Journal of Hepato‐Biliary‐Pancreatic Sciences最新文献

{"title":"Influence of the Functional Reserve of the Remnant Liver on Major Hepatectomy Combined With Pancreatoduodenectomy","authors":"Takashi Mizuno,&nbsp;Shunsuke Onoe,&nbsp;Nobuyuki Watanabe,&nbsp;Mihoko Yamada,&nbsp;Shoji Kawakatsu,&nbsp;Junpei Yamaguchi,&nbsp;Masaki Sunagawa,&nbsp;Taisuke Baba,&nbsp;Tomoki Ebata","doi":"10.1002/jhbp.70026","DOIUrl":"10.1002/jhbp.70026","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Purpose</h3>\u0000 \u0000 <p>Major hepatopancreatoduodenectomy (HPD) is associated with a high risk of postoperative mortality, often due to pancreatic fistula formation and liver failure. We evaluated the impact of the functional reserve of the remnant liver on postoperative pancreatic fistula (POPF) formation and mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients who underwent resection of ≥ 3 hepatic segments with pancreatoduodenectomy were retrospectively analyzed. The association of the future liver remnant-to-body weight ratio (FLR/BW) with POPF formation and mortality was assessed. With receiver operating characteristic (ROC) curve analysis, the optimal cutoff values were determined. Underlying pancreatic conditions were also examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>POPFs occurred in 64% of 177 patients. The predictors of POPFs included a high BMI, low pancreatic CT attenuation, and small pancreatic duct diameter. The FLR/BW was not associated with POPF formation. Postoperative mortality occurred in 6% of patients, mostly due to Grade C postpancreatectomy hemorrhage. An FLR/BW &lt; 0.8% was an independent predictor of mortality (OR 15.79); patients with a ratio below 0.8% had a 14% mortality rate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Poor remnant liver functional reserve is not associated with POPF formation but significantly increases mortality after major HPD. Ensuring sufficient liver reserve, perhaps through more proactive use of portal vein embolization or parenchyma-sparing procedures, may improve outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"33 2","pages":"94-103"},"PeriodicalIF":2.8,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145488893","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}

{"title":"Mixed Reality–Based Education Using a Three-Dimensional Anatomical Model Before and During Transpapillary Pancreatic Duct Stenting","authors":"Yuki Tanisaka,&nbsp;Shomei Ryozawa,&nbsp;Takao Itoi,&nbsp;Masafumi Mizuide,&nbsp;Akashi Fujita,&nbsp;Ryuichi Watanabe,&nbsp;Ryosuke Hamamura,&nbsp;Maki Sugimoto","doi":"10.1002/jhbp.70025","DOIUrl":"10.1002/jhbp.70025","url":null,"abstract":"<p>Tanisaka and colleagues describe the use of mixed reality-based three-dimensional anatomical models for education and guidance before and during transpapillary pancreatic duct stenting. Using a head-mounted display and hand controllers, clinicians visualize patient-specific pancreatic duct anatomy from multiple perspectives, supporting preprocedural understanding and intraoperative navigation in a technically challenging procedure.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"32 12","pages":"e73-e75"},"PeriodicalIF":2.8,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145488831","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}

{"title":"Evaluation of Contact Resistance Between Catheters and Guidewires in Pancreatobiliary Endoscopy: Influence of Material and Mechanical Properties","authors":"Tadahisa Inoue,&nbsp;Shun Futagami,&nbsp;Masato Yano,&nbsp;Tomoya Kitada,&nbsp;Rena Kitano,&nbsp;Kazumasa Sakamoto,&nbsp;Satoshi Kimoto,&nbsp;Jun Arai,&nbsp;Kiyoaki Ito","doi":"10.1002/jhbp.70024","DOIUrl":"10.1002/jhbp.70024","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Guidewire manipulation is critical in pancreatobiliary endoscopy and is always performed in combination with catheters. However, the impact of catheter–guidewire interactions on contact resistance remains unclear. This study aimed to evaluate the contact resistance between various commercially available catheters and guidewires.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An ex vivo experiment was conducted using 9 catheters and 15 guidewires. Contact resistance during guidewire insertion and withdrawal was measured for each catheter–guidewire combination. Subgroup analyses were performed by categorizing the catheters and guidewires according to their materials and mechanical properties.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 750 insertion and withdrawal tests were performed. High-density polyethylene (HDPE) catheters consistently exhibited the lowest contact resistance across all guidewires. Among the guidewire materials, perfluoroalkoxy alkanes (PFAs) showed significantly lower resistance than the other materials. Guidewires with a friction-reducing surface had lower resistance, and stiffness showed a V-shaped correlation with insertion resistance. Both excessively high and low stiffness increased resistance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Catheter–guidewire contact resistance was significantly influenced by material, surface processing, and guidewire stiffness. HDPE catheters and PFA guidewires with moderate stiffness and friction-reducing surfaces may optimize performance. These findings offer useful insights for the selection of clinical devices and guidewire development.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"33 2","pages":"151-160"},"PeriodicalIF":2.8,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145452182","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}

