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Purpose: Hepatopancreatoduodenectomy (HPD) is a potentially curative option for selected patients with advanced cholangiocarcinoma or gallbladder cancer, but it is associated with substantial morbidity. In this study, we evaluated short- and long-term outcomes after HPD and identified prognostic factors.

Materials and Methods: Patients who underwent HPD at the Seoul National University Hospital, South Korea from 2000 to 2023 were included. Prospectively collected data on patient and tumor characteristics, perioperative and survival outcomes were analyzed. Prognostic factors were assessed using Cox proportional hazards models, and risk factors for disease-free survival (DFS) <12 months were explored using logistic regression.

Results: The 30-day mortality rate was 0%, the 90-day mortality rate was 6%, and major complications (Clavien–Dindo grade ≥III) occurred in 58% of patients. The median overall survival (OS) was 21 months, and median DFS was 12 months. The 5-year survival rate was 16%. In multivariable analysis, angiolymphatic invasion was an independent prognostic factor for both OS and DFS. Adjuvant treatment was associated with an improved OS. For DFS <12 months, preoperative carbohydrate antigen (CA) 19-9 level and angiolymphatic invasion were independent risk factors.

Conclusion: Despite high morbidity, HPD can provide meaningful long-term survival in carefully selected patients. Preoperative CA 19-9 and angiolymphatic invasion may aid risk stratification. Associations between adjuvant treatment and survival outcomes should be interpreted cautiously and warrant confirmation in larger, prospective multicenter studies.

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Role of fat-free mass-adjusted cardiorespiratory fitness in predicting hospitalization risk in patients with heart failure Young Seok Kim, Wonhee Lee, Tae Im Yi p. 449-457, [1-5]
Optimizing antibiotic use for urinary tract infections : a qualitative assessment of regular prescribing practices Je Eun Song, Yongseop Lee, Hyo Won Park, I Ji Yun, Seok-Jae Heo, Jong Hoon Hyun, Yoon Soo Park, Bongyoung Kim, Yee Gyung Kwak, Yong Chan Kim p. 458-465, [1-7]
SpyGlass direct visualization system : a cost-effective approach enhancing nutritional and immune recovery in difficult bile duct stone management Kyung In Shin, Galam Leem, Jungchul Koo, Jee Hoon Kim, In Rae Cho, Jung Hyun Jo, Hee Seung Lee, Jeong Youp Park, Seungmin Bang, Seung Woo Park, Moon Jae Chung p. 466-476, [1]
(The) risk of incident diabetes mellitus in relation to egg consumption among working-aged Korean adults Sung Keun Park, Yeongu Chung, Chang-Mo Oh, Jae-Hong Ryoo, Ju Young Jung p. 477-483
Outcomes and prognostic factors in hepatopancreatoduodenectomy Go-Won Choi, Duminda Subasinghe, Younsoo Seo, Inhyuck Lee, Youngmin Han, Yoon Soo Chae, Won-Gun Yun, Young Jae Cho, Hye-Sol Jung, Wooil Kwon, Jin-Young Jang, Joon Seong Park p. 484-491, [1-5]
Bone bridge effect for the treatment of acute osteoporotic vertebral compression fractures : a multistrategic approach using an anabolic agent Ja-Yeong Yoon, Sung-Min Kim, Seong-Hwan Moon, Hak-Sun Kim, Kyung-Soo Suk, Si-Young Park, Ji-Won Kwon, Byung Ho Lee p. 492-501
(The) role of YouTube as an information platform for ovarian cancer : the educational quality and reliability Soo Young Jeong, Jiye Kim, Jisong Hwang, Sung Taek Park, Sung Ho Park p. 502-507

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