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New Advances in Hepato-Pancreato-Biliary (HPB) Surgery

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Dear Colleagues,

The treatment of malignant tumors located in the pancreas, the liver or the extrahepatic biliary tree requires an MDT approach. Surgery represents the only treatment option with curative intent. Recently, significant progress has been documented in regard to the operative and the oncological outcomes following various HPB procedures. However, we still have a long way to go and focused research on the field becomes of paramount importance.

We are pleased to invite you to contribute your valuable work to the Special Issue “New Advances in HPB surgery”. This Special Issue aims to highlight the most recent innovations in the management of patients with pancreatic, liver and biliary malignancies focusing especially on perioperative management and the operative / interventional outcomes.

We look forward to receiving your contributions.

Dr. Dimitrios Symeonidis
Prof. Dr. Dimitris Zacharoulis
Prof. Dr. Konstantinos Tepetes
Guest Editors

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12 pages, 9862 KiB

Open AccessArticle

Prognostic Value of Combined Neutrophil-to-Lymphocyte Ratio and Imaging Tumor Capsule in Solitary Hepatocellular Carcinoma Patients after Narrow-Margin Hepatectomy

by Desheng Chen, Pengjuan Mao, Chen Sun, Xuhui Fan, Qi Zhu, Zeping Chen, Zeping He, Yichao Lou and Hongcheng Sun

J. Clin. Med. 2024, 13(2), 351; https://doi.org/10.3390/jcm13020351 - 8 Jan 2024

Viewed by 1098

Abstract

Background: The study aimed to investigate the clinical value and prognostic patterns of the neutrophil-to-lymphocyte ratio (NLR) and imaging tumor capsule (ITC) in solitary hepatocellular carcinoma (HCC) patients undergoing narrow-margin hepatectomy. Methods: Data for solitary HCC patients treated with narrow-margin surgery were extracted from Shanghai General Hospital. Clinical features of recurrence-free survival (RFS), overall survival (OS), and early recurrence were investigated by Cox/logistic regression. The significant variables were subsequently incorporated into the nomogram pattern. Survival analysis stratified by NLR and ITC was also performed. Results: The study included a cohort of 222 patients, with median RFS and OS of 24.083 and 32.283 months, respectively. Both an NLR ≥ 2.80 and incomplete ITC had a significant impact on prognosis. NLR and ITC independently affected RFS and OS, whereas alpha-fetoprotein (AFP) and ITC were identified as independent factors for early relapse. The RFS and OS nomogram, generated based on the Cox model, demonstrated good performance in validation. The combination of NLR and ITC showed greater predictive accuracy for 5-year RFS and OS. Subgroups with an NLR ≥ 2.80 and incomplete ITC had the worst prognosis. Conclusions: Both NLR and ITC significantly affected RFS, OS, and early recurrence among solitary HCC patients who underwent narrow-margin hepatectomy. The combination of NLR and ITC has the potential to guide rational clinical treatment and determine the prognosis. Full article

(This article belongs to the Special Issue New Advances in Hepato-Pancreato-Biliary (HPB) Surgery)

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17 pages, 931 KiB

Open AccessSystematic Review

BILE: A Literature Review Based Novel Clinical Classification and Treatment Algorithm of Iatrogenic Bile Duct Injuries

by Dimitrios Symeonidis, Konstantinos Tepetes, George Tzovaras, Athina A. Samara and Dimitrios Zacharoulis

J. Clin. Med. 2023, 12(11), 3786; https://doi.org/10.3390/jcm12113786 - 31 May 2023

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Abstract

Purposes: The management of patients with iatrogenic bile duct injuries (IBDI) is a challenging field, often with dismal medico legal projections. Attempts to classify IBDI have been made repeatedly and the final results were either analytical and extensive but not useful in everyday clinical practice systems, or simple and user friendly but with limited clinical correspondence approaches. The purpose of the present review is to propose a novel, clinical classification system of IBDI by reviewing the relevant literature. Methods: A systematic literature review was conducted by performing bibliographic searches in the available electronic databases, including PubMed, Scopus, and the Cochrane Library. Results: Based on the literature results, we propose a five (5) stage (A, B, C, D and E) classification system for IBDI (BILE Classification). Each stage is correlated with the recommended and most appropriate treatment. Although the proposed classification scheme is clinically oriented, the anatomical correspondence of each IBDI stage has been incorporated as well, using the Strasberg classification. Conclusions: BILE classification represents a novel, simple, and dynamic in nature classification system of IBDI. The proposed classification focuses on the clinical consequences of IBDI and provides an action map that can appropriately guide the treatment plan. Full article

(This article belongs to the Special Issue New Advances in Hepato-Pancreato-Biliary (HPB) Surgery)

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