life (QoL). This study aimed to evaluate QoL in patients with GPs, compare it to the general population, and identify factors associated with QoL.
Methods
Patients diagnosed with GPs were included from 26 Dutch centres from 2018 to 2020, and followed until 2024. QoL was assessed at multiple time points using generic (EQ-5D) and disease-specific (GIQLI) instruments. Demographics, imaging, and surgical data were analysed.
Results
Among 207 patients, 42 (20.3 %) underwent cholecystectomy; neoplastic polyps were found in 3 (1.4 %). Overall, baseline EQ-5D scores were similar to the general population (0.85 vs 0.87; p = 0.20), while GIQLI scores were lower (116.1 vs 122.6; p < 0.001). Anxiety was reported by 39 % and was the strongest predictor of reduced QoL (EQ-5D: β = −0.095; GIQLI: β = −15.49; p < 0.001). QoL was not associated with GP characteristics.
Conclusion
GPs are associated with reduced QoL, driven predominantly by anxiety. Structured counselling on low malignancy risk and less intensive surveillance may alleviate anxiety and reduce overtreatment.
背景：胆囊息肉（GPs）患者由于有恶性肿瘤的风险，经常接受监测或胆囊切除术。由于大多数全科医生被证明是良性的，潜在的过度治疗可能影响生活质量（QoL）。本研究旨在评估全科医生患者的生活质量，将其与普通人群进行比较，并确定与生活质量相关的因素。方法：从2018年至2020年，从26个荷兰中心纳入诊断为全科医生的患者，并随访至2024年。使用通用（EQ-5D）和疾病特异性（GIQLI）仪器在多个时间点评估生活质量。对人口统计学、影像学和手术资料进行分析。结果：207例患者中，42例（20.3%）行胆囊切除术；3例（1.4%）发现肿瘤性息肉。总体而言，基线EQ-5D评分与一般人群相似（0.85 vs 0.87; p = 0.20），而GIQLI评分较低（116.1 vs 122.6; p < 0.001）。39%的人报告焦虑，并且是生活质量降低的最强预测因子（EQ-5D: β = -0.095; GIQLI: β = -15.49; p < 0.001）。生活质量与GP特征无关。结论：全科医生与生活质量下降有关，主要由焦虑引起。低恶性肿瘤风险的结构化咨询和不那么密集的监测可以减轻焦虑和减少过度治疗。
{"title":"Quality of life in patients with gallbladder polyps: a multicentre prospective cohort study","authors":"Sander R.W.J. Martens , Mike van Dooren , Jarmila van der Bilt , Marieke T. de Boer , Djamila Boerma , Philip Bos , Andries E. Braat , Steve M.M. de Castro , Bartholomeus J.G.A. Corten , Freek Daams , Joris I. Erdmann , Floris Ferenschild , Ansje S. Fortuin , Anna van Geloven , Erik van der Hoeven , Rutger Klicks , Flip M. Kruyt , Barbara S. Langenhoff , Mike S.L. Liem , Philip V.M. Linsen , Philip R. de Reuver","doi":"10.1016/j.hpb.2025.12.008","DOIUrl":"10.1016/j.hpb.2025.12.008","url":null,"abstract":"<div><h3>Background</h3><div>Patients with gallbladder polyps (GPs) are frequently subject to surveillance or cholecystectomy due to a risk of malignancy. As most GPs prove to be benign, potential overtreatment may impact quality of life (QoL). This study aimed to evaluate QoL in patients with GPs, compare it to the general population, and identify factors associated with QoL.</div></div><div><h3>Methods</h3><div>Patients diagnosed with GPs were included from 26 Dutch centres from 2018 to 2020, and followed until 2024. QoL was assessed at multiple time points using generic (EQ-5D) and disease-specific (GIQLI) instruments. Demographics, imaging, and surgical data were analysed.</div></div><div><h3>Results</h3><div>Among 207 patients, 42 (20.3 %) underwent cholecystectomy; neoplastic polyps were found in 3 (1.4 %). Overall, baseline EQ-5D scores were similar to the general population (0.85 vs 0.87; <em>p</em> = 0.20), while GIQLI scores were lower (116.1 vs 122.6; <em>p</em> < 0.001). Anxiety was reported by 39 % and was the strongest predictor of reduced QoL (EQ-5D: <em>β</em> = −0.095; GIQLI: <em>β</em> = −15.49; <em>p</em> < 0.001). QoL was not associated with GP characteristics.</div></div><div><h3>Conclusion</h3><div>GPs are associated with reduced QoL, driven predominantly by anxiety. Structured counselling on low malignancy risk and less intensive surveillance may alleviate anxiety and reduce overtreatment.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 3","pages":"Pages 359-368"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-12-04DOI: 10.1016/j.hpb.2025.12.009
Kaidi Wang
{"title":"Patient expectations following pancreatectomy: the unmeasured influences of information sources and psychological hope","authors":"Kaidi Wang","doi":"10.1016/j.hpb.2025.12.009","DOIUrl":"10.1016/j.hpb.2025.12.009","url":null,"abstract":"","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 3","pages":"Page 312"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145849881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-12-13DOI: 10.1016/j.hpb.2025.12.022
Marco Palucci , Gabriela D. Angel -Millán , Fabio Giannone , Mariantonietta Alagia , Celeste Del Basso , Marco Lodin , Igor Monsellato , Federico Sangiuolo , Gianluca Cassese , Fabrizio Panaro
Background
Intraoperative localization of pancreatic neuroendocrine tumors (pNETs) is challenging, particularly for small lesions during minimally invasive surgery due to the lack of tactile feedback. Indocyanine green (ICG) fluorescence imaging is a promising technique to enhance tumor visualization and surgical guidance. This systematic review evaluates current evidence on ICG use in pNET surgery, focusing on indications, timing, dosage, and intraoperative strategies.
