Pub Date : 2025-11-07DOI: 10.1016/j.hpb.2025.11.001
Ethan S Agritelley, Julia Button, Matthew Bao, Elishama N Kanu, Ryne C Ramaker, Peter J Allen, Daniel P Nussbaum
{"title":"Comparing traditional versus total neoadjuvant chemotherapy for patients with localized pancreatic cancer.","authors":"Ethan S Agritelley, Julia Button, Matthew Bao, Elishama N Kanu, Ryne C Ramaker, Peter J Allen, Daniel P Nussbaum","doi":"10.1016/j.hpb.2025.11.001","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.11.001","url":null,"abstract":"","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145587177","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 : 2025-11-05DOI: 10.1016/j.hpb.2025.10.015
Evangelia Florou, Andreas Prachalias
{"title":"Liver venous deprivation: bridging volume and function in future liver remnant hypertrophy.","authors":"Evangelia Florou, Andreas Prachalias","doi":"10.1016/j.hpb.2025.10.015","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.10.015","url":null,"abstract":"","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145540648","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 : 2025-11-03DOI: 10.1016/j.hpb.2025.10.016
Saxon Connor
{"title":"A new perspective of the CVS in cholecystectomy.","authors":"Saxon Connor","doi":"10.1016/j.hpb.2025.10.016","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.10.016","url":null,"abstract":"","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145540642","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 : 2025-11-01DOI: 10.1016/S1365-182X(25)01650-8
{"title":"Highlights in this issue","authors":"","doi":"10.1016/S1365-182X(25)01650-8","DOIUrl":"10.1016/S1365-182X(25)01650-8","url":null,"abstract":"","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 11","pages":"Page iii"},"PeriodicalIF":2.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398497","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 : 2025-11-01DOI: 10.1016/j.hpb.2025.07.017
Benjamin A.Y. Cher , Christopher J. Zimmermann , Juan G. Favela , Linda C. Stafford , Daniel Bolt , Shishir K. Maithel , Mihir M. Shah , Syed A. Ahmad , Sameer H. Patel , Robert Martin , Charles R. Scoggins , Nipun Merchant , Jash Datta , Hj Kim , Michael LeCompte , Chet W. Hammill , Rebecca A. Snyder , Alexander A. Parikh , Sharon M. Weber , Daniel E. Abbott
Background
Pancreatic resection offers the only chance for cure for pancreatic ductal adenocarcinoma, but resection is associated with significant morbidity. Data are lacking about whether patients understand the risks/benefits of surgical resection. This survey study prospectively assessed patient understanding of expected oncologic outcomes after pancreatectomy.
Methods
A 14-question survey was distributed between 2020 and 2022 to patients planning to undergo pancreatectomy at eight geographically diverse institutions performing high-volume pancreatic surgery. The survey assessed demographics, expectations about post-resection outcomes, and perceived quality of patient-surgeon communication. Associations between demographics and survey responses were assessed with Fisher's exact test and Goodman-Kruskal's lambda.
Results
152 surveys were received (response rate 39 %; n = 152/376). Almost all patients believed surgery was likely to prolong survival (146/147, 99 %); cure their cancer (126/141, 89 %); and/or ameliorate health problems due to cancer (127/136, 93 %). Regarding patient-surgeon communication, 134/150 (89 %) reported surgeons always listened carefully, and 134/150 (89 %) reported surgeons gave clear explanations. There were no meaningful associations between demographics and understanding of expected post-resection outcomes.
Discussion
Most patients believed surgery was likely curative and were satisfied with patient-surgeon communication. These data outline a critical opportunity for surgical oncologists to improve pre-operative counseling and ensure patients have accurate information to support complex decision-making.
