Background: s/Aims: Hepatocellular carcinoma (HCC) is the sixth most common cancer and second leading cause of cancer-related deaths in South Korea. This study evaluated the characteristics of Korean patients newly diagnosed with HCC in 2016-2018. Methods: Data from the Korean Primary Liver Cancer Registry (KPLCR), a representative database of patients newly diagnosed with HCC in South Korea, were analyzed. This study investigated 4,462 patients with HCC registered in the KPLCR in 2016-2018. Results: The median patient age was 63 years (interquartile range, 55-72). 79.7% of patients were male. Hepatitis B infection was the most common underlying liver disease (54.5%). The Barcelona Clinic Liver Cancer (BCLC) staging system classified patients as follows: stage 0 (14.9%), A (28.8%), B (7.5%), C (39.0%), and D (9.8%). The median overall survival was 3.72 years (95% confidence interval, 3.47-4.14), with 1-, 3-, and 5-year overall survival rates of 71.3%, 54.1%, and 44.3%, respectively. In 2016-2018, there was a significant shift toward BCLC stage 0-A and Child-Turcotte-Pugh liver function class A (P<0.05), although survival rates did not differ by diagnosis year. In the treatment group (n=4,389), the most common initial treatments were transarterial therapy (31.7%), surgical resection (24.9%), best supportive care (18.9%), and local ablation therapy (10.5%). Conclusions Between 2016 and 2018, HCC tended to be diagnosed at earlier stages, with better liver function in later years. However, since approximately half of the patients remained diagnosed at an advanced stage, more rigorous and optimized HCC screening strategies should be implemented.

Background: s/Aims: Hepatocellular carcinoma (HCC) is the sixth most common cancer and second leading cause of cancer-related deaths in South Korea. This study evaluated the characteristics of Korean patients newly diagnosed with HCC in 2016-2018. Methods: Data from the Korean Primary Liver Cancer Registry (KPLCR), a representative database of patients newly diagnosed with HCC in South Korea, were analyzed. This study investigated 4,462 patients with HCC registered in the KPLCR in 2016-2018. Results: The median patient age was 63 years (interquartile range, 55-72). 79.7% of patients were male. Hepatitis B infection was the most common underlying liver disease (54.5%). The Barcelona Clinic Liver Cancer (BCLC) staging system classified patients as follows: stage 0 (14.9%), A (28.8%), B (7.5%), C (39.0%), and D (9.8%). The median overall survival was 3.72 years (95% confidence interval, 3.47-4.14), with 1-, 3-, and 5-year overall survival rates of 71.3%, 54.1%, and 44.3%, respectively. In 2016-2018, there was a significant shift toward BCLC stage 0-A and Child-Turcotte-Pugh liver function class A (P<0.05), although survival rates did not differ by diagnosis year. In the treatment group (n=4,389), the most common initial treatments were transarterial therapy (31.7%), surgical resection (24.9%), best supportive care (18.9%), and local ablation therapy (10.5%). Conclusions Between 2016 and 2018, HCC tended to be diagnosed at earlier stages, with better liver function in later years. However, since approximately half of the patients remained diagnosed at an advanced stage, more rigorous and optimized HCC screening strategies should be implemented.

Background: s/Aims: Hepatocellular carcinoma (HCC) is the sixth most common cancer and second leading cause of cancer-related deaths in South Korea. This study evaluated the characteristics of Korean patients newly diagnosed with HCC in 2016-2018. Methods: Data from the Korean Primary Liver Cancer Registry (KPLCR), a representative database of patients newly diagnosed with HCC in South Korea, were analyzed. This study investigated 4,462 patients with HCC registered in the KPLCR in 2016-2018. Results: The median patient age was 63 years (interquartile range, 55-72). 79.7% of patients were male. Hepatitis B infection was the most common underlying liver disease (54.5%). The Barcelona Clinic Liver Cancer (BCLC) staging system classified patients as follows: stage 0 (14.9%), A (28.8%), B (7.5%), C (39.0%), and D (9.8%). The median overall survival was 3.72 years (95% confidence interval, 3.47-4.14), with 1-, 3-, and 5-year overall survival rates of 71.3%, 54.1%, and 44.3%, respectively. In 2016-2018, there was a significant shift toward BCLC stage 0-A and Child-Turcotte-Pugh liver function class A (P<0.05), although survival rates did not differ by diagnosis year. In the treatment group (n=4,389), the most common initial treatments were transarterial therapy (31.7%), surgical resection (24.9%), best supportive care (18.9%), and local ablation therapy (10.5%). Conclusions Between 2016 and 2018, HCC tended to be diagnosed at earlier stages, with better liver function in later years. However, since approximately half of the patients remained diagnosed at an advanced stage, more rigorous and optimized HCC screening strategies should be implemented.

The posterior superior alveolar artery (PSAA) is a branch of the maxillary artery that supplies blood to the lateral wall of the sinus and the overlying membrane. It is located in the lateroposterior wall of the maxillary sinus and is almost intra-osseous, making surgeries there challenging for the risk of injury during routine endoscopic sinus surgery (ESS). Indeed, there is approximately 20% risk of damage in situations such as Le Fort I fracture surgery, maxillary sinus expansion, removal of lesions and inflammation in the maxillary sinus, surgical procedures involving orthognathic surgery and dental implant treatment, as well as in occurrences of fractures and fenestration during surgery, potentially leading to significant bleeding. We present a rare case of facial hematoma due to PASS injury following ESS, with subsequent improvement and no additional complications after treatment.

