Pancreas最新文献

{"title":"Drain Fluid White Blood Cell Count Enhances Prediction of Clinically Relevant Pancreatic Fistula After Pancreaticoduodenectomy.","authors":"Shunta Ishizaki, Kenei Furukawa, Koichiro Haruki, Yoshihiro Shirai, Takeshi Gocho, Toru Ikegami","doi":"10.1097/MPA.0000000000002669","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002669","url":null,"abstract":"","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841253","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":"Advancements in Understanding the Interplay between Mitophagy and Acute Pancreatitis: A Comprehensive Research Overview.","authors":"Xin Liu, Zhenzhen Huang, Peiwu Li","doi":"10.1097/MPA.0000000000002664","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002664","url":null,"abstract":"<p><p>Acute pancreatitis (AP) is characterized by the abnormal activation of pancreatic enzymes within the pancreas, triggering inflammatory responses such as auto-digestion and necrosis of tissue. As a prevalent clinical condition, AP manifests with symptoms including abdominal pain, nausea, and fever, and in severe cases can be fatal. Despite its prevalence, the etiology of AP is complex, with an unknown cause and a scarcity of effective treatments. Possible triggers for AP include bile duct obstruction from gallstones, prolonged and excessive alcohol consumption, pancreatic vascular embolism, infection, and dysfunction. A noteworthy contributor to AP is the dysfunction of pancreatic cells induced by mitochondrial autophagy, an increasingly prominent focus of research in this field. Inflammatory vesicles, reactive oxygen radicals, endoplasmic reticulum stress, calcium overload, and iron-induced death are intricately linked to both mitochondrial autophagy and AP. This review consolidates insights into the pathogenesis of mitochondrial autophagy and AP, offering novel perspectives and avenues for the diagnosis and treatment of AP.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841260","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":"Effects of glucagon-like Peptide 1, glucagon, and Glucose-Dependent Insulinotropic Polypeptide on Fluid Secretion in Guinea-Pig Pancreatic Duct Cells.","authors":"Mayuko Furuhashi-Higuchi, Akiko Yamamoto, Kotoyo Fujiki, Miyuki Nakakuki, Itsuka Taniguchi, Nao Nomura, Libin Liu, Yuka Kozawa, Erina Niwa, Suzuna Sato, Makoto Yamaguchi, Hiroshi Ishiguro","doi":"10.1097/MPA.0000000000002661","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002661","url":null,"abstract":"<p><strong>Objectives: </strong>We examined the direct effects of glucagon-like peptide 1 (GLP-1), glucagon, and glucose-dependent insulinotropic polypeptide (GIP) on the physiological function of pancreatic duct cells by using interlobular duct segments isolated from the guinea-pig pancreas.</p><p><strong>Methods: </strong>The rate of fluid secretion was continuously measured by monitoring the luminal volume of isolated duct segments. cAMP production was measured in individual ducts by ELISA. Messenger RNA expression of GLP-1, glucagon, and GIP receptors in pancreatic duct cells was examined by quantitative reverse transcriptase-polymerase chain reaction.</p><p><strong>Results: </strong>All of GLP-1, glucagon, and GIP concentration-dependently stimulated fluid secretion. While the potency of GLP-1 was equivalent to that of secretin in physiological (10 and 30 pM) to pharmacological concentrations, higher concentrations (over 100 pM) of GIP were required for significant stimulation. The potency of glucagon was relatively weak. While GLP-1 and secretin additively stimulated fluid secretion, GIP and secretin synergistically stimulated fluid secretion, when physiological concentrations were applied. On the contrary, glucagon inhibited secretin-stimulated fluid secretion in a competitive manner. GLP-1 (1 nM) significantly increased cAMP production in isolated pancreatic ducts. Messenger RNA expression of GLP-1, glucagon, and GIP receptors were detected in isolated ducts. GLP-1 receptor immunoreactivity was detected in epithelial cells of pancreatic ducts.</p><p><strong>Conclusions: </strong>Physiological concentrations of GLP-1 and GIP directly stimulate pancreatic duct fluid secretion via elevation of intracellular cAMP and interact with secretin in the guinea-pig. The physiological role of glucagon in the regulation of pancreatic duct fluid secretion is limited.