Pancreas最新文献

{"title":"Significance of Pancreatic Steatosis as a Predictor of New-Onset Diabetes Mellitus Following Pancreatectomy.","authors":"Keinosuke Ishido, Hiroaki Fujita, Norihisa Kimura, Hayato Nagase, Yusuke Wakasa, Satoru Tsuruta, Takahiro Muroya, Kenichi Hakamada","doi":"10.1097/MPA.0000000000002508","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002508","url":null,"abstract":"<p><strong>Background: </strong>Despite advancements in pancreatic surgery, new-onset diabetes mellitus following pancreatectomy (NODMP), persists, affecting patients' quality of life. Predicting NODMP before surgery could significantly enhance postoperative care.</p><p><strong>Methods: </strong>This study included 220 patients who underwent pancreatoduodenectomy or distal pancreatectomy at Hirosaki University Hospital between January 2008 and December 2020. Patients with preoperative diabetes or <6 months' follow-up were excluded. The anticipated remnant pancreatic-to-splenic parenchyma computed tomography value ratio (remP/S ratio) was used to assess pancreatic fat content, with its cutoff determined using the receiving operator characteristic curve. Time to diabetes onset was analyzed using the Kaplan-Meier method. The risk factors for NODMP were identified using the Cox proportional hazards model.</p><p><strong>Results: </strong>The mean diabetes-free period was 89.2 months over a median follow-up of 25.1 months. The incidence rates of NODMP at 1, 3, and 5 years after resection were 7.21%, 21.3%, and 28.0%, respectively. The significant risk factors for NODMP identified by univariate analysis were pancreatic cancer, preoperative HbA1c >5.7%, remP/S ratio <0.66, and remnant pancreatic volume <32.7 cm3. Multivariate analysis confirmed that a remP/S ratio <0.66 and preoperative HbA1c >5.7% were independent predictors of NODMP. The risk scoring system indicated that patients with both risk factors have a fivefold higher risk of developing NODMP within 2 years compared with those without either risk factor.</p><p><strong>Conclusions: </strong>Preoperative remP/S ratio and HbA1c were significant predictors of NODMP, enabling the effective stratification of NODMP risk and facilitating the early treatment of the disease.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term Outcomes of Splanchnic Venous Thrombosis in Acute Pancreatitis.","authors":"Patlori Samanvith, Paul Deepak, Nicholas Vijay Rao, Gauri Kumbhar, Ajith Thomas, Reuben Thomas Kurien, Betty Simon, Sudipta Dhar Chowdhury","doi":"10.1097/MPA.0000000000002524","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002524","url":null,"abstract":"<p><strong>Background: </strong>Splanchnic venous thrombosis (SVT) involving veins in the vicinity of the pancreas is a significant complication of acute pancreatitis (AP). The natural history of SVT especially the rates of recanalization is poorly understood.</p><p><strong>Aim: </strong>This study aimed to evaluate the natural history of SVT in AP, with a focus on recanalization rates and identifying predictors of non-recanalization.</p><p><strong>Methods: </strong>This was an observational study in which patients with SVT in the setting of AP were included. Patients were followed for at least six months. Recanalization was assessed using Doppler ultrasound or CT imaging, and outcomes were classified as complete recanalization, partial recanalization, or non-recanalization. Statistical analysis was done to identify predictors of non-recanalization.</p><p><strong>Results: </strong>Among 814 patients with AP, 92 (11.3%) developed SVT. Of these, 70 met the inclusion criteria. The mean age was 38.1 years, with 92.8% male predominance. Alcohol was the most common etiology (62.8%). The retropancreatic splenic vein was the most commonly affected vessel. At follow-up, complete recanalization was observed in 54.3% of cases, partial recanalization in 2.9%, while 42.8% showed no evidence of recanalization. Therapeutic anticoagulation was administered to 20% of patients without significantly influencing recanalization rates. A BISAP score ≥2 was a significant predictor of non-recanalization (P=0.007).</p><p><strong>Conclusion: </strong>Most patients with SVT following AP demonstrate spontaneous recanalization. A key predictor for non recanalization is the severity of pancreatitis.