{"title":"Patient expectations about the oncologic benefit of pancreatectomy for pancreatic ductal adenocarcinoma","authors":"Benjamin A.Y. Cher , Christopher J. Zimmermann , Juan G. Favela , Linda C. Stafford , Daniel Bolt , Shishir K. Maithel , Mihir M. Shah , Syed A. Ahmad , Sameer H. Patel , Robert Martin , Charles R. Scoggins , Nipun Merchant , Jash Datta , Hj Kim , Michael LeCompte , Chet W. Hammill , Rebecca A. Snyder , Alexander A. Parikh , Sharon M. Weber , Daniel E. Abbott","doi":"10.1016/j.hpb.2025.07.017","DOIUrl":"10.1016/j.hpb.2025.07.017","url":null,"abstract":"<div><h3>Background</h3><div>Pancreatic resection offers the only chance for cure for pancreatic ductal adenocarcinoma, but resection is associated with significant morbidity. Data are lacking about whether patients understand the risks/benefits of surgical resection. This survey study prospectively assessed patient understanding of expected oncologic outcomes after pancreatectomy.</div></div><div><h3>Methods</h3><div>A 14-question survey was distributed between 2020 and 2022 to patients planning to undergo pancreatectomy at eight geographically diverse institutions performing high-volume pancreatic surgery. The survey assessed demographics, expectations about post-resection outcomes, and perceived quality of patient-surgeon communication. Associations between demographics and survey responses were assessed with Fisher's exact test and Goodman-Kruskal's lambda.</div></div><div><h3>Results</h3><div>152 surveys were received (response rate 39 %; n = 152/376). Almost all patients believed surgery was likely to prolong survival (146/147, 99 %); cure their cancer (126/141, 89 %); and/or ameliorate health problems due to cancer (127/136, 93 %). Regarding patient-surgeon communication, 134/150 (89 %) reported surgeons always listened carefully, and 134/150 (89 %) reported surgeons gave clear explanations. There were no meaningful associations between demographics and understanding of expected post-resection outcomes.</div></div><div><h3>Discussion</h3><div>Most patients believed surgery was likely curative and were satisfied with patient-surgeon communication. These data outline a critical opportunity for surgical oncologists to improve pre-operative counseling and ensure patients have accurate information to support complex decision-making.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 11","pages":"Pages 1410-1417"},"PeriodicalIF":2.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855107","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 : 2025-11-01DOI: 10.1016/j.hpb.2025.08.002
Dorothy Hughes , Betel Yibrehu , Peter Kingham , Kristoffer Lassen , Alejandro Serrablo , Catherine Teh , Lisa Yarrow , Brendan Visser , Mehan Siriwardhane
Background
The rise in malignant hepatopancreatobiliary tumors disproportionately affects low- and middle-income countries (LMICs) due to systemic challenges. In 2023, the International Hepatopancreatobiliary Association (IHPBA) launched a relationship-building initiative to mitigate outcome disparities by increasing capacity and quality. This study aimed to understand the dynamics and value of such collaborations.
Methods
This was a qualitative, descriptive study utilizing virtual, semi-structured interviews of surgeons and proceduralists engaged in international HPB surgery collaborations. Transcripts were coded inductively, allowing themes to emerge.
Results
Sixteen surgeons and one proceduralist participated from six world regions. Six were from high-income countries and 11 from LMICs. Overarching themes were: Interconnected Resources, Relationships, and Experiences. Country resources, professional relationships, and previous and ongoing collaborations were highly inter-connected. The IHPBA and individuals' resources presented both barriers and facilitators to collaboration.
Conclusion
Increasing access to and mutual understanding of resources is foundational for successful partnerships. Professional networks are also essential, and access to networking should be expanded and diversified. Partners must understand environments' constraints and needs. Associations like IHPBA should be networking drivers, increasing surgeons' informal and formal platform use. Surgical associations have a responsibility to create a culture that promotes and prioritizes participants' experiences beyond productivity.
{"title":"Building effective relationships in global surgery: an exploratory qualitative study","authors":"Dorothy Hughes , Betel Yibrehu , Peter Kingham , Kristoffer Lassen , Alejandro Serrablo , Catherine Teh , Lisa Yarrow , Brendan Visser , Mehan Siriwardhane","doi":"10.1016/j.hpb.2025.08.002","DOIUrl":"10.1016/j.hpb.2025.08.002","url":null,"abstract":"<div><h3>Background</h3><div>The rise in malignant hepatopancreatobiliary tumors disproportionately affects low- and middle-income countries (LMICs) due to systemic challenges. In 2023, the International Hepatopancreatobiliary Association (IHPBA) launched a relationship-building initiative to mitigate outcome disparities by increasing capacity and quality. This study aimed to understand the dynamics and value of such collaborations.</div></div><div><h3>Methods</h3><div>This was a qualitative, descriptive study utilizing virtual, semi-structured interviews of surgeons and proceduralists engaged in international HPB surgery collaborations. Transcripts were coded inductively, allowing themes to emerge.</div></div><div><h3>Results</h3><div>Sixteen surgeons and one proceduralist participated from six world regions. Six were from high-income countries and 11 from LMICs. Overarching themes were: Interconnected Resources, Relationships, and Experiences. Country resources, professional relationships, and previous and ongoing collaborations were highly inter-connected. The IHPBA and individuals' resources presented both barriers and facilitators to collaboration.</div></div><div><h3>Conclusion</h3><div>Increasing access to and mutual understanding of resources is foundational for successful partnerships. Professional networks are also essential, and access to networking should be expanded and diversified. Partners must understand environments' constraints and needs. Associations like IHPBA should be networking drivers, increasing surgeons' informal and formal platform use. Surgical associations have a responsibility to create a culture that promotes and prioritizes participants' experiences beyond productivity.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 11","pages":"Pages 1427-1436"},"PeriodicalIF":2.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006021","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 : 2025-11-01DOI: 10.1016/j.hpb.2025.08.001
Elena Panettieri , Agostino M. De Rose , Eduardo A. Vega , William T. Kawahara , Alessandro Coppola , Francesco Ardito , Felice Giuliante
Background
Indication to neoadjuvant chemotherapy and resectability of intrahepatic cholangiocarcinoma (iCCA) are not clearly defined. Aim of this survey was to assess practice patterns of iCCA treatment.
