Expert Review of Gastroenterology & Hepatology最新文献

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Is oncolytic adenoviral-mediated immunotherapy through p53-overexpression the solution to refractory pancreatic ductal adenocarcinoma? 通过 p53 表达的溶瘤性腺病毒介导的免疫疗法是难治性胰腺导管腺癌的解决方案吗?
IF 3.8 3区 医学
Expert Review of Gastroenterology & Hepatology Pub Date : 2024-06-01 Epub Date: 2024-06-17 DOI: 10.1080/17474124.2024.2363222
Lucy J A Harriss, Lewis Stevens, Charles J Rayner, Guy Simpson, Nicola E Annels, Adam E Frampton
{"title":"Is oncolytic adenoviral-mediated immunotherapy through p53-overexpression the solution to refractory pancreatic ductal adenocarcinoma?","authors":"Lucy J A Harriss, Lewis Stevens, Charles J Rayner, Guy Simpson, Nicola E Annels, Adam E Frampton","doi":"10.1080/17474124.2024.2363222","DOIUrl":"10.1080/17474124.2024.2363222","url":null,"abstract":"<p><p><b>Evaluation of:</b> Araki H, Tazawa H, Kanaya N, et al. Oncolytic virus-mediated p53 overexpression promotes immunogenic cell death and efficacy of PD-1 blockade in pancreatic cancer. Mol Ther Oncolytics. 2022;27:3-13.Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy with poor prognosis. PDAC has a dense, desmoplastic stroma and immunosuppressive microenvironment, which impedes current treatment options. Immunotherapy delivered via oncolytic virotherapy is one potential solution to these barriers. Immune checkpoint inhibitors may facilitate immunogenic cell death by improving immune cell infiltration in cancer cells. PD-1 blockade shows better clinical outcomes for certain cancers. The addition of p53 to stimulate cell cycle arrest remains a novel field of research. The evaluated article by Araki <i>et al</i>. explores the efficacy of PD-1 blockade with oncolytic adenovirus platforms on immunogenic cell death and the possibility of combining PD-1 blockade and p53-activation. <i>In vitro</i> analysis showed increased cell death in multiple cell lines infected with AdV mediating p53 expression. The underlying process may attribute to apoptosis and autophagy, with evidence of increased immunogenic cell death. <i>In vivo</i> models demonstrated improved efficacy of p53-expressing AdV, particularly with the addition of PD-1 blockade which appears to be related to CD8+ cell infiltration.</p>","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"223-226"},"PeriodicalIF":3.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141179200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cost-effectiveness of tislelizumab plus chemotherapy vs chemotherapy as first-line treatment of PD-L1 positive advanced gastric or gastroesophageal junction adenocarcinoma from a Chinese perspective. 从中国人的视角看PD-L1阳性晚期胃癌或胃食管交界腺癌一线治疗中替斯利珠单抗联合化疗与化疗的成本效益对比。
IF 3.8 3区 医学
Expert Review of Gastroenterology & Hepatology Pub Date : 2024-06-01 Epub Date: 2024-06-28 DOI: 10.1080/17474124.2024.2373730
Wei Li, Li Wan, Jiangyan Zhang
{"title":"Cost-effectiveness of tislelizumab plus chemotherapy vs chemotherapy as first-line treatment of PD-L1 positive advanced gastric or gastroesophageal junction adenocarcinoma from a Chinese perspective.","authors":"Wei Li, Li Wan, Jiangyan Zhang","doi":"10.1080/17474124.2024.2373730","DOIUrl":"10.1080/17474124.2024.2373730","url":null,"abstract":"<p><strong>Background: </strong>This work was designed to assess the cost-effectiveness of front-line tislelizumab plus chemotherapy (TIS+Chemo) in advanced gastric cancer (GC) or gastroesophageal junction cancer (GEJC) with positive expression of programmed cell death ligand 1 (PD-L1) from the perspective of Chinese healthcare system.</p><p><strong>Research design and methods: </strong>A 10-year partitioned survival model was undertaken utilizing clinical data from RATIONALE 305. Costs and utilities were both discounted at an annual rate of 5%. The primary outcome was incremental cost-effectiveness ratios (ICERs) and calculated as the cost per quality-adjusted life years (QALYs). The willingness-to-pay (WTP) threshold was set as $18,625/QALY. Only direct medical costs were considered. Sensitivity analyses and subgroup analyses were performed to evaluate the robustness of the model.</p><p><strong>Results: </strong>In the base-case analysis, the incremental cost and effectiveness associated with TIS+Chemo vs Chemo was 7,361 and 0.38 QALYs, respectively, leading to an ICER of 19,371/QALY. At the WTP threshold of $18,625/QALY, the TIS+Chemo was not a cost-effective first-line treatment option. The model outcomes were robust.</p><p><strong>Conclusions: </strong>TIS+Chemo did not provide a cost-effective approach for PD-L1 positive advanced GC/GEJC in China setting. However, TIS+Chemo might be cost-effective in provinces with higher WTP threshold.</p><p><strong>Clinical trial registration: </strong>RATIONALE 305, www.clinicaltrials.gov, identifier is NCT03777657.</p>","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"293-301"},"PeriodicalIF":3.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141456126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