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841313","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":"Association Between Social Determinants of Health and the Risk of Acute Pancreatitis and Related Diseases: A Prospective Cohort Study in the UK Biobank.","authors":"Yajie Wang, Jike Fang, Jiangyuan Huang, Renyuan Sun, Yue Chen, Quanzhang Li, Zelong Wu, Shanzhou Huang, Jiayu Yang, Baohua Hou, Chuanzhao Zhang","doi":"10.1097/MPA.0000000000002595","DOIUrl":"10.1097/MPA.0000000000002595","url":null,"abstract":"<p><strong>Background: </strong>Social determinants of health (SDH) encompass socioeconomic and environmental factors that influence individual health outcomes. While SDH has been studied in relation to cardiovascular and metabolic diseases, its potential relationship with acute pancreatitis (AP) remains insufficiently explored.</p><p><strong>Methods: </strong>We conducted a prospective cohort study using data from the UK Biobank, including over 340,000 participants without a history of AP at baseline. A composite SDH score was constructed from multiple indicators, and the association between SDH and incident AP was examined using Cox proportional hazards models. Restricted cubic spline (RCS) regression was used to assess dose-response relationships. Stratified analyses were performed by demographic and clinical subgroups. Associations between SDH and AP-related diseases were also investigated.</p><p><strong>Results: </strong>Elevated SDH scores were significantly associated with increased AP risk ( P < 0.001), with a linear dose-response relationship confirmed by RCS analysis. After full adjustment, the risk of AP was found to be higher in participants with unfavorable SDH (HR: 1.52, 95% CI: 1.37-1.70) compared with those with favorable SDH. In post-AP individuals, participants in the higher SDH group had increased risks of chronic pancreatitis (CP) and type 2 diabetes mellitus (T2DM). However, no significant association was found between SDH and post-AP pancreatic cancer (PC; P = 0.632).</p><p><strong>Conclusions: </strong>Social disadvantage, as reflected by higher SDH scores, is associated with high risk of AP and AP-related diseases. These findings underscore the importance of considering social context in clinical and public health efforts to reduce the burden of pancreatic diseases.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e489-e497"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145768765","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":"Acinar-to-Ductal Metaplasia: Bridging the Gap Between Cellular Plasticity and Treatment Innovations in Chronic Pancreatitis.","authors":"Menghui Wang, Jie Lu","doi":"10.1097/MPA.0000000000002588","DOIUrl":"10.1097/MPA.0000000000002588","url":null,"abstract":"<p><p>Chronic pancreatitis (CP) progressively destroys and fibroses the pancreatic parenchyma, ultimately impairing exocrine and endocrine functions. Acinar-to-ductal metaplasia (ADM), the transformation of acinar cells into duct-like cells, plays a critical role in the progression of CP. This review first provides an overview of the plasticity of various cell types in the exocrine pancreas. It then delves into the mechanisms underlying ADM, focusing on its driving factors, including genetic mutations, environmental influences, and signaling pathways such as Notch. Finally, it discusses emerging therapeutic strategies, such as small-molecule targeted drugs, nanomaterial-based drug delivery platforms, and cell regeneration therapies, that effectively alleviate inflammation and fibrosis. Although progress has been made, significant challenges remain in understanding the complex mechanisms of ADM and in ensuring the safety and efficacy of these therapies. This review aims to provide an in-depth understanding of the role of ADM in CP and to pave the way for efficacious therapeutic options.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e528-e538"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145422496","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":"Refining Prognostic Assessment in Acute Pancreatitis: A Vision for Integrating Clinical and Social Determinants.","authors":"Huizheng Lu","doi":"10.1097/MPA.0000000000002612","DOIUrl":"10.1097/MPA.0000000000002612","url":null,"abstract":"","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e541"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145743744","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":"Characteristics of Pancreatic Cancer-associated Ascites and Redefined Criteria for Bacterial Peritonitis.","authors":"Muhan Yeo, In Rae Cho, Sang Hyub Lee, Huapyong Kang, Eun Sun Jang, Jinwoo Ahn, Myoung-Jin Jang, Jin Ho Choi, Woo Hyun Paik, Ji Kon Ryu","doi":"10.1097/MPA.0000000000002606","DOIUrl":"10.1097/MPA.0000000000002606","url":null,"abstract":"<p><strong>Objectives: </strong>The diagnosis of spontaneous bacterial peritonitis relies on polymorphonuclear (PMN) cell counts (>250/mm 3 ) in cirrhotic ascites. However, ascites in pancreatic ductal adenocarcinoma (PDAC) develop through mixed mechanisms, presenting different profiles compared with those of cirrhotic ascites. This study aimed to investigate the characteristics of PDAC-associated ascites and propose redefined criteria for bacterial peritonitis diagnosis in patients with PDAC.