Pancreas最新文献_第4页

Surgical Trends in Chronic Pancreatitis from 2014 Through 2021. 2014 年至 2021 年慢性胰腺炎的手术趋势。

IF 1.7 4区医学

Pancreas Pub Date : 2024-11-25 DOI: 10.1097/MPA.0000000000002438

Andrew Turunen, Sushil Kumar Garg

{"title":"Surgical Trends in Chronic Pancreatitis from 2014 Through 2021.","authors":"Andrew Turunen, Sushil Kumar Garg","doi":"10.1097/MPA.0000000000002438","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002438","url":null,"abstract":"Objectives: We analyzed annual surgical trends for benign chronic pancreatitis (CP), studying specifically mortality, morbidity, and pancreatic fistula rates. We also aimed to identify predictors of pancreatic fistula formation.Methods: For this analysis, we used data from the American College of Surgeons National Surgical Quality Improvement Program from 2014 through 2021. The study included patients who underwent surgery for benign CP. Data collected included patient demographics, preoperative variables, and postoperative outcomes. Data were analyzed with univariate and multivariate analyses, with significance defined as P ≤ .05.Results: Over the study period, the number of pancreatic surgical procedures increased 49.3%, although surgery specifically for CP declined by 31.7%. The rate of pancreatic fistula formation decreased 44.9%, and mortality decreased 31.9%. Significant predictors of a pancreatic fistula included no diabetes, preoperative sepsis, soft texture of the pancreatic gland, and greater patient weight.Conclusion: Surgery for benign CP decreased substantially despite the established efficacy of surgical intervention for long-term pain management. The concurrent decline in mortality and rates of pancreatic fistula formation suggest advances over the study years in surgical and postoperative care.","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142731264","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

Pancreatic Body and Tail Adenocarcinoma: Upfront Resection Versus Neoadjuvant Therapy, A Contemporary Analysis. 胰体和胰尾腺癌：前期切除与新辅助治疗，当代分析。

IF 1.7 4区医学

Pancreas Pub Date : 2024-11-01 Epub Date: 2024-05-15 DOI: 10.1097/MPA.0000000000002372

Hiro Masuda, Nazim Bhimani, Angela Chou, Anthony J Gill, Jaswinder S Samra, Anubhav Mittal

{"title":"Pancreatic Body and Tail Adenocarcinoma: Upfront Resection Versus Neoadjuvant Therapy, A Contemporary Analysis.","authors":"Hiro Masuda, Nazim Bhimani, Angela Chou, Anthony J Gill, Jaswinder S Samra, Anubhav Mittal","doi":"10.1097/MPA.0000000000002372","DOIUrl":"10.1097/MPA.0000000000002372","url":null,"abstract":"Objectives: There is a paucity of data regarding the use of neoadjuvant therapy in pancreatic body or tail ductal adenocarcinomas. Given the differing tumor biology and aggressive nature of pancreatic body or tail adenocarcinomas, patients presenting with these tumors may benefit from upfront resection.Methods: A retrospective cohort study was performed analyzing patients who underwent distal pancreatectomy for pancreatic ductal adenocarcinoma between January 2013 and June 2022. Patients who underwent upfront resection were compared with those who underwent neoadjuvant therapy.Results: Forty-one patients underwent upfront distal pancreatectomy, whereas 40 patients underwent neoadjuvant therapy before curative intent resection. Neoadjuvant therapy did not improve overall survival (37 vs 34 months, P = 0.962) or disease-free survival (13 vs 15 months, P = 0.414), as compared with upfront resection. There was no significant difference in the rate or R 0 resection or postoperative outcomes.Conclusion: No significant improvement in survival was demonstrated for patients undergoing neoadjuvant therapy for pancreatic ductal adenocarcinoma of the pancreatic body or tail when compared with upfront resection. Considering the potential for disease progression given the more aggressive tumor biology of pancreatic body and tail adenocarcinomas, appropriate surgical candidates should be offered upfront resection to provide the best chance of survival and cure.","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e783-e789"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140921179","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

Acute Venous Thromboembolism Is Common Following Acute Necrotizing Pancreatitis and Is Associated With Worse Clinical Outcomes. 急性静脉血栓栓塞症是急性坏死性胰腺炎后的常见病，与较差的临床预后有关。

