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Mortality trends for acute pancreatitis during the COVID-19 pandemic in the US. 美国 COVID-19 大流行期间急性胰腺炎的死亡率趋势。
IF 2.9 4区 医学
Pancreas Pub Date : 2024-09-12 DOI: 10.1097/mpa.0000000000002381
Camilla Mattiuzzi,Giuseppe Lippi
{"title":"Mortality trends for acute pancreatitis during the COVID-19 pandemic in the US.","authors":"Camilla Mattiuzzi,Giuseppe Lippi","doi":"10.1097/mpa.0000000000002381","DOIUrl":"https://doi.org/10.1097/mpa.0000000000002381","url":null,"abstract":"","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142178536","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}
引用次数: 0
Tumor immune microenvironment promotes cachexia in pancreatic cancer. 肿瘤免疫微环境促进胰腺癌恶病质的形成
IF 2.9 4区 医学
Pancreas Pub Date : 2024-09-12 DOI: 10.1097/mpa.0000000000002386
Suresh T Chari
{"title":"Tumor immune microenvironment promotes cachexia in pancreatic cancer.","authors":"Suresh T Chari","doi":"10.1097/mpa.0000000000002386","DOIUrl":"https://doi.org/10.1097/mpa.0000000000002386","url":null,"abstract":"","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142178535","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}
引用次数: 0
Increased PRIM2 expression associated with poor-prognosis in patients with pancreatic ductal adenocarcinoma. 胰腺导管腺癌患者的 PRIM2 表达增加与预后不良有关。
IF 2.9 4区 医学
Pancreas Pub Date : 2024-09-12 DOI: 10.1097/mpa.0000000000002387
Jingyang Yin,Shixiang Guo,Jiali Yang,Renpei Xia,Huaizhi Wang
{"title":"Increased PRIM2 expression associated with poor-prognosis in patients with pancreatic ductal adenocarcinoma.","authors":"Jingyang Yin,Shixiang Guo,Jiali Yang,Renpei Xia,Huaizhi Wang","doi":"10.1097/mpa.0000000000002387","DOIUrl":"https://doi.org/10.1097/mpa.0000000000002387","url":null,"abstract":"OBJECTIVESTo explore the association between PRIM2 expression and prognosis of patients with pancreatic ductal adenocarcinoma (PDAC) from multi clinic centers.METHODSSamples from PDAC patients were collected and processed to tissue microarray (TMA). PRIM2 expression was detected by immunohistochemistry (IHC) of in 127 enrolled PDAC patients, which underwent surgical resection from January 2012 to December 2018, with complete follow-up, were enrolled and grouped by PRIM2 stain level into two groups. The expression differences, the association to clinicopathologic features and the survival were evaluated by the groups. Data of RNA/protein expression and clinical features from public databases were used for validation.RESULTSPRIM2 was highly expressed in PDAC patients and associated with poor-prognosis in patients with PDAC. Association was found between increased PRIM2 levels and pathology grade (p = 0.050). Moreover, in multivariate analysis of survival, the highly expression of PRIM2 was identified as an independent risk factor for poor survival (HR1.78, p = 0.031). Analysis on public databases validated above results.CONCLUSIONSHigh expression of PRIM2 associated with poor prognosis in PDAC patients, PRIM2 could be used as an independent risk indicator.","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142178530","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}
引用次数: 0
Characterization of Human Pancreatic Islet Cells using a Single-Cell Western Blot Platform. 利用单细胞 Western Blot 平台表征人类胰岛细胞
IF 2.9 4区 医学
Pancreas Pub Date : 2024-09-12 DOI: 10.1097/mpa.0000000000002385
Gal Lenz,Lynn Miao,Ayelet Lenz,Jacob Mares,Janine Quijano,Heather N Zook,Hirotake Komatsu,Pablo Garcia,Kevin Ferreri,Hsun Teresa Ku,Fouad Kandeel