Methods
A systematic search of PubMed, Embase, and Web of Science was conducted up to May 2025, following PRISMA guidelines. Included studies reported intraoperative ICG use in pNET surgery. Preclinical studies, non-English articles, and those lacking data on ICG protocol or dosage were excluded.
Results
Fifteen studies involving 43 patients were included. Diagnoses were insulinoma (39.5 %), unspecified pNETs (58.2 %), and one case of neuroendocrine hyperplasia. ICG identified tumors in 88.4 % of cases, with a positive predictive value of 95.0 %. ICG was mostly administered intravenously after pancreatic exposure, with doses ranging from 1 to 25 mg. Fluorescence appeared within 5 min and was homogeneous in 97.4 % of cases. No adverse events were reported.
Discussion
ICG fluorescence is a safe and effective tool for localizing pNETs. Further studies are needed to standardize protocols and optimize clinical use.
背景：胰腺神经内分泌肿瘤（pNETs）的术中定位具有挑战性，特别是微创手术中由于缺乏触觉反馈的小病变。吲哚菁绿（ICG）荧光成像是一种很有前途的技术，可以增强肿瘤的可视化和手术指导。本系统综述评估了目前在pNET手术中使用ICG的证据，重点是指征、时机、剂量和术中策略。方法：系统检索PubMed， Embase和Web of Science，直到2025年5月，遵循PRISMA指南。纳入的研究报告了术中ICG在pNET手术中的应用。排除了临床前研究、非英文文章以及缺乏ICG方案或剂量数据的研究。结果：纳入15项研究，共43例患者。诊断为胰岛素瘤（39.5%），不明pNETs(58.2%)， 1例神经内分泌增生。ICG对肿瘤的鉴别率为88.4%，阳性预测值为95.0%。ICG主要在胰腺暴露后静脉注射，剂量范围为1至25毫克。荧光在5分钟内出现，97.4%的病例荧光均匀。无不良事件报告。讨论：ICG荧光是一种安全有效的pNETs定位工具。需要进一步的研究来规范方案和优化临床应用。
{"title":"A systematic review of the application of indocyanine green in pancreatic neuroendocrine tumors: Technical details, surgical indications, and outcomes","authors":"Marco Palucci , Gabriela D. Angel -Millán , Fabio Giannone , Mariantonietta Alagia , Celeste Del Basso , Marco Lodin , Igor Monsellato , Federico Sangiuolo , Gianluca Cassese , Fabrizio Panaro","doi":"10.1016/j.hpb.2025.12.022","DOIUrl":"10.1016/j.hpb.2025.12.022","url":null,"abstract":"<div><h3>Background</h3><div>Intraoperative localization of pancreatic neuroendocrine tumors (pNETs) is challenging, particularly for small lesions during minimally invasive surgery due to the lack of tactile feedback. Indocyanine green (ICG) fluorescence imaging is a promising technique to enhance tumor visualization and surgical guidance. This systematic review evaluates current evidence on ICG use in pNET surgery, focusing on indications, timing, dosage, and intraoperative strategies.</div></div><div><h3>Methods</h3><div>A systematic search of PubMed, Embase, and Web of Science was conducted up to May 2025, following PRISMA guidelines. Included studies reported intraoperative ICG use in pNET surgery. Preclinical studies, non-English articles, and those lacking data on ICG protocol or dosage were excluded.</div></div><div><h3>Results</h3><div>Fifteen studies involving 43 patients were included. Diagnoses were insulinoma (39.5 %), unspecified pNETs (58.2 %), and one case of neuroendocrine hyperplasia. ICG identified tumors in 88.4 % of cases, with a positive predictive value of 95.0 %. ICG was mostly administered intravenously after pancreatic exposure, with doses ranging from 1 to 25 mg. Fluorescence appeared within 5 min and was homogeneous in 97.4 % of cases. No adverse events were reported.</div></div><div><h3>Discussion</h3><div>ICG fluorescence is a safe and effective tool for localizing pNETs. Further studies are needed to standardize protocols and optimize clinical use.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 3","pages":"Pages 276-285"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145862959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-12-05DOI: 10.1016/j.hpb.2025.12.015
Tianci Luo , Hucheng Ma , Weiwei Zong , Jin Peng , Bing Han , Wei Hu , Fei Wang , Dongjun Luo , Yifan Ji , Xinhua Zhu , Decai Yu
Background
The advantages of robotic hepatectomy (Rob-H) over laparoscopic hepatectomy (Lap-H) remain unclear. This study compares the outcomes between Rob-H and Lap-H in a single-center setting.
Methods
