Pancreas最新文献

{"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":2.2,"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":2.2,"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":"Risk Prediction Models for Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis: A Systematic Review and Meta-Analysis.","authors":"Xiao-Qing Xu, Jing-Yan Zhang, Hong-Zhu Diao, Pei Zhang, Xian Tian, Hong-Mei Wu","doi":"10.1097/MPA.0000000000002564","DOIUrl":"10.1097/MPA.0000000000002564","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic retrograde cholangiopancreatography (ERCP) serves as an essential procedure for diagnosing and treating pancreaticobiliary disorders, however it frequently results in post-ERCP pancreatitis (PEP), its most common complication. Identifying risk factors for PEP is crucial given its potential for significant morbidity and mortality.</p><p><strong>Objective: </strong>To systematically review and evaluate existing PEP risk prediction models, thereby establishing an evidence-based framework to inform clinical decision-making and guide future model development.</p><p><strong>Design: </strong>Systematic review and meta-analysis conducted in accordance with PRISMA 2020 guidelines.</p><p><strong>Materials and methods: </strong>We performed a comprehensive literature search across multiple databases (PubMed, Scopus, Embase, etc.) from their inception till February 2025. The inclusion criteria focused on studies that developed or validated predictive models for PEP in adult patients undergoing ERCP. Two reviewers independently extracted data and assessed methodological quality using the PROBAST tool.</p><p><strong>Results: </strong>From 466 initially identified records, we analyzed 11 studies comprising 12 predictive models. The pooled area under the receiver operating characteristic curve (AUC) was 0.798 (95% confidence interval: 0.727-0.876). Key independent predictors of PEP included endoscopic sphincterotomy (EST), previous pancreatitis, age, operative time, and intubation difficulty. However, significant methodological heterogeneity and potential bias were evident across studies. Most models were developed using logistic regression, with only one study employing machine learning techniques. Notably, only three studies conducted external validation, underscoring substantial limitations in current predictive modeling approaches.</p><p><strong>Conclusion: </strong>Existing PEP prediction models demonstrate overall good discrimination but are limited by methodological heterogeneity and scarce external validation. Clinically validated models can support risk stratification to guide preventive strategies (e.g., rectal NSAIDs, aggressive hydration, selective prophylactic pancreatic stenting) alongside clinical judgment. Future research should prioritize multicenter prospective validation, robust calibration and decision-curve analyses, impact assessments, and explainable machine learning models integrated with electronic health record systems.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e431-e439"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145768875","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":"Pancreatic and Peripancreatic Neural Crest-Derived Tumors: An Updated Contemporary Single Center Experience.","authors":"Feras Shamoun, Elie M Ghabi, Elizabeth D Thompson, John L Cameron, Christopher R Shubert, Kelly J Lafaro, Richard A Burkhart, William R Burns, Jin He","doi":"10.1097/MPA.0000000000002556","DOIUrl":"10.1097/MPA.0000000000002556","url":null,"abstract":"<p><strong>Background: </strong>Schwannomas, paragangliomas, and gangliocytic paragangliomas are rare tumors of the pancreas and peripancreas. Diagnosis and management of these tumors remain challenging.</p><p><strong>Methods: </strong>A retrospective review was conducted at a single institution. Nineteen cases were identified from 1990 to 2022. Descriptive statistics summarized the demographic, clinicopathologic, and long-term outcome data.</p><p><strong>Results: </strong>Schwannomas were encountered within the pancreatic parenchyma, whereas half of the paragangliomas were intraparenchymal and the other half were in the peripancreatic connective tissue. Symptoms varied and occurred in half of the patients encountered. Imaging characteristics were nonspecific. When obtained, EUS-FNA (n = 16) and nuclear imaging (n = 3) assisted in making a preoperative diagnosis. Intraparenchymal tumors were predominantly managed with a pancreatectomy (n = 12) while tumors in the peripancreatic connective tissue were managed with tumor resection without a pancreatectomy (n = 4). The median follow-up for schwannomas and gangliocytic paragangliomas was 66.8 and 13.6 months, respectively, during which time zero recurrences occurred. Paraganglioma patients had a median follow-up of 21.4 months, and tumor recurrence was encountered in 50% of patients.</p><p><strong>Conclusion: </strong>Schwannomas and gangliocytic paragangliomas are benign tumors. Paragangliomas have malignant potential and should be managed with an oncologic resection. Accurate preoperative diagnosis using EUS-FNA and nuclear imaging is crucial for recommending the appropriate surgical intervention and minimizing surgical morbidity.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e423-e430"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964070","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":"Clinical Characteristics of Acute and Chronic Pancreatitis in Children and Impact of Obesity.","authors":"In Sook Jeong, Yeoun Joo Lee, Soon Chul Kim, Yoo Min Lee, Dae Yong Yi, So Yoon Choi, Ju Young Kim, Eun Hye Lee, Eun Sil Kim, You Jin Choi, Hyun Jin Kim","doi":"10.1097/MPA.0000000000002572","DOIUrl":"10.1097/MPA.0000000000002572","url":null,"abstract":"<p><strong>Objectives: </strong>In the context of increasing rates of obesity in children, through this study, we aimed to evaluate the impact of obesity on Asian pediatric acute pancreatitis (AP) and chronic pancreatitis (CP).