Pancreatology最新文献

{"title":"Natural history of low-risk branch-duct intraductal papillary mucinous neoplasms and indeterminate pancreatic cysts: Implications on surveillance intervals by cyst size.","authors":"Hwee-Leong Tan, Jonathan Hee, Jania Wu, Grace R S Lim, Damien M Y Tan, Albert S Low, Choon-Hua Thng, Ye-Xin Koh, Brian K P Goh","doi":"10.1016/j.pan.2024.11.014","DOIUrl":"https://doi.org/10.1016/j.pan.2024.11.014","url":null,"abstract":"<p><strong>Background: </strong>The optimal surveillance strategy for low-risk branch-duct intraductal papillary mucinous neoplasms (BD-IPMN) remains unclear. We aim to evaluate the natural history of low-risk BD-IPMN/indeterminate pancreatic cysts to determine optimal surveillance intervals.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of patients with radiologically-diagnosed low-risk BD-IPMN/indeterminate pancreatic cysts from 1998 to 2021 at a tertiary referral center. Low-risk BD-IPMN, worrisome features (WF) and high-risk stigmata (HRS) were defined as per existing guidelines. Patients were grouped into three categories based on cyst size at diagnosis: <10 mm, 10-19 mm and 20-29 mm. The size distribution and cumulative incidence of WF and HRS development were charted annually for the first five years.</p><p><strong>Results: </strong>We studied 1668 patients, with 794 (47.6 %), 652 (39.1 %) and 222 (13.3 %) with cysts <10 mm, 10-19 mm and 20-29 mm at baseline respectively. Overall WF and HRS development was seen in 11.7 % and 1.4 % of patients respectively, with higher proportion of WF (6.8 vs 9.8 vs 34.7 %, p < 0.001) and HRS (0.9 vs 1.4 vs 3.6 %, p = 0.011) development with increasing baseline size category. Cysts <10 mm had 94.3 % < 30 mm at five years, 2.0 % WF at one year and a single case of HRS at two years. Cysts 10-19 mm had 94.7 % < 30 mm at five years, 2.2 % WF at one year and the first incident case of HRS at one year. Cysts 20-29 mm had 63.8 % < 30 mm at five years, 9.5 % WF and 1.1 % (4 cases) HRS by one year.</p><p><strong>Conclusion: </strong>Baseline cyst size can be used to guide surveillance intervals for low-risk BD-IPMN/indeterminate pancreatic cysts.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Endoscopic and surgical drainage for pancreatic fluid collections are better than percutaneous drainage: Meta-analysis\" [Pancreatol 20 1 (2020) 132-141].","authors":"Lajos Szakó, Péter Mátrai, Péter Hegyi, Dániel Pécsi, Zoltán Gyöngyi, Dezső Csupor, Judit Bajor, Bálint Erőss, Alexandra Mikó, Zsolt Szakács, Dalma Dobszai, Ágnes Meczker, Katalin Márta, Ildikó Rostás, Áron Vincze","doi":"10.1016/j.pan.2024.11.007","DOIUrl":"https://doi.org/10.1016/j.pan.2024.11.007","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatic atrophy is a predictor for exocrine pancreatic dysfunction: Data from a large cohort of patients with chronic pancreatitis.","authors":"Ingrid Kvåle Nordaas, Audun M Trelsgård, Erling Tjora, Jens Brøndum Frøkjær, Ingfrid S Haldorsen, Søren Schou Olesen, Kristina Zviniene, Antanas Gulbinas, Camilla Nøjgaard, Srdan Novovic, Asbjørn Mohr Drewes, Trond Engjom","doi":"10.1016/j.pan.2024.11.009","DOIUrl":"https://doi.org/10.1016/j.pan.2024.11.009","url":null,"abstract":"<p><strong>Objectives: </strong>Pancreatic atrophy is commonly observed in end-stage chronic pancreatitis (CP). Diagnostic standards for pancreatic atrophy not well established. The present cross-sectional observation study explored two-point pancreatic size measurements in a large CP cohort from the Scandinavian Baltic Pancreatic Club (SBPC) database to validate clinically relevant cutoffs for pancreatic atrophy and explore associations to etiological factors and disease outcomes.</p><p><strong>Methods: </strong>Patients with CP according to M-ANNHEIM diagnostic criteria were included. We measured maximal axial dimension of the pancreatic head and body and recorded presence of calcifications and pancreatic duct changes on cross-sectional imaging. We calculated cutoffs for clinically relevant atrophy related to exocrine pancreatic dysfunction (EPD) defined as fecal elastase (FE) < 200. Associations between pancreatic atrophy and smoke, alcohol, sex, body size and disease outcomes were analysed using multivariate logistic regression.