</p><p><strong>Methods: </strong>This retrospective study was conducted at 3 tertiary medical centers in Korea. The etiology (peritoneal carcinomatosis, portal hypertension, or mixed etiology) and characteristics of PDAC-associated ascites of the exploration cohort (n=493) were analyzed. Diagnostic criteria for bacterial peritonitis were then derived from patients with elevated PMN cell counts (>250/mm 3 , n=183) in ascites. Subsequently, these criteria were validated in an external cohort (n=614).</p><p><strong>Results: </strong>Peritoneal carcinomatosis and portal hypertension showed similar proportions as ascites etiologies. Median PMN cell counts and proportions were higher in peritoneal carcinomatosis (106/mm 3 , 13%) than in portal hypertension (15/mm 3 , 7%; P <0.001) and mixed etiology (38/mm 3 , 9%; P <0.05). In the derivation analysis, PMN cell proportion was the sole statistically significant variable for bacterial peritonitis diagnosis, with an optimal cutoff value of >35.5%. The redefined diagnostic criteria for bacterial peritonitis (PMN cell proportion >35% with counts >250/mm 3 ) increased the specificity from 85% to 92% (RR: 1.08, 95% CI: 1.04-1.13, P <0.001) in external validation, with minimal compromise in the sensitivity.</p><p><strong>Conclusions: </strong>PDAC-associated ascites exhibited distinct characteristics according to their etiology. Redefined diagnostic criteria could aid in a more specific diagnosis of bacterial peritonitis in patients with PDAC.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e471-e480"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145763536","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 Correlation Between the Stenosis of Celiac Axis and Superior Mesenteric Artery and Complications After Pancreatoduodenectomy.","authors":"Yuping Shu, Yuran Dai, Lin Fang, Siyao Yu, Jishu Wei, Qing Xu","doi":"10.1097/MPA.0000000000002596","DOIUrl":"10.1097/MPA.0000000000002596","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the correlation between the stenosis of the celiac axis (CA) and the superior mesenteric artery (SMA) and complications after pancreatoduodenectomy (PD).</p><p><strong>Materials and methods: </strong>This retrospective study analyzed patients undergoing PD at the Pancreas Center of our hospital between January 2021 and December 2023. The stenosis of CA and SMA was measured using preoperative arterial phase imaging of contrast-enhanced multidetector computed tomography (MDCT). CA and SMA stenosis were defined as a stenosis rate ≥50%. The correlation between celiac axis stenosis (CAS), SMA stenosis, and postoperative complications was systematically evaluated. Univariate and multivariate logistic regression analyses were performed to identify risk factors for major complications after PD.</p><p><strong>Results: </strong>A total of 900 patients were enrolled in this study. CAS was identified in 70 (7.8%) patients, and SMA stenosis was identified in 43 (4.8%) patients. CAS was significantly associated with postoperative pancreatic fistula (POPF) ( P =0.044), postpancreatectomy hemorrhage (PPH) ( P =0.003), delayed gastric emptying (DGE) ( P =0.013) and biliary fistula (BF) ( P =0.014). Multivariate analysis revealed that CAS was an independent risk factor for POPF (OR: 2.632, 95% CI: 1.409-4.917, P =0.002) and PPH (OR: 3.745, 95% CI: 1.699-8.257, P =0.001). No significant correlation was found between SMA stenosis and complications after PD.</p><p><strong>Conclusions: </strong>CAS identified by preoperative contrast-enhanced MDCT was associated with the risk of complications after PD. Radiologists and surgeons should evaluate the condition of CAS in patients before PD.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e518-e527"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145459426","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":"Episodic and Long-term Costs of Acute Pancreatitis Requiring Hospitalization Among Adults in US Clinical Practice.","authors":"Asia Sikora Kessler, Daniel E Soffer, Lisa Abramovitz, Montserrat Vera-Llonch, Emily Kutrieb, Aaron Moynahan, Derek Weycker, Seth J Baum","doi":"10.1097/MPA.0000000000002599","DOIUrl":"10.1097/MPA.0000000000002599","url":null,"abstract":"<p><strong>Objectives: </strong>Acute pancreatitis (AP) is associated with significant morbidity and mortality. While most patients fully recover following the acute phase of illness, some develop long-term complications. The objective of this study was to estimate short- and long-term costs among adults hospitalized with AP in US clinical practice, overall and within subgroups defined by AP cause.