The posterior superior alveolar artery (PSAA) is a branch of the maxillary artery that supplies blood to the lateral wall of the sinus and the overlying membrane. It is located in the lateroposterior wall of the maxillary sinus and is almost intra-osseous, making surgeries there challenging for the risk of injury during routine endoscopic sinus surgery (ESS). Indeed, there is approximately 20% risk of damage in situations such as Le Fort I fracture surgery, maxillary sinus expansion, removal of lesions and inflammation in the maxillary sinus, surgical procedures involving orthognathic surgery and dental implant treatment, as well as in occurrences of fractures and fenestration during surgery, potentially leading to significant bleeding. We present a rare case of facial hematoma due to PASS injury following ESS, with subsequent improvement and no additional complications after treatment.

The posterior superior alveolar artery (PSAA) is a branch of the maxillary artery that supplies blood to the lateral wall of the sinus and the overlying membrane. It is located in the lateroposterior wall of the maxillary sinus and is almost intra-osseous, making surgeries there challenging for the risk of injury during routine endoscopic sinus surgery (ESS). Indeed, there is approximately 20% risk of damage in situations such as Le Fort I fracture surgery, maxillary sinus expansion, removal of lesions and inflammation in the maxillary sinus, surgical procedures involving orthognathic surgery and dental implant treatment, as well as in occurrences of fractures and fenestration during surgery, potentially leading to significant bleeding. We present a rare case of facial hematoma due to PASS injury following ESS, with subsequent improvement and no additional complications after treatment.

The posterior superior alveolar artery (PSAA) is a branch of the maxillary artery that supplies blood to the lateral wall of the sinus and the overlying membrane. It is located in the lateroposterior wall of the maxillary sinus and is almost intra-osseous, making surgeries there challenging for the risk of injury during routine endoscopic sinus surgery (ESS). Indeed, there is approximately 20% risk of damage in situations such as Le Fort I fracture surgery, maxillary sinus expansion, removal of lesions and inflammation in the maxillary sinus, surgical procedures involving orthognathic surgery and dental implant treatment, as well as in occurrences of fractures and fenestration during surgery, potentially leading to significant bleeding. We present a rare case of facial hematoma due to PASS injury following ESS, with subsequent improvement and no additional complications after treatment.

The posterior superior alveolar artery (PSAA) is a branch of the maxillary artery that supplies blood to the lateral wall of the sinus and the overlying membrane. It is located in the lateroposterior wall of the maxillary sinus and is almost intra-osseous, making surgeries there challenging for the risk of injury during routine endoscopic sinus surgery (ESS). Indeed, there is approximately 20% risk of damage in situations such as Le Fort I fracture surgery, maxillary sinus expansion, removal of lesions and inflammation in the maxillary sinus, surgical procedures involving orthognathic surgery and dental implant treatment, as well as in occurrences of fractures and fenestration during surgery, potentially leading to significant bleeding. We present a rare case of facial hematoma due to PASS injury following ESS, with subsequent improvement and no additional complications after treatment.

Background: s/Aims: Reported incidence of extrahepatic bile duct cancer is higher in Asians than in Western populations. Korea, in particular, is one of the countries with the highest incidence rates of extrahepatic bile duct cancer in the world. Although research and innovative therapeutic modalities for extrahepatic bile duct cancer are emerging, clinical guidelines are currently unavailable in Korea. The Korean Society of Hepato-Biliary-Pancreatic Surgery in collaboration with related societies (Korean Pancreatic and Biliary Surgery Society, Korean Society of Abdominal Radiology, Korean Society of Medical Oncology, Korean Society of Radiation Oncology, Korean Society of Pathologists, and Korean Society of Nuclear Medicine) decided to establish clinical guideline for extrahepatic bile duct cancer in June 2021. Methods: Contents of the guidelines were developed through subgroup meetings for each key question and a preliminary draft was finalized through a Clinical Guidelines Committee workshop. Results: In November 2021, the finalized draft was presented for public scrutiny during a formal hearing. Conclusions The extrahepatic guideline committee believed that this guideline could be helpful in the treatment of patients.

Background/Aims: Quick sequential organ failure assessment (qSOFA) is believed to identify patients at risk of poor outcomes in those with suspected infection. We aimed to evaluate the ability of modified qSOFA (m-qSOFA) to identify high-risk patients among those with acutely deteriorated chronic liver disease (CLD), especially those with acute-onchronic liver failure (ACLF). Methods: We used data from both the Korean Acute-on-Chronic Liver Failure (KACLiF) and the Asian Pacific Association for the Study of the Liver ACLF Research Consortium (AARC) cohorts. qSOFA was modified by replacing the Glasgow Coma Scale with hepatic encephalopathy, and an m-qSOFA ≥2 was considered high. Results: Patients with high m-qSOFA had a significantly lower 1-month transplant-free survival (TFS) in both cohorts and higher organ failure development in KACLiF than those with low m-qSOFA (Ps<0.05). Subgroup analysis by ACLF showed that patients with high m-qSOFA had lower TFS than those with low m-qSOFA. m-qSOFA was an independent prognostic factor (hazard ratios, HR=2.604, 95% confidence interval, CI 1.353–5.013, P=0.004 in KACLiF and HR=1.904, 95% CI 1.484– 2.442, P<0.001 in AARC). The patients with low m-qSOFA at baseline but high m-qSOFA on day 7 had a significantly lower 1-month TFS than those with high m-qSOFA at baseline but low m-qSOFA on day 7 (52.6% vs. 89.4%, P<0.001 in KACLiF and 26.9% vs. 61.5%, P<0.001 in AARC). Conclusions Baseline and dynamic changes in m-qSOFA may identify patients with a high risk of developing organ failure and short-term mortality among CLD patients with acute deterioration.