IF 1.7 4区医学

Pancreas Pub Date : 2024-11-01 Epub Date: 2024-06-03 DOI: 10.1097/MPA.0000000000002375

Ritu R Singh, Ragesh B Thandassery, Saurabh Chawla

{"title":"Acute Venous Thromboembolism Is Common Following Acute Necrotizing Pancreatitis and Is Associated With Worse Clinical Outcomes.","authors":"Ritu R Singh, Ragesh B Thandassery, Saurabh Chawla","doi":"10.1097/MPA.0000000000002375","DOIUrl":"10.1097/MPA.0000000000002375","url":null,"abstract":"Objectives: Although splanchnic vein thrombosis (SVT) is a well-known local complication of acute pancreatitis, extrasplanchnic venous thromboembolism (ESVT) is inadequately studied. Here, we aim to explore the incidence of venous thromboembolism (VTE) in acute necrotizing pancreatitis (ANP) and the associated mortality.Methods: Adults with a diagnosis of ANP from January 2017 to December 2022 were identified using appropriate International Classification of Diseases, 10th Revision, Clinical Modification codes. The primary outcome was development of acute ESVT within 1 month of ANP. Secondary outcomes were 90-day mortality, 30-day rehospitalization, and oral anticoagulant (OAC) use in patients with ESVT. Propensity score matching (1:1) was performed for baseline characteristics and common comorbidities.Results: During the study period, 17,942 (7.11%) patients were diagnosed with ANP, and about 10% (1,737) of them had a diagnosis of ESVT. Of all VTEs, 61% were ESVT with or without SVT, and 63% (n = 1799) were SVT. Ninety-day mortality (16.3% vs 5.7%; risk ratio [RR], 2.86; 95% confidence interval, 2.29-3.56) and 30-day rehospitalization (31% vs 19%; RR, 1.63; 95% confidence interval, 1.49-1.79) were higher in patients with ESVT compared with non-VTE patients. Sixty percent of patients with ESVT were on OAC, and OAC use was associated with lower 90-day mortality (8.9% vs 19.4%; RR, 0.46) without increased risk of adverse events (acute gastrointestinal bleeding, intracranial bleeding, or need for transfusion).Conclusions: Systemic VTE is common in patients with ANP and may contribute to increased mortality and risk of readmissions. Prospective studies can confirm our findings and explore the role of aggressive VTE prophylaxis in patients with ANP during hospital stay and in the immediate ambulatory period.","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e802-e807"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141184179","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

Genetic Assessment of Intraductal Papillary Mucinous Neoplasm for Predicting Concomitant Pancreatic Ductal Adenocarcinoma. 对 IPMN 进行基因评估以预测并发胰腺导管腺癌。

IF 1.7 4区医学

Pancreas Pub Date : 2024-11-01 Epub Date: 2024-05-15 DOI: 10.1097/MPA.0000000000002373

Hideyuki Oi, Yuto Hozaka, Toshiaki Akahane, Kosuke Fukuda, Tetsuya Idichi, Kiyonori Tanoue, Yoichi Yamasaki, Yota Kawasaki, Yuko Mataki, Hiroshi Kurahara, Michiyo Higashi, Akihide Tanimoto, Takao Ohtsuka

