Pub Date : 2025-12-01DOI: 10.1016/j.hbpd.2025.09.005
Tomoya Emori , Reiko Ashida , Masayuki Kitano
The prevalence of sarcopenia tends to be high in patients with biliopancreatic disease. Sarcopenia is a risk factor of poor prognosis in patients with acute and chronic pancreatitis and biliary tract and pancreatic cancer. Several studies have suggested that sarcopenia may be a risk factor for perioperative complications and decreased recurrence-free or overall survival in patients with biliary tract and pancreatic cancer after surgery. Sarcopenia in biliary tract and pancreatic cancer may also increase chemotherapy-induced toxicities and worsen quality of life and survival in neoadjuvant or palliative chemotherapy. Moreover, sarcopenia is a risk factor for biliary stent occlusion in patients with malignant biliary obstruction, predictors of the efficacy of endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) for pain relief, EUS-guided drainage, and endoscopic necrosectomy for walled-off necrosis (WON). Diagnosis of sarcopenia prior to the treatment of biliopancreatic diseases and endoscopy may predict treatment efficacy, and appropriate nutritional and exercise therapy improve therapeutic outcomes of patients with biliopancreatic diseases.
{"title":"Sarcopenia is risk factor for prognosis of patients with biliopancreatic diseases","authors":"Tomoya Emori , Reiko Ashida , Masayuki Kitano","doi":"10.1016/j.hbpd.2025.09.005","DOIUrl":"10.1016/j.hbpd.2025.09.005","url":null,"abstract":"<div><div>The prevalence of sarcopenia tends to be high in patients with biliopancreatic disease. Sarcopenia is a risk factor of poor prognosis in patients with acute and chronic pancreatitis and biliary tract and pancreatic cancer. Several studies have suggested that sarcopenia may be a risk factor for perioperative complications and decreased recurrence-free or overall survival in patients with biliary tract and pancreatic cancer after surgery. Sarcopenia in biliary tract and pancreatic cancer may also increase chemotherapy-induced toxicities and worsen quality of life and survival in neoadjuvant or palliative chemotherapy. Moreover, sarcopenia is a risk factor for biliary stent occlusion in patients with malignant biliary obstruction, predictors of the efficacy of endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) for pain relief, EUS-guided drainage, and endoscopic necrosectomy for walled-off necrosis (WON). Diagnosis of sarcopenia prior to the treatment of biliopancreatic diseases and endoscopy may predict treatment efficacy, and appropriate nutritional and exercise therapy improve therapeutic outcomes of patients with biliopancreatic diseases.</div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"24 6","pages":"Pages 598-606"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310071","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 : 2025-12-01DOI: 10.1016/j.hbpd.2025.10.001
Guo-Dong Zhao , Yu-Hang Cheng , Xing-Ru Wang , Jun Feng , Jian-Yu Han , Pan Gao , Jia-Tong Xu , Hong Qin
{"title":"Robotic duodenum-preserving pancreatic head resection in a 21-month-old infant with benign disease: Redefining the ‘‘minimum feasible age’’ for robotic surgery (with video)","authors":"Guo-Dong Zhao , Yu-Hang Cheng , Xing-Ru Wang , Jun Feng , Jian-Yu Han , Pan Gao , Jia-Tong Xu , Hong Qin","doi":"10.1016/j.hbpd.2025.10.001","DOIUrl":"10.1016/j.hbpd.2025.10.001","url":null,"abstract":"","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"24 6","pages":"Pages 695-697"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356894","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 : 2025-12-01DOI: 10.1016/j.hbpd.2025.08.002
Chuan-Zhi Tang , Zhong-Jun Wu , Da-Di Peng
Background
Laparoscopic pancreaticoduodenectomy (LPD) has gained growing acceptance for the resection of periampullary carcinoma. However, postoperative ascites (POA) frequently occurs after LPD, yet little is known about the underlying factors that promote POA under this laparoscopic approach. This study aimed to explore the clinical influence of POA after LPD and its potential predictors.
Methods
Patients diagnosed with periampullary carcinoma who subsequently underwent LPD from December 2015 to February 2023 were reviewed. Patients were assigned to the two groups by whether daily abdominal drainage > 500 mL for at least three consecutive days, followed by subgroup analysis of pancreatic fistula (PF)-POA and non-PF-POA. Variables, including preoperative laboratory tests, past history, surgery-related factors, and incidence of complications, were compared. In addition, logistic regression analysis was applied to reveal the potential independent risk factors for PF-POA and non-PF-POA.
