Pancreas最新文献

{"title":"Impact of ERCP on Long-term Pain Medication Needs in Chronic Pancreatitis Patients: A Retrospective Cohort Study.","authors":"Carolyn Brooks, Rishi Das, Ikenna Kingsley Emelogu, Kirk Easley, Field Willingham, Saurabh Chawla","doi":"10.1097/MPA.0000000000002604","DOIUrl":"10.1097/MPA.0000000000002604","url":null,"abstract":"","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e508-e510"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145809587","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 Challenge of Pancreatic Duct Cannulation in Chronic Pancreatitis.","authors":"Fred Karaisz, Delvise Fogwe, Melica Nikahd, Georgios I Papachristou, Erica Park, Samuel Han","doi":"10.1097/MPA.0000000000002598","DOIUrl":"10.1097/MPA.0000000000002598","url":null,"abstract":"","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e539-e540"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145636488","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":"Whole Metagenomic Profiling Identifies a Gut Microbial Signature for Chronic Pancreatitis via Machine Learning.","authors":"Thais F Bartelli, Seyda Baydogan, Ismet Sahin, Kristi L Hoffman, Joseph Petrosino, Kyle W Blackburn, Jing Zhao, Amy Wood, Tulin Ayvaz, Anil Surathu, Martha Navarro Cagigas, Erick Carrasco Barcenas, Tomera Mata, Vincent Kim Nguyen, Alejandro Zulbaran-Rojas, Le Li, Erika Y Faraoni, James R White, Nadim Ajami, Liang Li, Dhiraj Yadav, Darwin L Conwell, Jose Serrano, Stephen J Pandol, Evan L Fogel, Stephen K Van Den Eden, Santhi Swaroop Vege, Mark D Topazian, Walter G Park, Phil A Hart, Chris Forsmark, Melena D Bellin, Anirban Maitra, Manoop S Bhutani, Michael Kim, George Van Buren, William E Fisher, Florencia McAllister","doi":"10.1097/MPA.0000000000002618","DOIUrl":"10.1097/MPA.0000000000002618","url":null,"abstract":"<p><strong>Background: </strong>Pancreatitis significantly alters the microbial composition of the oral and intestinal compartments, causing dysbiosis that may contribute to disease mechanisms and potentially serve as a basis for diagnosis or treatment.</p><p><strong>Objective: </strong>To determine whether the oral or gut microbial signature can classify chronic pancreatitis (CP).</p><p><strong>Methods: </strong>Stool samples (n=707) were collected from participants in the Prospective Evaluation of Chronic Pancreatitis for Epidemiologic and Translational Studies (PROCEED). Samples were distributed among 200 healthy (HC), 310 CP, 49 acute pancreatitis (AP), and 148 recurrent acute pancreatitis (RAP). In addition, saliva samples were collected for a subset of participants (n=156). Whole genome sequencing was performed to assess microbiome composition. Machine learning algorithms were utilized to identify a signature with microbial features predictive of CP.</p><p><strong>Results: </strong>Gut alpha diversity was significantly decreased in AP, RAP, and CP compared with HC, with CP exhibiting the lowest diversity. In contrast, oral microbial diversity showed no significant variation across groups. Beta diversity analysis revealed distinct gut microbiome compositions between HC and pancreatitis subtypes, with CP showing the most pronounced differences. Random forest models using gut microbial species demonstrated robust predictive performance for CP using a minimum of 10 species (Area under the curve-AUC: 0.834; accuracy: 0.774). Despite similarities in gut microbiome composition across pancreatitis subtypes, a unique gut microbial signature for CP was identified highlighting the microbiome's potential in CP diagnosis.</p><p><strong>Conclusion: </strong>Our study reveals a gut microbial signature predictive of CP using machine learning models in a large US multi-institutional cohort.