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Article ; Online: The hepatocellular carcinoma Early Recurrence Score (ERS)-Ready for clinical implementation?

Reeves, Helen L / Hammond, John S

Liver international : official journal of the International Association for the Study of the Liver

2023 Volume 43, Issue 11, Page(s) 2346–2347

MeSH term(s)	Humans ; Carcinoma, Hepatocellular/pathology ; Liver Neoplasms/pathology ; Prognosis ; Neoplasm Recurrence, Local/pathology ; Chronic Disease ; Retrospective Studies ; Hepatectomy
Language	English
Publishing date	2023-10-17
Publishing country	United States
Document type	Editorial ; Research Support, Non-U.S. Gov't
ZDB-ID	2102783-3
ISSN	1478-3231 ; 1478-3223
ISSN (online)	1478-3231
ISSN	1478-3223
DOI	10.1111/liv.15741
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Article ; Online: A systematic review of the impact of portal vein pressure changes on clinical outcomes following hepatic resection.

Gavriilidis, Paschalis / Hammond, John S / Hidalgo, Ernest

HPB : the official journal of the International Hepato Pancreato Biliary Association

2020 Volume 22, Issue 11, Page(s) 1521–1529

Abstract: Background: There are evolving data correlating elevated post-hepatic resection portal vein pressure (PVP) with risk of developing post-resection liver failure (PLF) and other complications. As a consequence, modulation of PVP presents a potential ... ...

Abstract	Background: There are evolving data correlating elevated post-hepatic resection portal vein pressure (PVP) with risk of developing post-resection liver failure (PLF) and other complications. As a consequence, modulation of PVP presents a potential strategy to improve outcomes following liver resection (LR). The primary aim of this study was to review the existing evidence regarding the impact of post-resection PVP on clinical outcomes in patients undergoing a LR. Methods: Systematic literature searches of electronic databases in accordance with PRISMA were conducted. Changes in PVP and clinical outcomes following liver resection were defined according to the existing literature. Results: Ten studies, consisting of 712 patients with a median age 61 (52-68) years, were identified that met the inclusion criteria. Of those, 77% (n = 550) underwent a major LR and 27% (n = 195) of patients had cirrhosis. Following LR, the median (range) PVP increased from 11.4 mmHg (median baseline, range 7.3-16.4) to 15.9 mmHg (7.9-19). The overall median incidence of PLF was 19%. Six of the ten studies found an elevated PVP after LR predicted PLF. One study found elevated PVP after LR predicted mortality after LR. Conclusion: Elevated PVP following hepatic resection was associated with increased rates of PLF. It was not possible to define a specific threshold PVP for predicting PLF. Modulation of PVP therefore presents a potential strategy to mitigate the incidence of LR. Future studies should standardize on reporting liver remnant and haemodynamics to better characterize clinical outcomes following LR.
MeSH term(s)	Hepatectomy/adverse effects ; Humans ; Liver Failure ; Middle Aged ; Portal Pressure ; Portal Vein/diagnostic imaging ; Portal Vein/surgery
Language	English
Publishing date	2020-08-10
Publishing country	England
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	2131251-5
ISSN	1477-2574 ; 1365-182X
ISSN (online)	1477-2574
ISSN	1365-182X
DOI	10.1016/j.hpb.2020.07.006
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Article ; Online: Cholecystectomy in patients with cirrhosis: a population-based cohort study from England.

Adiamah, Alfred / Crooks, Colin J / Hammond, John S / Jepsen, Peter / West, Joe / Humes, David J

HPB : the official journal of the International Hepato Pancreato Biliary Association

2022 Volume 25, Issue 2, Page(s) 189–197

Abstract: Background: This population-based cohort study aimed to determine postoperative outcomes after emergency and elective cholecystectomy in patients with cirrhosis.: Methods: Linked electronic healthcare data from England were used to identify all ... ...

