Hepatobiliary Surgery: Recent Developments and Emerging Trends

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: 30 July 2024 | Viewed by 2174

Special Issue Editor


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Guest Editor
Department of General Surgery and Transplantation, Sheba Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Hashomer, Ramat-Gan 52621, Israel
Interests: hepato-pancreato-biliary surgery; abdominal transplant surgery; liver regenration; immune regulation; myeloid derived suppresor cells (MDSC); artificila intelegence in HPB and transplant surgery; molecular genetics; transcriptomics

Special Issue Information

Dear Colleagues,

The field of hepatobiliary surgery and liver transplantation has witnessed significant progress, with minimally invasive procedures, advanced imaging technologies, refined surgical techniques, and enhanced perioperative care contributing to improved outcomes. Our ability to surgically treat complex diseases in the liver, biliary system, and pancreas, is constantly expanding, accompanied by a growing range of indications for surgery and transplantation. Furthermore, procedures once exclusive to specialized referal center are now being performed in smaller HPB and transplant centers worldwide. Given these advancements, it is imperative to keep consolidating our knowledge and disseminate up-to-date information to ensure optimal patient outcomes.

To this end, I invite clinicians, researchers, and experts in HPB and liver transplantation to contribute their insights and research findings to a dedicated volume focused on the advancements in the field. This volume aims to create a platform for sharing expertise, discussing novel approaches, and fostering collaboration. Key topics of interest include the exploration of biomarkers and outcome prediction, advancements in complex liver and pancreas surgeries, and the development of innovative surgical techniques.

Dr. Niv Pencovich
Guest Editor

Manuscript Submission Information

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Keywords

  • liver resection
  • pancreatectomy
  • minimally invasive HPB and transplantation surgery
  • robotic surgery
  • translational HPB research
  • biomarkers in HPB and transplantation
  • outcome
  • prediction in HPB and transplantation
  • AI in HPB and transplantation

Published Papers (2 papers)

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Research

11 pages, 1434 KiB  
Article
Perioperative Platelet Count Ratio Predicts Long-Term Survival after Left Pancreatectomy and Splenectomy for Pancreatic Adenocarcinoma
by Ido Nachmany, Hallbera Gudmundsdottir, Hila Meiri, Pavel Eidelman, Ofir Ziv, Lior Bear, Nadav Nevo, Harel Jacoby, Rony Eshkenazy, Ron Pery and Niv Pencovich
J. Clin. Med. 2024, 13(4), 1050; https://doi.org/10.3390/jcm13041050 - 12 Feb 2024
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Abstract
Background: The value of platelet characteristics as a prognostic factor in patients with pancreatic adenocarcinoma (PDAC) remains unclear. Methods: We assessed the prognostic ability of post-splenectomy thrombocytosis in patients who underwent left pancreatectomy for PDAC. Perioperative platelet count ratio (PPR), defined as the [...] Read more.
Background: The value of platelet characteristics as a prognostic factor in patients with pancreatic adenocarcinoma (PDAC) remains unclear. Methods: We assessed the prognostic ability of post-splenectomy thrombocytosis in patients who underwent left pancreatectomy for PDAC. Perioperative platelet count ratio (PPR), defined as the ratio between the maximum platelet count during the first five days following surgery and the preoperative level, was assessed in relation to long-term outcomes in patients who underwent left pancreatectomy for PDAC between November 2008 and October 2022. Results: A comparative cohort of 245 patients who underwent pancreaticoduodenectomy for PDAC was also evaluated. The median PPR among 106 patients who underwent left pancreatectomy was 1.4 (IQR1.1, 1.8). Forty-six had a PPR ≥ 1.5 (median 1.9, IQR1.7, 2.4) and 60 had a PPR < 1.5 (median 1.2, IQR1.0, 1.3). Patients with a PPR ≥ 1.5 had increased median overall survival (OS) compared to patients with a PPR < 1.5 (40 months vs. 20 months, p < 0.001). In multivariate analysis, PPR < 1.5 remained a strong predictor of worse OS (HR 2.24, p = 0.008). Among patients who underwent pancreaticoduodenectomy, the median PPR was 1.1 (IQR1.0, 1.3), which was significantly lower compared to patients who underwent left pancreatectomy (p > 0.001) and did not predict OS. Conclusion: PPR is a biomarker for OS after left pancreatectomy for PDAC. Further studies are warranted to consolidate these findings. Full article
(This article belongs to the Special Issue Hepatobiliary Surgery: Recent Developments and Emerging Trends)
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19 pages, 2392 KiB  
Article
Pancreaticogastrostomy versus Pancreaticojejunostomy and the Proposal of a New Postoperative Pancreatic Fistula Risk Score
by Bogdan Mastalier, Victor Cauni, Constantin Tihon, Marius Septimiu Petrutescu, Bogdan Ghita, Valentin Popescu, Dan Andras, Ion Mircea Radu, Vasile Gabriel Vlasceanu, Marius Florian Floroiu, Cristian Draghici, Cristian Botezatu, Dragos Cretoiu, Valentin Nicolae Varlas and Angela Madalina Lazar
J. Clin. Med. 2023, 12(19), 6193; https://doi.org/10.3390/jcm12196193 - 25 Sep 2023
Cited by 1 | Viewed by 1134
Abstract
Despite the substantial decrease in mortality rates following a pancreaticoduodenectomy to less than 5%, morbidity rates remain significant, reaching even 73%. Postoperative pancreatic fistula is one of the most frequent major complications and is significantly associated with other complications, including patient death. Currently, [...] Read more.
Despite the substantial decrease in mortality rates following a pancreaticoduodenectomy to less than 5%, morbidity rates remain significant, reaching even 73%. Postoperative pancreatic fistula is one of the most frequent major complications and is significantly associated with other complications, including patient death. Currently, there is no consensus regarding the ideal type of pancreatic anastomosis, as the question of the choice between a pancreaticogastrostomy and pancreaticojejunostomy is still open. Furthermore, worldwide implementation of an ideal pancreatic fistula risk prediction score is missing. Our study found several significant predictive factors for the postoperative occurrence of fistulas, such as the soft consistency of the pancreas, non-dilated Wirsung duct, important intraoperative blood loss, other perioperative complications, preoperative patient hypoalbuminemia, and patient weight loss. Our study also revealed that for patients who exhibit fistula risk factors, pancreaticogastrostomy demonstrates a significantly lower pancreatic fistula rate than pancreaticojejunostomy. The occurrence of pancreatic fistulas has been significantly associated with the development of other postoperative major complications, and patient death. As the current pancreatic fistula risk scores proposed by various authors have not been consensually validated, we propose a simple, easy-to-use, and sensitive score for the risk prediction of postoperative pancreatic fistula occurrence based on important predictors from statistical analyses that have also been found to be significant by most of the reported studies. The new pancreatic fistula risk score proposed by us could be extremely useful for improved therapeutic management of cephalic pancreaticoduodenectomy patients. Full article
(This article belongs to the Special Issue Hepatobiliary Surgery: Recent Developments and Emerging Trends)
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