PancreasPub Date : 2026-03-01DOI: 10.1097/MPA.0000000000002619
Akshay S Bandi, Sanish Ancil, Ujjwal Gorsi, Mandeep Kang, Vaneet Jearth, Kamal Kishore, Rajesh Gupta, Surinder Singh Rana
{"title":"Impact of Splanchnic Vein Thrombosis on Outcomes of Interventions in Patients With Pancreatic Fluid Collections Following Acute Pancreatitis-A Prospective Observational Study.","authors":"Akshay S Bandi, Sanish Ancil, Ujjwal Gorsi, Mandeep Kang, Vaneet Jearth, Kamal Kishore, Rajesh Gupta, Surinder Singh Rana","doi":"10.1097/MPA.0000000000002619","DOIUrl":"10.1097/MPA.0000000000002619","url":null,"abstract":"<p><strong>Background: </strong>Splanchnic vein thrombosis (SVT) is common in acute pancreatitis (AP) and often leads to intra-abdominal collaterals, increasing the risk of bleeding during interventions. However, data on its impact on intervention outcomes are limited. We prospectively assessed the effect of SVT on outcomes of interventions for symptomatic pancreatic fluid collections (PFCs).</p><p><strong>Methods: </strong>Fifty patients (mean age: 40.9 y; 62% male) with symptomatic PFCs were prospectively evaluated. Contrast-enhanced CT was used to assess PFCs, detect SVT, and identify intra-abdominal venous collaterals (IAVCs). Patients underwent percutaneous drainage (PCD), endoscopic transmural drainage (TMD), or surgery, based on the treating clinician's discretion. Follow-up lasted 6 months, and outcomes were compared between patients with and without SVT.</p><p><strong>Results: </strong>SVT was present in 18 (36%) patients; IAVCs were seen in 8 (16%). Splenic vein thrombosis occurred in 17 (34%), portal vein in 7 (14%), and superior mesenteric vein in 8 (16%). Thirty-nine (78%) underwent PCD, 11 (22%) TMD, and 13 (26%) required surgery. Eleven (22%) patients died, with similar mortality between the SVT and non-SVT groups. Hospital and ICU stay lengths were comparable. Bleeding rates did not differ significantly [SVT vs. no SVT: 2 (11.1%) vs. 2 (6.25%); P =0.612].</p><p><strong>Conclusions: </strong>SVT was not associated with increased complications, bleeding risk, or mortality following interventions for symptomatic PFCs in AP.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e261-e266"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145809857","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":"Evaluation of Malignant Predictive in Pancreatic Intraductal Papillary Mucinous Neoplasm Using Diffusion-weighted Imaging and Apparent Diffusion Coefficient Values: A Comparative Analysis With Histopathology.","authors":"Wataru Ujita, Jun Nakahodo, Mizuka Suzuki, Shin-Ichiro Horiguchi, Kazuro Chiba, Hiroki Tabata, Toshiro Iizuka, Terumi Kamisawa, Yoshinori Igarashi, Takahisa Matsuda","doi":"10.1097/MPA.0000000000002566","DOIUrl":"10.1097/MPA.0000000000002566","url":null,"abstract":"<p><strong>Objectives: </strong>Differentiating benign and malignant intraductal papillary mucinous neoplasms (IPMNs) can facilitate optimal clinical management. However, the current high-risk stigmata (HRS) criteria lack specificity. In this study, we aim to evaluate the diagnostic accuracy of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) values, which are reported to improve diagnostic accuracy, for distinguishing benign and malignant IPMNs.</p><p><strong>Materials and methods: </strong>This study included 50 patients who underwent pancreatic resection for IPMN or intraductal papillary mucinous carcinoma (IPMC) from 2013 to 2023. The benign group comprised intraductal papillary mucinous adenoma, whereas the malignant group included high-grade IPMN and invasive IPMC. Imaging findings were compared with histopathologic results. ADC values were measured using regions of interest (ROIs) on DWI, with 800 s/mm2 b-value. The optimal ADC cutoff value for malignancy prediction was determined by operating characteristic curve analysis.</p><p><strong>Results: </strong>Diagnostic accuracy of DWI was 85%, outperforming HRS at 64%. The malignant group had significantly lower minimum ADC values in ROIs than the benign group (1780 vs 1,181 mm2/s, P < 0.01). The mean ADC in 2438 mm2/s ROI cutoff value yielded 79% sensitivity, 79% specificity, and 0.761 area under the curve. In addition, the malignant group had significantly large mural nodules and low ADC values (r = -0.43842, P = 0.0033).</p><p><strong>Conclusions: </strong>DWI and ADC mapping are valuable diagnostic tools for differentiating benign and malignant IPMNs. These modalities can complement existing diagnostic criteria, reduce unnecessary surgeries, and enhance clinical decision-making.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":"55 3","pages":"e284-e294"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146166151","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}