{"title":"A Novel Immunohistochemistry Classifier for Ampullary Carcinoma: Highlighting the Prognostic Power of CDX2","authors":"Raiza Philip,&nbsp;M. J. Aparna,&nbsp;Rijo Issac,&nbsp;Shailaja Balakumar,&nbsp;Thomas Alex Kodiatte","doi":"10.1002/jhbp.70021","DOIUrl":"10.1002/jhbp.70021","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Ampullary carcinomas (AC) pose a diagnostic challenge while delineating into their prognostically distinct subtypes, pancreaticobiliary (PB) and intestinal (INT). This study aimed to correlate AC's histomorphological (HE) subtypes with its immunohistochemical (IHC) subtypes and evaluate their prognostic outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was conducted in the Department of Pathology at a tertiary care cancer hospital. One hundred cases of ACs in pancreatoduodenectomy specimens were selected. Slides were reviewed for HE subtyping of ACs, including Intra-Ampullary papillary-tubular Neoplasms into HE-PB and HE-INT subtypes. IHCs (MUC1, MUC2, MUC5AC, CDX2 and CK20) were performed. ACs were classified into IHC-PB or IHC-INT types using various IHC schemata. IHC and HE subtypes were correlated using Pearson's Chi-square test. Sensitivity, specificity, positive predictive values, and negative predictive values were calculated for the IHCs. Survival status was analyzed using the Kaplan–Meier survival analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results and Conclusion</h3>\u0000 \u0000 <p>The PB subtype showed a higher pathological tumor stage than INT. Among the various schemas evaluated, the Harthimmer Integrated Liu Layered Scoring system performed best with a significant correlation between HE and IHC subtypes. INT subtypes had better prognostic outcomes than PB subtypes. We found an essential prognostic role of CDX2 in the stratification of ACs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"32 12","pages":"928-937"},"PeriodicalIF":2.8,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145444963","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}

{"title":"Preoperative Serum High-Density Lipoprotein Cholesterol Serves as a Prognostic Marker for Postoperative Prognosis of Distal Cholangiocarcinoma","authors":"Han-xuan Wang,&nbsp;Jin-can Huang,&nbsp;Shao-cheng Lyu,&nbsp;You-wei Ma,&nbsp;Qiang He,&nbsp;Ren Lang,&nbsp;Fei Pan","doi":"10.1002/jhbp.70022","DOIUrl":"10.1002/jhbp.70022","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Researches revealed a close correlation between serum lipid and tumor prognosis. The current study aimed to explore the predictive value of preoperative serum lipid levels for the postoperative prognosis of distal cholangiocarcinoma (dCCA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study retrospectively included 203 dCCA patients who underwent radical surgery in our department. The Kaplan–Meier method and Cox regression model were used for univariate and multivariate analysis. Six machine-learning models were used to build a prediction model for postoperative prognosis. Subgroup and correlation analyses were conducted to reveal influencing factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Preoperative high-density lipoprotein cholesterol (HDL-c) had the best area under the ROC curve with a cutoff value of 0.415 mmol/L. Overall survival and disease-free survival were significantly lower in the low HDL-c group (<i>p</i> &lt; 0.05). Univariate and multivariate analyses identified HDL-c ≤ 0.415 mmol/L as an independent risk factor for postoperative tumor recurrence and overall survival. The survival prediction model incorporating HDL-c constructed by the random forest model exhibited optimal prediction value. Subgroup analysis confirmed HDL-c ≤ 0.415 mmol/L as an independent risk factor for postoperative tumor recurrence and overall survival in patients with tumor infiltration depth ≥ 12 mm, lymph node metastasis and elevated preoperative CA19-9.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>HDL-c ≤ 0.415 mmol/L is an independent risk factor for postoperative prognosis in dCCA patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"33 2","pages":"113-128"},"PeriodicalIF":2.8,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145409285","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}

