Background and Aims: The prognosis of intrahepatic cholangiocarcinoma (ICC) after radical resection is far from satisfactory; however, the clinical value of adjuvant therapy (AT) remains controversial. This multicenter study aimed to evaluate the clinical value of AT and identify potential patients who would be benefited from AT.Methods: Data from ICC patients who underwent radical resection were retrospectively collected from 12 hepatobiliary centers in China between December 2012 and December 2015. Patients were divided into AT and non‐AT groups based on whether AT was administered or not. Overall survival (OS) and disease‐free survival (DFS) were analyzed using the Kaplan‐Meier method before and after 1:2 propensity score matching (PSM). Subgroup analyses were conducted based on the established staging systems.Results: A total of 412 patients were enrolled in this study, and 77 patients (18.9%) received AT, including 32 (7.8%) patients who received transarterial chemoembolization (TACE), 21 (5.1%) patients who received chemotherapy, 10 (2.4%) patients who received radiotherapy, and 14 (3.4%) patients who received adjuvant chemoradiotherapy. The median OS and DFS were both longer in the AT group than in the non‐AT group (43.0 months vs 21.0 months, P = .015; 16.0 months vs 11.0 months, P = .045, respectively), and the advantage of AT was confirmed for both the OS and DFS (P = .023; P = .046, respectively) after 1:2 PSM. Furthermore, based on the established nomogram, only “middle‐risk” patients receiving AT cherished a longer median OS (43.0 months vs 20.0 months, P = .033). In subgroup analyses that were stratified by different AT strategies, patients receiving postoperative chemotherapy had a longer median OS (37.0 months vs 21.0 months, P = .039), while patients receiving postoperative TACE had a longer median DFS (50.0 months vs 11.0 months, P = .007).Conclusion: With the current data, we conclude that AT benefits ICC patients following radical resection, especially those “middle‐risk” patients, as evaluated by the established nomogram. However, exactly which patients are the most suitable for AT requires further study and validation.

Objective: To investigate the clinical value of the adjuvant transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) after radical resection, and identify the potential beneficiaries. Methods: Patients were identified through the primary liver cancer big data (PLCBD) between 2012 and 2015. Overall survival (OS) between adjuvant TACE group and non-TACE was evaluated by Kaplan-Meier before and after propensity scoring match (PSM). Subgroup analysis was conducted stratified by risk factors. Results: A total of 2066 HCC patients receiving radical resection were identified. Patients with multiple tumors, tumor diameter >5 cm, satellite, and advanced stage were more likely to accept adjuvant TACE. Before PSM, the 1-, 3-, and 5-year OS rates in the TACE group and non-TACE group were 89%, 58%, 17%, and 88%, 53%, 13% (p = .43), respectively. While, the corresponding rates were 89%, 58%, 17%, and 86%, 49%, 11%, (p = .038), respectively after 1:1 PSM. In addition, patients were found to significantly benefit from adjuvant TACE if they had age ≥50 years, no cirrhosis, AFP ≤ 200 ng/ml, surgical margin 5 cm, no capsule, no satellite, or CN stage Ib/IIa (all p < .05), but patients with age < 50 years, tumor size ≤5 cm, or CN stage Ia were found to significantly benefit from radical resection in DFS (all p < .05). Conclusion: Currently, we concluded that not all of patients with HCC would benefit from adjuvant TACE. Patients with age ≥50 years, tumor size >5 cm, or CN stage Ib/IIa were strongly recommended to receive adjuvant TACE.

Background: The organ most commonly invaded in echinococcosis is the liver; the lungs, brain, kidneys, heart, and spleen are rarely invaded, and multi-organ involvement in echinococcosis is even rarer. No studies have reported renal invasion after liver transplantation for hepatic alveolar echinococcosis. Case presentation: We report here a case of renal invasion 2 years after allogeneic liver transplantation in a 53-year-old female patient with hepatic alveolar echinococcosis combined with lung metastases. At the time of the first consultation, the lesion had been found to involve the second hepatic hilum combined with lung metastases, but the patient requested conservative treatment, and the lesion was not controlled by taking albendazole for 3 years. After discussion in the treatment group, it was decided to use allogeneic liver transplantation and lung segmental resection for surgical treatment, after which the patient was put on long-term oral immunosuppression. She was hospitalized 2 years later for low back pain and diagnosed with renal alveolar echinococcosis. Due to significant compression and left-sided renal insufficiency, the final option was to remove the diseased kidney. It is worth mentioning that signs of unexplained urinary tract infection were present throughout the course of treatment. Conclusion: This study suggests that extra attention should be paid to the presence of cryptogenic lesions in patients with hepatic alveolar echinococcosis who already have definite metastatic lesions. Immunosuppressive drugs after liver transplantation in patients with hepatic echinococcosis may cause occult lesions to develop into active ones. In clinical practice, particular attention should be paid to patients with hepatic alveolar echinococcosis with long-term concomitant signs of unexplained urinary tract infections, which may be a precursor clinical feature of cryptogenic renal alveolar echinococcosis.