</p><p><strong>Results: </strong>We included 539 CP patients (356 male) from four centres in the SBPC study group. Small pancreatic size represented by sum of two-point maximal axial dimension less than 31 mm for females and 37.5 mm for males predicted EPD with good specificity (males: 0.89 (95 % CI, 0.81, 0.95), females: 0.96 (95 % CI, 0.85, 0.99)) but poor sensitivity (males: 0.38 (95 % CI, 0.31, 0.45), females 0.25 (95 % CI, 0.18, 0.35). Male sex, increasing age and long duration of CP were clearly associated with pancreatic atrophy. Corrected for other factors reducing exocrine capacity, pancreatic atrophy was still strongly associated to EPD.</p><p><strong>Conclusion: </strong>We conclude that following the suggested cutoffs, pancreatic atrophy in CP is independently associated with EPD.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Next-generation sequencing improves diagnostic accuracy of imaging and carcinoembryonic antigen alone for pancreatic cystic neoplasms.","authors":"Hanna Belfrage, Sonja Boyd, Johanna Louhimo, Soili Kytölä, Katarina Johansson, Andrea Tenca, Lauri Puustinen, Arto Kokkola, Perttu Arkkila, Johanna Arola, Hanna Seppänen","doi":"10.1016/j.pan.2024.11.006","DOIUrl":"https://doi.org/10.1016/j.pan.2024.11.006","url":null,"abstract":"<p><strong>Background: </strong>New tools are needed to determine the pancreatic cysts that require surgical resection. This study aimed to evaluate whether next-generation sequencing (NGS) is useful for identifying mucinous, malignant, or pre-malignant cysts leading to surgery.</p><p><strong>Methods: </strong>Laboratory, cytological, and histological data from 97 patients with worrisome features on imaging or an unclear pancreatic cystic lesion (PCL) who were indicated for further investigation and who underwent endoscopic ultrasound (EUS) and fine-needle aspiration (FNA) between 2018 and 2022 were analyzed. A multidisciplinary team evaluated MRI, CT, EUS-FNA, and NGS findings.</p><p><strong>Results: </strong>Among the 40 mucinous cysts, 53 % had KRAS and/or GNAS mutations, yielding a sensitivity of 53 % and specificity of 92 % compared to 33 and 100 % for cytology and 53 and 89 % for cystic fluid CEA. Combining NGS findings with CEA levels increased sensitivity and specificity in detecting mucinous lesions to 78 and 87 %, respectively. Surgically treated high-grade dysplasia PCLs did not show worrisome mutations in cyst fluid, while 80 % of the malignant lesions had mutations typical for advanced lesions. The advanced neoplasias showed 95 % specificity for worrisome gene mutations, with the highest diagnostic accuracy observed for NGS mutations, achieving an AUC of 0.777 in the ROC curve analysis compared to 0.631 for CEA. Patients with worrisome gene mutations were offered surgical treatment. NGS results contributed to the decision to operate in 11 out of 23 cases. In 71 % of all cases, NGS supported the diagnosis, with 3 % false positives and 12 % false negatives.</p><p><strong>Conclusions: </strong>NGS analysis of pancreatic cyst fluid demonstrates high specificity and may serve as an additional diagnostic tool to CEA. Combining cystic fluid CEA and NGS increases the accuracy in determining whether a lesion is mucinous and NGS showed a higher diagnostic accuracy in advanced lesions compared to CEA. While the absence of alarming NGS findings should not preclude surgical treatment, patients with alarming mutations should be considered for surgery.