Abstract	Background: This population-based cohort study aimed to determine postoperative outcomes after emergency and elective cholecystectomy in patients with cirrhosis. Methods: Linked electronic healthcare data from England were used to identify all patients undergoing cholecystectomy between January 2000 and December 2017. Length of stay (LOS), re-admission, case fatality and the odds ratio of 90-day mortality were calculated for patients with and without cirrhosis, adjusting for age, sex and co-morbidity using logistic regression. Results: Of the total 69,141 eligible patients who underwent a cholecystectomy, 511 (0.74%) had cirrhosis. In patients without cirrhosis 86.55% underwent a laparoscopic procedure compared with 57.53% in patients with cirrhosis (p < 0.0001). LOS was longer in those with cirrhosis (3 IQR 1-8 vs 1 IQR 1-3 days,p < 0.0001). 90-day re-admission was greater in patients with cirrhosis, 36.79% compared with 14.95% in those without cirrhosis. 90-day case fatality after elective cholecystectomy in patients with and without cirrhosis was 2.79% and 0.43%; and 12.82% and 2.39% following emergency cholecystectomy. This equated to a 3-fold (OR 3.22, IQR 1.72-6.02) and a 4-fold (OR 4.52, IQR 2.46-8.33) increased odds of death at 90-days following elective and emergency cholecystectomy after adjusting for confounders. Conclusion: Patients with cirrhosis undergoing cholecystectomy have an increased 90-day risk of postoperative mortality, which is significantly worse after emergency procedures.
MeSH term(s)	Humans ; Cholecystectomy, Laparoscopic ; Cohort Studies ; Cholecystectomy ; Liver Cirrhosis ; England ; Length of Stay ; Retrospective Studies
Language	English
Publishing date	2022-08-23
Publishing country	England
Document type	Journal Article
ZDB-ID	2131251-5
ISSN	1477-2574 ; 1365-182X
ISSN (online)	1477-2574
ISSN	1365-182X
DOI	10.1016/j.hpb.2022.08.006
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Article ; Online: Outcomes after emergency appendicectomy in patients with liver cirrhosis: a population-based cohort study from England.

Adiamah, Alfred / Rashid, Adil / Crooks, Colin J / Hammond, John S / Jepsen, Peter / West, Joe / Humes, David J

Langenbeck's archives of surgery

2023 Volume 408, Issue 1, Page(s) 362

Abstract: Introduction: The mortality risk after appendicectomy in patients with liver cirrhosis is predicted to be higher than in the general population given the associated risk of perioperative bleeding, infections and liver decompensation. This population- ... ...

Abstract	Introduction: The mortality risk after appendicectomy in patients with liver cirrhosis is predicted to be higher than in the general population given the associated risk of perioperative bleeding, infections and liver decompensation. This population-based cohort study aimed to determine the 90-day mortality risk following emergency appendicectomy in patients with cirrhosis. Methods: Adult patients undergoing emergency appendicectomy in England between January 2001 and December 2018 were identified from two linked primary and secondary electronic healthcare databases, the clinical practice research datalink and hospital episode statistics data. Length of stay, re-admission, case fatality and the odds ratio of 90-day mortality were calculated for patients with and without cirrhosis, adjusting for age, sex and co-morbidity using logistic regression. Results: A total of 40,353 patients underwent appendicectomy and of these 75 (0.19%) had cirrhosis. Patients with cirrhosis were more likely to be older (p < 0.0001) and have comorbidities (p < 0.0001). Proportionally, more patients with cirrhosis underwent an open appendicectomy (76%) compared with 64% of those without cirrhosis (p = 0.03). The 90-day case fatality rate was 6.67% in patients with cirrhosis compared with 0.56% in patients without cirrhosis. Patients with cirrhosis had longer hospital length of stay (4 (IQR 3-9) days versus 3 (IQR 2-4) days and higher readmission rates at 90 days (20% vs 11%, p = 0.019). Most importantly, their odds of death at 90 days were 3 times higher than patients without cirrhosis, adjusted odds ratio 3.75 (95% CI 1.35-10.49). Conclusion: Patients with cirrhosis have a threefold increased odds of 90-day mortality after emergency appendicectomy compared to those without cirrhosis.
MeSH term(s)	Adult ; Humans ; Cohort Studies ; Liver Cirrhosis/complications ; Liver Cirrhosis/surgery ; Appendectomy ; England/epidemiology ; Databases, Factual
Language	English
Publishing date	2023-09-18
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-023-03072-3
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Article ; Online: Racial disparities in outcomes after liver transplantation in the UK: registry analysis.

