ObjectiveTo investigate the influencing factors and independent risk factors for lower extremity deep vein thrombosis （DVT） in patients with acute necrotizing pancreatitis （ANP）， to analyze the effectiveness of three commonly used risk assessment models for thrombosis （Caprini score， Padua score， and Wells score）， and to provide a reference for clinical identification of high-risk individuals and optimization of prevention and treatment strategies. MethodsA retrospective analysis was performed for the clinical data of 320 patients with ANP who were admitted to Luzhou People’s Hospital and The Affiliated Hospital of Southwest Medical University from April 2013 to April 2024， and according to the presence or absence of DVT during hospitalization， the patients were divided into thrombosis group with 25 patients and control group with 295 patients. After propensity score matching， the two groups were compared in terms of past history and various examination results during hospitalization. The risk factors for lower extremity DVT in ANP patients during hospitalization were analyzed through univariate and multivariate Logistic regression， and a DVT risk prediction model was established based on independent influencing factors. The receiver operating characteristic （ROC） curve was used to assess the performance of models， and the DeLong test was used for comparison of the area under the ROC curve （AUC）， sensitivity， and specificity. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups； the chi-square test was used for comparison of categorical data between groups. ResultsAfter matching， the patients were divided into thrombosis group with 24 patients and control group with 112 patients. The clinical characteristics analysis showed that compared with the control group， the thrombosis group had significantly higher degree of pancreatic necrosis， D-dimer level， Bedside Index for Severity in Acute Pancreatitis （BISAP） score， and proportion of patients undergoing dialysis （all P<0.05）. The multivariable Logistic regression analysis showed that BISAP score， degree of pancreatic necrosis， and D-dimer level were independent risk factors for lower extremity DVT in ANP patients during hospitalization （all P<0.05）. The BISAP-Caprini score model had an AUC of 0.832 （95% confidence interval： 0.722 — 0.942， P<0.001） in predicting the risk of lower extremity DVT， with a Youden index of 1.661， an optimal cut-off value of 0.26， a sensitivity of 75.0%， and a specificity of 91.1%. ConclusionD-dimer， BISAP score， and the degree of pancreatic necrosis are independent risk factors for lower extremity DVT in patients with ANP during hospitalization， and the BISAP-Caprini score model can effectively predict the risk of DVT in ANP patients.

Objective To systematically evaluate the efficacy and safety of three-dimensional visualization technology in assisting ablation therapy for hepatocellular carcinoma.Methods This study was conducted according to PRISMA guidelines,with a PROSPERO registration number of CRD42023488398.PubMed,Embase,Web of Science,the Cochrane Library,CNKI,Wanfang Data,VIP,and CBM were searched for Chinese and English articles on three-dimensional visualization technology in assisting ablation therapy for hepatocellular carcinoma published up to March 2023.After quality assessment and data extraction of the studies included,RevMan 5.4 software was used to perform the meta-analysis.Results A total of 11 studies were included,with 972 patients in total,among whom 447 underwent ablation assisted by three-dimensional visualization technology(3D group)and 525 underwent ablation assisted by traditional two-dimensional imaging technology(2D group).The meta-analysis showed that compared with the 2D group,the 3D group had significantly higher success rate of first-time ablation treatment(odds ratio[OR]=5.43,95%confidence interval[CI]:2.64—11.18,P<0.001),technical efficiency(OR=6.15,95%CI:3.23—11.70,P<0.001),and complete ablation rate(OR=2.50,95%CI:1.08—5.78,P=0.03),as well as significantly lower incidence rate of major complications(OR=0.45,95%CI:0.24—0.87,P=0.02),local recurrence rate(OR=0.35,95%CI:0.17—0.72,P=0.004),and local tumor progression rate(OR=0.29,95%CI:0.16—0.50,P<0.001),while there was no significant difference in the incidence rate of mild complications between the two groups(P>0.05).Conclusion Three-dimensional visualization technology is safe and feasible in assisting ablation therapy for hepatocellular carcinoma and can improve ablation rate and reduce the incidence rate of serious complications,local recurrence rate,and local tumor progression rate,thereby showing an important application value in clinical practice.

ObjectiveTo systematically evaluate the effect of Pringle’s measure (PM) versus hemihepatic vascular occlusion (HVO) in hepatectomy for primary liver cancer. MethodsRelated Chinese and English databases were searched for control studies on HVI versus PM in the treatment of primary liver cancer published up to June 2020. After quality evaluation and data extraction of the included studies, RevMan5.3 software was used for the meta-analysis. ResultsA total of 10 studies were included in the Meta-analysis, with 1272 patients in total. On days 1 and 3 after surgery, the HVO group had a significantly lower level of alanine aminotransferase than the PM group (day 1: mean difference ［MD］=-172.71, 95% confidence interval ［CI］: -289.26 to -56.16, P=0.004; day 3: MD=-130.35, 95%CI: -221.25 to -39.45, P=0.005). On day 3 after surgery, the HVO group had a significantly lower level of aspartate aminotransferase than the PM group (MD=-84.56, 95%CI: -166.47 to -2.65, P=0.04), and on days 1 and 3 after surgery, the HVO group had a significantly higher level of albumin than the PM group (day 1: MD=1.31, 95%CI: 0.06-2.56, P=0.04; day 3: MD=1.81, 95%CI: 027-335, P=0.02). The HVO group had a significantly longer time of operation than the PM group (MD=8.95, 95%CI: 4.30-13.60, P＜0.01). ConclusionHVO is a safe and effective method for vascular occlusion, and compared with PM, it can effectively alleviate liver injury. However, surgeons should select a suitable method for occlusion based on their own personal experience, patients’ conditions, and specific situation during surgery.

ObjectiveTo systematically evaluate the efficacy and safety of laparoscopic liver resection (LLR) versus open liver resection (OLR) in the treatment of colorectal cancer liver metastasis (CRLM). MethodsChinese databases (CNKI, Wanfang, and VIP) and English databases (PubMed, Cochrane Library, and Embase) were searched for controlled clinical trials on LLR versus OLR in the treatment of CRLM published up to June 2019. Chinese search words were colorectal cancer liver metastasis, laparoscopic liver resection, and open liver resection, and English search words were colorectal cancer, colorectal liver metastases, laparoscopic hepatectomy, laparoscopic liver resection, open hepatectomy, and open liver resection. Quality assessment and data extraction were performed for the studies included, and RevMan5.3 software was used to perform the meta-analysis. ResultsA total of 23 studies were included, and there were 4204 patients in total, with 1558 patients in LLR group and 2646 in OLR group. The results of the meta-analysis showed that compared with the OLR group, the LLR group had significantly lower intraoperative blood loss (mean difference ［MD］=-145.48, 95% confidence interval ［CI］: -190.96 to-100.00, P＜0.001), lower transfusion rate (odds ratio ［OR］=0.41, 95%CI: 0.29-0.60, P＜0.001), lower incidence rate of postoperative complications (OR=0.55, 95%CI: 0.47-0.65, P＜0.001), and shorter length of postoperative hospital stay (MD=-2.69, 95%CI: -3.29 to -2.10, P＜0.001). There were no significant differences between the two groups in time of operation, perioperative mortality rate, R0 resection rate, 1- and 5-year overall survival rates, and disease-free survival rate (all P＞005). ConclusionLLR is safe and feasible in the treatment of CRLM and has better short-term efficacy than OLR, but more randomized controlled trials are needed for verification.