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Influencing Factors of Acute Pancreatitis Complicated with Persistent Inflammation and Construction of a Prediction Model.","authors":"Yue Zou, Kunpeng Li, Ping Geng","doi":"10.1097/MPA.0000000000002526","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002526","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the contributing factors for the development of systemic inflammatory response syndrome (SIRS) in acute pancreatitis (AP) patients and subsequently develop a novel nomogram prediction model.</p><p><strong>Methods: </strong>A multivariate logistic regression analysis was conducted to determine independent predictors of SIRS, where the variables were chosen based on statistical significance from univariate analysis. Based on their presence, 238 AP patients were grouped into non-sIRS (n=170) and sIRS (n=68). Logistic regression analysis identified independent predictors of sIRS complications. We then developed a visual nomogram prediction model alongside a logistic regression model. The model's predictive power cut-off was determined by receiver operating characteristic (ROC) curve analysis, providing sensitivity, specificity, and predictive accuracy.</p><p><strong>Results: </strong>The study found that in the cohort of acute pancreatitis (AP) patients, systemic inflammatory response syndrome (SIRS) incidence was 28.6%. From our analysis, we determined that red blood cell distribution width (RDW), fibrinogen (FIB), amylase (AMY), blood glucose (Glu), and lactate dehydrogenase (LDH) were independent risk factors for SIRS. Additionally, we calculated the area under the ROC curve (AUC) for our prediction model of SIRS reached 0.816, which exceeded the AUCs of the individual risk indicators (RDW, FIB, AMY, Glu, LDH) and the bedside index of severity in acute pancreatitis (BISAP) score. In addition, we conducted a correlation analysis to validate the relationships among the predictive factors and to eliminate possible multicollinearity. The calibration curve plot showed that the nomogram agreed well between the predicted SIRS and actual risks. Finally, the clinical decision curve for our model also indicated its clinical utility by guiding decision-making for timely interventions at a threshold probability range of 0.4 to 1.</p><p><strong>Conclusion: </strong>The model predicted non-SIRS with a critical value ≥0.332, a sensitivity of 71.3% and specificity of 87.1%, and a Kappa value of 0.56. These results indicate that this prediction model is based on admission data, with recommended additional validation assessments at multiple time points (e.g., 24, 48, and 72 h) to characterize the progression of SIR's risk fully. Overall, this nomogram prediction model provides an efficient and simple means to predict SIRS for patients with AP.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Biliary Drainage Techniques for MBO: A Meta-Analysis.","authors":"Feng Qiu, Tianchi Yang, Wei Han","doi":"10.1097/MPA.0000000000002504","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002504","url":null,"abstract":"<p><strong>Background: </strong>Malignant biliary obstruction (MBO) impacts patient health and quality of life. Biliary drainage techniques, including percutaneous transhepatic biliary drainage (PTBD) and endoscopic biliary drainage (EBD), are commonly used, yet their relative advantages remain unclear.</p><p><strong>Objective: </strong>To compare the effectiveness and complications of EBD and PTBD in treating MBO.</p><p><strong>Methods: </strong>A systematic literature search in databases such as PubMed and EMBASE identified case-control trials comparing EBD and PTBD from January 2010 to the present. Five studies comprising 721 participants were analyzed. Outcome measures included technical success rate, incidence of complications, post-drainage pancreatitis, bleeding, major complications, hospital stay duration, and implant metastasis rates. Statistical analysis was conducted using RevMan 5.3 software.</p><p><strong>Results: </strong>There was no significant difference between the two groups regarding major complications, bleeding incidents, hospital stay, or implantation metastasis rates. However, PTBD showed a significantly lower incidence of complications and post-drainage pancreatitis compared to EBD.</p><p><strong>Conclusion: </strong>PTBD may offer advantages over EBD in managing MBO, including fewer complications and reduced incidence of pancreatitis, suggesting PTBD as a potentially safer and more effective treatment option. Nonetheless, further large-scale, high-quality studies are needed to validate these findings.