{"title":"Characterization of Human Pancreatic Islet Cells using a Single-Cell Western Blot Platform.","authors":"Gal Lenz,Lynn Miao,Ayelet Lenz,Jacob Mares,Janine Quijano,Heather N Zook,Hirotake Komatsu,Pablo Garcia,Kevin Ferreri,Hsun Teresa Ku,Fouad Kandeel","doi":"10.1097/mpa.0000000000002385","DOIUrl":"https://doi.org/10.1097/mpa.0000000000002385","url":null,"abstract":"OBJECTIVEIslet transplantation is an effective treatment for type 1 diabetes. However, transplant success depends on quick islet assessment because islets deteriorate 2-3 days after isolation. A new tool, single-cell Western blot (scWestern), offers results within one day. In this study, we aimed to test the suitability of scWestern to detect protein markers for beta (insulin), alpha (glucagon), and delta (somatostatin) cells, the three major endocrine cell types in islets.METHODSWe characterized the antibody specificity, signal intensity, and cell identification on the scWestern platform, and then compared the islet cell composition analysis between scWestern and immunohistochemistry performed by the Integrated Islet Distribution Program (IIDP).RESULTSIslet cell composition is comparable for alpha and beta cells, but not delta cells. Protein expression levels of insulin, glucagon, and somatostatin in individual islet cells varied greatly, highlighting cell type heterogeneity. Surprisingly, scWestern revealed double-hormonal cells (~1%), co-expressing insulin and somatostatin or insulin and glucagon, in non-diabetic and non-obese adult human islets, which was confirmed by confocal immunofluorescence microscopy.CONCLUSIONSThese results demonstrate that each alpha, beta, and delta cells express varying levels of peptide hormones, and a small subpopulation co-expresses double hormones in normal human islets. The scWestern platform will enable timely assessment of beta cell mass in isolated islets before clinical transplantation.","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142178532","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}
引用次数: 0
Individualized Pain Treatment in Chronic Pancreatitis (INPAIN): An International, Multicenter, Investigator-initiated, Prospective, Cohort Study. 慢性胰腺炎的个体化疼痛治疗 (INPAIN):一项国际性、多中心、研究者发起的前瞻性队列研究。
IF 2.9 4区 医学
Pancreas Pub Date : 2024-09-12 DOI: 10.1097/mpa.0000000000002388
Rasmus Hagn-Meincke,Ana Dugic,Ankit Agarwal,Anna Evans Phillips,Anna Waage,Dhiraj Yadav,Divya Pillai,Elaina Vivian,Enrique de-Madaria,Imran Khan Niazi,Jeffrey Easler,Jens Brøndum Frøkjær,Julia McNabb-Baltar,Louise Kuhlmann Asferg,Mahya Faghih,Maria Belen Garay Montiel,Mathias Cook,Misbah Unnisa,Paul Tarnasky,Peter Hegyi,Pramod Garg,Rasmus Bach Nedergaard,Robert Edwards,Rupjyoti Talukdar,Shagufta Farheen,Søren Schou Olesen,Soumya Jagannath,Suzette Schmidt,Vikesh Singh,Zoltán Hajnády,Asbjørn Mohr Drewes,
{"title":"Individualized Pain Treatment in Chronic Pancreatitis (INPAIN): An International, Multicenter, Investigator-initiated, Prospective, Cohort Study.","authors":"Rasmus Hagn-Meincke,Ana Dugic,Ankit Agarwal,Anna Evans Phillips,Anna Waage,Dhiraj Yadav,Divya Pillai,Elaina Vivian,Enrique de-Madaria,Imran Khan Niazi,Jeffrey Easler,Jens Brøndum Frøkjær,Julia McNabb-Baltar,Louise Kuhlmann Asferg,Mahya Faghih,Maria Belen Garay Montiel,Mathias Cook,Misbah Unnisa,Paul Tarnasky,Peter Hegyi,Pramod Garg,Rasmus Bach Nedergaard,Robert Edwards,Rupjyoti Talukdar,Shagufta Farheen,Søren Schou Olesen,Soumya Jagannath,Suzette Schmidt,Vikesh Singh,Zoltán Hajnády,Asbjørn Mohr Drewes,","doi":"10.1097/mpa.0000000000002388","DOIUrl":"https://doi.org/10.1097/mpa.0000000000002388","url":null,"abstract":"INTRODUCTIONPain is the foremost complication of chronic pancreatitis (CP), affecting about 70% of patients. However, the pathophysiological understanding and management of CP-related pain is complex, likely as patients have diverse \"pain phenotypes\" responding differently to treatment. This study aims to develop a bedside test panel to identify distinct pain phenotypes, investigate the temporal evolution, and determine whether they can be used to predict treatment response.METHODThe INPAIN study is an international, multi-center, observational, longitudinal cohort study comprised of 4 sub-studies. The studies will prospectively enroll 400 CP patients (50 without pain and 350 