{"title":"Early Definitive Surgery for Congenital Biliary Dilatation in Children Is Associated With Lower Morbidity: Comparison of Infant and School-Age Children From 231 Consecutive Cases in a Multicenter Study in the Kyushu Area of Japan During the Past Decade","authors":"Masakazu Murakami,&nbsp;Koshiro Sugita,&nbsp;Shohei Maeda,&nbsp;Kina Miyoshi,&nbsp;Yusuke Yamane,&nbsp;Taichiro Kosaka,&nbsp;Shun Onishi,&nbsp;Makoto Hayashida,&nbsp;Toshiharu Matsuura,&nbsp;Kimio Asagiri,&nbsp;Motofumi Torikai,&nbsp;Yukihiro Tatekawa,&nbsp;Takeshi Yamanouchi,&nbsp;Taizo Hibi,&nbsp;Tatsuro Tajiri,&nbsp;Satoshi Ieiri","doi":"10.1002/jhbp.70023","DOIUrl":"10.1002/jhbp.70023","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>There has been little discussion on the differences in characteristics and long-term outcomes of congenital biliary dilation (CBD) by age group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a regional multicenter study to investigate all pediatric cases of CBD in the Kyushu area of Japan over the past decade. Patient background, operative results, and postoperative complications were investigated. Results were compared between preschool children under 7 years of age and school-age children over 7 years of age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 187 preschool children and 44 school-aged children with CBD were included. The preschool group had a significantly shorter operative time and lower blood loss. The school-age group had significantly more biliary leakage (4.8% vs. 13.6%, <i>p</i> = 0.03) and more anastomotic stenosis (2.1% vs. 9.1%, <i>p</i> = 0.02). For biliary leakage and anastomotic stenosis, an ROC analysis demonstrated the moderate predictive power for age in months at surgery (AUC = 0.739, 95% CI: 0.577–0.901), with 75.0% sensitivity and 74.0% specificity at a cutoff value of 65.0.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Relative to preschool children, school-age children were more likely to suffer postoperative complications such as biliary leakage and anastomotic stenosis. Early definitive surgery in the infantile period is recommended for pediatric CBD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"32 12","pages":"910-919"},"PeriodicalIF":2.8,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhbp.70023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145400865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Prophylactic Drainage Tube Placement Clinically Useful After Laparoscopic Cholecystectomy in Patients With Gallbladder Drainage for Acute Cholecystitis? A Propensity Score-Matched Study: A Secondary Analysis of the CSGO-HBP-017","authors":"Shohei Takaichi,&nbsp;Yoshito Tomimaru,&nbsp;Kazuhiko Hashimoto,&nbsp;Nariaki Fukuchi,&nbsp;Shigekazu Yokoyama,&nbsp;Takuji Mori,&nbsp;Masahiro Tanemura,&nbsp;Shogo Kobayashi,&nbsp;Makoto Fujii,&nbsp;Yuichiro Doki,&nbsp;Hidetoshi Eguchi","doi":"10.1002/jhbp.70020","DOIUrl":"10.1002/jhbp.70020","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The aim of the study was to investigate whether prophylactic drainage tube (PD) is clinically useful after laparoscopic cholecystectomy (LC) in patients who undergo gallbladder drainage for acute cholecystitis (AC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Using data from our previous multicenter retrospective study exploring the optimal timing of LC after gallbladder drainage for AC, we performed a secondary analysis in which we compared surgical outcomes between patients who underwent gallbladder drainage and subsequent LC for AC with (<i>n</i> = 134) or without (<i>n</i> = 149) PD placement. The results of the comparison were verified by propensity score matching with 84 patients in each group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The postoperative length of stay (LOS) in the hospital was significantly longer in patients with a PD than those without a PD, and we identified several significant differences in preoperative and intraoperative characteristics between the two groups. After propensity score matching, the LOS remained significantly longer in patients with PDs, but there were no differences in postoperative complications. Matched multivariate analysis identified PD placement as an independent predictor of a prolonged postoperative hospital stay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PD placement after LC in patients with gallbladder drainage for AC did not impact the postoperative outcome and could prolong the postoperative LOS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"33 2","pages":"84-93"},"PeriodicalIF":2.8,"publicationDate":"2025-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145372695","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}

{"title":"Proposal of a Modified Adhesion Score as a Predictor of Technical Difficulty and Surgical Risks of Repeat Hepatectomy: The TORAD Score, Version 2.0","authors":"Junichi Shindoh,&nbsp;Yuta Kobayashi,&nbsp;Satoshi Okubo,&nbsp;Yasutaka Kuno,&nbsp;Hisashi Murakami,&nbsp;Takuma Okada,&nbsp;Masaru Matsumura,&nbsp;Masaji Hashimoto","doi":"10.1002/jhbp.70019","DOIUrl":"10.1002/jhbp.70019","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>TORAD score is a grading system that evaluates the technical difficulty of repeat hepatectomy (ReHx), and its clinical relevance has been reported in several studies. However, recent advances in minimally invasive surgery have rendered the ability of this scoring system to discriminate between different levels of adhesion severity inadequate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We developed a modified grading system to accurately evaluate the adhesion severity related to the difficulty of ReHx through a video review of 214 patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The modified grading system consists of three parts: (1) A score, the severity of adhesions around the hepatic hilum; (2) B score, the severity of adhesions around the liver; and (3) C score, the severity of adhesions at the site of the previous cut surface. Each of the scores is based on a four-level severity scale, and the sum of the three scores is termed the TORAD score, v2.0. High inter-observer agreement was confirmed in the assessment of these adhesion categories (kappa value: 0.972–1.000), and the TORAD scores, v2.0 were found to show good correlations with the short-term surgical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The modified grading system offers promise as an optimal scale for evaluating the technical difficulty and surgical risk of ReHx associated with adhesions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"32 12","pages":"871-877"},"PeriodicalIF":2.8,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355103","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}