miRNAs in patients with alcoholic liver disease: a systematic review and meta-analysis. 酒精性肝病患者体内的 miRNA:系统综述与荟萃分析。
IF 3.8 3区 医学
Expert Review of Gastroenterology & Hepatology Pub Date : 2024-06-01 Epub Date: 2024-07-08 DOI: 10.1080/17474124.2024.2374470
Tengyue Hu, Chang Hai Liu, Yurong Zheng, Jialin Ji, Yantong Zheng, Si-Ke He, Dongbo Wu, Wei Jiang, Qingmin Zeng, Nannan Zhang, Hong Tang
{"title":"miRNAs in patients with alcoholic liver disease: a systematic review and meta-analysis.","authors":"Tengyue Hu, Chang Hai Liu, Yurong Zheng, Jialin Ji, Yantong Zheng, Si-Ke He, Dongbo Wu, Wei Jiang, Qingmin Zeng, Nannan Zhang, Hong Tang","doi":"10.1080/17474124.2024.2374470","DOIUrl":"10.1080/17474124.2024.2374470","url":null,"abstract":"<p><strong>Introduction: </strong>Alcoholic liver disease (ALD) encompasses a spectrum of liver conditions, including liver steatosis, alcoholic hepatitis (AH), fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). microRNAs (miRNAs) have garnered significant interest as potential biomarkers for ALD.</p><p><strong>Methods: </strong>We searched PubMed, Embase, Web of Science and Cochrane Central Register of Controlled Trials (CENTRAL) systemically from inception to June 2024. All extracted data was stratified according to the stages of ALD. The vote-counting strategy performed a meta-analysis on miRNA expression profiles.</p><p><strong>Results: </strong>We included 40 studies. In serum of individuals with alcohol-use vs. no alcohol-use, miRNA-122 and miRNA-155 were upregulated, and miRNA-146a was downregulated. In patients with ALD vs. healthy controls, miRNA-122 and miRNA-155 were also upregulated, and miRNA-146a was downregulated. However, in patients with AH vs. healthy individuals, only the serum miRNA-122 level was upregulated. Due to insufficient data on diagnostic accuracy, we failed to conclude the ability of miRNAs to distinguish between different stages of ALD-related liver fibrosis. The results for ALD-related HCC were also insufficient and controversial.</p><p><strong>Conclusions: </strong>Circulating miRNA-122 was the most promising biomarker to manage individuals with ALD. More studies were needed for the diagnostic accuracy of miRNAs in ALD.</p><p><strong>Registration: </strong>This protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO) (www.crd.york.ac.uk/prospero/) with registration number CRD42023391931.</p>","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"283-292"},"PeriodicalIF":3.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141467314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Recent developments in the diagnosis of pancreatic neuroendocrine neoplasms 胰腺神经内分泌肿瘤诊断的最新进展
IF 3.9 3区 医学
Expert Review of Gastroenterology & Hepatology Pub Date : 2024-04-22 DOI: 10.1080/17474124.2024.2342837
Anna Battistella, Matteo Tacelli, Paola Mapelli, Marco Schiavo Lena, Valentina Andreasi, Luana Genova, Francesca Muffatti, Francesco De Cobelli, Stefano Partelli, Massimo Falconi
{"title":"Recent developments in the diagnosis of pancreatic neuroendocrine neoplasms","authors":"Anna Battistella, Matteo Tacelli, Paola Mapelli, Marco Schiavo Lena, Valentina Andreasi, Luana Genova, Francesca Muffatti, Francesco De Cobelli, Stefano Partelli, Massimo Falconi","doi":"10.1080/17474124.2024.2342837","DOIUrl":"https://doi.org/10.1080/17474124.2024.2342837","url":null,"abstract":"Pancreatic Neuroendocrine Neoplasms (PanNENs) are characterized by a highly heterogeneous clinical and biological behavior, making their diagnosis challenging. PanNENs diagnostic work-up mainly rel...","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":"30 1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140634677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Germline testing and genetic counselling in biliary tract cancer: an operative proposal to improve the state of art 胆道癌的基因检测和遗传咨询:提高技术水平的操作建议