A retrospective analysis was conducted on patients who underwent minimally invasive liver resection between 2014 and 2023. Patient demographics, perioperative parameters, and postoperative outcomes were reviewed. Propensity score matching (PSM) was employed to reduce selection bias.
Results
A total of 2999 patients were included in this study. 2375 patients underwent Lap-H and 624 patients underwent Rob-H. After PSM, 42 patients who underwent right hemihepatectomy. The results showed that, compared to the Lap-H group, the Rob-H group had lower intraoperative blood loss (P = 0.016). A total of 108 patients who underwent left hemihepatectomy were included. The Rob-H group had shorter operative time (P = 0.005), lower intraoperative blood loss (P = 0.049).For 108 patients who underwent right posterior segmentectomy, the Rob-H group showed shorter operative time (P < 0.001), less intraoperative blood loss (P = 0.012), shorter Pringle duration (P = 0.008).
Conclusion
Compared with the Lap-H group, intraoperative blood loss and operative time were lower in the Rob-H group, and the results were consistent with previous studies, suggesting that the robotic platform overcome the limitations of laparoscopic liver resection.
{"title":"Propensity score matching analysis comparing of robot-assisted and laparoscopic hepatectomy: an single-center study of 2999 cases","authors":"Tianci Luo , Hucheng Ma , Weiwei Zong , Jin Peng , Bing Han , Wei Hu , Fei Wang , Dongjun Luo , Yifan Ji , Xinhua Zhu , Decai Yu","doi":"10.1016/j.hpb.2025.12.015","DOIUrl":"10.1016/j.hpb.2025.12.015","url":null,"abstract":"<div><h3>Background</h3><div>The advantages of robotic hepatectomy (Rob-H) over laparoscopic hepatectomy (Lap-H) remain unclear. This study compares the outcomes between Rob-H and Lap-H in a single-center setting.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on patients who underwent minimally invasive liver resection between 2014 and 2023. Patient demographics, perioperative parameters, and postoperative outcomes were reviewed. Propensity score matching (PSM) was employed to reduce selection bias.</div></div><div><h3>Results</h3><div>A total of 2999 patients were included in this study. 2375 patients underwent Lap-H and 624 patients underwent Rob-H. After PSM, 42 patients who underwent right hemihepatectomy. The results showed that, compared to the Lap-H group, the Rob-H group had lower intraoperative blood loss (<em>P</em> = 0.016). A total of 108 patients who underwent left hemihepatectomy were included. The Rob-H group had shorter operative time (<em>P</em> = 0.005), lower intraoperative blood loss (<em>P</em> = 0.049).For 108 patients who underwent right posterior segmentectomy, the Rob-H group showed shorter operative time (<em>P</em> < 0.001), less intraoperative blood loss (<em>P</em> = 0.012), shorter Pringle duration (<em>P</em> = 0.008).</div></div><div><h3>Conclusion</h3><div>Compared with the Lap-H group, intraoperative blood loss and operative time were lower in the Rob-H group, and the results were consistent with previous studies, suggesting that the robotic platform overcome the limitations of laparoscopic liver resection.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 3","pages":"Pages 303-311"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-12-30DOI: 10.1016/j.hpb.2025.12.035
Thijmen H.T. Broekman , Simone Augustinus , Nanske Biesma , Bert A. Bonsing , Geert A. Cirkel , Ignace H.J.T. de Hingh , Marjolein Y.V. Homs , Jeanin E. van Hooft , B.(Marion) M. van der Kolk , Vincent E. de Meijer , Hjalmar van Santvoort , Judith de Vos-Geelen , Miriam L. Wumkes , Marc G. Besselink , J.(Hanneke) W. Wilmink , Lydia G. van der Geest , for the Dutch Pancreatic Cancer Group
Background
In the Netherlands, cancer care is increasingly organised within oncology networks involving multiple hospitals. This nationwide population-based study aims to assess variation between oncology networks for pancreatic adenocarcinoma (PAC).
