Prognostic Impact of HER2 Overexpression in Intraductal Papillary Neoplasm of the Bile Duct.

Background: Overexpression of human epidermal growth factor receptor 2 (HER2) is a recognized prognostic marker and therapeutic target in oncology. However, its clinical significance in intraductal papillary neoplasm of the bile duct (IPNB) remains unclear.

Methods: This retrospective study reviewed patients who underwent resection for IPNB between 1998 and 2011.

Close correlation between patients' positive mood and postoperative complication burden in hepato-biliary-pancreatic cancer: a prospective comparative cohort trial.

Background: The impact of preoperative mood on complications remains poorly understood in hepato-biliary-pancreatic (HBP) surgery.

Methods: This prospective cohort study included patients who underwent resection for pancreatic ductal carcinoma and cholangiocarcinoma. Preoperative positive mood were measured by Vigor-Activity score according to Profile of Mood States, 2nd edition.

Durvalumab-combined chemotherapy for biliary tract cancer in a Japanese expert center: initial 50 cases in daily practice.

Combination regimen consisting of gemcitabine, cisplatin, and durvalumab (GCD) has been employed for unresectable biliary tract cancer (BTC) since the end of 2022 in Japan. Here, we summarize our experience with GCD to demonstrate the clinical outcomes in a practical setting. Patients who underwent GCD for unresectable/recurrent BTC between January and December 2023 were investigated retrospectively.

Delayed Laparoscopic Cholecystectomy With Fluorescent Cholangiography for Acute Cholecystitis: Is It Safe?

Background: According to the Tokyo Guidelines 2018 (TG-18), delayed laparoscopic cholecystectomy (DLC) after recovering from acute cholecystitis (AC) is recommended for patients with poor status. Moreover, DLC for patients with good status remains controversial, and TG-18 does not include clinical questions regarding fluorescent cholangiography (FC). In this study, we evaluated the clinical value and safety of FC during DLC.

Pathological Complete Response after Pembrolizumab Treatment for Unresectable Perihilar Cholangiocarcinoma with High Microsatellite Instability: A Case Report.

Introduction: Pembrolizumab has been introduced to solid cancers with microsatellite instability (MSI)-high cases; however, its clinical experience for cholangiocarcinoma remains very limited. Here, we present a case who successfully underwent conversion surgery following pembrolizumab treatment for MSI-high perihilar cholangiocarcinoma, which pathologically exhibited complete response.

Case Presentation: A 69-year-old male with Bismuth IV perihilar cholangiocarcinoma with bulky lymphadenopathy was referred, who initially required left hepatic trisectionectomy, caudate lobectomy, bile duct resection, and portal vein resection and reconstruction (H123458-B-PV).

Clinical and Medical Economic Value of Screening Colonoscopy before Laparoscopic Cholecystectomy.

Objective: Clinical value of screening colonoscopy (SC) has been widely accepted; however, its clinical utility remains controversial in patients who undergo laparoscopic cholecystectomy (LC). The aim of this study was to evaluate the clinical value of medical care costs for SC before LC.

Subject And Methods: Of the 509 patients who underwent LC, 335 underwent preoperative SC before LC.

Prognostic impact of preoperative cachexia in patients undergoing major hepatopancreatobiliary surgery for malignancy.

Background & Aims: Data regarding the association between cachexia and clinical outcomes in hepatopancreatobiliary (HPB) malignancies are limited. This retrospective study sought to investigate the prognostic significance of preoperative cachexia in patients undergoing major HPB surgery for malignancies.

Methods: Data from patients, who underwent major open surgery for HPB malignancies between March 2014 and December 2018, were retrospectively reviewed.

Accumulating Genetic Mutations from Primary to Secondary Biliary Tract Cancers: Analysis of Four Patients With Metachronous Biliary Tract Cancer Using Comprehensive Genomic Profiling.

Background/aim: Metachronous biliary tract cancer (BTC) is a rare occurrence after curative resection of primary BTC. The genetic alterations and pathogenesis associated with metachronous BTC remain poorly understood.