IF 3.9 3区 医学
Expert Review of Gastroenterology & Hepatology Pub Date : 2024-04-08 DOI: 10.1080/17474124.2024.2337000
Margherita Rimini, Silvia Presi, Giovanni Battista Pipitone, Annalisa Russo Raucci, Francesca Ratti, Angelo Della Corte, Federica Pedica, Giuseppe Vanella, Giovanni Tonon, Valentina Burgio, Francesco Vitiello, Federico Rossari, Elisabeth Amadeo, Maria Giulia Cangi, Lorenza Pecciarini, Paolo Giorgio Arcidiacono, Francesca Falcinelli, Stefano Cascinu, Francesco De Cobelli, Luca Aldrighetti, Maria Grazia Patricelli, Paola Carrera, Andrea Casadei-Gardini
{"title":"Germline testing and genetic counselling in biliary tract cancer: an operative proposal to improve the state of art","authors":"Margherita Rimini, Silvia Presi, Giovanni Battista Pipitone, Annalisa Russo Raucci, Francesca Ratti, Angelo Della Corte, Federica Pedica, Giuseppe Vanella, Giovanni Tonon, Valentina Burgio, Francesco Vitiello, Federico Rossari, Elisabeth Amadeo, Maria Giulia Cangi, Lorenza Pecciarini, Paolo Giorgio Arcidiacono, Francesca Falcinelli, Stefano Cascinu, Francesco De Cobelli, Luca Aldrighetti, Maria Grazia Patricelli, Paola Carrera, Andrea Casadei-Gardini","doi":"10.1080/17474124.2024.2337000","DOIUrl":"https://doi.org/10.1080/17474124.2024.2337000","url":null,"abstract":"A genetic predisposition seems to be involved in biliary tract cancer, but the prevalence of germline mutations in BTC remains unclear, and the therapeutic role of the germline pathologic variants ...","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":"58 1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140594310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Combining Anti-epidermal Growth Factor Receptor (EGFR) Therapy with Immunotherapy in Metastatic Colorectal Cancer (mCRC). 将抗表皮生长因子受体 (EGFR) 疗法与免疫疗法相结合治疗转移性结直肠癌 (mCRC)。
IF 3.9 3区 医学
Expert Review of Gastroenterology & Hepatology Pub Date : 2024-04-01 Epub Date: 2023-09-13 DOI: 10.1080/17474124.2023.2232718
Feng Xiong, Yu-Wen Zhou, Ya-Ting Hao, Gui-Xia Wei, Xiao-Rong Chen, Meng Qiu
{"title":"Combining Anti-epidermal Growth Factor Receptor (EGFR) Therapy with Immunotherapy in Metastatic Colorectal Cancer (mCRC).","authors":"Feng Xiong, Yu-Wen Zhou, Ya-Ting Hao, Gui-Xia Wei, Xiao-Rong Chen, Meng Qiu","doi":"10.1080/17474124.2023.2232718","DOIUrl":"10.1080/17474124.2023.2232718","url":null,"abstract":"<p><strong>Introduction: </strong>Monoclonal antibodies binding the EGFR, such as cetuximab and panitumumab, have been extensively used as targeted therapy for the treatment of mCRC. However, in clinical practice, it has been found that these treatment options have some limitations and fail to fully exploit their immunoregulatory activities. Meanwhile, because of the limited effects of current treatments, immunotherapy is being widely studied for patients with mCRC. However, previous immunotherapy trials in mCRC patients have had unsatisfactory outcomes as monotherapy. Thus, combinatorial treatment strategies are being researched.</p><p><strong>Areas covered: </strong>The authors retrieved relevant documents of combination therapy for mCRC from PubMed and Medline. This review elaborates on the knowledge of immunomodulatory effects of anti-EGFR therapy alone and in combination with immunotherapy for mCRC.</p><p><strong>Expert opinion: </strong>Although current treatment options have improved median overall survival (OS) for advanced disease to 30 months, the prognosis remains challenging for those with metastatic disease. More recently, the combination of anti-EGFR therapy with immunotherapy has been shown activity with complementary mechanisms. Hence, anti-EGFR therapy in combination with immunotherapy may hold the key to improving the therapeutic effect of refractory mCRC.</p>","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"185-192"},"PeriodicalIF":3.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10235520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Novel therapeutics to treat chronic pancreatitis: targeting pancreatic stellate cells and macrophages. 治疗慢性胰腺炎的新疗法:靶向胰腺星状细胞和巨噬细胞。
IF 3.9 3区 医学
Expert Review of Gastroenterology & Hepatology Pub Date : 2024-04-01 Epub Date: 2024-05-18 DOI: 10.1080/17474124.2024.2355969
Srikanth Iyer, Macie Enman, Preeti Sahay, Vikas Dudeja