Method
Patients with PAC (2015–2020) were included from the Netherlands Cancer Registry and assigned to eight oncology networks based on first hospital visit. Multilevel multivariable logistic and survival regression models were used.
Results
Among 16,130 patients with PAC, tumour-directed treatment was applied in 40 % (range 35 %–44 % across regions), resection in 15 % (12 %–19 %), and chemotherapy in 33 % (29 %–37 %) of patients. Casemix also varied significantly between regions. Compared to the grand mean, the probability to undergo resection was higher in one region (odds ratio [OR] = 1.25, 95 % confidence interval [CI] 1.07–1.45) and lower in another (OR = 0.70, 95%CI: 0.56–0.87). Chemotherapy use followed similar patterns (OR = 1.21, 95%CI 1.06–1.38, and OR = 0.81, 95%CI 0.72–0.92). Median overall survival was 3.7 months (range 3.4–4.3; log-rank p < 0.001), multivariable multilevel analysis revealed no significant survival differences (p = 0.245).
Conclusion
Although the likelihood of receiving chemotherapy and resection for patients with PAC varied between Dutch oncology networks, no clinical meaningful survival differences were found after case-mix adjustment. Concerningly, the majority of patients with PAC do not receive any tumour-directed treatment.
{"title":"Regional variation for tumour-directed treatment and survival in patients with pancreatic adenocarcinoma: a nationwide population-based analysis","authors":"Thijmen H.T. Broekman , Simone Augustinus , Nanske Biesma , Bert A. Bonsing , Geert A. Cirkel , Ignace H.J.T. de Hingh , Marjolein Y.V. Homs , Jeanin E. van Hooft , B.(Marion) M. van der Kolk , Vincent E. de Meijer , Hjalmar van Santvoort , Judith de Vos-Geelen , Miriam L. Wumkes , Marc G. Besselink , J.(Hanneke) W. Wilmink , Lydia G. van der Geest , for the Dutch Pancreatic Cancer Group","doi":"10.1016/j.hpb.2025.12.035","DOIUrl":"10.1016/j.hpb.2025.12.035","url":null,"abstract":"<div><h3>Background</h3><div>In the Netherlands, cancer care is increasingly organised within oncology networks involving multiple hospitals. This nationwide population-based study aims to assess variation between oncology networks for pancreatic adenocarcinoma (PAC).</div></div><div><h3>Method</h3><div>Patients with PAC (2015–2020) were included from the Netherlands Cancer Registry and assigned to eight oncology networks based on first hospital visit. Multilevel multivariable logistic and survival regression models were used.</div></div><div><h3>Results</h3><div>Among 16,130 patients with PAC, tumour-directed treatment was applied in 40 % (range 35 %–44 % across regions), resection in 15 % (12 %–19 %), and chemotherapy in 33 % (29 %–37 %) of patients. Casemix also varied significantly between regions. Compared to the grand mean, the probability to undergo resection was higher in one region (odds ratio [OR] = 1.25, 95 % confidence interval [CI] 1.07–1.45) and lower in another (OR = 0.70, 95%CI: 0.56–0.87). Chemotherapy use followed similar patterns (OR = 1.21, 95%CI 1.06–1.38, and OR = 0.81, 95%CI 0.72–0.92). Median overall survival was 3.7 months (range 3.4–4.3; log-rank p < 0.001), multivariable multilevel analysis revealed no significant survival differences (p = 0.245).</div></div><div><h3>Conclusion</h3><div>Although the likelihood of receiving chemotherapy and resection for patients with PAC varied between Dutch oncology networks, no clinical meaningful survival differences were found after case-mix adjustment. Concerningly, the majority of patients with PAC do not receive any tumour-directed treatment.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 3","pages":"Pages 417-425"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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