Journal of Hepatology ’s Post

🎉 New Publication 🎉 We’re excited to share our latest manuscript published in Langenbeck's Archives of Surgery, showing that our in-development stage TriVerity Classifier (version IMX-BVN-3b) identified bacterial infections in liver transplant patients earlier than routine biomarkers.     We look forward to conducting more studies to demonstrate the ability of our host-response classifiers to rapidly and accurately identify infections in liver transplant and other immunocompromised patients as early as possible. If successful, this would provide medical professionals with important information to enhance treatment decision making. 📚 Read the full publication: [https://lnkd.in/ewe9J5bP] Follow us to stay updated on more innovative research! #HealthcareInnovation #Diagnostics #LiverTransplant #Immunocompromised #Inflammatix #MedicalResearch #PatientCare

Hepatectomy: A Vital Procedure Against Liver Tumors Hepatectomy, a crucial surgical intervention, removes portions of the diseased liver, saving human lives by treating various liver disorders This surgical procedure involves partial or complete resection of the liver, depending on the severity and extent of the disease. Its primary purpose is to treat benign and malignant liver tumors, providing a valid therapeutic solution. When

📃Scientific paper: The Role of Preoperative Inflammatory Markers in Pancreatectomy: a Norwegian Nationwide Cohort Study Abstract: Background and purpose Preoperative inflammatory markers, such as Glasgow prognostic score, modified Glasgow prognostic score and C-reactive protein to albumin ratio, were shown to be associated with prognosis in patients undergoing pancreatectomy for cancer. However, little is known about their predictive role in a Western population. Methods The Norwegian National Registry for Gastrointestinal Surgery (NORGAST) was used to capture all pancreatectomies performed within the study period (November 2015—April 2021). The association between the preoperative inflammatory markers and postoperative outcomes was studied. Their impact on survival was examined in patients operated for pancreatic ductal adenocarcinoma. Results A total of 1554 patients underwent pancreatectomy in this period. Glasgow prognostic score, modified Glasgow prognostic score and C-reactive protein to albumin ratio were associated with severe complications (Accordion grade ≥ III) in the univariable but not in the multivariable analysis. C-reactive protein to albumin ratio, but not Glasgow prognostic score and modified Glasgow prognostic score, was linked to survival following pancreatectomy for ductal adenocarcinoma. In the multivariable model, age, neoadjuvant chemotherapy, ECOG score, C-reactive protein to albumin ratio and total pancreatectomy correlated with survival. Also, preoperative C-reactive protein to albumin ratio was significantly associated with survival after pancreatoduodenectomy. Co... Continued on ES/IODE ➡️ https://etcse.fr/E1UM ------- If you find this interesting, feel free to follow, comment and share. We need your help to enhance our visibility, so that our platform continues to serve you.

Anatomic hepatectomy based on portal vein region (PT) and edge priority (MPT-AR) maximizes the removal of PT liver tissue while providing sufficient surgical margin to enable rapid treatment and perioperative recovery of hepatocellular carcinoma. https://ja.ma/3yXcjqZ

The long-term efficacy of imatinib with hepatic resection or other local treatment for gastrointestinal stromal tumours liver metastases: a retrospective cohort study International Journal of Surgery 110(4):p 2151-2161, April 2024. Background: The liver is the most common site of metastasis from gastrointestinal stromal tumors (GISTs). The authors aimed to evaluate imatinib (IM) combined with hepatic resection (HR) or other local treatments such as radiofrequency ablation (RFA) and transarterial chemoembolization (TACE), compared to IM monotherapy in long-term survival benefits in patients suffering from GIST liver metastases. Methods: Our research encompassed 238 patients diagnosed with liver metastases of GISTs from January 2002 to April 2022 at the First Affiliated Hospital of Sun Yat-Sen University. The oncological outcomes of concern included overall survival (OS), progression-free survival (PFS), and liver-specific PFS. Results: Of all 238 patients, 126 were treated with IM alone (IM group), 81 with IM combined with HR (IM+HR group), and 31 with IM combined with RFA/TACE (IM+RFA/TACE group). The median follow-up time was 44.83 months. The median OS in the IM group was 132.60 months and was not reached in either the IM+HR group or the IM+RFA/TACE group. The 10-year OS rate in the IM+HR group was significantly superior to the IM group and the IM+RFA/TACE group (91.9% vs. 61.1% vs. 55.2%, respectively, P=0.015), and the liver-specific PFS (P=0.642) and PFS (P=0.369) in the three groups showed a beneficial trend in the combined treatment group. Multivariate analyses showed that age less than or equal to 60 years (HR 0.280, P<0.001) and IM+HR (HR 0.361, P=0.047) were independently associated with better OS. Achieving no evidence of disease through surgical intervention was independently correlated with enhanced OS (HR 0.099, P=0.034), liver-specific PFS (HR 0.388, P=0.014), and PFS (HR 0.402, P=0.004). Conclusions: In patients with GIST liver metastases, IM combined with HR might improve OS in selected patients compared with IM alone and IM combined with RFA/TACE. Achieving no evidence of disease status with surgical treatment of patients results in significant prolonging of OS, liver-specific PFS, and PFS.