Mahendran, Balaji / Tingle, Samuel J / Malik, Abdullah K / Figueiredo, Rodrigo / Hammond, John S / Sen, Gourab / Amer, Aimen / Talbot, David / Manas, Derek M / Sharp, Linda / Exley, Catherine / White, Steven / Wilson, Colin H

The British journal of surgery

2024 Volume 111, Issue 2

MeSH term(s)	Humans ; United States ; Liver Transplantation ; Racial Groups ; Ethnicity ; Registries ; United Kingdom/epidemiology ; Healthcare Disparities
Language	English
Publishing date	2024-02-16
Publishing country	England
Document type	Journal Article
ZDB-ID	2985-3
ISSN	1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
ISSN (online)	1365-2168
ISSN	0263-1202 ; 0007-1323 ; 1355-7688
DOI	10.1093/bjs/znae020
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Article ; Online: Mortality following elective and emergency colectomy in patients with cirrhosis: a population-based cohort study from England.

Adiamah, Alfred / Crooks, Colin J / Hammond, John S / Jepsen, Peter / West, Joe / Humes, David J

International journal of colorectal disease

2021 Volume 37, Issue 3, Page(s) 607–616

Abstract: Background: Patients with cirrhosis undergoing colectomy have a higher risk of postoperative mortality, but contemporary estimates are lacking and data on associated risk and longer term outcomes are limited. This study aimed to quantify the risk of ... ...

Abstract	Background: Patients with cirrhosis undergoing colectomy have a higher risk of postoperative mortality, but contemporary estimates are lacking and data on associated risk and longer term outcomes are limited. This study aimed to quantify the risk of mortality following colectomy by urgency of surgery and stage of cirrhosis. Data sources: Linked primary and secondary-care electronic healthcare data from England were used to identify all patients undergoing colectomy from January 2001 to December 2017. These patients were classified by the absence or presence of cirrhosis and severity. Case fatality rates at 90 days and 1 year were calculated, and cox regression was used to estimate the hazard ratio of postoperative mortality controlling for age, gender and co-morbidity. Results: Of the total, 36,380 patients undergoing colectomy, 248 (0.7%) had liver cirrhosis, and 70% of those had compensated cirrhosis. Following elective colectomy, 90-day case fatality was 4% in those without cirrhosis, 7% in compensated cirrhosis and 10% in decompensated cirrhosis. Following emergency colectomy, 90-day case fatality was higher; it was 16% in those without cirrhosis, 35% in compensated cirrhosis and 41% in decompensated cirrhosis. This corresponded to an adjusted 2.57 fold (95% CI 1.75-3.76) and 3.43 fold (95% CI 2.02-5.83) increased mortality risk in those with compensated and decompensated cirrhosis, respectively. This higher case fatality in patients with cirrhosis persisted at 1 year. Conclusion: Patients with cirrhosis undergoing emergency colectomy have a higher mortality risk than those undergoing elective colectomy both at 90 days and 1 year. The greatest mortality risk at 90 days was in those with decompensation undergoing emergency surgery.
MeSH term(s)	Cohort Studies ; Colectomy/adverse effects ; Elective Surgical Procedures ; England/epidemiology ; Humans ; Liver Cirrhosis/complications ; Liver Cirrhosis/surgery ; Retrospective Studies
Language	English
Publishing date	2021-12-11
Publishing country	Germany
Document type	Journal Article
ZDB-ID	84975-3
ISSN	1432-1262 ; 0179-1958
ISSN (online)	1432-1262
ISSN	0179-1958
DOI	10.1007/s00384-021-04061-y
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Article ; Online: Prehabilitation prior to surgery for pancreatic cancer: A systematic review.

Bundred, James R / Kamarajah, Sivesh K / Hammond, John S / Wilson, Colin H / Prentis, James / Pandanaboyana, Sanjay

Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.

2020 Volume 20, Issue 6, Page(s) 1243–1250

Abstract: Introduction: Prehabilitation aims to improve fitness and outcomes of patients undergoing major surgery. This systematic review aimed to appraise current available evidence regarding the role of prehabilitation in patients undergoing oncological ... ...