</p><p><strong>Materials and methods: </strong>The medical records of patients aged younger than 18 years with AP and CP across 11 Korean centers were reviewed retrospectively. To stratify the severity of acute pancreatitis, Ranson score, modified Glasgow score and revised Atlanta severity classification were used. Patients were categorized by body mass index percentile for the analysis. We also evaluated blood parameters to predict severe AP.</p><p><strong>Results: </strong>We enrolled 301 patients (obesity: n = 61; overweight: n = 40; normal-weight: n = 200) with AP and 19 patients (obesity: n = 5; overweight: n = 4; normal-weight: n = 10) with CP. The rate of moderately severe/severe AP was significantly higher in the obesity group than that in the overweight and normal-weight groups (41.0% vs 17.5% vs 4.5%). The obesity group demonstrated a significantly higher incidence of organ failure (16.4% vs 1.5%) and pancreatic necrosis (41.0% vs 4.0%) than the normal-weight group. According to multivariate analysis, obesity and overweight were predictors of moderately severe/severe AP. Among the various blood parameters, glucose was found to be most highly correlated with AP severity in receiver operating characteristic analysis. In CP, the mean number of hospital admission was 5.2 times, and the times computed tomography was performed was 3. Genetic and imaging abnormalities occurred in 12 (63.2%) and 12 (63.2%) patients, respectively. Exocrine and endocrine pancreatic insufficiencies occurred in 2 (10.5%) and 5 (26.3%) patients, respectively.</p><p><strong>Conclusions: </strong>Obesity significantly impacted both length of hospital stay and AP severity in Asian children.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e337-e346"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075867","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":"Therapeutic Mechanisms of Sanhuang Xiexin Decoction in Severe Acute Pancreatitis-Associated Lung Injury: Modulation of the NF-κB Signaling Pathway.","authors":"Ying Hou, Hui Wang, Hongju You, Yuanxia Zou","doi":"10.1097/MPA.0000000000002584","DOIUrl":"10.1097/MPA.0000000000002584","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the therapeutic mechanisms of Sanhuang Xiexin Decoction (SHXXD) in treating severe acute pancreatitis-associated lung injury (PALI) by modulating the NF-κB signaling pathway.</p><p><strong>Materials and methods: </strong>Active components and potential targets of SHXXD were identified through the TCMSP database. A protein-protein interaction (PPI) network was constructed, followed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. In vivo and in vitro experiments were performed to evaluate the anti-inflammatory effects of SHXXD in CAE-induced and LPS-induced mouse models and cellular experiments. NF-κB pathway activation and inflammatory cytokine expression were analyzed by Western blot and Quantitative Real-Time PCR (qPCR).</p><p><strong>Results: </strong>Fifty-two active components of SHXXD were identified, including quercetin, baicalin, emodin, and berberine. On the basis of molecular docking results, these components were found to bind strongly with key inflammatory proteins, such as TNF, IL6, IL1B, and MMP9. In vivo experiments showed significant reductions in serum amylase and lipase levels and inhibited NF-κB pathway activation and inflammatory cytokine expression.</p><p><strong>Conclusions: </strong>SHXXD exerts therapeutic effects in treating severe acute pancreatitis-associated lung injury by modulating the NF-κB signaling pathway, making it a potential alternative treatment for PALI. Its active components, including quercetin and baicalin, reduce inflammation.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e368-e377"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145422177","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":"Immune Checkpoint Inhibitor-Induced Pancreatic Injury: An Emerging Form of Immune-Mediated Pancreatitis.","authors":"Tareq Alsaleh, John George","doi":"10.1097/MPA.0000000000002582","DOIUrl":"10.1097/MPA.0000000000002582","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICI) are increasingly utilized in cancer management due to their favorable outcomes. Pancreatic injury from ICIs (ICI-PI) is a heterogenous entity ranging from silent lipase elevation to clinical pancreatitis. Its distinct immunologic mechanisms and phenotype position it as a novel form of immune-mediated pancreatic injury.</p><p><strong>Methods: </strong>We performed a narrative review of the emerging literature on ICI-PI, highlighting its mechanisms, epidemiology, clinical and imaging features, histology, management, outcomes, and critical knowledge gaps.</p><p><strong>Results: </strong>ICI-PI often appears within months of starting therapy and frequently presents as isolated enzyme elevation rather than acute pancreatitis. Early imaging can be unremarkable, but later scans may show pancreatic volume loss or atrophy. Tissue examination shows neutrophil-predominant and CD8-predominant infiltrates. Unlike other forms of autoimmune pancreatitis (AIP), storiform fibrosis, obliterative phlebitis, granulocytic epithelial lesions, or IgG4-rich plasma cells are not seen. Management focuses on supportive care, exclusion of alternative causes, and a temporary ICI hold for clinical pancreatitis. Corticosteroids are reasonable for symptomatic or radiographically confirmed disease, though evidence for long-term benefit is limited. Rechallenge with ICIs appears feasible in selected patients after recovery, with a low recurrence rate observed in available data. Some patients develop delayed exocrine or endocrine insufficiency, underscoring the need for follow-up.</p><p><strong>Conclusions: </strong>ICI-PI is an uncommon yet clinically important entity that shows a distinct clinicopathologic profile from other forms of AIP. Clear diagnostic criteria, practical treatment pathways, and prospective registries are needed to guide therapy, inform rechallenge decisions, and define long-term outcomes.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e378-e384"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280916","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}