{"title":"Global Trends in Perioperative Imaging Workups and Records for Hepatobiliary and Pancreatic Surgery: Reports From 103 Facilities Worldwide","authors":"Yoshihiro Sakamoto,&nbsp;Goro Honda,&nbsp;Taizo Hibi,&nbsp;Tomoyuki Yoshida,&nbsp;Shohei Kudo,&nbsp;Nobuhiro Hasui,&nbsp;Hirokazu Momose,&nbsp;Ryota Matsuki,&nbsp;Masaharu Kogure,&nbsp;Mureo Kasahara","doi":"10.1002/jhbp.70017","DOIUrl":"10.1002/jhbp.70017","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Perioperative imaging workups and records, including preoperative schema-drawing, three-dimensional tomographic image simulation, intraoperative ultrasonography, fluorescence imaging in hepatectomy, and postoperative record with illustration, may be helpful to perform and educate safe and accurate hepato-biliary-pancreatic (HBP) surgery. The purpose of this study is to elucidate the global usage of image-analyzing methods in HBP surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-four questions were sent to 182 HBP and transplantation surgeons in 177 academic institutions in 34 countries worldwide to examine the usage of perioperative image-analyzing methods, surgical volume, and introduction of minimally invasive (MI) approaches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Questionnaire responses were obtained from 107 surgeons at 103 institutions across 27 countries (response rate, 58.2%). Perioperative schema-drawing (97% vs. 41%), three-dimensional simulation (100% vs. 58%), and operation record with illustration (100% vs. 41%), were best utilized in Japan (<i>p</i> &lt; 0.001). The number of hepatectomy, liver transplantation, pancreatectomy, introduction of MI approaches was significantly associated with a larger number of surgical staffs (≥ 12) in each institution, but not with the imaging workups and records.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Japan made optimal use of perioperative image-analyzing methods; however, they are not of global standard. Surgical volume and introduction of MI-HBP surgery were associated with the number of surgical staff.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"33 2","pages":"76-83"},"PeriodicalIF":2.8,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292426","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}

{"title":"A Pilot Study on the Efficacy and Safety of Sedation With Remimazolam in Japanese Patients Undergoing Endoscopic Retrograde Cholangiopancreatography","authors":"Shuhei Shintani,&nbsp;Takayoshi Mizuno,&nbsp;Jun Matsubayashi,&nbsp;Takuya Okamoto,&nbsp;Kosuke Hiroe,&nbsp;Atsushi Nishida,&nbsp;Hirotoshi Kitagawa,&nbsp;Osamu Inatomi,&nbsp;Takuji Iwashita","doi":"10.1002/jhbp.70018","DOIUrl":"10.1002/jhbp.70018","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Remimazolam is a novel, ultra-short-acting benzodiazepine. Remimazolam is characterized by rapid induction and recovery and low cardiopulmonary effects. The present study aimed to examine the safety and efficacy of a sedation method combining remimazolam and pentazocine during endoscopic retrograde cholangiopancreatography (ERCP) in a Japanese cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The present investigation was a single-center, single-arm, Phase 2 study. The primary endpoint was successful endoscopic sedation. The initial dose was induced with remimazolam (0.1 mg/kg) and pentazocine (3.75 mg). Remimazolam (0.05 mg/kg) and the same dose of pentazocine as the initial dose were added as needed in response to body movements or signs of discomfort during the procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 59 patients [median age (range): 75 years (48–87 years), 47 male (79.7%)] were enrolled. Successful endoscopic sedation was achieved in all patients. One patient (1.7%) experienced transient circulatory depression, with no instances of respiratory depression or need for flumazenil reversal. Post-procedure alertness was achieved within 5 and 10 min in 52 (88.1%) and 58 patients (98.3%), respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Sedation with remimazolam and pentazocine in ERCP demonstrated high efficacy and a favorable safety profile in the Japanese population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>This trial was registered in the Japan Registry of Clinical Trials (jRCTs051230088)</p>\u0000 </section>\u0000 </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"32 12","pages":"938-944"},"PeriodicalIF":2.8,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280332","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}