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e458-e468"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575167","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":"Commentary on \"Lifetime Smoking History and Marijuana Co-Use in Patients With Alcohol-Related Acute Pancreatitis\".","authors":"Qiongying Xu, Jiehua Han","doi":"10.1097/MPA.0000000000002610","DOIUrl":"10.1097/MPA.0000000000002610","url":null,"abstract":"","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e541-e542"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145763579","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 Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer (CPDPC): 10 Years of Past Accomplishments and Looking Forward to the Next 5 Years of the Chronic Pancreatitis Clinical Research Consortium (CPCRC).","authors":"Chris E Forsmark, Stephen Pandol","doi":"10.1097/MPA.0000000000002629","DOIUrl":"10.1097/MPA.0000000000002629","url":null,"abstract":"<p><p>This article provides an overview of 10 years of accomplishments of the National Institute of Diabetes and Digestive and Kidney Diseases-supported Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer (CPDPC) and outlines strategies for the next 5 years as the Chronic Pancreatitis Clinical Research Consortium (CPCRC). The overriding objectives of the CPDPC have been to provide an enhanced understanding of the natural history of recurrent acute and chronic pancreatitis in children and adults; to investigate the interrelationships between diabetes on both the progressive forms of pancreatitis and pancreatic cancer; and to develop methods for diagnosis, treatment, and clinical management of these pancreatic disorders. This article also serves as an introduction for 2 papers in this issue of Pancreas describing the progress and direction for 2 of the 4 working groups of CPDPC-the Pediatric and the Adult Recurrent Acute and Chronic Pancreatitis Groups. These 2 working groups have made great progress in studies of the natural history, mechanisms, etiology, complications, and treatment of pancreatitis in adults and children. The working groups investigating diabetes due to pancreatitis or pancreatic cancer (Diabetes Mellitus and Pancreatic Cancer Working Group and the Type 3c Diabetes Working Group) have also made great progress in studies focused on the interrelationships between the endocrine and exocrine pancreas, and these are published in the journal Pancreatology .</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e455-e457"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344846","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 Follow-up of Spontaneous Resolution of a Pancreatic Arteriovenous Malformation.","authors":"Koh Kitagawa, Shohei Asada, Jun-Ichi Hanatani, Hitoshi Yoshiji","doi":"10.1097/MPA.0000000000002620","DOIUrl":"10.1097/MPA.0000000000002620","url":null,"abstract":"","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e469-e470"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906368","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":"Investigation of Clinical and Laboratory Findings of 40-49-Year-Old Patients With Fatty Pancreas by Magnetic Resonance Imaging and Evaluation of the Potential Relationship With Metabolic Dysfunction-associated Steatotic Liver Disease (MASLD).","authors":"Hatice Demir, Salim Tece, Hasan Yigit, Levent Filik","doi":"10.1097/MPA.0000000000002607","DOIUrl":"10.1097/MPA.0000000000002607","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to investigate the relationship between nonalcoholic fatty pancreas disease (NAFPD) and metabolic dysfunction-associated steatotic liver disease (MASLD), and to evaluate the effects of pancreatic steatosis on clinical and laboratory parameters in patients aged 40-49 years. The secondary aim was to identify independent predictors of pancreatic steatosis and discuss their clinical relevance for early detection and prevention.</p><p><strong>Methods: </strong>This retrospective single-center study included 132 patients aged 40-49 years who underwent abdominal magnetic resonance imaging (MRI). Pancreatic and hepatic fat fractions were measured using a chemical shift-based MRI technique. Demographic data, comorbidities, and laboratory parameters were analyzed. Patients with a history of alcohol intake, pancreatitis, or incomplete data were excluded.