PancreasPub Date : 2026-03-01DOI: 10.1097/MPA.0000000000002617
Maayan Tiosano, Liron Birimberg-Schwartz, Michael Wilschanski, Emmanuelle Masson, Jian-Min Chen, Philippe Ruszniewski, Vinciane Rebours, Manar Matar, Ron Shaoul, Baruch Yerushalmi, Batya Weiss, Oren Ledder, Michal Kori, Efrat Broide, Chani Topf-Olivestone, Michael Cohen, Ayelet Gamliel, Claude Férec
{"title":"Genetic and Electrophysiological Characterization of Acute Recurrent Pancreatitis in Israeli Patients.","authors":"Maayan Tiosano, Liron Birimberg-Schwartz, Michael Wilschanski, Emmanuelle Masson, Jian-Min Chen, Philippe Ruszniewski, Vinciane Rebours, Manar Matar, Ron Shaoul, Baruch Yerushalmi, Batya Weiss, Oren Ledder, Michal Kori, Efrat Broide, Chani Topf-Olivestone, Michael Cohen, Ayelet Gamliel, Claude Férec","doi":"10.1097/MPA.0000000000002617","DOIUrl":"10.1097/MPA.0000000000002617","url":null,"abstract":"<p><strong>Objectives: </strong>Genetics is a significant contributor to acute recurrent pancreatitis. This study evaluates the prevalence of genetic variants and assesses electrophysiological characteristics in Israeli patients.</p><p><strong>Methods: </strong>Patients with ≥2 episodes of acute pancreatitis, no history of drug use, normal IgG4 levels, and normal cholangiopancreatographic findings were included. Genetic analysis targeted the PRSS1, SPINK1, CTRC, CFTR, CPA1 , and TRPV6 genes, as well as the CEL-HYB1 allele. Sweat testing and nasal potential difference measurements were also performed.</p><p><strong>Results: </strong>Seventy-nine patients (median age: 13 y; range: 2-61) were referred between 2015 and 2021. Forty-five (57.0%) carried at least one genetic variant; 18 patients carried 2 or more variants. CFTR variants were the most common (35.4%), followed by PRSS1 (11.4%), SPINK1 (10.1%), and CTRC (10.1%). The rare PRSS1 p.Lys23Arg variant was prevalent among Jewish Georgian patients (n=8). Patients with genetic variants were younger than those without ( P <0.0035). Of the 71 patients who underwent nasal potential difference testing, 2 (5.6%) had abnormal results. Sweat test in 66 patients showed a mean value of 36 ± 16 mmol/L; 6 had results above 60 mmol/L; 2 of these carried CFTR variants TG[11]T[5] and p.Leu997Phe but had normal nasal potential.</p><p><strong>Conclusions: </strong>More than half of acute recurrent pancreatitis cases had a genetic basis, presenting at a younger age. CFTR variants were the most prevalent. The high prevalence of the PRSS1 p.Lys23Arg variant among Jewish Georgian individuals suggests a potential founder effect. These findings highlight the importance of genetic evaluation in the diagnosis and management of acute recurrent pancreatitis.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e253-e260"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145794470","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}
PancreasPub Date : 2026-03-01DOI: 10.1097/MPA.0000000000002578
Dhruv J Patel, William B Hyslop, Joseph Maniaci, Mu Jin, Alina Iuga, Andrew Woodward, Chris B Agala, Melissa E Chen, Chirag S Desai
{"title":"Pancreatic Calcification and Pathologic Fibrosis Score: Correlation With Islet Yield and Insulin Independence After Total Pancreatectomy With Islet Autotransplantation (TPIAT).","authors":"Dhruv J Patel, William B Hyslop, Joseph Maniaci, Mu Jin, Alina Iuga, Andrew Woodward, Chris B Agala, Melissa E Chen, Chirag S Desai","doi":"10.1097/MPA.0000000000002578","DOIUrl":"10.1097/MPA.0000000000002578","url":null,"abstract":"<p><strong>Objectives: </strong>Total pancreatectomy with islet autotransplantation (TPIAT) is offered to patients with advanced chronic pancreatitis, even with calcified and fibrotic glands, yet rarely are these manifestations of chronic pancreatitis objectively quantified and correlated with subsequent islet yield and endocrine outcomes after surgery.</p><p><strong>Methods: </strong>All patients who underwent TPIAT at a single institution between 2018 and 2024 were included. Preoperative computed tomography (CT) imaging was reviewed and scored for the distribution and severity of pancreatic calcification burden. All pathologic specimens were scored based on the degree of fibrosis severity. Bivariate linear regression and logistic regression were performed to assess the relationship between clinical, radiographic, and pathologic variables with islet yield and insulin independence.