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilization of relative evaluation of pancreatic perfusion CT parameters to support appropriate pancreatic adenocarcinoma diagnosis.","authors":"Yoshihiro Konno, Kazuho Takisawa, Masafumi Kanoto, Yoshiki Ishii, Yoshie Obata, Tetsuya Ishizawa, Akiko Matsuda, Yasuharu Kakizaki","doi":"10.1016/j.pan.2024.11.008","DOIUrl":"https://doi.org/10.1016/j.pan.2024.11.008","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the effect of relative evaluation of perfusion computed tomography (PCT) parameters in the diagnosis of pancreatic adenocarcinoma (PAC).</p><p><strong>Methods: </strong>Of the 117 patients in which PCT was performed (May 2019 to June 2023), 99 patients with mass lesions (MLs), including 50 PAC and 11 patients with mass-forming pancreatitis (MFP), and 15 patients without MLs but with main pancreatic duct (MPD) abnormalities, including 6 PAC and 7 no diagnosis of malignancy (NDM) cases were enrolled in this study. Parameter values were obtained from parametric maps of blood flow (BF), blood volume (BV), and mean transit time (MTT) for the ML and abnormal MPD part (AMP), pancreas and spleen. Diagnostic performance was evaluated based on receiver operating characteristic analysis for absolute values and relative values for pancreas and spleen.</p><p><strong>Results: </strong>BF_ML, BV_ML, BF_ML/Pancreas, BF_ML/Spleen, BV_ML/Pancreas and BV_ML/Spleen were significantly lower in PAC than MFP cases. Areas under the curve (AUCs) for BF_ML, BF_ML/Pancreas, BF_ML/Spleen were 0.71 (sensitivity, 54 %; specificity, 91 %), 0.80 (sensitivity, 74 %; specificity, 82 %) and 0.79 (sensitivity, 68 %; specificity. 91 %), respectively. The AUCs for BV_ML, BV_ML/Pancreas, BV_ML/Spleen were 0.72 (sensitivity, 48 %; specificity, 100 %), 0.85 (sensitivity, 76 %; specificity, 91 %) and 0.87 (sensitivity, 76 %; specificity, 91 %), respectively, with significantly better diagnostic performance on relative evaluation (P < 0.05). BV_AMP/Spleen and MTT_AMP/Spleen were significantly higher in PAC than NDM cases, with AUCs of 1 (100 % sensitivity and specificity) and 0.91 (sensitivity, 86 %; specificity, 100 %), respectively.</p><p><strong>Conclusions: </strong>Relative evaluation of PCT parameters is expected to contribute to more appropriate diagnosis of PAC.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the role of neoadjuvant therapy for resectable pancreatic cancer.","authors":"Aasim Akthar Ahmed, Tarun Kumar Suvvari, Jibin Johnson, Feba Wilson, Vimal Thomas","doi":"10.1016/j.pan.2024.11.002","DOIUrl":"https://doi.org/10.1016/j.pan.2024.11.002","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ca²⁺ signaling of pancreatic acinar cells in malignant hyperthermia susceptibility.","authors":"Nikolett Geyer, Gyula Diszházi, Zsuzsanna É Magyar, Beatrix Dienes, Réka Csáki, Péter Enyedi, Tamara Madácsy, József Maléth, János Almássy","doi":"10.1016/j.pan.2024.11.005","DOIUrl":"https://doi.org/10.1016/j.pan.2024.11.005","url":null,"abstract":"<p><strong>Background: </strong>Malignant hyperthermia susceptibility (MHS) and acute pancreatitis (AP) share a common cellular pathomechanism that is Ca²⁺-overload of the muscle fiber and the pancreatic acinar cell (PAC). In the muscle, gain-of-function mutations of the ryanodine receptor (RyR1) make the Ca²⁺-release mechanism hypersensitive to certain ligands, including Ca²⁺, volatile anaesthetics and succinylcholine, creating a medical emergency when the patient is exposed to these drugs. As RyR1 was shown to contribute to Ca²⁺-overload in PAC, we presumed that pancreata of MHS individuals are more prone to AP. Accordingly, a recent case study reported coincidence of MHS with recurrent AP, indicating a pathological link between the two diseases.</p><p><strong>Methods: </strong>We tested if MHS poses a risk for AP in mice carrying the Y522S MHS mutation. Fluorescent Ca²⁺ imaging was performed in PACs. Conventional histopathological analysis and plazma amylase measurement was performed using a cerulein-induced pancreatitis mouse model.