Background: Pancreatic resection is a critical treatment for pancreatic cancer and other pancreatic diseases. Somatostatin analogs are commonly used to prevent complications following pancreatic resection, but their efficacy and safety remain debated. Methods: Following PRISMA guidelines, a systematic search was conducted across multiple databases, including PubMed, EMBASE, Scopus, Cochrane Library, Ovid, ClinicalTrials.gov, Web of Science, CNKI, and WanFang Data. The search focused on studies comparing the use of somatostatin analogs after pancreatic surgery. Key outcomes included postoperative pancreatic fistula (POPF), clinically relevant POPF (CR-POPF), mortality, and morbidity. Statistical analysis was performed using a consistency model, calculating relative risk ratios (RR) with 95% confidence intervals (CI), and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool was used to assess the quality of evidence. Results: In the absence of stratification based on the surgical procedure, For POPF prevention, pasireotide showed a relative risk (RR) of 0.46 (95% CI: 0.23, 0.87, Low) compared to placebo, and octreotide had an RR of 0.76 (95% CI: 0.66, 0.88, Moderate). Somatostatin and vapreotide showed no significant differences. In preventing CR-POPF, pasireotide had an RR of 0.46 (95% CI: 0.23, 0.86, Low), somatostatin had an RR of 0.60 (95% CI: 0.36, 0.99, Moderate), and octreotide had an RR of 0.61 (95% CI: 0.39, 0.94, Moderate). Regarding postoperative mortality, vapreotide showed an RR of 0 (95% CI: 0.00, 0.29, Low), while octreotide, somatostatin and pasireotide did not demonstrate significant effects. For reducing morbidity, octreotide had an RR of 0.74 (95% CI: 0.66, 0.82, Moderate), somatostatin had an RR of 0.76 (95% CI: 0.66, 0.87, Moderate), vapreotide and pasireotide showed no significant effect.In Pancreaticoduodenectomy subgroup, somatostatin showed an RR of 0.22(95% CI: 0.03, 0.84, Moderate) for preventing CR-POPF.For all the other outcomes, neither somatostatin nor octreotide proved effective. Conclusion: While robust evidence confirms the efficacy of octreotide in preventing POPF, a critical concern regarding its inconsistent efficacy within the PD subgroup persists. This variability indicates that the overall clinical benefit of octreotide may be predominantly attributable to its utility in non-PD pancreatic resections.

Objective: This meta-analysis aims to evaluate the effect of prophylactic abdominal drainage on post-pancreatectomy complications, a topic that is still debated in the medical community. Materials and methods: Following PRISMA guidelines, the authors conducted a systematic search across databases such as PubMed, EMBASE, Scopus, Cochrane Library, Ovid, clinicaltrials.gov, Web of Science, CNKI, and WanFang Data, focusing on studies comparing intraperitoneal drainage with no drainage after pancreatic surgery. Key outcomes included postoperative pancreatic fistula (POPF), clinically relevant POPF (CR-POPF), mortality, complications, delayed gastric emptying, bile leakage, intestinal fistula, abdominal abscess, postoperative bleeding, interventional radiology drainage, reoperation, and unplanned readmissions. Statistical analyses were conducted using either a Beta Normal Hierarchical Model or a random-effects model, providing combined odds ratios (ORs) with 95% confidence intervals (CIs). Subgroup analyses were also performed based on surgical procedures, specifically Distal Pancreatectomy (DP) and Pancreatoduodenectomy (PD). Results: This meta-analysis, incorporating five RCTs and 10 non-RCTs, identified a significant link between routine abdominal drainage and higher rates of POPF, CR-POPF, and unplanned readmissions. The overall ORs were 2.46 (95% CI: 1.90–3.63), 1.92 (95% CI: 1.38–2.64), and 1.32 (95% CI: 1.04–1.65). In the DP subgroup, the ORs were 2.48 (95% CI: 1.49–5.00), 2.75 (95% CI: 1.65–5.21), and 1.46 (95% CI: 1.06–2.18). In the PD subgroup, the ORs were 2.34 (95% CI: 1.70–3.36), 1.95 (95% CI: 1.17–3.19), and 1.25 (95% CI: 1.00–1.60). The use of drainage was associated with a decreased mortality following PD, with an OR of 0.49 (95% CI: 0.23–0.96); however, this association was not observed in relation to other surgical methods. No significant differences were found among the groups for the other outcomes. Conclusion: For surgeries other than PD, omitting drainage tubes may benefit patients postoperatively. However, unselected cessation of intraperitoneal drainage after PD correlates with reduced pancreatic fistulas but higher mortality. Future randomized trials should compare routine versus selective drainage.