</p><p><strong>Results: </strong>Pancreatic steatosis was present in 35.6% of participants. Patients with pancreatic steatosis had significantly higher rates of diabetes mellitus (59.6% vs. 21.2%), obesity (61.7% vs. 14.1%), hypertension (38.3% vs. 17.6%), and hyperlipidemia (44.7% vs. 20%) (all P <0.01). Pancreatic steatosis was strongly associated with hepatic steatosis (80.9% vs. 11.8%, P <0.001). Fasting glucose, HbA1c, HOMA-IR, and triglycerides were higher, whereas HDL and amylase were lower in the steatosis group. In multivariate logistic regression, diabetes mellitus (OR 8.06, 95% CI: 1.15-56.76, P =0.036) and HOMA-IR (OR 1.54, 95% CI: 1.19-1.99, P =0.001) were identified as independent predictors of pancreatic steatosis. Among patients with pancreatic steatosis, 80.9% also had hepatic steatosis, demonstrating a significant association between pancreatic and hepatic fat accumulation.</p><p><strong>Conclusion: </strong>A significant association was found between pancreatic steatosis and metabolic risk factors such as diabetes, obesity, insulin resistance, and MASLD. MRI-based quantification provided accurate detection, supporting its value as the most reliable imaging modality for assessing pancreatic fat. Lifestyle interventions such as weight loss and physical activity may help mitigate pancreatic steatosis and related metabolic consequences. Further studies are needed to clarify causality and underlying pathways, such as lipotoxicity, inflammation, and β-cell dysfunction.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e498-e507"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145763554","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":"Endoscopic Ultrasound-guided Transluminal Drainage of Walled-off Necrosis using Naso-cystic Drain with Metal Stent versus Metal Stent Alone: A Randomized Controlled Pilot Study.","authors":"Nilanjan Kar, Surinder Singh Rana, Rajesh Gupta, Vaneet Jearth, Jimil Shah, Mandeep Kang, Kamal Kishore, Arnab Pal, Vikas Gautam","doi":"10.1097/MPA.0000000000002659","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002659","url":null,"abstract":"<p><strong>Background and aims: </strong>Endoscopic ultrasound (EUS)-guided drainage using a lumen-apposing metal stent (LAMS) has become the standard of care in managing symptomatic walled-off necrosis (WON). However, the role of nasocystic drainage (NCD) in addition to stent placement remains uncertain. We conducted a pilot study to compare outcomes of EUS-guided drainage with and without NCD in patients with WON.</p><p><strong>Methods: </strong>In this open-label, prospective, block-randomized controlled pilot trial, forty patients with symptomatic WON undergoing EUS-guided drainage using LAMS were randomized into two groups: NCD (n=20) and non-NCD (n=20). The two groups were compared for clinical success, defined as symptomatic improvement accompanied by a reduction in the size of the WON to ≤3 cm on cross-sectional imaging, as well as for the number of necrosectomy sessions required, duration of hospitalisation, readmissions, procedure-related complications, and mortality.</p><p><strong>Results: </strong>Technical success was achieved in all patients. Clinical success at day three was observed in 55% (n=11) in the NCD arm and 45% (n=9) in the non-NCD arm (P=0.527). Time to clinical success and the number of necrosectomy sessions were comparable between groups. The median hospital stay was significantly shorter in the non-NCD group (P=0.038). Readmission (P=0.093), reintervention (P=0.495), complications (P=0.072), and mortality rates (P=0.147) were similar across both groups.</p><p><strong>Conclusion: </strong>The addition of nasocystic drainage to EUS-guided LAMS drainage did not improve clinical outcomes in patients with WON. However, due to the small sample size and baseline imbalance, findings are exploratory and require confirmation in larger, adequately powered randomised trials.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778003","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":"Predictive Power of Imaging: Assessing Parenchymal Fibrosis in Pediatric Chronic Pancreatitis.","authors":"Michelle Saad, Alexander Redman, Nadeen Abu Ata, Christopher Anton, Lin Fei, David S Vitale, Yin Zhang, Maisam Abu-El-Haija, Andrew T Trout","doi":"10.1097/MPA.0000000000002658","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002658","url":null,"abstract":"<p><strong>Objectives: </strong>The primary aim is to identify pancreatic parenchymal imaging markers of fibrosis in children with chronic pancreatitis (CP). Secondary aims include describing the pattern of histopathologic fibrosis in different pancreatic regions and examining the impact of fibrosis on exocrine pancreatic insufficiency (EPI) and baseline glycemic status.