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Tri-modal death distribution towards personalized management of intraductal papillary neoplasm of the bile duct patients: Every story has its own conclusion 对胆管内乳头状肿瘤患者进行个性化治疗的三模式死亡分布:每个故事都有自己的结局
IF 3.3 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-01-20 DOI: 10.1016/j.hbpd.2024.01.004
Vor Luvira
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引用次数: 0
Liver transplantation as an alternative for the treatment of perihilar cholangiocarcinoma: A critical review 肝移植作为治疗肝周胆管癌的替代方案:评论性综述
IF 3.3 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-01-20 DOI: 10.1016/j.hbpd.2024.01.003
Wellington Andraus, Francisco Tustumi, Alexandre Chagas Santana, Rafael Soares Nunes Pinheiro, Daniel Reis Waisberg, Liliana Ducatti Lopes, Rubens Macedo Arantes, Vinicius Rocha Santos, Rodrigo Bronze de Martino, Luiz Augusto Carneiro D'Albuquerque

Background

Perihilar cholangiocarcinoma (phCCC) is a dismal malignancy. There is no consensus regarding the best treatment for patients with unresectable phCCC. The present review aimed to gather the current pieces of evidence for liver transplantation and liver resection as a treatment for phCCC and to build better guidance for clinical practice.

Data sources

The search was conducted in PubMed, Embase, Cochrane, and LILACS. The related references were searched manually. Inclusion criteria were: reports in English or Portuguese literature that a) patients with confirmed diagnosis of phCCC; b) patients treated with a curative intent; c) patients with the outcomes of liver resection and liver transplantation. Case reports, reviews, letters, editorials, conference abstracts and papers with full-text unavailability were excluded from the analysis.

Results

Most of the current literature is based on observational retrospective studies with low grades of evidence. Liver resection has better long-term outcomes than systemic chemotherapy or palliation therapy and liver transplantation is a good alternative for selected patients with unresectable phCCC. All candidates for resection or transplantation should be medically fit and free of intrahepatic or extrahepatic diseases. As a general rule, patients presenting with a tumor having a longitudinal size > 3 cm or extending below the cystic duct, lymph node disease, confirmed extrahepatic dissemination; intraoperatively diagnosed metastatic disease; a history of other malignancies within the last five years, and did not complete chemoradiation regimen and were medically unfit should not be considered for transplantation. Some of these criteria should be individually assessed. Liver transplantation or resection should only be considered in highly experienced hepatobiliary centers, and any decision-making must be based on a multidisciplinary evaluation.

Conclusions

phCCC is a complex condition with high morbidity. Surgical therapies, including hepatectomy and liver transplantation, are the best option for better long-term disease-free survival.

背景肝周胆管癌(phCCC)是一种令人沮丧的恶性肿瘤。对于无法切除的 phCCC 患者的最佳治疗方法,目前尚无共识。本综述旨在收集肝移植和肝切除术治疗 phCCC 的现有证据,为临床实践提供更好的指导。数据来源在 PubMed、Embase、Cochrane 和 LILACS 中进行了检索。人工检索了相关参考文献。纳入标准为:英语或葡萄牙语文献中关于以下内容的报告:a)确诊为咽癌变的患者;b)以治愈为目的进行治疗的患者;c)肝切除和肝移植结果的患者。病例报告、综述、信件、社论、会议摘要以及无法获得全文的论文均未纳入分析范围。与全身化疗或姑息治疗相比,肝切除术的长期疗效更好,而肝移植则是部分无法切除的咽癌变患者的良好选择。所有接受切除或移植手术的患者都应身体健康,没有肝内或肝外疾病。一般来说,肿瘤纵向大小超过 3 厘米或延伸至囊管以下、淋巴结病变、确诊肝外播散、术中确诊转移性疾病、近五年内有其他恶性肿瘤病史、未完成化疗且身体状况不佳的患者不应考虑移植。其中一些标准应单独评估。只有在经验丰富的肝胆中心才能考虑肝移植或切除,而且任何决策都必须基于多学科评估。包括肝切除术和肝移植在内的外科疗法是提高长期无病生存率的最佳选择。
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引用次数: 0
Hepatic vein reconstruction during hepatectomy: A feasible and underused technique 肝切除术中的肝静脉重建:一种可行但使用不足的技术
IF 3.3 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-01-15 DOI: 10.1016/j.hbpd.2024.01.002
Manish Ahuja , Kunal Joshi , Chris Coldham , Paulo Muiesan , Bobby Dasari , Manuel Abradelo , Ravi Marudanayagam , Darius Mirza , John Isaac , David Bartlett , Nikolaos A Chatzizacharias , Robert P Sutcliffe , Keith J Roberts
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引用次数: 0
Timing of hepatectomy following the Omicron variant infection for vaccinated-patients: A retrospective cohort study 已接种疫苗的患者在感染奥米克龙变异病毒后进行肝切除术的时机:回顾性队列研究
IF 3.6 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-01-15 DOI: 10.1016/j.hbpd.2024.01.001
Wu-Gui Yang, Yu-Fu Peng, Yu-Bo Yang, Bo Li, Yong-Gang Wei, Fei Liu
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引用次数: 0
Meetings and Courses 会议和课程
IF 3.3 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-01-04 DOI: 10.1016/S1499-3872(23)00227-8
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引用次数: 0
A rare case of thymic carcinoma metastasize to liver 胸腺癌转移至肝脏的罕见病例
IF 3.3 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-12-31 DOI: 10.1016/j.hbpd.2023.12.003
YF Jiang, J Wu, DY Chen
Abstract not available
无摘要
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引用次数: 0
Liver transplantation as an alternative for the treatment of non-resectable liver colorectal cancer: Advancing the therapeutic algorithm 肝移植作为治疗不可切除肝结直肠癌的替代方案:推进治疗算法
IF 3.3 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-12-30 DOI: 10.1016/j.hbpd.2023.12.002
Badi Rawashdeh , Richard Bell , Abdul Hakeem , Raj Prasad