{"title":"Novel therapeutics to treat chronic pancreatitis: targeting pancreatic stellate cells and macrophages.","authors":"Srikanth Iyer, Macie Enman, Preeti Sahay, Vikas Dudeja","doi":"10.1080/17474124.2024.2355969","DOIUrl":"10.1080/17474124.2024.2355969","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic pancreatitis (CP) is a persistent, recurrent, and progressive disorder that is characterized by chronic inflammation and irreversible fibrosis of the pancreas. It is associated with severe morbidity, resulting in intense abdominal pain, diabetes, exocrine and endocrine dysfunction, and an increased risk of pancreatic cancer. The etiological factors are diverse and the major risk factors include smoking, chronic alcoholism, as well as other environmental and genetic factors. The treatment and management of CP is challenging, and no definitive curative therapy is currently available.</p><p><strong>Areas covered: </strong>This review paper aims to provide an overview of the different cell types in the pancreas that is known to mediate disease progression and outline potential novel therapeutic approaches and drug targets that may be effective in treating and managing CP. The information presented in this review was obtained by conducting a NCBI PubMed database search, using relevant keywords.</p><p><strong>Expert opinion: </strong>In recent years, there has been an increased interest in the development of novel therapeutics for CP. A collaborative multi-disciplinary approach coupled with a consistent funding for research can expedite progress of translating the findings from bench to bedside.</p>","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"171-183"},"PeriodicalIF":3.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140957062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Trends and challenges in home enteral feeding methods for children with gastrointestinal disorders: an expert review on bolus feeding delivery methods. 胃肠疾病儿童家庭肠内喂养方法的发展趋势和挑战:专家对丸式喂养方法的综述。
IF 3.8 3区 医学
Expert Review of Gastroenterology & Hepatology Pub Date : 2024-04-01 Epub Date: 2023-12-04 DOI: 10.1080/17474124.2023.2289530
Claudio Romano, Paolo Lionetti, Maria Immacolata Spagnuolo, Sergio Amarri, Antonella Diamanti, Elvira Verduci, Antonella Lezo, Simona Gatti
{"title":"Trends and challenges in home enteral feeding methods for children with gastrointestinal disorders: an expert review on bolus feeding delivery methods.","authors":"Claudio Romano, Paolo Lionetti, Maria Immacolata Spagnuolo, Sergio Amarri, Antonella Diamanti, Elvira Verduci, Antonella Lezo, Simona Gatti","doi":"10.1080/17474124.2023.2289530","DOIUrl":"10.1080/17474124.2023.2289530","url":null,"abstract":"<p><strong>Introduction: </strong>New evidence supports the benefits of bolus feeding for children receiving home enteral feeding (HEN). Current home methods of bolus feeding have certain limitations, particularly in mobile or restless patients. Therefore, innovative delivery methods have been introduced to provide more flexible methods of reducing feeding time and formula handling.</p><p><strong>Areas covered: </strong>This manuscript presents an expert review of the updates in HEN for children and the results of an online user experience questionnaire about an innovative new cap-based bolus feeding system. A literature bibliographic search was conducted on Medline via PubMed up to September 2023 to collect relevant studies. We presented recent evidence demonstrating a dramatic increase in HEN use among children requiring EN and its benefits on patients' nutritional status and quality of life. In addition, the article examined the clinical and social benefits of bolus feeding and current challenges in delivery methods. We described the benefits of the new system and its user experience.</p><p><strong>Expert opinion: </strong>The uses and indications for bolus feeding in HEN are increasing among children. However, there are still some unmet needs regarding traditional delivery methods. Innovative techniques can improve flexibility, reduce feeding time, and improve user experience and quality of life.</p>","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"193-202"},"PeriodicalIF":3.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138458940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
What are the true benefits of robotic pancreaticoduodenectomy for patients with pancreatic cancer? 机器人胰十二指肠切除术对胰腺癌患者的真正益处是什么?
