Xiang-qian Zhao

Comparison of percutaneous transhepatic biliary drainage and endoscopic biliary drainage in the management of malignant biliary tract obstruction: A meta‐analysis

To compare percutaneous transhepatic biliary drainage (PTBD) and endoscopic biliary drainage (EBD) for management of malignant biliary tract obstruction (MBTO).

Prognosis of ampullary cancer based on immunohistochemical type and expression of osteopontin

BackgroundAmpullary cancer (AC) was classified as pancreatobiliary, intestinal, or other subtype based on the expression of cytokeratin 7 (CK7) and cytokeratin 20 (CK20). We aimed to explore the association of AC subtype with patient prognosis.MethodsThe relationship of AC subtype and expression of Osteopontin (OPN) with the prognosis of 120 AC patients after pancreaticoduodenectomy was investigated.ResultsThe patients had pancreatobiliary (CK7+/CK20-, n = 24, 20%), intestinal (CK7-/CK20+, n = 29, 24.2%) or other (CK7+/CK20+ or CK7-/CK20-, n = 67, 55.8%) subtypes of AC, and their median survival times were 23 ± 4.2, 38 ± 2.8 and 64 ± 16.8 months, respectively. The survival times of 64 OPN- patients (53.3%) and 56 OPN+ patients (46.7%) were 69 ± 18.4 and 36 ± 1.3 months, respectively. There was no significant effect of AC subtype on survival of OPN- patients. For OPN+ patients, those with pancreatobiliary AC had a shorter survival time (22 ± 6.6 months) than those with intestinal AC (37 ± 1.4 months, p = 0.041), and other AC subtype (36 ± 0.9 months, p = 0.010); intestinal and other AC subtypes had similar survival times.ConclusionsThe prognosis of AC patients can be estimated based on immunohistochemical classification and OPN status.

Anticancer effect of xanthohumol induces growth inhibition and apoptosis of human liver cancer through NF-κB/p53-apoptosis signaling pathway

Xanthohumol may prevent and cure diabetes and atherosis, have oxidation resistance and antiviral function as well as anticancer effect preventing cancer cell metastasis. We investigate whether the anticancer effect of xanthohumol induces growth inhibition and apoptosis of human liver cancer through NF-κB/p53-apoptosis signaling pathway. Human liver cancer HepG2 cell were treated with 10, 20, 30 and 40 µM xanthohumol for 48 h. The present study showed that the anticancer effect of xanthohumol was effective in inhibiting proliferation and inducing apoptosis of human liver cancer HepG2 cells. Furthermore, the caspase-3 activity of human liver cancer HepG2 cells was increased by xanthohumol. In addition, 48-h treatment with xanthohumol suppressed NF-κB expression and promoted p53, cleaved PARP, AIF and cytochrome c expression and downregulated XIAP and Bcl-2/Bax expression in human liver cancer HepG2 cells. Therefore, the anticancer effect of xanthohumol induces growth inhibition and apoptosis of human liver cancer through the NF-κB/p53-apoptosis signaling pathway.

The effects of different preoperative biliary drainage methods on complications following pancreaticoduodenectomy.

AbstractThe objective of this study was to investigate the effects of different preoperative biliary drainage (PBD) methods on complications in jaundiced patients following pancreaticoduodenectomy. We retrospectively analyzed 270 extrahepatic bile duct cancer patients who underwent pancreaticoduodenectomy. A total of 170 patients without PBD treatment were defined as the non-PBD group. According to different PBD methods, 45, 18, and 37 patients were classified into the percutaneous transhepatic biliary drainage (PTBD), endoscopic nasobiliary drainage (ENBD), and endoscopic retrograde biliary stent (ERBS) groups, respectively. Clinical characteristics and complications were compared among the 4 groups.Preoperative cholangitis occurred in 14 (8.2%) and 8 (21.6%) patients in the non-PBD and ERBS group, respectively (P = 0.04). Compared with the non-PBD group, delayed gastric emptying (DGE) and wound infection occurred significantly more often in the ERBS group. The incidence of severe complications was significantly lower in the PTBD group than the non-PBD group (P = 0.03). Postoperative hospital stay and complication rates were significantly higher in the ERBS group than the PTBD group. There were no significant differences in complications between ENBD and other groups.In conclusion, PTBD can improve surgical outcomes by reducing severe complication rate in jaundiced patients following pancreaticoduodenectomy. ERBS increased the rates of DGE and wound infection due to high incidence of cholangitis before operative intervention and should be avoided. ENBD carried no special effect on complications and needs further analysis.