</p><p><strong>Results: </strong>Thirty-two patients met the inclusion criteria. Median total fibrosis score was 9. Four patients (13%) had mild (total fibrosis score ≤6), 14 (47%) had moderate (score 7-9), and 12 (40%) had severe (score 10-12) fibrosis. On univariable analysis of factors associated with islet yield (IEQ/kg), increasing calcification burden in the pancreatic head [linear estimate (LE): -783 IEQ/kg, 95% CI: -1529, -37, P =0.040] and pancreatic body/tail [LE: -1152 IEQ/kg, 95% CI: (-1748, -557), P <0.001] were both associated with reduced islet yield. Increasing total fibrosis score [LE: -426 IEQ/kg, 95% CI (-730, -123), P =0.008] was also associated with reduced islet yield on unadjusted analysis. After adjusting for covariates, only increasing calcification burden in the pancreatic body/tail remained a significant predictor of islet yield [beta coefficient: -1511 IEQ/kg (95% CI: -2252 to -770, P <0.001)]. At the time of discharge, 15 patients (47%) were insulin-independent, and at 1 year, 9 (28%) remained independent.</p><p><strong>Conclusions: </strong>Increasing severity of calcification burden in the pancreatic body/tail was associated with around 1500 IEQ/kg reduction in islet yield following TPIAT for chronic pancreatitis. The presence of pancreatic head calcifications may be associated with a more favorable islet yield.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e278-e283"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13417637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252022","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}
PancreasPub Date : 2026-03-01DOI: 10.1097/MPA.0000000000002586
Amit Dangi, Mahesh Rajashekhara, Rohit Jain, Pritheesh Rajan, Uma Vijayashankar, Deeban Ganesan, Sanjay Kumar Tripathi, Jaya Nigam, Abhijit Chandra
{"title":"Clinical Outcome and Quality of Life After Frey Procedure and Longitudinal Pancreaticojejunostomy for Chronic Pancreatitis.","authors":"Amit Dangi, Mahesh Rajashekhara, Rohit Jain, Pritheesh Rajan, Uma Vijayashankar, Deeban Ganesan, Sanjay Kumar Tripathi, Jaya Nigam, Abhijit Chandra","doi":"10.1097/MPA.0000000000002586","DOIUrl":"10.1097/MPA.0000000000002586","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluated the long-term outcomes of surgery for chronic pancreatitis (Frey procedure and longitudinal pancreaticojejunostomy), focusing on pain relief, endocrine and exocrine insufficiency, and postoperative quality of life.</p><p><strong>Methods: </strong>This was a single-centre prospective longitudinal study using a prospectively maintained database of patients who underwent surgery for chronic pancreatitis between January 2016 and December 2022, with follow-up continued through December 2024. The primary outcome was pain relief, assessed using the Izbicki pain score at 12 months, with descriptive reporting at 24 months. Secondary outcomes included postoperative quality of life (SF-36), endocrine and exocrine function, nutritional status, and occupational rehabilitation.</p><p><strong>Results: </strong>Fifty-seven patients (38 Frey's, 19 LPJ; median age 30yr) were included, with a median follow-up of 41 months (range: 25-108). Idiopathic chronic pancreatitis was the most common etiology (63%). At 12 months, 75% achieved complete pain relief (Izbicki ≤10), and improvements were sustained at 24 months. SF-36 scores showed significant improvements across all domains, particularly pain and general health. New-onset exocrine insufficiency developed in 20% and endocrine insufficiency in 7%. Nearly 95% of patients returned to normal work and daily activities.</p><p><strong>Conclusions: </strong>Both Frey procedure and LPJ provided durable pain relief and improved quality of life. Surgical selection should be guided by pancreatic morphology to optimize long-term pain outcomes.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e295-e308"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145422501","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}
PancreasPub Date : 2026-03-01DOI: 10.1097/MPA.0000000000002574
Jami L Saloman, Dana K Andersen, Maisam Abu-El-Haija, Melena D Bellin, Darwin L Conwell, Mahya Faghih, Christopher E Forsmark, Mark O Goodarzi, Aiste K Gulla, Phil A Hart, Steven J Hughes, Braden Kuo, Jennifer M Ladd, Bomi Lee, Stephen J Pandol, Anna Evans Phillips, Kristen M Roberts, Sarah Jane Schwarzenberg, Vikesh K Singh, Ronald M Summers, Temel Tirkes, Frederico G S Toledo, Guru Trikudanathan, Aliye Uc, Clive H Wasserfall, David C Whitcomb, Dhiraj Yadav, Christine Yost, Wenying Zhang, A Jay Freeman
