Gozo Kiguchi

Pancreaticobiliary maljunction (PBM) is a congenital anomaly in which the pancreatic and bile ducts join outside the duodenal wall.1,2 Reflux of pancreatic

Hydrogen has antioxidant and anti-inflammatory properties that may attenuate perioperative stress responses. However, its clinical impact on postoperative recovery remains unclear. This randomized, double-blind, placebo-controlled trial evaluated whether perioperative hydrogen inhalation improves early recovery after hepatectomy. Sixty-eight patients undergoing elective hepatectomy were randomized (1:1) to receive 5% hydrogen gas or placebo air via nasal cannula from postoperative day (POD) 1 to POD7. The primary endpoint was the total Quality of Recovery-40 (QoR-40) score on POD3, analyzed at α = 0.2 with 80% confidence intervals in accordance with the pre-specified statistical analysis plan. Secondary and exploratory outcomes, analyzed at α = 0.05, included postoperative liver function, oxidative stress markers, and QoR-40 subdomain scores. Analyses were performed in the modified intention-to-treat population using the Mann–Whitney U test. Sixty-four patients (hydrogen, n = 31; placebo, n = 33) were analyzed. At POD3, the median QoR-40 score was 192.0 (184.0–198.0) vs. 163.0 (140.0–190.0) (p < 0.001), indicating significantly better early recovery in the hydrogen group. As supportive findings, prothrombin activity was higher with hydrogen (85.0% vs. 76.2%, p = 0.005), and QoR-40 subdomain analysis showed significantly higher emotions and physical independence scores, whereas comfort, pain, and patient support domains showed no difference. No other between-group differences were observed in biochemical parameters or urinary 8-OHdG levels. Perioperative hydrogen inhalation significantly improved early postoperative recovery after hepatectomy, primarily through psychophysical domains of well-being. These findings suggest that hydrogen may selectively enhance emotional stability and functional independence during the early recovery phase.

Background/Objectives: Adipophilin (ADP) is a protein associated with lipid droplets, and its expression is related to poor prognosis in certain cancers. However, its impact on the survival of patients with colorectal liver metastases (CRLMs) remains unclear. This study investigated the impact of ADP expression on long-term survival following hepatectomy in patients with CRLM. Methods: We retrospectively analyzed 102 consecutive patients who underwent hepatectomy between 2006 and 2022. ADP expression was examined in resected specimens through immunohistochemical staining using tissue microarrays. Long-term outcomes for ADP-positive (n = 51) and ADP-negative (n = 51) groups were compared with Kaplan–Meier survival analysis. Results: We found significantly decreased 5-year recurrence-free survival (RFS) and overall survival (OS) rates for ADP-positive patients relative to ADP-negative patients (29.4% versus 52.1%, respectively; p = 0.001 and 43.7% versus 72.2%, respectively; p = 0.003). Moreover, multivariate Cox hazards analysis demonstrated that patients with ADP-positive CRLM had a worse prognosis after hepatectomy than those with ADP-negative CRLM, as reflected by both RFS (HR 2.46, 95% CI 1.39–4.36, p = 0.002) and OS (HR: 2.89, 95% CI 1.43–5.85, p = 0.003). Conclusions: ADP expression had a significant prognostic impact on the survival of patients with CRLM following liver resection and may aid in optimal treatment planning.