Patients And Methods: We analyzed four patients with metachronous BTC who underwent resection at the Nagoya University Hospital between 2010 and 2024.

New Tumor Classification Using Invasion Depth in Biliary Tract Cancer Around the Cystic Duct Junction.

Objective: To propose a shared T classification system for biliary cancers located around the cystic duct junction.

Summary Background Data: These cancers include perihilar cholangiocarcinoma (PCC), distal cholangiocarcinoma (DCC), and cystic duct carcinoma (CDC), which are staged according to discrete tumor classification.

Methods: From 2011 to 2019, patients with biliary cancers that clinically invaded the junction (junctional cholangiocarcinoma [JCC] ) were classified as having PCC, DCC, CDC, or unclassifiable tumor (UT) based on topologic predominance.

Reappraisal of carcinoma in situ residue at the bile duct margin: a single-center review of 681 patients with perihilar cholangiocarcinoma.

Background: A histologically involved surgical margin (R1) is often observed after resection for cholangiocarcinoma. Compared with a negative margin (R0), R1 with invasive carcinoma (R1inv) markedly worsens survival, whereas the prognostic effect of R1 with carcinoma in situ (R1cis) remains controversial.

Methods: Patients who underwent resection for perihilar cholangiocarcinoma between 2002 and 2019 were retrospectively reviewed.

Application of fluorescent cholangiography to complex biliary variants of the confluence of the cystic duct and the infraportal type of the left lateral bile duct during single-incision laparoscopic cholecystectomy: A case report.

A 21-year-old man was diagnosed with segmental adenomyomatosis of the gallbladder based on ultrasonography and computed tomography images. Computed tomography with drip infusion cholangiography revealed that the cystic duct joined the infraportal type of the left lateral bile duct (IPLLBD), which runs caudal to the umbilical portion, and that the left medial bile duct joined the right hepatic duct without forming the left hepatic duct. We planned a single-incision laparoscopic cholecystectomy with fluorescent cholangiography.

Risk factors for recurrent biliary obstruction following suprapapillary placement of a plastic stent as preoperative biliary drainage for perihilar biliary malignancy.

Background/purpose: The usefulness of endoscopic biliary stenting by deploying a plastic stent suprapapillary, called inside-stent (IS) placement, as preoperative biliary drainage (PBD) for perihilar biliary malignancy (PHBM) has been demonstrated. This study investigated risk factors for recurrent biliary obstruction (RBO) after IS placement.

Methods: Consecutive patients with potentially resectable PHBM treated with IS placement as PBD between 2017 and 2023 at Nagoya University Hospital were retrospectively reviewed.

TLK1 Inhibition Enhances the Anticancer Effect of Deep UV Irradiation Through CHK1 Activation.

Background/aim: A deep ultraviolet (DUV) light-emitting diode (LED) is a device that can irradiate electromagnetic waves from 250 nm to 350 nm. Tousled-like kinase 1 (TLK1) encodes a nuclear serine/threonine kinase, which is thought to influence the effects of DUV irradiation in cancer. The aim of this study was to clarify the interaction of TLK1 with DUV irradiation-induced DNA damage in cancer cells.

Trefoil factor 1 suppresses stemness and enhances chemosensitivity of pancreatic cancer.

Background And Aims: Pancreatic cancer is one of the most lethal malignancies, partly due to resistance to conventional chemotherapy. The chemoresistance of malignant tumors is associated with epithelial-mesenchymal transition (EMT) and the stemness of cancer cells. The aim of this study is to investigate the availability and functional mechanisms of trefoil factor family 1 (TFF1), a tumor-suppressive protein in pancreatic carcinogenesis, to treat pancreatic cancer.

A clinical assessment of three-dimensional-printed liver model navigation for thrice or more repeated hepatectomy based on a conversation analysis.

Purposes: We performed a conversation analysis of the speech conducted among the surgical team during three-dimensional (3D)-printed liver model navigation for thrice or more repeated hepatectomy (TMRH).