</p><p><strong>Methods: </strong>A retrospective cohort design and health care claims database were employed. The study population comprised adults hospitalized for AP (first admission = index admission), and was considered overall as well as by AP cause (alcohol-induced, biliary-induced, drug-induced, cause unknown, and multiple causes). AP-related health care utilization/expenditures were evaluated during the short-term episode (index admission + encounters separated by <30 days) and long-term follow-up period (1 year from end of episode).</p><p><strong>Results: </strong>Among the 5051 hospitalized AP patients in the study population, 7% (range by AP cause: 6%-8%) had necrosis, 22% (19%-26%) had organ failure, 12% (6%-16%) had sepsis, and 14% (9%-19%) had systemic inflammatory response syndrome. During the long-term follow-up period, rates of recurrent AP and chronic pancreatitis were 14 (8-29) and 15 (10-25), respectively, per 100 person-years. Mean AP-related expenditures were $31,119 ($22,963-$37,733) during the short-term episode, and $12,470 ($9,614-$20,657) during the long-term follow-up period; total expenditures averaged $43,598 ($32,577-$58,390) per patient.</p><p><strong>Conclusions: </strong>The cost of AP requiring hospitalization is high, for the treatment of both acute disease as well as associated long-term complications, which underscores the potential economic benefits from the prevention of this condition.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e481-e488"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145669477","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 Symptom Burden After Total Pancreatectomy With Islet Autotransplantation: A Prospective Observational Cohort Study.","authors":"William Hirsch, Elissa M Downs, Martin Freeman, Gregory Beilman, David Martin, Guru Trikudanathan, Karthik Ramanathan, Byron P Vaughn, Melena D Bellin","doi":"10.1097/MPA.0000000000002587","DOIUrl":"10.1097/MPA.0000000000002587","url":null,"abstract":"<p><strong>Introduction: </strong>Total pancreatectomy with islet autotransplantation (TPIAT) is performed for the most disabling cases of recurrent acute pancreatitis and chronic pancreatitis. Post-TPIAT, patients often report gastrointestinal (GI) symptoms suggestive of dysmotility and small intestinal bacterial overgrowth. The goal of this study was to characterize patient-reported outcomes related to GI health and quality of life (QoL) after TPIAT.</p><p><strong>Methods: </strong>Patients aged 18 years or older who underwent TPIAT at the University of Minnesota since July 2006 were eligible for enrollment. In addition to providing demographic information, participants completed the following questionnaires electronically: National Institutes of Health (NIH) Patient-Reported Outcomes Measurement System GI Symptom Scale, RAND 36-Item Short Form Survey, and the NIH Health-Related Quality of Life 14 Survey.</p><p><strong>Results: </strong>Study surveys were completed by 27% (82/300) of patients contacted, at a median of 8 years after surgery. Participants reported significantly more severe belly pain ( t -score 57.9, 95% CI: 55.1-60.7), gas/bloating (57.7, 56.1-59.2), nausea/vomiting (56.8, 54.6-59.0), and diarrhea (53.6, 51.5-55.8) compared with the general population. A previous diagnosis of small intestinal bacterial overgrowth (SIBO) was associated with more severe belly pain (coefficient 8.54, 95% CI: 2.58-14.50, P =0.006), gas/bloating (5.65, 2.66-8.64, P <0.001), and nausea/vomiting (4.85, 0.34-9.34, P =0.035). More severe nausea/vomiting and diarrhea were negatively associated with several QoL measures.</p><p><strong>Conclusion: </strong>Post-TPIAT, patients experience severe belly pain, gas/bloating, nausea/vomiting, and diarrhea at higher rates compared with the general population. Patients who report a diagnosis of SIBO were more likely to have these symptoms, with the exception of diarrhea. Nausea/vomiting and diarrhea appear to have the largest impact on QoL measures.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e511-e517"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145421987","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}