Abstract	Introduction: Prehabilitation aims to improve fitness and outcomes of patients undergoing major surgery. This systematic review aimed to appraise current available evidence regarding the role of prehabilitation in patients undergoing oncological pancreatic resection. Methods: A systematic literature search of PUBMED, MEDLINE, EMBASE databases identified articles describing prehabilitation programmes before pancreatic resection for malignancy. Data collected included timing of prehabilitation, programme type, duration, adherence and post-operative outcome reporting. Results: Six studies, including 193 patients were included in the final analysis. Three studies included patients undergoing neoadjuvant therapy followed by resection and 3 studies included patients undergoing upfront resection. Time from diagnosis to surgery ranged between 2 and 22 weeks across all studies. Two studies reported a professionally supervised exercise programme, and four described unsupervised programmes. Exercise programmes varied from 5 days to 6 months in duration. Adherence to exercise programmes was better with supervised programmes (99% reaching weekly activity goal vs 85%) and patients not undergoing neoadjuvant therapy (90% reaching weekly activity goal vs 82%). All studies reported improvement in muscle mass or markers of muscle function following prehabilitation. Two studies reported the impact of Prehabilitation on postoperative outcomes and Prehabilitation was associated with lower delayed gastric emptying and a shorter hospital stay with no impact on other postoperative outcomes. Conclusion: Early evidence demonstrates that Prehabilitation programmes may improve postoperative outcomes following pancreatic surgery. However current Prehabilitaton programmes for patients undergoing pancreatic resection report diverse exercise regimens with no consensus regarding timing or length of Prehabilitation, warranting a need for standardisation of Prehabilitation programmes in pancreatic surgery.
MeSH term(s)	Combined Modality Therapy ; Digestive System Surgical Procedures ; Exercise ; Humans ; Pancreatectomy/methods ; Pancreatic Neoplasms/surgery ; Pancreaticoduodenectomy/methods ; Postoperative Complications/epidemiology ; Preoperative Exercise ; Treatment Outcome
Language	English
Publishing date	2020-08-03
Publishing country	Switzerland
Document type	Journal Article ; Systematic Review
ZDB-ID	2056680-3
ISSN	1424-3911 ; 1424-3903
ISSN (online)	1424-3911
ISSN	1424-3903
DOI	10.1016/j.pan.2020.07.411
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Article ; Online: Emerging roles for biomaterials in the treatment of liver disease.

Hammond, John S / Lobo, Dileep N

Expert review of medical devices

2012 Volume 9, Issue 2, Page(s) 181–188

Abstract: This review explores potential roles for biomaterials in the field of liver surgery and hepatology. The studies reviewed are presented in three sections. The first section discusses liver regeneration and strategies to modulate it. The second section ... ...

Abstract	This review explores potential roles for biomaterials in the field of liver surgery and hepatology. The studies reviewed are presented in three sections. The first section discusses liver regeneration and strategies to modulate it. The second section outlines the pathophysiology of liver inflammation and fibrosis and highlights novel therapeutic targets. The final section summarises the current challenges in liver surgery and discusses how biomaterials may be used to address these challenges and focuses on early translational applications for biomaterials for drug delivery and liver surgery.
MeSH term(s)	Biocompatible Materials/therapeutic use ; Diagnostic Imaging ; Genetic Therapy ; Humans ; Liver/drug effects ; Liver/pathology ; Liver/surgery ; Liver Diseases/drug therapy ; Liver Diseases/therapy ; Liver Regeneration/drug effects
Chemical Substances	Biocompatible Materials
Language	English
Publishing date	2012-03
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2250857-0
ISSN	1745-2422 ; 1743-4440
ISSN (online)	1745-2422
ISSN	1743-4440
DOI	10.1586/erd.11.70
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Article ; Online: Risk factors for decompensation and death following umbilical hernia repair in patients with end-stage liver disease.

Malik, Abdullah K / Varghese, Chris / Pandanaboyana, Sanjay / Sen, Gourab / Robinson, Stuart / McPherson, Stuart / Dyson, Jessica / Manas, Derek M / Masson, Steven / Hammond, John S

European journal of gastroenterology & hepatology

2022 Volume 34, Issue 10, Page(s) 1060–1066

Abstract: Introduction: Symptomatic umbilical hernias are a common cause of morbidity and mortality in patients with cirrhosis and end-stage liver disease (ESLD). This study set out to characterise the factors predicting outcome following repair of symptomatic ... ...