IF 3.9 3区 医学
Expert Review of Gastroenterology & Hepatology Pub Date : 2024-04-01 Epub Date: 2024-05-10 DOI: 10.1080/17474124.2024.2351398
Irena Stefanova, Francesca Vescio, Felix Nickel, Nabeel Merali, Michele Ammendola, Rajiv P Lahiri, Tim D Pencavel, Tim R Worthington, Adam E Frampton
{"title":"What are the true benefits of robotic pancreaticoduodenectomy for patients with pancreatic cancer?","authors":"Irena Stefanova, Francesca Vescio, Felix Nickel, Nabeel Merali, Michele Ammendola, Rajiv P Lahiri, Tim D Pencavel, Tim R Worthington, Adam E Frampton","doi":"10.1080/17474124.2024.2351398","DOIUrl":"10.1080/17474124.2024.2351398","url":null,"abstract":"<p><strong>Introduction: </strong>Pancreatic ductal adenocarcinoma (PDAC) is a devastating disease, and multimodal treatment including high-quality surgery can improve survival outcomes. Pancreaticoduodenectomy (PD) has evolved with minimally invasive approaches including the implementation of robotic PD (RPD). In this special report, we review the literature whilst evaluating the 'true benefits' of RPD compared to open approach for the treatment of PDAC.</p><p><strong>Areas covered: </strong>We have performed a mini-review of studies assessing PD approaches and compared intraoperative characteristics, perioperative outcomes, post-operative complications and oncological outcomes.</p><p><strong>Expert opinion: </strong>RPD was associated with similar or longer operative times, and reduced intra-operative blood loss. Perioperative pain scores were significantly lower with shorter lengths of stay with the robotic approach. With regards to post-operative complications, post-operative pancreatic fistula rates were similar, with lower rates of clinically relevant fistulas after RPD. Oncological outcomes were comparable or superior in terms of margin status, lymph node harvest, time to chemotherapy and survival between RPD and OPD. In conclusion, RPD allows safe implementation of minimally invasive PD. The current literature shows that RPD is either equivalent, or superior in certain aspects to OPD. Once more centers gain sufficient experience, RPD is likely to demonstrate clear superiority over alternative approaches.</p>","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"133-139"},"PeriodicalIF":3.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140848294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effectiveness of the pharmacological therapy to prevent post ERCP acute pancreatitis: a network meta-analysis. 预防ERCP术后急性胰腺炎的药物治疗效果:网络荟萃分析。
IF 3.9 3区 医学
Expert Review of Gastroenterology & Hepatology Pub Date : 2024-04-01 Epub Date: 2024-05-09 DOI: 10.1080/17474124.2024.2345640
Edgar Julián Rojas-Victoria, Sara Isabel Hernández-Ruiz, Herney Andrés García-Perdomo
{"title":"Effectiveness of the pharmacological therapy to prevent post ERCP acute pancreatitis: a network meta-analysis.","authors":"Edgar Julián Rojas-Victoria, Sara Isabel Hernández-Ruiz, Herney Andrés García-Perdomo","doi":"10.1080/17474124.2024.2345640","DOIUrl":"10.1080/17474124.2024.2345640","url":null,"abstract":"<p><strong>Objective: </strong>To determine the effectiveness of the different pharmacological agents in preventing post-ERCP acute pancreatitis.</p><p><strong>Methods: </strong>We included clinical trials of pharmacological interventions for prophylaxis of acute post-ERCP pancreatitis. The event evaluated was acute pancreatitis. We conducted a search strategy in MEDLINE (OVID), EMBASE, and Cochrane Central Register of Controlled Trials from inception to nowadays. We reported the information in terms of relative risks (RR) with a 95% confidence interval. We assessed the heterogeneity using the I<sup>2</sup> test.</p><p><strong>Results: </strong>We included 84 studies for analysis (30,463 patients). The mean age was 59.3 years (SD ± 7.01). Heterogeneity between studies was low (I2 = 34.4%) with no inconsistencies (<i>p</i> = 0.2567). Post ERCP pancreatitis was less in prophylaxis with NSAIDs (RR 0.65 95% CI [0.52 to 0.80]), aggressive hydration with Lactate Ringer (RR 0.32 95% CI [0.12-0.86]), NSAIDs + isosorbide dinitrate (RR 0.28 95% CI [0.11-0.71]) and somatostatin and analogues (RR 0.54 [0.43 to 0.68]) compared with placebo.</p><p><strong>Conclusions: </strong>NSAIDs, the Combination of NSAIDs + isosorbide dinitrate, somatostatin and analogues, and aggressive hydration with lactate ringer are pharmacological strategies that can prevent post-ERCP pancreatitis when compared to placebo. More clinical trials are required to determine the effectiveness of these drugs.</p>","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"203-215"},"PeriodicalIF":3.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140897766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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