Laparoscopic radiofrequency ablation of solitary small hepatocellular carcinoma in the caudate lobe

OBJECTIVE Surgical resection in the treatment of hepatocellular carcinoma (HCC) originating in the caudate lobe is challenging because of its deep location in the liver and possibly worse prognosis. We evaluated the overall survival of patients with solitary caudate small HCC who underwent laparoscopic radiofrequency ablation (RFA). METHODS This is a retrospective study on patients who underwent laparoscopic RFA (RFA) for solitary small HCC. RESULTS Twenty-seven (27) patients underwent laparoscopic caudate lobe RFA for solitary small HCC. The average tumor size was 2.8 cm. The overall survival rates were 96.3%, 88.9%, 74.1%, 74.1% and 62.9% at 1, 2, 3, 4 and 5 years respectively. The disease-free survival after RFA was 92.6%, 52.9%, 44.4%, 33.3% and 33.3% at 1, 2, 3, 4 and 5 years respectively. Most common postoperative complication was pleural effusion (7/27, 25.9%), and followed by transient hemoglobinuria (2/27, 7.4%). CONCLUSIONS Laparoscopic RFA for caudate lobe small HCC is a safe and feasible procedure without perioperative mortality. Through a systematic review of other therapeutic options on caudate HCC, its overall outcome is comparable to that of surgical resection.

Agaricoglycerides Protect against Hepatic Ischemia/Reperfusion Injury by Attenuating Inflammatory Response, Oxidative Stress, and Expression of NF-κB

We have investigated the effects of agaricoglycerides (AG) in a mouse model of hepatic I/R injury. I/R triggered increases/changes in markers of liver injury, hepatic oxidative stress, tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and nuclear factor κB (NF-κB). AG significantly reduced the extent of liver inflammation and oxidative stress and also attenuated the NF-κB activation as well as TNF-α and IL-1β production. Our results indicate that AG may represent a novel protective strategy against I/R-induced injury and inflammatory diseases.

''One-Off'' Complete Radiofrequency Ablation for Hepatocellular Carcinoma in a ''High-Risk Location'' Adjacent to the Major Bile Duct and Hepatic Blood Vessel

Radiofrequency ablation (RFA) is an effective, minimally invasive treatment option for unresectable hepatocellular carcinomas (HCCs) located in high-risk areas or for patients with poor hepatic functional reserve. However, for tumors adjacent to major bile ducts and hepatic blood vessels, complete ablation is difficult to achieve for fear of causing a postoperative bile leak, bilioma or bile duct stenosis. Therefore, RFA is often combined with multiple alcohol injections to eliminate residual tumor tissues in adjacent bile duct or blood vessels; however, the injections directly affect the efficacy and prognosis of RFA. This study reports three successful “one-off” cases of complete ablation of HCCs adjacent to major bile ducts and blood vessels in neighboring hepatic segments or hepatic lobes, highlighting both the efficacy and safety of RFA for HCC tumors in these high-risk locations.

Prognostic factors for survival of patients with ampullary carcinoma after local resection

Local resection (LR) is a potentially effective alternative to pancreaticoduodenectomy for treatment of ampullary cancer, but the prognostic factors remain undefined. The purpose of this study was to identify the prognostic factors for ampullary cancer patients who had undergone LR.

Comparison between two types of local resection in the treatment of ampullary cancer

This study aims to compare the effects of two different local resection procedures on the prognosis of ampullary cancer.