Cornea Update: Clinical Outcomes and Indications of In-Office Sutureless Dried Gamma Ray-Sterilized Human Amniotic Membrane Transplantation With Bandage Contact Lenses in Various Ocular Surface Disorders: Purpose: The purpose of this study was to investigate the efficacy and indications of using dried gamma ray-sterilized amniotic membrane (AM) transplantation with bandage contact lenses for the in-office sutureless treatment of various ocular surface diseases. Methods: This study retrospectively included 56 eyes of 52 patients with various ocular surface diseases treated with sutureless dehydrated AM-assisted therapeutic contact lenses. The patients were followed up and assessed 1, 2, and 4 weeks after the treatment, and the therapeutic contact lenses were removed after 1 or 2 weeks. The size of the corneal lesion and the degree of pain experienced by each patient before and after the procedure were measured. Corneal re-epithelization rate and clinical aspects related to re-epithelialization were evaluated. Results: Complete corneal re-epithelialization of the epithelial defect was observed in 40 eyes. The complete re-epithelialization rates of persistent epithelial defect caused by infectious ulcers, neurotrophic ulcers, ulcers due to burn, toxic keratopathy, previous penetrating keratoplasty or other corneal surgeries, and severe dry eye disease were 69.2%, 80.0%, 77.8%, 100%, 75.0%, and 100%, respectively. Five patients with uncontrolled infectious ulcers, neurotrophic ulcer, bullous keratopathy, and ulcers associated with rheumatic disease did not show significant improvement. Patient pain scores significantly decreased after the procedure. Conclusions: Dehydrated AM transplantation with a bandage contact lens is minimally invasive and easily applicable through in-office procedures. This approach is expected to be more actively applied in various ocular surface disorders, not only in severe corneal diseases but also in relatively mild corneal surface diseases. http://dlvr.it/T3Tql0 #Cornea #Ophthalmology #Ophthotwitter

Statins, metformin, and aspirin have been reported to reduce the incidence of hepatocellular carcinoma (HCC). However, the effect of their perioperative use on survival outcomes of HCC patients following curative liver resection still remains unclear. In our study, 353 patients with a first diagnosis of HCC who underwent curative liver resection were included. Propensity score matching analysis with a users: nonusers ratio of 1:2 were performed for each of the medications (statins, metformin, and aspirin). Overall survival (OS) and recurrence-free survival (RFS) were evaluated and multivariable Cox proportional hazard analysis was performed. In our study, 62 patients received statins, 48 patients used metformin, and 53 patients received aspirin for ≥90 days before surgery. None of the medications improved OS. RFS of statin users was significantly longer than that of nonusers (p = 0.021) in the matched cohort. Users of hydrophilic statins, but not lipophilic ones had a significantly longer RFS than nonusers. Multivariable analysis showed that statin use significantly improved RFS (hazard ratio [HR]: 0.41, 95% confidence interval [CI]: 0.17–0.97, p = 0.044). No difference was seen in RFS between metformin users and nonusers. Among patients with diabetes, RFS was nonsignificantly longer in metformin users than in non-metformin users (84.1% vs. 60.85%, p = 0.069) in the matched cohort. No difference in postoperative RFS was seen between aspirin users and nonusers. Therefore, we concluded that preoperative use of statins in patients with HCC can increase RFS after curative liver resection, but metformin and aspirin were not associated with improved survival. Randomized controlled trials are needed to confirm the findings of the present study. The results of our study are now available in the Cancer medicine journal at the following link: https://lnkd.in/ep7nQQ9p #HCC #Surgery #Hepatology #Statin #Aspirin #Metformin #Hepatectomy #Liverresection #Liver_resection #survival #recurrence #liver