Methods: Seventeen patients underwent 3D-printed liver navigation surgery for TMRH. After transcription of the utterances recorded during surgery, the transcribed utterances were coded by the utterer, utterance object, utterance content, sensor, and surgical process during conversation.

Intraductal papillary neoplasms of the bile ducts: a comparative study of a rare disease in Europe and Nagoya, Japan.

Background: Intraductal papillary neoplasm of the bile ducts (IPNB) is a rare disease in Western countries. The aim of this study was to compare tumor characteristics, management strategies, and outcomes between Western and Eastern patients who underwent surgical resection for IPNB.

Methods: A multi-institutional retrospective series of patients with IPNB undergoing surgery between January 2010 and December 2020 was gathered under the auspices of the European-African Hepato-Pancreato-Biliary Association (E-AHPBA), and at Nagoya University Hospital, Japan.

Utility of modified pancreaticoduodenectomy (Hi-cut PD) for middle-third cholangiocarcinoma: an alternative to hepatopancreaticoduodenectomy.

Background: The standard procedure for middle-third cholangiocarcinoma (MCC) is pancreaticoduodenectomy (PD); hepatopancreaticoduodenectomy (HPD) is often performed despite its high risk. There is no clear selection guidance for these procedures.

Methods: Patients with MCC who underwent HPD or PD were retrospectively evaluated.

Liver remnant volume to body weight ratio of 0.65% as a lower limit in right hepatic trisectionectomy with bile duct resection.

Background: Previous studies have suggested the utility of an indocyanine green plasma clearance rate of the future liver remnant (FLR) (ICGK-F) ≥0.05 in hepatobiliary resection to reduce the surgical risk. The present study aimed to verify whether future liver remnant size rather than ICGK-F matters in extended hepatobiliary resection.

Standard versus delayed initiation of S-1 adjuvant chemotherapy after surgery for pancreatic cancer: a secondary analysis of a nationwide cohort by the Japan Pancreas Society.

Background: Based on the Japan Adjuvant Study Group of Pancreatic Cancer-01 results, S-1 adjuvant chemotherapy has been the standard in resected pancreatic ductal adenocarcinoma (PDAC) patients in Japan and elsewhere, initiated within 10 weeks after surgery. To assess the clinical impact of this timing, we conducted a secondary analysis of a nationwide survey by the Japan Pancreas Society.

Methods: A total of 3361 patients were divided into two groups: 2681 (79.

Clinical value of fluorescent cholangiography for the infraportal type of right posterior bile duct.

Background: The infraportal type of the right posterior bile duct (infraportal RPBD) is a well-known anatomical variation that increases the potential risk of intraoperative biliary injury. The aim of this study is to clarify the clinical value of fluorescent cholangiography during single-incision laparoscopic cholecystectomy (SILC) for patients with infraportal RPBD.

Material And Methods: Our procedure for SILC utilized the SILS-Port, and another 5-mm forceps was inserted an umbilical incision.

Two-step arterial reconstruction technique for en bloc resection of a large retroperitoneal liposarcoma involving the common iliac artery.

Retroperitoneal liposarcoma (RPLS) is a rare but challenging neoplasm, which is frequently associated with iliac vessel invasion. We describe how we used a two-step arterial reconstruction technique to perform en bloc resection of a large RPLS involving the iliac arteries in three patients. A temporal long in situ graft bypass was established using a prosthetic vascular graft during dissection of the tumor.

The Goal of Intraoperative Blood Loss in Major Hepatobiliary Resection for Perihilar Cholangiocarcinoma: Saving Patients From a Heavy Complication Burden.

Objective: To determine the goal of intraoperative blood loss in hepatectomy for perihilar cholangiocarcinoma.

Background: Although massive bleeding can negatively affect the postoperative course, the target value of intraoperative bleeding to reduce its adverse impact is unknown.

Methods: Patients who underwent major hepatectomy for perihilar cholangiocarcinoma between 2010 and 2019 were included.