Results
A total of 38 patients (17.4%) developed POA, with 17 having PF-POA and 21 having non-PF-POA. Patients with grade B PF-POA experienced a higher incidence of intra-abdominal infection, and a longer hospital stay compared with other groups. Multivariate analysis demonstrated that prothrombin time > 14 s and main pancreatic duct diameter < 3 mm were independent risk factors for PF-POA. Moreover, male sex, total bilirubin > 34.2 μmol/L and platelet count < 100 × 109/L were independent risk factors for non-PF-POA. The areas under the receiver operating characteristic curve were 0.682 and 0.786 for predicting PF-POA and non-PF-POA, respectively.
Conclusions
LPD recovery and postoperative complications are impacted by POA, where PF-POA is the most clinically relevant POA. Prolonged prothrombin time and narrowed main pancreatic duct were independent risk factors for PF-POA; male sex, elevated total bilirubin level, and decreased platelet count were independent risk factors for non-PF-POA.
{"title":"Predictive factors of postoperative ascites after laparoscopic pancreaticoduodenectomy for periampullary carcinoma","authors":"Chuan-Zhi Tang , Zhong-Jun Wu , Da-Di Peng","doi":"10.1016/j.hbpd.2025.08.002","DOIUrl":"10.1016/j.hbpd.2025.08.002","url":null,"abstract":"<div><h3>Background</h3><div>Laparoscopic pancreaticoduodenectomy (LPD) has gained growing acceptance for the resection of periampullary carcinoma. However, postoperative ascites (POA) frequently occurs after LPD, yet little is known about the underlying factors that promote POA under this laparoscopic approach. This study aimed to explore the clinical influence of POA after LPD and its potential predictors.</div></div><div><h3>Methods</h3><div>Patients diagnosed with periampullary carcinoma who subsequently underwent LPD from December 2015 to February 2023 were reviewed. Patients were assigned to the two groups by whether daily abdominal drainage > 500 mL for at least three consecutive days, followed by subgroup analysis of pancreatic fistula (PF)-POA and non-PF-POA. Variables, including preoperative laboratory tests, past history, surgery-related factors, and incidence of complications, were compared. In addition, logistic regression analysis was applied to reveal the potential independent risk factors for PF-POA and non-PF-POA.</div></div><div><h3>Results</h3><div>A total of 38 patients (17.4%) developed POA, with 17 having PF-POA and 21 having non-PF-POA. Patients with grade B PF-POA experienced a higher incidence of intra-abdominal infection, and a longer hospital stay compared with other groups. Multivariate analysis demonstrated that prothrombin time > 14 s and main pancreatic duct diameter < 3 mm were independent risk factors for PF-POA. Moreover, male sex, total bilirubin > 34.2 μmol/L and platelet count < 100 × 10<sup>9</sup>/L were independent risk factors for non-PF-POA. The areas under the receiver operating characteristic curve were 0.682 and 0.786 for predicting PF-POA and non-PF-POA, respectively.</div></div><div><h3>Conclusions</h3><div>LPD recovery and postoperative complications are impacted by POA, where PF-POA is the most clinically relevant POA. Prolonged prothrombin time and narrowed main pancreatic duct were independent risk factors for PF-POA; male sex, elevated total bilirubin level, and decreased platelet count were independent risk factors for non-PF-POA.</div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"24 6","pages":"Pages 684-691"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876829","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 : 2025-12-01DOI: 10.1016/j.hbpd.2025.06.009
Bo Peng , Kai Liu , Xu-Yu Xiang , Yu-Fei Zhang , Hao Li , Peng-Peng Zhang , Jun-Hui Li , Ying-Zi Ming
Background
Acute-on-chronic liver failure (ACLF) is a severe syndrome with high short-term mortality. Triggering receptor expressed on myeloid cells-2 (TREM2) is highly expressed in the livers of patients with ACLF, but the role of its soluble form, soluble TREM2 (sTREM2), in ACLF is not clear.
Methods
We enrolled 96 consecutive patients receiving liver transplantation (LT), including 40 ACLF patients and 56 non-ACLF patients, and collected plasma at pre-LT and day 3, 7 and 14 after LT. We also enrolled 22 healthy controls (HC). The plasma sTREM2 level was detected using the enzyme-linked immunosorbent assay. The expression of TREM2 in the livers was examined using quantitative polymerase chain reaction.