</p><p><strong>Methods: </strong>Single center cross-sectional study that included children aged 0-21 years who underwent total pancreatectomy islet auto-transplantation (TPIAT) prior to December 2022. Those with prior pancreatic surgeries, missing imaging, or missing histology were excluded.</p><p><strong>Results: </strong>Ninety-five patients (56% female, median age 13.3 y) were included. Multiple parenchymal imaging variables were significantly associated with histologic pancreatic fibrosis. A 5 mL decrease in segmented pancreas volume (odds ratio (OR)=1.2, 95% confidence interval (CI): 1.1-1.4, P<0.05) and 0.1 unit decrease in T1 signal intensity ratio (SIR) pancreas/spleen (P/s) (OR=1.7, 95% CI: 1.2-2.2, P<0.05) had increased fibrosis odds. A multivariable model with pancreas volume and T1 SIRp/s predicted severe fibrosis with an area under the receiver operating characteristic curve (AUROC) of 0.8 (95% CI:0.7-0.9). Histologic fibrosis scores showed substantial agreement between pancreatic sampling locations (kappa=0.7, 95% CI: 0.6-0.9). EPI by fecal elastase (FE-1) was associated with increased odds of severe fibrosis (OR=11.7, 95% CI: 2.5-54.1, P<0.05) and higher Ammann scores were seen in participants with prediabetes and diabetes (9.0, interquartile range (IQR): 8.0-12.0, P=0.08).</p><p><strong>Conclusions: </strong>The pancreatic parenchyma provides insights into pediatric CP through fibrosis assessment, which correlates with pancreatic function. A predictive model using pancreas volume and T1 SIR shows promise for forecasting pancreatic parenchymal fibrosis in children with CP.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778036","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":"Dietary Patterns Following an Episode of Acute Pancreatitis: a Post-hoc Analysis From the PAPPEI Multi-Center, Prospective Study.","authors":"Kristen M Roberts, Sasathorn Thongkhao-On, Stacey Culp, Djibril M Ba, Joseph Bejjani, Shanlin Ke, Melica Nikahd, Anna Evans Phillips, Peter J Lee, Vikesh K Singh, Mitchell L Ramsey, Georgios I Papachristou, Phil A Hart","doi":"10.1097/MPA.0000000000002644","DOIUrl":"10.1097/MPA.0000000000002644","url":null,"abstract":"<p><strong>Background: </strong>Acute pancreatitis (AP) is a common disease resulting in local and systemic inflammation. It is now recognized that long-term complications can develop following an AP episode, including persistent GI symptoms, exocrine pancreatic dysfunction (EPD), and recurrence of AP. While nutrition plays a key role in recovery, the impact of diet patterns on gastrointestinal (GI) symptoms and recurrent AP remains unclear.</p><p><strong>Methods: </strong>A secondary analysis of participants from the multicenter, post-acute pancreatic exocrine insufficiency (PAPPEI) study who completed a standardized dietary questionnaire was performed to assess dietary patterns after AP. A dietary pattern score was developed to compare dietary changes over time, where a higher score reflects a more favorable dietary pattern.</p><p><strong>Results: </strong>Significant changes in dietary pattern scores were observed over time with average scores peaking at three months (10.3 ± 3.0) then declining at one year (9.2 ± 3.0) ( P =0.024). Lower baseline dietary pattern scores were linked to recurrent AP ( P = 0.035), >10% weight loss ( P =0.016) and persistent GI symptoms ( P =0.030) at 12 months.</p><p><strong>Conclusion: </strong>Dietary patterns may contribute to the development of GI symptoms, weight loss and recurrent AP. Further research validating our observations and investigations into dietary interventions to reduce GI symptoms and disease recurrence is warranted.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778009","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}