Biliary Parasitic Diseases Associated with Hepatobiliary Carcinoma.

Background: Despite long-term preventative efforts by local public health authorities, the prevalence of fluke infection remains high in specific areas in eastern and southeastern Asia. Recently increasing travel or migration activities have led to the transfer and spread of such infections from endemic areas to other regions. Summary: The epidemiology, clinical signs, and symptoms for three common blood and liver flukes, namely Schistosoma japonicum, Clonorchis sinensis, and Opisthorchis viverrini, are described in this review, and their current diagnosis and management strategy are reviewed. These flukes are considered clinically important because of the increased risk of liver or biliary cancer. Key Messages: Early treatment and prevention of disease spread can reduce the incidence of related hepatobiliary cancer. Recognition of these fluke infection is essential for a correct diagnosis and early treatment to prevent the development of deadly cancers.

Preoperative Decision to Perform Portal Vein Resection Improves Survival in Patients With Resectable Pancreatic Head Cancer Adjacent to Portal Vein.

Objective: We hypothesized that preoperatively planned portal vein resection (PVR), which prevents from approaching tumors, improves survival in patients with resectable pancreatic head cancer adjacent to the portal vein (PhC-PV). Summary: The decision to perform PVR is difficult in patients with resectable PhC-PV. Methods: This is a retrospective, bi-institutional study of patients undergoing pancreatoduodenectomy (PD) for resectable PhC-PV from 2009 to 2018. We compared clinical data of patients who underwent PD with preoperatively planned PVR (planned PVR group) and those who underwent conventional PD (cPD) in which decision to perform PVR was made intraoperatively (cPD group). Results: Among the study population of 176 patients, 53 patients (30.1%) underwent PD with planned PVR. The remaining 123 patients (69.9%) underwent cPD. Tumor characteristics were similar between the 2 groups. Operation time and major complication rates did not differ between the 2 groups. The local recurrence rate of patients in the planned PVR group (28.3%) was lower than that of the cPD group (44.7%; P = 0.041). Median overall survival (OS) was longer in the planned PVR group than in the cPD group (32 vs 27 months; P = 0.011). Multivariate analysis revealed that having undergone planned PVR was an independent factor for favorable OS (hazard ratio = 1.65; 95% confidence interval = 1.08-2.61; P = 0.021). Conclusions: The preoperative decision to perform PVR improves survival by enhancing local control of resectable PhC-PV.