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long Non-Coding RNA n336928 Facilitates the Progression of Pancreatic Neuroendocrine Neoplasms via NF-κB Pathway Mediated by EZH2.","authors":"Mujie Ye, Ping Yu, Yi Ding, Jialing Pan, Jianshu Liu, Qin Long, Ye Tian, Qiyun Tang","doi":"10.1097/MPA.0000000000002525","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002525","url":null,"abstract":"<p><p>Pancreatic neuroendocrine neoplasms (pNENs) are among the most frequently occurring neuroendocrine neoplasms (NENs). In this study, we aimed to investigate the role and impact of LncRNA-n336928 (n336928) in pNENs. We evaluated changes in cell proliferation using CCK-8, colony formation, and EDU assays, and assessed the effects on cell migration and invasion through transwell assays. RNA-seq analysis was performed to explore the potential mechanisms underlying n336928-induced pNEN progression. Subcutaneous tumorigenesis models were constructed to verify the function of n336928 in vivo. Our findings indicate that overexpression of n336928 significantly accelerated the proliferation, migration, and invasion of pNEN cell lines, while concurrently suppressing apoptosis. Furthermore, transcriptome sequencing revealed that the NF-κB pathway was activated in pNEN cells following n336928 overexpression. We have established that the upregulation of n336928 promotes the progression of pNENs via the NF-κB signaling pathway, thereby implicating it in the occurrence and development of pNENs.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lifetime Smoking History and Marijuana co-use in Patients With Alcohol-related Acute Pancreatitis.","authors":"Esther A Adeniran, Sungjin Kim, Stephen J Pandol, Dhiraj Yadav, Georgios I Papachristou, James L Buxbaum, Joseph R Pisegna, Christie Y Jeon","doi":"10.1097/MPA.0000000000002523","DOIUrl":"10.1097/MPA.0000000000002523","url":null,"abstract":"<p><strong>Objectives: </strong>Smoking increases the risk of the first episode of acute pancreatitis (AP), its recurrence, and progression to chronic pancreatitis. Co-use of cigarettes with marijuana may exacerbate health risks, complicating pancreatitis management. Our study aims to investigate the lifetime smoking history and co-use of cigarettes and marijuana in AP patients.</p><p><strong>Methods: </strong>We analyzed smoking history and marijuana use data from a multicenter case-crossover study of alcohol-associated AP patients (n=145) recruited from June 2020 to June 2024. Lifetime cigarette use was categorized as: history of smoking <1 pack-per day [PPD], ≥1 PPD, and non-smokers. Age-based smoking prevalence was estimated across two birth cohorts (1956-1979 and 1980-1998). Risk factors for co-use were also assessed.</p><p><strong>Results: </strong>Of the 143 participants enrolled and who completed smoking history interview, 76% were current smokers and 24% were former smokers. Median cumulative pack-years of smoking until enrollment was 20.4 years in ≥1 PPD smokers vs. 4.2 years in <1 PPD smokers ( P <0.001). Peak smoking prevalence was higher in females born in 1980-1998 than females born in 1956-1979 (100% vs. 67%), while males showed an opposite trend (61% for 1956-1979 vs 52% for 1980-1998). Of all participants, 20% reported co-use of cigarettes and marijuana, 22% cigarette-only use, and 14% marijuana-only use. Trauma and stressor-related disorders were associated with a lower likelihood of co-use than cigarette-only use (AOR: 0.19, 95% CI: 0.05-0.63, P =0.010).</p><p><strong>Conclusions: </strong>Smoking is highly prevalent in patients with alcohol-associated AP, many of whom also use marijuana. Tailored smoking cessation interventions are needed for AP patients.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"rs928508 of miR-30c-5p is Associated with the Risk of Post-ERCP Pancreatitis.","authors":"Yunyun Sun, Xia Li, Liang Chen, Jun Zhang","doi":"10.1097/MPA.0000000000002527","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002527","url":null,"abstract":"<p><strong>Objective: </strong>Endoscopic retrograde cholangiopancreatography (ERCP) is a widely utilized endoscopic technique for the diagnosis and therapy of biliary and pancreatic diseases. It usually leads to different complications including post-ERCP pancreatitis (PEP). This study aimed to evaluate the correlation between miR-30c-5p rs928508 polymorphism and the risk of PEP and to analyze the effect of it on serum miR-30c-5p level.