Colorectal cancer is a leading cause of cancer-related mortality, with nearly half of the affected patients developing liver metastases. For three decades, liver resection (LR) has been the primary curative strategy, yet its applicability is limited to about 20% of cases. Liver transplantation (LT) for unresectable metastases was attempted unsuccessfully in the 1990s, with high rates of perioperative death and recurrence. There is now more interest in this strategy due to improvements in systemic therapies and surgical techniques. A significant study conducted by the Oslo group showed that patients receiving liver transplants had a 60% chance of survival after five years. Significantly better results have been achieved by using advanced imaging for risk stratification and further refining selection criteria, especially in the Norvegian SECA trials. This review carefully charts the development and history of LT as a treatment option for colorectal cancer liver metastases. The revolutionary path from the early days of exploratory surgery to the current situation of cautious optimism is traced, highlighting the critical clinical developments and improved patient selection standards that have made LT a potentially curative treatment for such challenging very well selected cases.

结直肠癌是导致癌症相关死亡的主要原因,近一半的患者会出现肝转移。三十年来,肝切除术(LR)一直是主要的治愈策略,但其适用范围仅限于约 20% 的病例。20 世纪 90 年代,人们曾尝试对无法切除的转移灶进行肝移植(LT),但未获成功,围手术期的死亡率和复发率都很高。现在,由于系统疗法和手术技术的改进,人们对这一策略有了更多的兴趣。奥斯陆小组进行的一项重要研究显示,接受肝移植的患者五年后的存活率为 60%。通过使用先进的成像技术进行风险分层,并进一步完善选择标准,特别是在挪威的SECA试验中,取得了明显更好的效果。这篇综述仔细描绘了LT作为结直肠癌肝转移治疗方案的发展和历史。文章追溯了从早期的探索性手术到目前的谨慎乐观的革命性道路,强调了关键的临床发展和患者选择标准的改进,这些都使LT成为一种可能治愈的治疗方法,适用于这类极具挑战性的、经过严格筛选的病例。
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引用次数: 0
Early-life exposure to gestational diabetes mellitus predisposes offspring to pediatric nonalcoholic fatty liver disease 早年妊娠糖尿病使后代易患小儿非酒精性脂肪肝
IF 3.3 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-12-30 DOI: 10.1016/j.hbpd.2023.12.007
Qian-Ren Zhang, Yan Dong, Jian-Gao Fan

Nonalcoholic fatty liver disease (NAFLD) has emerged as the prevailing chronic liver disease in the pediatric population due to the global obesity pandemic. Evidence shows that prenatal and postnatal exposure to maternal abnormalities leads to a higher risk of pediatric NAFLD through persistent alterations in developmental programming. Gestational diabetes mellitus (GDM) is a hyperglycemic syndrome which has become the most prevalent complication in pregnant women. An increasing number of both epidemiologic investigations and animal model studies have validated adverse and long-term outcomes in offspring following GDM exposure in utero. Similarly, GDM is considered a crucial risk factor for pediatric NAFLD. This review aimed to summarize currently published studies concerning the inductive roles of GDM in offspring NAFLD development during childhood and adolescence. Dysregulations in hepatic lipid metabolism and gut microbiota in offspring, as well as dysfunctions in the placenta are potential factors in the pathogenesis of GDM-associated pediatric NAFLD. In addition, potentially effective interventions for GDM-associated offspring NAFLD are also discussed in this review. However, most of these therapeutic approaches still require further clinical research for validation.

由于全球肥胖症的流行,非酒精性脂肪肝(NAFLD)已成为儿科人群中最常见的慢性肝病。有证据表明,产前和产后接触母体异常会导致发育程序的持续改变,从而增加小儿罹患非酒精性脂肪肝的风险。妊娠糖尿病(GDM)是一种高血糖综合征,已成为孕妇最常见的并发症。越来越多的流行病学调查和动物模型研究证实,在子宫内暴露于 GDM 后,会对后代产生不良和长期的影响。同样,GDM 也被认为是小儿非酒精性脂肪肝的重要危险因素。本综述旨在总结目前已发表的有关 GDM 对儿童和青少年时期后代非酒精性脂肪肝发展的诱导作用的研究。后代肝脏脂质代谢和肠道微生物群的失调以及胎盘功能障碍是 GDM 相关小儿非酒精性脂肪肝发病机制的潜在因素。此外,本综述还讨论了针对GDM相关后代非酒精性脂肪肝的潜在有效干预措施。然而,这些治疗方法中的大多数仍需要进一步的临床研究来验证。
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引用次数: 0
Laparoscopic anatomic segmentectomy S8: Indocyanine green fluorescence approach and Glissonean approach (with videos) 腹腔镜解剖节段切除术 S8:吲哚菁绿荧光方法和格利索内方法(附视频)
IF 3.3 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-12-30 DOI: 10.1016/j.hbpd.2023.12.005
Feng Gao, Jun-Jun Jia, Jun-Fang Deng, Zhou Shao, Shu-Sen Zheng
Abstract not available
无摘要
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引用次数: 0
Liver transplantation and liver resection as alternative treatments for primary hepatobiliary and secondary liver tumors: Competitors or allies? 肝移植作为原发性肝胆肿瘤和继发性肝肿瘤的替代治疗方法:竞争对手还是盟友?
IF 3.3 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-12-30 DOI: 10.1016/j.hbpd.2023.12.001
Jan Lerut
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Hepatobiliary & Pancreatic Diseases International
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