{"title":"Genetic Assessment of Intraductal Papillary Mucinous Neoplasm for Predicting Concomitant Pancreatic Ductal Adenocarcinoma.","authors":"Hideyuki Oi, Yuto Hozaka, Toshiaki Akahane, Kosuke Fukuda, Tetsuya Idichi, Kiyonori Tanoue, Yoichi Yamasaki, Yota Kawasaki, Yuko Mataki, Hiroshi Kurahara, Michiyo Higashi, Akihide Tanimoto, Takao Ohtsuka","doi":"10.1097/MPA.0000000000002373","DOIUrl":"10.1097/MPA.0000000000002373","url":null,"abstract":"Objective: The role of Krüppel-like transcription factor 4 ( KLF4 ) mutations in IPMNs with concomitant pancreatic ductal adenocarcinoma (PDAC) remains unclear. This study clarified the rate and effect of KLF4 mutations in IPMN with concomitant PDAC.Materials and methods: DNA was extracted from 65 formalin-fixed and paraffin-embedded samples from 52 patients including 13 IPMNs with concomitant PDAC and 39 IPMNs alone. A comprehensive screening using next-generation sequencing and then targeted sequencing for KLF4 , GNAS , and KRAS mutations were performed.Results: In next-generation sequencing screening, KRAS mutations were observed in all samples except for one, GNAS mutation in 2 IPMNs with concomitant PDAC, and a KLF4 mutation in 1 IPMN with concomitant PDAC. Targeted sequence detected KLF4 mutations in 11 of the 52 IPMNs. Concomitant PDAC developed only in the nonintestinal, noninvasive, and branch-duct IPMNs, and KLF4 mutations were more frequent in this IPMN type than in the other type. For this IPMN type with KLF4 mutation, PDAC-prediction sensitivity, specificity, and accuracy were 63%, 82%, and 79%, respectively.Conclusion: For selected IPMNs with nonintestinal, noninvasive, and branch-duct, genetic assessment might be helpful for predicting the possible development of concomitant PDAC, although a prospective validation study using a larger study population is needed.","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e790-e795"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140921178","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

Real Risk Factors for Post-ERCP Pancreatitis Patients. ERCP术后胰腺炎患者的真实风险因素。

IF 1.7 4区医学

Pancreas Pub Date : 2024-11-01 Epub Date: 2024-05-17 DOI: 10.1097/MPA.0000000000002368

Wanjun Wu, Zheng Peng

引用次数: 0

Diagnostic Accuracy of Preoperative Imaging for Differentiation of Branch Duct Versus Mixed Duct Intraductal Papillary Mucinous Neoplasms: Erratum.

IF 1.7 4区医学

Pancreas Pub Date : 2024-11-01 DOI: 10.1097/MPA.0000000000002380

引用次数: 0

Total Pancreatectomy With Percutaneous Islet Autotransplant After Remote Islet Processing: A Viable Paradigm? 全胰腺切除术与远程胰岛处理后的经皮胰岛自体移植：可行的范例？

IF 1.7 4区医学

Pancreas Pub Date : 2024-11-01 Epub Date: 2024-06-03 DOI: 10.1097/MPA.0000000000002376

Kyle A Lewellen, Thomas K Maatman, Michael G House, Kathleen McGreevy, Melissa K Cavaghan, Michael R Dorwart, Evan L Fogel, Paul M Haste, Anne Mary Montero, Alexandra M Roch, Nicholas J Zyromski

{"title":"Total Pancreatectomy With Percutaneous Islet Autotransplant After Remote Islet Processing: A Viable Paradigm?","authors":"Kyle A Lewellen, Thomas K Maatman, Michael G House, Kathleen McGreevy, Melissa K Cavaghan, Michael R Dorwart, Evan L Fogel, Paul M Haste, Anne Mary Montero, Alexandra M Roch, Nicholas J Zyromski","doi":"10.1097/MPA.0000000000002376","DOIUrl":"10.1097/MPA.0000000000002376","url":null,"abstract":"Objectives: Total pancreatectomy with islet autotransplant (TPIAT) is important therapy for select chronic pancreatitis (CP) patients. The specialized technique of islet isolation limits widespread TPIAT use. We hypothesized that remote islet isolation provides satisfactory islet yield and perioperative outcomes.Methods: A retrospective review of TPIAT patients between 2020 and 2022 was conducted. Islet isolation was performed off-site, with percutaneous intraportal islet autotransplant (IAT) completed the morning following pancreatectomy. Demographics and perioperative outcomes were analyzed.Results: Fourteen patients underwent TPIAT; median age was 43 (interquartile range, 12.5) years. Operation occurred 7.5 (14.8) years after pancreatitis diagnosis. The most common pancreatitis etiology was genetic (50%). All patients underwent preoperative endoscopic therapy; three underwent prior pancreatectomy. Operative time was 236 (51) minutes; subsequent percutaneous IAT time was 87 (35) minutes. The islet equivalent (IEQ)/kilogram (kg) yield was 3456 (3815) IEQ/kg. Nine patients had positive islet cultures. Two thromboembolic events and one bacteremia occurred. One perihepatic hematoma occurred after percutaneous portal venous access. The median postoperative length of stay was 14.5 days, and five patients (36%) were readmitted within 90 days. All patients were discharged home on insulin. No mortality occurred.Conclusions: Total pancreatectomy with remote islet isolation provides excellent islet yield for autotransplant and satisfactory perioperative outcomes.","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e796-e801"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141184110","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

