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Biomedicines
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Next-Generation Approaches to Hepatobiliary Disorders
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Next-Generation Approaches to Hepatobiliary Disorders

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: 30 September 2026 | Viewed by 2223

Editor

Dr. Lorenzo Petagna

E-Mail Website
Guest Editor
Division of Hepatic Surgery and Liver Transplantation, Azienda Ospedaliera Universitaria Pisana, 56124 Pisa, Italy
Interests: liver transplantation; multiorgan donors; perfusion machines; HPB surgery; minimally invasive liver surgery; new technologies and advances in liver transplantation and HPB surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue, “Next-Generation Approaches to Hepatobiliary Disorders”, aims to explore the rapid evolution of multidisciplinary care management in hepatobiliary disorders.

This Special Issue primarily aims to address the latest clinical and scientific advances in hepatobiliary diseases, focusing on innovations that could transform patient care. The management of these disorders has become multidisciplinary and multimodal, with interventional radiology and advanced endoscopy being integrated with laboratory diagnostics, molecular research, and translational studies, thus refining diagnostic and therapeutic strategies across the spectrum of hepatobiliary disorders. The convergence of these technologies not only enhances precision and reduces invasiveness but also facilitates the timing of and approach to treatment, allowing for earlier interventions and improved outcomes.

Liver transplantation is also undergoing significant advancements: new indications for transplantation are emerging alongside efforts to expand donor pools. While the implementation of DCD and perfusion machines is crucial, more work should be conducted to develop biomarkers for viability.

We welcome contributions from clinicians and researchers that explore these transformations in hepatobiliary disorders, hoping to provide novel insights and practical advances in this field.

Dr. Lorenzo Petagna
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Biomedicines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • hepatobiliary disorders
  • interventional radiology
  • interventional endoscopy
  • advances in HPB surgery
  • advances in liver transplantation
  • liver transplant viability biomarkers

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Published Papers (2 papers)

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Research

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9 pages, 3073 KB  
Article
Trans-Gastric Versus Trans-Duodenal Endoscopic Ultrasound-Guided Gallbladder Drainage: Which Is the Optimal Access Route?
by Serena Stigliano, Claudia Marinaccio, Benedetto Neri, Nicolò Citterio, Marta Pettinelli, Dario Biasutto and Francesco Maria Di Matteo
Biomedicines 2026, 14(7), 1429; https://doi.org/10.3390/biomedicines14071429 - 24 Jun 2026
Viewed by 285
Abstract
Background/Objectives: Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) with Lumen-Apposing Metal Stent (LAMS) is an established option for high-surgical-risk patients, with high technical and clinical success. Indications include acute cholecystitis and palliation of jaundice in malignant distal biliary obstruction (MDBO). Both trans-gastric and trans-duodenal [...] Read more.
Background/Objectives: Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) with Lumen-Apposing Metal Stent (LAMS) is an established option for high-surgical-risk patients, with high technical and clinical success. Indications include acute cholecystitis and palliation of jaundice in malignant distal biliary obstruction (MDBO). Both trans-gastric and trans-duodenal approaches are used, but the optimal route remains debated. The aim of the study was to compare trans-gastric and trans-duodenal access in terms of technical success, adverse events, readmissions, and reinterventions. Methods: We implemented a single-centre retrospective study of consecutive EUS-GBD procedures with LAMS at a tertiary endoscopy unit (January 2020–January 2026). Demographic, clinical, and procedural data were analyzed using appropriate statistical tests. Results: Seventy patients were included (51.4% male; mean age 77 ± 12 years). Indications were acute cholecystitis (64.3%) and MDBO (35.7%). Trans-gastric access was used in 48.5% of cases. A Hot-Axios LAMS was deployed in 77.2% of cases, mostly >10 mm. Technical success was achieved in 98.5% of cases. Naso-cystic drainage (NCD) was used through the LAMS in 47.1% of patients, while a double pig-tail plastic stent was used in 7.2% of patients. Adverse events were rare (1.4% misdeployment). LAMS obstruction occurred in 10% of patients, with reintervention required in 12.8% of patients. No differences were found between access routes in indication, technical success, LAMS type/size, or adjunctive drainage. However, trans-gastric access was associated with a higher reintervention rate (p = 0.01). Conclusions: EUS-GBD is a safe and effective procedure. While both approaches are comparable in most outcomes, the trans-gastric route may carry a higher risk of reintervention and should be avoided when alternative access is feasible. Full article
(This article belongs to the Special Issue Next-Generation Approaches to Hepatobiliary Disorders)
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Review

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15 pages, 501 KB  
Review
Endobariatric Management of Metabolic Dysfunction-Associated Steatotic Liver Disease: A Narrative Review
by Muaaz Masood, Reem Z. Sharaiha, Asma Siddique, Shanley Deal and Richard A. Kozarek
Biomedicines 2026, 14(2), 345; https://doi.org/10.3390/biomedicines14020345 - 2 Feb 2026
Viewed by 1478
Abstract
As the rates of type 2 diabetes and obesity have increased globally, the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD), previously termed non-alcoholic steatotic fatty liver disease (NAFLD), has risen concomitantly worldwide. MASLD is now the most common etiology of chronic liver [...] Read more.
As the rates of type 2 diabetes and obesity have increased globally, the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD), previously termed non-alcoholic steatotic fatty liver disease (NAFLD), has risen concomitantly worldwide. MASLD is now the most common etiology of chronic liver disease and is the leading indication for liver transplantation in the United States. Patients with MASLD have an increased risk of progression to metabolic dysfunction-associated steatohepatitis (MASH), cirrhosis, hepatocellular carcinoma, extrahepatic malignancies, as well as liver- and cardiovascular-related mortality. Diet and lifestyle modifications with a goal of ≥10% total body weight loss—required to reverse steatosis, steatohepatitis, and fibrosis—are often challenging and ineffective. Although novel pharmacotherapies have recently been approved and others are in development, cost, adherence, and adverse effects remain potential limitations. Bariatric surgery, including Roux-en-Y gastric bypass and sleeve gastrectomy, is highly efficacious and a cost-effective treatment for obesity and associated medical problems. However, bariatric surgery may be associated with morbidity and mortality. Endoscopic bariatric and metabolic therapy (EBMT) has recently emerged as a promising treatment modality and offers an alternative to surgery. Primary EBMTs include intragastric balloon placement, aspiration therapy, endoscopic sleeve gastroplasty, duodenal mucosal resurfacing, duodenal–jejunal bypass liner, and primary obesity surgery endoluminal (POSE 2.0). Secondary EBMTs include transoral outlet reduction, argon plasma coagulation of the anastomosis, and revisional endoscopic sleeve procedure. We review the recent literature on primary EBMTs and secondary EBMTs for the treatment of obesity and MASLD, the pathophysiologic mechanisms, efficacy, safety, and patient outcomes in MASLD in this narrative review. Full article
(This article belongs to the Special Issue Next-Generation Approaches to Hepatobiliary Disorders)
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