Results
The pre-LT sTREM2 of the ACLF group was significantly higher than that of the non-ACLF group (13.4 ng/mL vs. 2.6 ng/mL, P < 0.001) and the HC group (13.4 ng/mL vs. 0.57 ng/mL, P < 0.001), but sTREM2 did not correlate with the grades of ACLF. The level of sTREM2 was positively correlated with the expression of TREM2 in the livers and had tight correlations with liver function and liver failure-related scores. To diagnose ACLF, sTREM2 showed an area under the receiver operating characteristic curve (AUC) of 0.863 (P < 0.001). When the cut-off value was 6.5 ng/mL, the sensitivity was 74.3% and the specificity was 93.0%. sTREM2 levels tested at day 7 and 14 after LT were associated with mortality [hazard ratio (HR): 1.187 and 1.078, P < 0.001 and P = 0.043, respectively], and sTREM2 tested at day 3 after LT was a risk factor for early allograft dysfunction (EAD) [odds ratio (OR): 1.060, P = 0.023].
Conclusions
sTREM2 was a good biomarker for liver injury. Pre-LT sTREM2 could be used to diagnose ACLF and persistently high levels of sTREM2 after LT predicted poor survival and incidence of EAD.
背景：急性伴慢性肝衰竭（ACLF）是一种短期死亡率高的严重综合征。骨髓细胞上表达的触发受体-2 （TREM2）在ACLF患者的肝脏中高表达，但其可溶性形式可溶性TREM2 （sTREM2）在ACLF中的作用尚不清楚。方法：我们招募了96例连续接受肝移植（LT）的患者，包括40例ACLF患者和56例非ACLF患者，并在LT前和LT后第3、7和14天收集血浆。我们还招募了22名健康对照组（HC）。采用酶联免疫吸附法检测血浆sTREM2水平。采用定量聚合酶链反应检测肝脏中TREM2的表达。结果：ACLF组lt前sTREM2显著高于非ACLF组（13.4 ng/mL vs. 2.6 ng/mL, P < 0.001）和HC组（13.4 ng/mL vs. 0.57 ng/mL, P < 0.001），但sTREM2与ACLF分级无关。TREM2水平与肝脏中TREM2表达呈正相关，与肝功能及肝功能衰竭相关评分密切相关。sTREM2在诊断ACLF时，受试者工作特征曲线下面积（AUROC）为0.863 （P < 0.001）。截止值为6.5 ng/mL时，敏感性为74.3%，特异性为93.0%。移植后第7天和第14天检测的strem - 2水平与死亡率相关[危险比（HR）： 1.187和1.078,P < 0.001和P = 0.043]，移植后第3天检测的strem - 2是早期同种异体移植物功能障碍（EAD）的危险因素[优势比（OR）： 1.060, P = 0.023]。结论：sTREM2是肝损伤的良好生物标志物。LT前sTREM2可用于诊断ACLF， LT后持续高水平的sTREM2可预测生存率差和EAD发生率。
{"title":"Soluble TREM2 is a novel diagnostic and prognostic biomarker of acute-on-chronic liver failure in patients receiving liver transplantation","authors":"Bo Peng , Kai Liu , Xu-Yu Xiang , Yu-Fei Zhang , Hao Li , Peng-Peng Zhang , Jun-Hui Li , Ying-Zi Ming","doi":"10.1016/j.hbpd.2025.06.009","DOIUrl":"10.1016/j.hbpd.2025.06.009","url":null,"abstract":"<div><h3>Background</h3><div>Acute-on-chronic liver failure (ACLF) is a severe syndrome with high short-term mortality. Triggering receptor expressed on myeloid cells-2 (TREM2) is highly expressed in the livers of patients with ACLF, but the role of its soluble form, soluble TREM2 (sTREM2), in ACLF is not clear.</div></div><div><h3>Methods</h3><div>We enrolled 96 consecutive patients receiving liver transplantation (LT), including 40 ACLF patients and 56 non-ACLF patients, and collected plasma at pre-LT and day 3, 7 and 14 after LT. We also enrolled 22 healthy controls (HC). The plasma sTREM2 level was detected using the enzyme-linked immunosorbent assay. The expression of TREM2 in the livers was examined using quantitative polymerase chain reaction.</div></div><div><h3>Results</h3><div>The pre-LT sTREM2 of the ACLF group was significantly higher than that of the non-ACLF group (13.4 ng/mL vs. 2.6 ng/mL, <em>P</em> < 0.001) and the HC group (13.4 ng/mL vs. 0.57 ng/mL, <em>P</em> < 0.001), but sTREM2 did not correlate with the grades of ACLF. The level of sTREM2 was positively correlated with the expression of TREM2 in the livers and had tight correlations with liver function and liver failure-related scores. To diagnose ACLF, sTREM2 showed an area under the receiver operating characteristic curve (AUC) of 0.863 (<em>P</em> < 0.001). When the cut-off value was 6.5 ng/mL, the sensitivity was 74.3% and the specificity was 93.0%. sTREM2 levels tested at day 7 and 14 after LT were associated with mortality [hazard ratio (HR): 1.187 and 1.078, <em>P</em> < 0.001 and <em>P</em> = 0.043, respectively], and sTREM2 tested at day 3 after LT was a risk factor for early allograft dysfunction (EAD) [odds ratio (OR): 1.060, <em>P</em> = 0.023].</div></div><div><h3>Conclusions</h3><div>sTREM2 was a good biomarker for liver injury. Pre-LT sTREM2 could be used to diagnose ACLF and persistently high levels of sTREM2 after LT predicted poor survival and incidence of EAD.</div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"24 6","pages":"Pages 625-633"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214476","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 : 2025-12-01DOI: 10.1016/j.hbpd.2025.09.006