Methods
Data were collected from an online survey approved by the International Hepato-Pancreato-Biliary Association consisting of 33 questions.
Results
Of 167 surgeons surveyed from 44 countries, 83 % work at academic centers and 74.8 % routinely discuss iCCA cases in a multidisciplinary setting. Criteria of unresectability in absence of distant metastases included: insufficient future liver remnant volume (82.0 %), inability to obtain negative margins (71.3 %), contralateral nodules (62.9 %), contact with future remaining portal pedicles (49.1 %) and hepatic veins (44.3 %), multiple unilateral/satellite nodules (31.3 %), and positive regional lymph nodes (19.8 %). The most common indications for preoperative chemotherapy were initially unresectable disease (91.6 %) and radiologically enlarged regional lymph nodes (40.1 %). When planning hepatectomy for iCCA, 74.8 % of surgeons surveyed would consider administering neoadjuvant chemotherapy to increase the likelihood of achieving R0 resection (80.0 %), shrink tumor (81.6 %), and select patients with favorable tumor biology (73.6 %).
Conclusion
While expert consensus would help define unresectability for iCCA, preoperative chemotherapy is considered a suitable tool to help downstage disease and select patients with favorable tumor characteristics to increase R0 resection rates.
{"title":"International survey on the use of preoperative chemotherapy in the setting of multimodality management of intrahepatic cholangiocarcinoma","authors":"Elena Panettieri , Agostino M. De Rose , Eduardo A. Vega , William T. Kawahara , Alessandro Coppola , Francesco Ardito , Felice Giuliante","doi":"10.1016/j.hpb.2025.08.001","DOIUrl":"10.1016/j.hpb.2025.08.001","url":null,"abstract":"<div><h3>Background</h3><div>Indication to neoadjuvant chemotherapy and resectability of intrahepatic cholangiocarcinoma (iCCA) are not clearly defined. Aim of this survey was to assess practice patterns of iCCA treatment.</div></div><div><h3>Methods</h3><div>Data were collected from an online survey approved by the International Hepato-Pancreato-Biliary Association consisting of 33 questions.</div></div><div><h3>Results</h3><div>Of 167 surgeons surveyed from 44 countries, 83 % work at academic centers and 74.8 % routinely discuss iCCA cases in a multidisciplinary setting. Criteria of unresectability in absence of distant metastases included: insufficient future liver remnant volume (82.0 %), inability to obtain negative margins (71.3 %), contralateral nodules (62.9 %), contact with future remaining portal pedicles (49.1 %) and hepatic veins (44.3 %), multiple unilateral/satellite nodules (31.3 %), and positive regional lymph nodes (19.8 %). The most common indications for preoperative chemotherapy were initially unresectable disease (91.6 %) and radiologically enlarged regional lymph nodes (40.1 %). When planning hepatectomy for iCCA, 74.8 % of surgeons surveyed would consider administering neoadjuvant chemotherapy to increase the likelihood of achieving R0 resection (80.0 %), shrink tumor (81.6 %), and select patients with favorable tumor biology (73.6 %).</div></div><div><h3>Conclusion</h3><div>While expert consensus would help define unresectability for iCCA, preoperative chemotherapy is considered a suitable tool to help downstage disease and select patients with favorable tumor characteristics to increase R0 resection rates.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 11","pages":"Pages 1418-1426"},"PeriodicalIF":2.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952182","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 : 2025-11-01DOI: 10.1016/j.hpb.2025.08.003
Jane McClements , Amanda Koh , Harivinthan Sellappan , Lauren Blackburn , Adam Brooks , Jake Clements , Nabeel Merali , Adam Frampton , Syeda Gulbahar , Brian Davidson , Eyas Almomani , David Bartlett , Georgios Papadopoulos , Dimitrios Karavias , Alistair Rowcroft , James Lucocq , Ewen M. Harrison , Victoria Morrison-Jones , Fenella Welsh , Adithya Pathanki , Shahin Hajibandeh
Background
The role of liver transplantation as a treatment option for de novo resectable peri-hilar cholangiocarcinoma (pCCA) is controversial. This study investigated the outcomes following resection of early-stage pCCA in the UK.
Methods
Patients undergoing resection for pCCA between 2014 and 2022 across 22 UK centres were included. Early-stage pCCA was defined as tumour size<3cm with no nodal disease (N0) on histopathology analysis. Clinical and survival data were collated.