Abstract	Introduction: Symptomatic umbilical hernias are a common cause of morbidity and mortality in patients with cirrhosis and end-stage liver disease (ESLD). This study set out to characterise the factors predicting outcome following repair of symptomatic umbilical hernias in ESLD at a single institution. Methods: A retrospective review was performed of all patients with ESLD who underwent repair of a symptomatic umbilical hernia between 1998 and 2020. Overall survival was predicted using the Kaplan-Meier method. Logistic regression was used to determine predictors of decompensation and 30-day, 90-day and 1-year mortality. Results: One-hundred-and-eight patients with ESLD underwent umbilical hernia repair (emergency n = 78, 72.2%). Transjugular shunting was performed in 29 patients (26.9%). Decompensation occurred in 44 patients (40.7%) and was predicted by emergency surgery (OR, 13.29; P = 0.001). Length of stay was shorter in elective patients compared to emergency patients (3-days vs. 7-days; P = 0.003). Thirty-day, 90-day and 1-year survival was 95.2, 93.2 and 85.4%, respectively. Model for ESLD score >15 predicted 90-day mortality (OR, 18.48; P = 0.030) and hyponatraemia predicted 1-year mortality (OR, 5.31; P = 0.047). Transjugular shunting predicted survival at 1 year (OR, 0.15; P = 0.038). Conclusions: Repair of symptomatic umbilical hernias in patients with ESLD can be undertaken with acceptable outcomes in a specialist centre, however, this remains a high-risk intervention. Patients undergoing emergency repair are more likely to decompensate postoperatively, develop wound-related problems and have a longer length of stay. Transjugular shunting may confer a benefit to survival, but further prospective trials are warranted.
MeSH term(s)	Elective Surgical Procedures/adverse effects ; Elective Surgical Procedures/methods ; End Stage Liver Disease/complications ; End Stage Liver Disease/diagnosis ; End Stage Liver Disease/surgery ; Hernia, Umbilical/etiology ; Hernia, Umbilical/surgery ; Humans ; Retrospective Studies ; Risk Factors
Language	English
Publishing date	2022-08-24
Publishing country	England
Document type	Journal Article
ZDB-ID	1034239-4
ISSN	1473-5687 ; 0954-691X
ISSN (online)	1473-5687
ISSN	0954-691X
DOI	10.1097/MEG.0000000000002417
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Article ; Online: Meta-Analysis and Meta-Regression of Risk Factors for Surgical Site Infections in Hepatic and Pancreatic Resection.

Mentor, Keno / Ratnayake, Bathiya / Akter, Nasreen / Alessandri, Giorgio / Sen, Gourab / French, Jeremy J / Manas, Derek M / Hammond, John S / Pandanaboyana, Sanjay

World journal of surgery

2020 Volume 44, Issue 12, Page(s) 4221–4230

Abstract: Background: The risk factors for surgical site infection (SSI) after HPB surgery are poorly defined. This meta-analysis aimed to quantify the SSI rates and risk factors for SSI after pancreas and liver resection.: Methods: The PUBMED, MEDLINE and ... ...

Abstract	Background: The risk factors for surgical site infection (SSI) after HPB surgery are poorly defined. This meta-analysis aimed to quantify the SSI rates and risk factors for SSI after pancreas and liver resection. Methods: The PUBMED, MEDLINE and EMBASE databases were systematically searched using the PRISMA framework. The primary outcome measure was pooled SSI rates. The secondary outcome measure was risk factor profile determination for SSI. Results: The overall rate of SSI after pancreatic and liver resection was 25.1 and 10.4%, respectively (p < 0.001). 32% of pancreaticoduodenectomies developed SSI vs 23% after distal pancreatectomy (p < 0.001). The rate of incisional SSI in the pancreatic group was 9% and organ/space SSI 16.5%. Biliary resection during liver surgery was a risk factor for SSI (25.0 vs 15.7%, p = 0.002). After liver resection, the incisional SSI rate was 7.6% and the organ space SSI rate was 10.2%. Pancreas-specific SSI risk factors were pre-operative biliary drainage (p < 0.001), chemotherapy (p < 0.001) and radiotherapy (p = 0.007). Liver-specific SSI risk factors were smoking (p = 0.046), low albumin (p < 0.001) and significant blood loss (p < 0.001). The rate of organ/space SSI in patients with POPF was 47.7% and in patients without POPF 7.3% (p < 0.001). Organ/space SSI rate was 43% in patients with bile leak and 10% in those without (p < 0.001). Conclusions: The risk factors for SSI following pancreatic and liver resections are distinct from each other, with higher SSI rates after pancreatic resection. Pancreaticoduodenectomy has increased risk of SSI compared to distal pancreatectomy. Similarly, biliary resections during liver surgery increase the rates of SSI.
MeSH term(s)	Hepatectomy/adverse effects ; Humans ; Liver ; Pancreatectomy/adverse effects ; Risk Factors ; Surgical Wound Infection/epidemiology ; Surgical Wound Infection/etiology
Language	English
Publishing date	2020-08-18
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Review
ZDB-ID	224043-9
ISSN	1432-2323 ; 0364-2313
ISSN (online)	1432-2323
ISSN	0364-2313
DOI	10.1007/s00268-020-05741-6
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