with pain) and 50 control subjects, conducting biannual observations for four years. The test panel is comprised of comprehensive subjective and objective assessment parameters. Statistical analysis strategies differ across the sub-studies. A model to predict treatment efficacy will be developed using various machine learning techniques, including an artificial intelligence approach, with internal cross-validation. Trajectories in pain parameters will be characterized by graphical analysis and mixed effect models.DISCUSSIONThe INPAIN study aims to comprehensively understand pain in CP through a test panel developed for routine clinical use. This tool has the potential to personalize treatments, improve clinical practice, enhance patient care, improve quality of life, and minimize treatment side effects.","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142178533","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}
引用次数: 0
A Case of Thrombotic Microangiopathy Within Acute Pancreatitis. 一例急性胰腺炎血栓性微血管病。
IF 1.7 4区 医学
Pancreas Pub Date : 2024-09-01 Epub Date: 2024-03-27 DOI: 10.1097/MPA.0000000000002355
Marwin A Farrugia, Anaïs Darnaude, Elena Santos-Pérez, Eve Gelsi
{"title":"A Case of Thrombotic Microangiopathy Within Acute Pancreatitis.","authors":"Marwin A Farrugia, Anaïs Darnaude, Elena Santos-Pérez, Eve Gelsi","doi":"10.1097/MPA.0000000000002355","DOIUrl":"10.1097/MPA.0000000000002355","url":null,"abstract":"","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140294216","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}
引用次数: 0
Exosomes Derived From Cerulein-Stimulated Pancreatic Acinar Cells Mediate Peritoneal Macrophage M1 Polarization and Pyroptosis via an miR-24-3p/MARCH3/NLRP3 Axis in Acute Pancreatitis. 通过 miR-24-3p/MARCH3/NLRP3 轴介导急性胰腺炎中腹膜巨噬细胞 M1 极化和脓毒症的发生
IF 1.7 4区 医学
Pancreas Pub Date : 2024-09-01 Epub Date: 2024-03-27 DOI: 10.1097/MPA.0000000000002351
Xiao-Ju Su, Yan Chen, Qi-Chen Zhang, Xiao-Bo Peng, Ya-Ping Liu, Lei Wang, Yi-Qi Du
{"title":"Exosomes Derived From Cerulein-Stimulated Pancreatic Acinar Cells Mediate Peritoneal Macrophage M1 Polarization and Pyroptosis via an miR-24-3p/MARCH3/NLRP3 Axis in Acute Pancreatitis.","authors":"Xiao-Ju Su, Yan Chen, Qi-Chen Zhang, Xiao-Bo Peng, Ya-Ping Liu, Lei Wang, Yi-Qi Du","doi":"10.1097/MPA.0000000000002351","DOIUrl":"10.1097/MPA.0000000000002351","url":null,"abstract":"<p><strong>Objectives: </strong>Acute pancreatitis (AP) has a high incidence of hospitalizations, morbidity, and mortality worldwide. A growing number of studies on AP pathogenesis are based on cerulein-induced experimental model, which simulates human AP in vivo. It has been demonstrated that both pancreatic acinar cells and peritoneal macrophages are involved in pancreatic inflammation and damage. However, their connection has not been well understood.</p><p><strong>Methods: </strong>A cerulein-induced AP model was established on the pancreatic acinar cell line AR42J. Rat macrophages were isolated from the peritoneal cavity. The effects of cerulein-induced pancreatic exosomes on the peritoneal macrophage and pancreas in vivo and in vitro were examined. The underlying molecular mechanism was investigated by exploring the regulatory role of downstream molecules.</p><p><strong>Results: </strong>We found that exosomes derived from cerulein-treated AR42J cells induced rat peritoneal macrophage M1 polarization and pyroptosis. miR-24-3p was upregulated in cerulein-stimulated exosomes, whereas the miR-24-3p inhibitor counteracted the effect of pancreatic exosomes on peritoneal macrophage M1 polarization and pyroptosis. Furthermore, miR-24-3p inhibited March3 expression, whereas MARCH3 mediated NLRP3 ubiquitination in rat peritoneal macrophages, which, in turn, contributed to the apoptosis, reactive oxygen species production, and inflammation in AR42J cells.</p><p><strong>Conclusions: </strong>Exosomes derived from cerulein-stimulated pancreatic acinar cells mediate peritoneal macrophage M1 polarization and pyroptosis via an miR-24-3p/MARCH3/NLRP3 axis in AP.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140294171","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}