Chang-Yi Ji , Meng-Meng Gu , Lan Huang , Jian Wu , Hong-Tao Wang
Background
Hepatitis E virus (HEV) may induce acute self-limiting illnesses or persistent infections. Chronic hepatitis E frequently occurs in immunocompromised persons, including organ transplant recipients, HIV-positive patients, and those with hematological malignancies. It poses a risk of liver fibrosis and cirrhosis.
Data sources
Relevant articles published till September 2024 were located using PubMed searches. The further search terms utilized were: “immunocompromised”, “solid organ transplant”, “HIV”, “hematological malignancy”, and “hepatitis E virus”. A manual search of references from pivotal articles extended further publications. The search parameters encompass publications in English.
Results
The epidemiology, clinical manifestations, diagnostic measures, and therapeutic modalities of chronic hepatitis E were discussed. Immunocompromised individuals who are infected with HEV are at an increased risk of developing chronic infections, which may progress to liver fibrosis and cirrhosis. Current understanding of HEV is still limited, and there is no medicine that specifically targets hepatitis E. Consequently, the prevention and management of hepatitis E continue to present a significant challenge.
Conclusions
Chronic hepatitis E patients need special attention in clinical practice. The relevant risk factors must be identified to facilitate accurate diagnosis and the implementation of more effective preventive measures, thereby enhancing the monitoring, treatment, and prevention of immunocompromised individuals.
{"title":"Chronic hepatitis E: The neglected liver killer","authors":"Chang-Yi Ji , Meng-Meng Gu , Lan Huang , Jian Wu , Hong-Tao Wang","doi":"10.1016/j.hbpd.2025.09.006","DOIUrl":"10.1016/j.hbpd.2025.09.006","url":null,"abstract":"<div><h3>Background</h3><div>Hepatitis E virus (HEV) may induce acute self-limiting illnesses or persistent infections. Chronic hepatitis E frequently occurs in immunocompromised persons, including organ transplant recipients, HIV-positive patients, and those with hematological malignancies. It poses a risk of liver fibrosis and cirrhosis.</div></div><div><h3>Data sources</h3><div>Relevant articles published till September 2024 were located using PubMed searches. The further search terms utilized were: “immunocompromised”, “solid organ transplant”, “HIV”, “hematological malignancy”, and “hepatitis E virus”. A manual search of references from pivotal articles extended further publications. The search parameters encompass publications in English.</div></div><div><h3>Results</h3><div>The epidemiology, clinical manifestations, diagnostic measures, and therapeutic modalities of chronic hepatitis E were discussed. Immunocompromised individuals who are infected with HEV are at an increased risk of developing chronic infections, which may progress to liver fibrosis and cirrhosis. Current understanding of HEV is still limited, and there is no medicine that specifically targets hepatitis E. Consequently, the prevention and management of hepatitis E continue to present a significant challenge.</div></div><div><h3>Conclusions</h3><div>Chronic hepatitis E patients need special attention in clinical practice. The relevant risk factors must be identified to facilitate accurate diagnosis and the implementation of more effective preventive measures, thereby enhancing the monitoring, treatment, and prevention of immunocompromised individuals.</div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"24 6","pages":"Pages 607-615"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228708","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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