{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T16:14:37Z","timestamp":1770135277108,"version":"3.49.0"},"reference-count":23,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hepatology Research"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>Acute pancreatitis is a recognized complication of acute liver failure (ALF), but its incidence and predictive factors remain poorly defined. Current risk stratification relies primarily on conventional laboratory markers with limited discriminatory ability for pancreatic complications. This study aimed to determine the incidence and prognostic impact of acute pancreatitis in ALF patients and evaluate whether liver volumetry improves prediction beyond conventional markers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross\u2010sectional retrospective study utilized data from a nationwide survey\u2010based registry conducted by the Intractable Hepato\u2010Biliary Disease Study Group of Japan (2011\u20132021). We analyzed 142 ALF patients with available liver volumetry data and 90\u2010day outcome information. Patients with pre\u2010existing acute pancreatitis were excluded. Predictive models were developed comparing conventional markers (MELD score) versus an enhanced model incorporating computed tomography liver volume to standard liver volume ratio (CTLV\/SLV). Model performance was evaluated using ROC analysis, net reclassification index, and clinical validation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Acute pancreatitis developed in 19 patients (13.4%), typically within the first 8\u00a0weeks (84.3% of cases). Logistic regression identified acute pancreatitis as an independent risk factor for poor prognosis (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a00.2556,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.031). The CTLV\/SLV ratio was significantly lower in patients developing pancreatitis (0.80 vs. 1.07,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). The enhanced model (MELD\u00a0+\u00a0CTLV\/SLV) achieved superior discrimination (AUC 0.810) compared to MELD alone (AUC 0.704), with 81% relative risk reduction in the low\u2010risk category.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Incorporating liver volumetry significantly improves acute pancreatitis prediction in ALF patients, enabling more precise risk stratification and potentially optimizing clinical management strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hepr.70054","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T15:35:05Z","timestamp":1760024105000},"page":"233-245","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Liver Volumetry Enhances Prediction of Acute Pancreatitis in Acute Liver Failure: A Nationwide Registry Study"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9627-138X","authenticated-orcid":false,"given":"Keisuke","family":"Kakisaka","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Internal Medicine School of Medicine Iwate Medical University  Yahaba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1317-3272","authenticated-orcid":false,"given":"Nobuaki","family":"Nakayama","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Faculty of Medicine Saitama Medical University  Moroyama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tokio","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Internal Medicine School of Medicine Iwate Medical University  Yahaba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9532-7580","authenticated-orcid":false,"given":"Kotaro","family":"Kumagai","sequence":"additional","affiliation":[{"name":"Department of Digestive and Lifestyle Related Disease Health Research Course Human and Environmental Sciences Kagoshima University Graduate School of Medical and Dental Sciences  Kagoshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1471-1087","authenticated-orcid":false,"given":"Hidekatsu","family":"Kuroda","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Internal Medicine School of Medicine Iwate Medical University  Yahaba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0888-0420","authenticated-orcid":false,"given":"Ryuzo","family":"Abe","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Oita University  Oita Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6689-4989","authenticated-orcid":false,"given":"Taro","family":"Takami","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Yamaguchi University Graduate School of Medicine  Ube Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6002-5213","authenticated-orcid":false,"given":"Kazuaki","family":"Chayama","sequence":"additional","affiliation":[{"name":"Hiroshima Institute of Life Sciences  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahito","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Gifu University Graduate School of Medicine  Gifu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0006-8948","authenticated-orcid":false,"given":"Takuya","family":"Genda","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Juntendo University Shizuoka Hospital  Shizuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5439-635X","authenticated-orcid":false,"given":"Shuji","family":"Terai","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Graduate School of Medical and Dental Sciences Niigata University  Niigata Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuaki","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology International University of Health and Welfare Narita Hospital  Narita 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