{"title":"Complications of Pancreatitis-Knowledge Gaps and Research Opportunities: A Workshop Summary.","authors":"Jami L Saloman, Dana K Andersen, Maisam Abu-El-Haija, Melena D Bellin, Darwin L Conwell, Mahya Faghih, Christopher E Forsmark, Mark O Goodarzi, Aiste K Gulla, Phil A Hart, Steven J Hughes, Braden Kuo, Jennifer M Ladd, Bomi Lee, Stephen J Pandol, Anna Evans Phillips, Kristen M Roberts, Sarah Jane Schwarzenberg, Vikesh K Singh, Ronald M Summers, Temel Tirkes, Frederico G S Toledo, Guru Trikudanathan, Aliye Uc, Clive H Wasserfall, David C Whitcomb, Dhiraj Yadav, Christine Yost, Wenying Zhang, A Jay Freeman","doi":"10.1097/MPA.0000000000002574","DOIUrl":"10.1097/MPA.0000000000002574","url":null,"abstract":"<p><p>Endocrine and exocrine insufficiencies are well-recognized pancreatic-specific sequelae of chronic pancreatitis (CP), yet the impact of CP extends beyond the pancreas. The pathophysiology driving these complications is complex and poorly understood, resulting in inadequate recognition and an inability to stratify risk of disease progression. To address this topic, the Collaborative Alliance for Pancreatic Education and Research convened a workshop to summarize our current understanding and identify knowledge gaps related to the complications of CP. The clinical uncertainty related to who will develop systemic complications of CP, and when, negatively affects the patient's clinical experience and is an area of research that requires additional commitment. Adapting modeling strategies proven effective in other conditions (eg, type 2 diabetes) may be effective in identifying and predicting the onset of endocrine and exocrine insufficiencies. Improved understanding related to genetic risk factors, biomarkers, clinical testing, and advanced imaging techniques all represent pathways to better identify these complications and develop pancreatitis-specific interventions. Additional complications of CP, including pain, osteopathies, sarcopenia, malnutrition, and visceral neuropathies, can occur independently or as complications from endocrine and/or exocrine insufficiency. Better screening strategies to identify these conditions are required, many of which may be accomplished using opportunistic screening strategies. Future research will need to utilize existing treatment modalities and medications, in addition to developing new interventions, to treat these complications of CP that have a tremendous impact on patients' quality of life. Genetic testing in pancreatitis is likely to inform any research related to the complications of CP, but low penetrance of disease, poor genotype-phenotype associations, and health disparities that impact the use of testing across centers currently limit its clinical utility for all patients. Genetic testing remains critical in certain populations with CP and should be incorporated into research whenever possible to inform much-needed disease progression prediction models.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e267-e277"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158018","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":"Assessment of Skeletal Muscle Quality via Intramuscular Adipose Tissue Content Predicts Surgical Morbidity and Prognosis After Pancreatoduodenectomy.","authors":"Yutaka Suzuki, Masao Yoshida, Hideaki Mizuno, Saori Funakoshi, Nobuhiro Hasui, Hirokazu Momose, Ryota Matsuki, Masaharu Kogure, Yoshihiro Sakamoto","doi":"10.1097/MPA.0000000000002609","DOIUrl":"10.1097/MPA.0000000000002609","url":null,"abstract":"<p><strong>Objectives: </strong>Sarcopenia is characterized by skeletal mass reduction and is associated with surgical morbidity and poor prognosis after pancreatoduodenectomy (PD). Sarcopenia diagnosis requires a combination of motor functional tests and skeletal muscle mass measurements. Conversely, intramuscular adipose tissue content (IMAC), an indicator of skeletal muscle quality, requires only computed tomography, providing convenient diagnostic information regarding the patient's body composition. This study aimed to clarify the impact of IMAC on surgical morbidity and prognosis in patients undergoing PD.</p><p><strong>Methods: </strong>This study included 277 patients who underwent PD between January 2013 and December 2022. The relationship between surgical morbidity (Clavien-Dindo grade ≥ 3) and clinicopathological factors, including IMAC, was examined in all patients. Predictive factors associated with overall survival (OS) and recurrence-free survival (RFS) were evaluated in 122 pancreatic cancer patients.