The link between high factor VIII to protein C ratio values and poor liver function after major hepatectomy Our goal was to assess the coagulation profile in the immediate postoperative time after major liver surgery and its association with the liver function. Our hypothesis is that a decreased synthesis of the coagulation factor levels reflects an impaired liver synthesis following hepatic resection and will be associated with poor outcomes. This is a prospective, observational study recruiting consecutive patients scheduled for major liver resection in a tertiary hospital. Coagulation profile was assessed by conventional assays, viscoelastic assays and coagulation factor levels preoperatively and, on postoperative days 1, 2 and 6. Factor VIII to protein C (FVIII/PC) ratio has been used as a surrogate marker of hemostatic imbalance. Liver function was measured with conventional and indocyanine green (ICG) clearance tests, which were obtained preoperatively and on postoperative days 1 and 2. Sixty patients were recruited and 51 were included in the study. There is a clear increase in FVIII/PC ratio after surgery, which was significantly associated with low liver function, being more pronounced beyond postoperative day 2 and in patients with poorer liver function (P < 0.001). High FVIII/PC ratio values were significantly associated with higher postoperative morbidity, prolonged ICU and hospital stay and less survival (P < 0.05). High FVIII/PC ratio on postoperative day 2 was found to be predictor of posthepatectomy liver failure (PHLF; area under the ROC curve = 0.8129). Early postoperative high FVIII/PC ratio values are associated with low liver function, PHLF and poorer outcomes in patients undergoing major hepatic resection. Trial registration: ClinicalTrials.gov NCT00281353 . #clinicaltrial #liverfunction #hepatectomy #icg #indocyaninegreen #verdye #diagnosticgreen

ENW-XS grant awarded to Dr. Kaushal Parikh Enhancing Crohn’s Disease Surveillance through microbiome analyses of blood Crohn’s disease (CD) is a chronic inflammatory bowel disorder affecting millions worldwide. It often necessitates surgical interventions to manage its complications. A common surgical procedure for Crohn’s Disease is ileocecal resection (ICR), where damaged portions of the intestine are removed via surgery. However, one of the primary challenges in treating Crohn’s Disease is its tendency to recur after surgery. Up to 35% of patients experience recurrence. Current guidelines recommend starting preventive medication for high-risk patients. However, identifying these patients remains elusive due to the scarcity of reliable predictive markers. A recent study by Poore et al published in the journal Nature demonstrated the feasibility of discriminating healthy cancer-free individuals from patients with multiple types of cancer using only plasma-derived, cell-free microbial nucleic acids. Therefore, in this pilot project, a similar strategy will be used to systematically explore if microbial nucleic acids can serve as potential biomarkers for Crohn’s Disease recurrence. Through metagenomic next-generation sequencing of patient plasma, we aim to shed light on this uncharted territory. Our goal is to open new avenues for predicting and preventing disease recurrence after surgery. This project is supported by a 50,000 Eur ENW-XS grant from the NWO awarded Dr. Kaushal Parikh. It will be conducted with the collaborative support of Dr. Annemarie de Vries and the IBD clinical team at the department of Gastroenterology & Hepatology. Additionally, we extend our appreciation to the RDO for their invaluable guidance in securing funding for this critical initiative.

Laparoscopically Limited Anatomic Liver Resections: A Single-Center Analysis for Oncologic Outcomes of the Conceptual Procedure Background: Limited anatomic resections (LARs), such as segmentectomies, performed using a fully laparoscopic approach, have gained popularity for liver malignancies. However, the oncologic efficacy of laparoscopic LARs (Lap-LARs) needs further investigation. This cohort study evaluated the oncologic outcomes of Lap-LAR for hepatocellular carcinoma (HCC) and colorectal liver metastasis (CRLM). At a Japanese referral center, 112 patients underwent Lap-LAR using the Glissonean approach and indocyanine green (ICG) fluorescence navigation. Recurrence-free survival (RFS), overall survival (OS), time to interventional failure (TIF), and time to surgical failure (TSF) were assessed. Results: Among the 112 patients (median age, 74 years [range, 66-80 years]; 80 men [71.4 %]), Lap-LAR showed promising results. The median operative time was 348 min (range, 280-460 min), and the median blood loss was 190 mL (range, 95.5-452.0 mL). Lap-LAR showed favorable oncologic outcomes for HCC and CRLM. Its precise technique makes it a promising therapeutic option for liver malignancies. Further comparisons with conventional approaches are warranted. https://lnkd.in/e_ywtXeU #ICG #indocyaninegreen #GuidedSurgery #surgery #surgeons #imaging #fluorescent #fluorescence #thinkgreen #oncology #laparoscopicsurgery #patientsafety