引用次数: 0
Poly (Adp-Ribose) Polymerase-1 (PARP-1) Is a Good Prognostic Marker for Pancreatic/Periampullary Cancers. 聚(ADP-核糖)聚合酶-1(PARP-1)是胰腺癌/髓周癌的良好预后标志物。
IF 1.7 4区 医学
Pancreas Pub Date : 2024-09-01 Epub Date: 2024-03-27 DOI: 10.1097/MPA.0000000000002356
Kwangil Yim, Kyung Jin Seo, Jamshid Abdul-Ghafar, Mohammad Rizwan Alam, Kwang Yeol Paik, Yosep Chong, Ok Ran Shin
{"title":"Poly (Adp-Ribose) Polymerase-1 (PARP-1) Is a Good Prognostic Marker for Pancreatic/Periampullary Cancers.","authors":"Kwangil Yim, Kyung Jin Seo, Jamshid Abdul-Ghafar, Mohammad Rizwan Alam, Kwang Yeol Paik, Yosep Chong, Ok Ran Shin","doi":"10.1097/MPA.0000000000002356","DOIUrl":"10.1097/MPA.0000000000002356","url":null,"abstract":"<p><strong>Background: </strong>Periampullary cancer (PAC) is highly aggressive with no effective adjuvant therapy or prognostic markers. Recently, poly (ADP-ribose) polymerase-1 (PARP-1) has emerged as a target in solid cancers, and its relationship with epithelial-mesenchymal transition (EMT) has been observed. However, the relationship between PARP-1 and EMT in PAC has not explored well.</p><p><strong>Materials and methods: </strong>We assessed the prognostic significance of PARP-1 in 190 PACs patients and correlated it with EMT markers, including FGF8, FGFR4, MMP2, MMP3, Snail, and ZEB1. Immunohistochemistry for PARP-1 and EMT markers was performed using a tissue microarray.</p><p><strong>Results: </strong>PARP-1 and FGF8 expression were associated with better survival unlike other solid cancers ( P = 0.006 and P = 0.003), and MMP3 and ZEB1 expression were associated with poor prognosis in multivariate and survival analyses ( P = 0.009 and P < 0.001). In addition, PARP-1 is related negatively to Snail but not related with other EMT markers, implying an independent mechanism between PARP-1 and EMT in PACs. PARP-1 and FGF8 are independent good survival markers in PACs unlike other solid cancers.</p><p><strong>Conclusions: </strong>PARP-1 and FGF8 in PACs could not be related to the EMT pathway but must be rather understood in light of similar cancer-protective roles. Further studies are required on EMT-associated immune markers in PACs.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140294175","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}
引用次数: 0
HSP70 promotes pancreatic cancer cell epithelial-mesenchymal transformation and growth via the NF-κB signaling pathway. HSP70 通过 NF-κB 信号通路促进胰腺癌细胞上皮-间质转化和生长。
IF 1.7 4区 医学
Pancreas Pub Date : 2024-08-16 DOI: 10.1097/MPA.0000000000002398
Liumei Xiong, Danming Li, Gui Xiao, Sipin Tan, Linfang Xu, Guiliang Wang
{"title":"HSP70 promotes pancreatic cancer cell epithelial-mesenchymal transformation and growth via the NF-κB signaling pathway.","authors":"Liumei Xiong, Danming Li, Gui Xiao, Sipin Tan, Linfang Xu, Guiliang Wang","doi":"10.1097/MPA.0000000000002398","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002398","url":null,"abstract":"<p><strong>Objective: </strong>To study the effects of HSP70 on proliferation, migration, invasion, and epithelial-mesenchymal transformation (EMT) of pancreatic cancer cells and explore its underlying mechanisms.</p><p><strong>Methods: </strong>Pancreatic cancer cell models with either reduced HSP70 or increased HSP70 expression were established. RT-qPCR and Western blot assays were used to determine mRNA and protein levels of HSP70, IKK/IκBa/NF-κB signaling pathway-related genes, and EMT markers. The CCK-8 and cell cloning assays were used to evaluate cell proliferation and cloning abilities. Transwell and wound healing assays were used to assess the invasive and migratory properties of the cells. Effects of NF-κB signaling modulation were explored using an IKK inhibitor (BAY11-7082) and an IKK overexpression vector (pCMV-IKK). Electrophoretic mobility shift assay (EMSA) and luciferase reporter assays were conducted to analyze NF-κB's promoter binding and transcriptional activities.