</p><p><strong>Results: </strong>A high IMAC independently predicted major complications (odds ratio 1.776, P =0.046) and was independently associated with poor OS [hazard ratio (HR), 1.694; P =0.038] and RFS (HR, 1.582; P =0.038). Patients with both high IMAC and CAR ≥0.015 had a significantly poorer OS than those with only one of the factors (5-y survival rate, 12.3% vs. 45.8%; P <0.001).</p><p><strong>Conclusions: </strong>IMAC, an indicator of skeletal muscle quality, provides convenient and highly valuable diagnostic information on body composition and predicts postoperative complications and prognosis in patients with malignant tumors undergoing PD.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e241-e252"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145743714","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}
PancreasPub Date : 2026-03-01DOI: 10.1097/MPA.0000000000002557
Limei Yuan, Chong Zhang
{"title":"Comment on: \"The Significant Impact of Fibrinogen-C-Reactive Protein-Albumin Ratio on the Long-Term Outcomes After Pancreatic Resection for Pancreatic Cancer\".","authors":"Limei Yuan, Chong Zhang","doi":"10.1097/MPA.0000000000002557","DOIUrl":"10.1097/MPA.0000000000002557","url":null,"abstract":"","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e334"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859521","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":"Outcomes of Early Enteral Feeding (<48 Hours) in Patients With Predicted Severe Acute Pancreatitis.","authors":"Arjun Chatterjee, Zehra Naseem, Ridhima Kaul, Renan Prado, Raj Jessica Thomas, Hisham Wehbe, Rupayan Kundu, Renee Wu, Qijun Yang, John McMichael, Syed Mohiuddin, Tyler Stevens, Prabhleen Chahal","doi":"10.1097/MPA.0000000000002583","DOIUrl":"10.1097/MPA.0000000000002583","url":null,"abstract":"<p><strong>Background: </strong>Early enteral nutrition (EEN) is preferred for severe acute pancreatitis (SAP) patients, but the optimal timing is controversial. The clinical implications of initiating EEN within 48 hours versus later (>48 h) in predicted SAP patients are unclear. This study compares outcomes in predicted SAP patients receiving EEN within 48 hours to those receiving it later.</p><p><strong>Methods: </strong>Retrospective cohort study of adults (18 years or older) with predicted SAP (BISAP score ≥2) from May 2011 to July 2023. EEN was defined as initiation within 48 hours of diagnosis. Exclusions included inaccurate diagnoses, outside transfers, missing data, chronic pancreatitis, acute exacerbations of chronic pancreatitis, and TPN-only treatment. Statistical analysis included χ 2 , Fisher exact tests, and 2-sample t -tests.</p><p><strong>Results: </strong>Among 83 predicted SAP patients, 27 received EEN within 48 hours, and 56 received late feeding. Baseline characteristics, including age, gender, BMI, and BISAP score, were similar. Postpyloric feeding was used in 91.6%, and 45.6% reached goal feeding rates in <72 hours. The EEN group had statistically significant shorter ICU stays (14.7 vs. 25.4 d, P =0.011), fewer pancreatic fluid collections (22.2% vs. 48.2%, P =0.043), and fewer gastrointestinal complications (48.1% vs. 75%, P =0.03). Early EEN (<48 h) showed improved composite outcomes, including decreased mortality, ICU needs, early systemic complications, and lower hospital and ICU costs.</p><p><strong>Conclusion: </strong>This novel study demonstrated that initiating EEN within 48 hours in predicted SAP patients significantly improves outcomes, highlighting its importance in management. These findings support EEN as a clinical standard for SAP patients and call for future prospective studies to confirm its benefits.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e316-e322"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286670","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}
PancreasPub Date : 2026-03-01DOI: 10.1097/MPA.0000000000002551
Geoffrey Daves, Ashley Polachek, David M Troendle, Meghana Sathe
{"title":"Characterization of Pancreatic Cystosis Phenotype in People With Cystic Fibrosis.","authors":"Geoffrey Daves, Ashley Polachek, David M Troendle, Meghana Sathe","doi":"10.1097/MPA.0000000000002551","DOIUrl":"10.1097/MPA.0000000000002551","url":null,"abstract":"","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e323-e324"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855951","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}