Giant Cyst of Intrapancreatic Accessory Spleen Mimicking a Malignant Cystic Neoplasm of the Pancreas: A Case Report. 模仿胰腺恶性囊性肿瘤的胰腺内附属脾脏巨型囊肿：病例报告。

IF 1.7 4区医学

Pancreas Pub Date : 2024-11-01 Epub Date: 2024-06-24 DOI: 10.1097/MPA.0000000000002383

Yang Sun, Jieli Luo, Fengbo Huang, Pintong Huang, Risheng Yu

引用次数: 0

Increased Gremlin1 Expression in Pancreatic Ductal Adenocarcinoma Promotes a Fibrogenic Stromal Microenvironment. 胰腺导管腺癌中 Gremlin1 表达的增加促进了纤维基质微环境的形成。

IF 1.7 4区医学

Pancreas Pub Date : 2024-11-01 Epub Date: 2024-06-04 DOI: 10.1097/MPA.0000000000002378

Rachel R Tindall, Erika Y Faraoni, Jiajing Li, Yinjie Zhang, Shun-Ming Ting, Beanna Okeugo, Xiurong Zhao, Yuying Liu, Mamoun Younes, Qiang Shen, Jennifer M Bailey-Lundberg, Yanna Cao, Tien C Ko

{"title":"Increased Gremlin1 Expression in Pancreatic Ductal Adenocarcinoma Promotes a Fibrogenic Stromal Microenvironment.","authors":"Rachel R Tindall, Erika Y Faraoni, Jiajing Li, Yinjie Zhang, Shun-Ming Ting, Beanna Okeugo, Xiurong Zhao, Yuying Liu, Mamoun Younes, Qiang Shen, Jennifer M Bailey-Lundberg, Yanna Cao, Tien C Ko","doi":"10.1097/MPA.0000000000002378","DOIUrl":"10.1097/MPA.0000000000002378","url":null,"abstract":"Objective: Pancreatic ductal adenocarcinoma (PDAC) microenvironment is primarily composed of cancer-associated fibroblasts and immune cells. Gremlin1 (Grem1) is a profibrogenic factor that promotes tumorigenesis in several cancers. However, the role of Grem1 in the PDAC microenvironment is not defined.Materials and methods: We correlated Grem1 levels with activated stroma and immune cells in human PDAC using The Cancer Genome Atlas RNA-sequencing data and characterized expression of Grem1 transcripts and isoforms in pancreatic cell lines and PDAC tissues. We assessed the role of Grem1 in the microenvironment by in vitro studies.Results: Grem1 expression is associated with an activated stroma and increased M1 and M2 macrophages. Only full length Grem1 variant 1 and isoform 1 were detectable in human pancreatic cells, and remarkably high levels of Grem1 were observed in pancreatic fibroblasts. Immunohistochemistry detected Grem1 protein in PDAC tumor and stromal cells, which correlated with infiltrating macrophages in PDAC tumors. Grem1 knockdown in cancer-associated fibroblasts suppressed transforming growth factor β-induced extracellular matrix proteins. Grem1 recombinant protein treatment in vitro increased M1 and M2 macrophages.Conclusions: Grem1 acts as a profibrogenic factor in the PDAC microenvironment via modulation of fibroblasts and macrophages. Grem1 may have the potential to be developed as a therapeutic target for PDAC.","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e808-e817"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11615151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Regarding the Risk of Hypertriglyceridemic Acute Pancreatitis. 关于高甘油三酯急性胰腺炎的风险。

IF 1.7 4区医学

Pancreas Pub Date : 2024-10-01 Epub Date: 2024-04-30 DOI: 10.1097/MPA.0000000000002361

Beibei Wang, Zheng Peng

引用次数: 0