</p><p><strong>Results: </strong>HSP70 knockdown inhibited p-p65 nuclear translocation and reduced the expression of p-p65, p-IKKα/β, p-IκBα, N-cadherin, Vimentin, and Twist. It also decreased NF-κB's promoter binding and transcriptional activities, increased E-cadherin levels, and suppressed pancreatic cancer cell proliferation, cloning, migration, and invasion. In contrast, HSP70 overexpression led to increased expression of p-p65, p-IKKα/β, p-IκBα, N-cadherin, Vimentin, and Twist, decreased E-cadherin levels, and enhanced cell proliferation, cloning, migration, and invasion capabilities. NF-κB signaling pathway modulation reversed EMT changes induced by altered HSP70 expression levels. rhHSP70 also increased p-IKKα/β and p-IκBα protein levels.</p><p><strong>Conclusion: </strong>HSP70 promotes the EMT and enhances pancreatic cancer cell proliferation, migration, and invasion by activating the NF-κB pathway.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351455","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}
引用次数: 0
Combined EUS and ERCP in patients with malignant distal biliary obstruction is associated with reduced time to oncological therapy compared to ERCP and sampling alone. 在恶性远端胆道梗阻患者中联合使用 EUS 和 ERCP 与单独使用 ERCP 和取样相比,可缩短肿瘤治疗时间。
IF 1.7 4区 医学
Pancreas Pub Date : 2024-08-08 DOI: 10.1097/MPA.0000000000002401
James Gauci, Wei On, Bharat Paranandi, Matthew Huggett, Simon Everett
{"title":"Combined EUS and ERCP in patients with malignant distal biliary obstruction is associated with reduced time to oncological therapy compared to ERCP and sampling alone.","authors":"James Gauci, Wei On, Bharat Paranandi, Matthew Huggett, Simon Everett","doi":"10.1097/MPA.0000000000002401","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002401","url":null,"abstract":"<p><strong>Objectives: </strong>Standard ERCP sampling techniques for pancreaticobiliary malignancy have modest yields that could lead to delays in treatment. We aimed to evaluate whether combining EUS guided tissue acquisition (EUS-TA) with ERCP versus ERCP alone at the time of index procedure improved time to first outpatient evaluation and oncological treatment.</p><p><strong>Methods: </strong>All patients without a prior pathological diagnosis who underwent index ERCP at Leeds Teaching Hospitals NHS Trust, United Kingdom, for malignant distal biliary obstruction from 2015 to 2020 were considered.</p><p><strong>Results: </strong>A total of 292 patients were included, of whom 74.7% (n = 202) underwent EUS-TA/ERCP. A combined approach was more likely to establish a positive diagnosis (96.5% (n = 195) vs 57.8% (n = 52), p < 0.01) and less likely to require further sampling procedures (2.0% (n = 4) vs 17.8% (n = 16), p < 0.01). Mean times to first outpatient evaluation (16.9 vs 24.5 days (p = 0.01)) and oncological treatment (55.1 vs 79.3 days (p = 0.03)) were significantly shorter in the EUS-TA/ERCP group. A third (n = 86) of patients with a positive diagnosis did not receive oncological/surgical treatment.</p><p><strong>Conclusions: </strong>In our cohort of patients, a combined approach was associated with improved diagnostic yield, reduced need for repeat sampling procedures and reduced time to evaluation and treatment, with similar therapeutic success and adverse event rates. Careful multidisciplinary discussion is recommended to avoid performing unnecessary EUS procedures on patients who will not benefit from further treatment.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141902533","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}
引用次数: 0
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