Hepatocellular carcinoma (HCC) occurs in nearly three-quarters of all primary liver cancers, with the majority not amenable to curative therapies. We therefore aimed to re-evaluate the safety, efficacy, and survival benefits of treating patients with drug-eluting beads transcatheter arterial chemoembolization (DEB-TACE) compared to the conventional transcatheter arterial chemoembolization (C-TACE). Several databases were searched with a strict eligibility criterion for studies reporting on adult patients with unresectable or recurrent HCC. The pooled analysis included 34 studies involving 4841 HCC patients with a median follow-up of 1.5 to 18 months. There were no significant differences between DEB-TACE and C-TACE with regard to complete response, partial response and disease stability. However, disease control (OR: 1.42 (95% CI (1.03,1.96) and objective response (OR: 1.33 (95% CI (0.99, 1.79) were significantly more effective for DEB-TACE treatment with fewer severe complications and all-cause mortality. The pooled-analysis did not find superiority of DEB-TACE in complete or partial response, disease stability, controlling disease progression, and 30 day or end-mortality. However, results showed that DEB-TACE is associated with a better objective response, disease control, and lower all-cause mortality with severe complications compared to C-TACE treatment. Given that the safety outcomes are based on limited studies with a potential for bias, there was no clear improvement of DEB-TACE over C-TACE treatment.

Background & Aims: The accurate, noninvasive assessment of hepatic steatosis is essential in living liver donor evaluation, where disease prevalence is low, and donor safety is paramount. This study evaluated commonly used noninvasive diagnostic tools for detecting hepatic steatosis in a real-world donor screening setting. Methods: We analyzed 108 living liver donor candidates (18–53 years) with complete MRI, CT, transient elastography (FibroScan^®), and biochemical data obtained during routine donor evaluation. Hepatic steatosis was defined as an MRI-proton density fat fraction (PDFF) ≥5%, which served as the noninvasive reference standard. Diagnostic performance metrics, receiver operating characteristic (ROC) analyses, and correlations with serum fibrosis indices (FIB-4 and APRI) were assessed. Results: MRI-PDFF identified hepatic steatosis in 21 donors (19.4%). Controlled attenuation parameter (CAP), measured by transient elastography, demonstrated high sensitivity (90.5%) and negative predictive value (97.1%), supporting its role as a rule-out screening tool. CT showed excellent specificity (97.7%) but lower sensitivity (61.9%), consistent with a confirmatory role when MRI is unavailable. Serum fibrosis indices were generally low and did not correlate strongly with imaging-based steatosis. Conclusions: In the low-prevalence setting of living liver donor evaluation, CAP-based transient elastography provides effective noninvasive screening for hepatic steatosis, while MRI-PDFF serves as a confirmatory reference when indicated. These findings support a stepwise, clinically practical diagnostic approach that prioritizes donor safety and workflow efficiency.

Background and Clinical Significance: Biliary tract injuries, a known complication of laparoscopic cholecystectomy can lead to bile leaks, strictures, or fistulas if not addressed promptly. This report describes the use of a biodegradable biliary stent for managing a complex biliary injury and evaluates its outcomes in a Saudi patient. Case Report: A 58-year-old man sustained a Strasberg E1 biliary injury during laparoscopic cholecystectomy, initially misdiagnosed as a minor bile leak. Upon referral, he presented with a large biloma (78 × 52 mm) and sepsis. Endoscopic retrograde cholangio-pancreatography (ERCP) with plastic stent placement and percutaneous drainage resolved the leak, but a severe ductal stricture persisted. A biodegradable biliary stent was deployed, achieving stricture resolution and improved biliary lumen caliber at six months, with no complications. Conclusions: Biodegradable biliary stents show promise in reducing interventions for complex biliary injuries. Further studies are needed to confirm their long-term efficacy and safety.