Results
Of the 450 patients included, 138 patients underwent resection for early-stage pCCA. In the early-stage pCCA group, CD ≥ IIIa morbidity was 39.1 % (n = 54) and 90-day mortality was 10.1 % (n = 14). Sixty-four (46.4 %) patients received adjuvant chemotherapy, but this was reduced in those with CD ≥ IIIa morbidity (n = 17, 31.5 %). Early-stage tumours had a significantly lower vascular invasion (n = 57, 41.3 %) and R1 margin (n = 46, 33.3 %) compared to later-stage pCCA [62.2 % (n = 194) and 54.2 % (n = 169) respectively, p < 0.001). The median disease-free and overall survival was significantly better in patients with early-stage pCCA compared to more advanced tumours (p < 0.001). Male gender (p = 0.039) and Post-Hepatectomy Liver Failure (PHLF, p = 0.010) were associated with significantly worse disease-free survival, while biliary drainage (p = 0.013), PHLF (p < 0.001) and vascular invasion (p = 0.030) were associated with significantly poorer overall survival.
Conclusion
Resection of early-stage pCCA tumours is associated with good clinical and survival outcomes in centralised HPB centres.
{"title":"Peri-hilar cholangiocarcinoma: results from the UK nationwide CAPBIL study","authors":"Jane McClements , Amanda Koh , Harivinthan Sellappan , Lauren Blackburn , Adam Brooks , Jake Clements , Nabeel Merali , Adam Frampton , Syeda Gulbahar , Brian Davidson , Eyas Almomani , David Bartlett , Georgios Papadopoulos , Dimitrios Karavias , Alistair Rowcroft , James Lucocq , Ewen M. Harrison , Victoria Morrison-Jones , Fenella Welsh , Adithya Pathanki , Shahin Hajibandeh","doi":"10.1016/j.hpb.2025.08.003","DOIUrl":"10.1016/j.hpb.2025.08.003","url":null,"abstract":"<div><h3><strong>Background</strong></h3><div>The role of liver transplantation as a treatment option for <em>de novo</em> resectable peri-hilar cholangiocarcinoma (pCCA) is controversial. This study investigated the outcomes following resection of early-stage pCCA in the UK.</div></div><div><h3>Methods</h3><div>Patients undergoing resection for pCCA between 2014 and 2022 across 22 UK centres were included. Early-stage pCCA was defined as tumour size<3cm with no nodal disease (N0) on histopathology analysis. Clinical and survival data were collated.</div></div><div><h3>Results</h3><div>Of the 450 patients included, 138 patients underwent resection for early-stage pCCA. In the early-stage pCCA group, CD ≥ IIIa morbidity was 39.1 % (<em>n</em> = 54) and 90-day mortality was 10.1 % (<em>n</em> = 14). Sixty-four (46.4 %) patients received adjuvant chemotherapy, but this was reduced in those with CD ≥ IIIa morbidity (<em>n</em> = 17, 31.5 %). Early-stage tumours had a significantly lower vascular invasion (<em>n</em> = 57, 41.3 %) and R1 margin (<em>n</em> = 46, 33.3 %) compared to later-stage pCCA [62.2 % (<em>n</em> = 194) and 54.2 % (<em>n</em> = 169) respectively, <em>p</em> < 0.001). The median disease-free and overall survival was significantly better in patients with early-stage pCCA compared to more advanced tumours (<em>p</em> < 0.001). Male gender (<em>p</em> = 0.039) and Post-Hepatectomy Liver Failure (PHLF, <em>p</em> = 0.010) were associated with significantly worse disease-free survival, while biliary drainage (<em>p</em> = 0.013), PHLF (<em>p</em> < 0.001) and vascular invasion (<em>p</em> = 0.030) were associated with significantly poorer overall survival.</div></div><div><h3>Conclusion</h3><div>Resection of early-stage pCCA tumours is associated with good clinical and survival outcomes in centralised HPB centres.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 11","pages":"Pages 1367-1378"},"PeriodicalIF":2.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023122","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 : 2025-11-01DOI: 10.1016/j.hpb.2025.08.013
Giancarlo Ceccarelli, Francesco Branda, Marta Giovanetti, Fabio Scarpa, Massimo Ciccozzi
{"title":"Between cutting-edge guidelines and neglected vulnerabilities: an implementation agenda for HCC in the Asia–Pacific","authors":"Giancarlo Ceccarelli, Francesco Branda, Marta Giovanetti, Fabio Scarpa, Massimo Ciccozzi","doi":"10.1016/j.hpb.2025.08.013","DOIUrl":"10.1016/j.hpb.2025.08.013","url":null,"abstract":"","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 11","pages":"Pages 1479-1480"},"PeriodicalIF":2.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145052387","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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