</p><p><strong>Methods: </strong>Patients with PEP were collected as a case group, while patients without complications were gathered as a control group. miR-30c-5p levels were measured using qRT-PCR, and rs928508 genotyping was performed using the TaqMan method. Logistic regression analysis was used to recognize independent risk factors for PEP.</p><p><strong>Results: </strong>The case group had significantly lower miR-30c-5p levels, especially in AG/GG genotype carriers. rs928508 was correlated with increased PEP risk under GG vs. AA (OR=2.170, 95%CI=1.118-4.210), AG/GG vs. AA (P=0.032, OR=1.840, 95%CI=1.048-3.231) and G vs. A (P=0.026, OR=1.433, 95%CI=1.043-1.969) models. Meanwhile, AG (OR=33.023, 95%CI=1.026-8.906), GG (OR=3.344, 95%CI=1.070-10.450), and AG/GG (OR=3.138, 95%CI=1.103-8.932) genotypes were correlated with high severity of PEP. Multivariate analysis suggested that drinking (OR=2.091, 95%CI=1.102-3.968), difficult cannulation (OR=2.198, 95%CI=1.301-3.712), pancreatic duct visualization (OR=5.468, 95%CI=2.945-10.151), pancreatic duct stenting history (OR=3.415, 95%CI=1.742-6.693), and AG/GG genotypes of rs928508 (OR=2.137, 95%CI=1.114-4.100) were independent risk factors for PEP onset.</p><p><strong>Conclusion: </strong>miR-30c-5p rs928508 polymorphism is correlated with an enhanced risk and severity of PEP.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prevalence and Characteristics of Autoimmune Pancreatitis among Patients Presenting with Pancreatitis to a Quaternary Referral Centre in Melbourne, Australia.","authors":"Dilini Abeywickrama, Michael MacIsaac, Simon Hew","doi":"10.1097/MPA.0000000000002521","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002521","url":null,"abstract":"","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrointestinal Burden in Patients with Pancreatic Insufficient Cystic Fibrosis Before and After Elexacaftor/Tezacaftor/Ivacaftor Use.","authors":"Sasha-Jane Abi-Aad, Carolena Trocchia, Maua Mosha, Jacob A Mark, Daniel H Leung, Racha Khalaf","doi":"10.1097/MPA.0000000000002522","DOIUrl":"10.1097/MPA.0000000000002522","url":null,"abstract":"<p><strong>Background: </strong>The advent of highly effective modulator therapies (HEMT), namely elexacaftor, tezacaftor and ivacaftor (ETI), has resulted in substantial improvements in lung function, growth, and quality of life, for people with cystic fibrosis (PwCF). However, the understanding of the impact of ETI on gastrointestinal (GI) disease burden is evolving. This study aims to describe and compare the prevalence of GI manifestations, prescribed GI medications, and GI procedures between two time periods pre and post-ETI approval in children with CF (CwCF).</p><p><strong>Methods: </strong>This is a retrospective cohort study utilizing TriNetX, a multicenter database. The study includes patients between 6 to 21 years old with ICD-10 diagnostic codes for CF and a prescription for pancreatic enzyme replacement therapy (PERT) to match disease severity. We included 4 years before and 4 years after the release of ETI combination therapy.</p><p><strong>Results: </strong>When comparing CwCF taking PERT, on or off ETI, the prevalence of diagnostic codes for chronic pancreatitis, constipation, unspecified noninfective gastroenteritis, and colitis significantly decreased after ETI use (all P < 0.0001). The prevalence of other luminal disorders, liver disorders, and acute pancreatitis did not differ between the two groups. The prevalence of prescribed medications including mucolytics, vitamins, PPI, and antidiarrheal was similar for both groups except for a reduction in prescribed laxatives (p-value = 0.0001). The prevalence of GI procedures was also similar in both groups.</p><p><strong>Conclusion: </strong>The reduction in constipation and non-infective gastroenteritis and colitis is important as GI symptoms are linked to the quality of life of CwCF. There remains a great clinical need to evaluate the effects of ETI on GI disorders, especially as the age of initial use of this therapy decreases, and the duration of use increases.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary Acute Myeloid Leukemia following Treatment for Metastatic Poorly Differentiated Pancreatic Neuroendocrine Carcinoma: A Cautionary Sequel to an Exceptional Response.","authors":"Elizabeth S Nakasone, Stacey A Cohen","doi":"10.1097/MPA.0000000000002520","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002520","url":null,"abstract":"","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}