</p><p><strong>Results: </strong>The intracellular Ca²⁺-signals of PACs from MHS mice were slightly bigger then in wild type when stimulated with 0.2 and 2 μM carbachol (cch) or with 1 and 5 mM bile acid (taurocholic acid). Store-operated-Ca²⁺-entry was also higher in PACs from MHS mice. Nevertheless, histopathological analysis and plasma amylase levels did not indicate more severe AP in MHS.</p><p><strong>Conclusions: </strong>These results suggest that the Y522S RyR1 mutation alter the Ca²⁺-homeostasis in PACs, but not as much as to cause or aggravate AP.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An improved invagination pancreaticojejunostomy technique associated with a lower incidence of pancreatic fistula: A single-center study.","authors":"Jiayue Zou, Ding Sun, Weigang Zhang, Daobin Wang, Danyang Shen, Lei Qin, Xiaofeng Xue","doi":"10.1016/j.pan.2024.10.013","DOIUrl":"https://doi.org/10.1016/j.pan.2024.10.013","url":null,"abstract":"<p><strong>Purpose: </strong>This study compared the incidence of postoperative pancreatic fistula (POPF) between standard invagination pancreaticojejunostomy (PJ) and an improved PJ technique after pancreaticoduodenectomy and evaluated the clinical utility of the improved PJ procedure.</p><p><strong>Methods: </strong>Clinical and postoperative data of 363 patients who underwent pancreaticoduodenectomy at the First Affiliated Hospital of Soochow University from February 2018 to October 2021 were analyzed retrospectively. In our cohort, 155 patients underwent the improved PJ technique (group A), and 208 underwent standard invagination PJ (group B). Data on demographic characteristics, pathological nature, intraoperative factors, and postoperative complications, including POPF, were collected and analyzed.</p><p><strong>Results: </strong>There were no significant between-group differences in demographic characteristics (p > 0.05). The improved PJ technique was associated with a significantly lower incidence of clinically relevant POPF (CR-POPF) in the total cohort (11.6 % vs. 26.4 %, p < 0.001) and in the subgroup with high fistula risk scores (16.0 % vs. 38.6 %, p < 0.001).</p><p><strong>Conclusion: </strong>The improved invagination PJ technique reduces the incidence of CR-POPF and improves prognosis.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The combined effect of hypoxia activation and radiosensitization by a multifunctional nanoplatform system enhances the therapeutic efficacy of chemoradiotherapy in pancreatic cancer.","authors":"Maoen Pan, Xiangqun Fan, Zuwu Wei, Heguang Huang, Ronggui Lin","doi":"10.1016/j.pan.2024.11.003","DOIUrl":"https://doi.org/10.1016/j.pan.2024.11.003","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic cancer is a highly malignant tumor, which is still a major global health problem. Chemotherapy and radiotherapy are regularly used in adjuvant therapy for pancreatic cancer but their therapeutic efficacy is limited.</p><p><strong>Methods: </strong>In the present study, nanoparticle（MSN-AuNPs） was used as a drug carrier loaded with tirapazamine(TPZ) and hyaluronic acid (HA) to synthesize a multifunctional nanoplatform HA@TPZ-MSN-AuNPs (HTMA) for hypoxia activation and radiotherapy sensitization, which can be combined with radiotherapy therapy and synergistically enhance the therapeutic effect in pancreatic cancer. The anti-tumor performance of the nano platform was verified by in vivo and in vitro experiments.</p><p><strong>Result: </strong>First, the HA@TPZ-MSN-AuNPs (HTMA) was successfully synthesized. Drug release experiments showed that acidic environment and hyaluronidase promoted drug release in the nanoplatform. In vitro experiments, CCK-8, live-dead staining, clonal formation assay and flow cytometry confirmed the combined anti-tumor effect of hypoxia activation and radiotherapy sensitization with HTMA. In the drug uptake experiment, the nanoplatform showed the function of targeting and binding pancreatic cancer cells. In vivo, HTMA demonstrated good antitumor properties and good biocompatibility.</p><p><strong>Conclusions: </strong>The nanoplatform had a good targeting effect and synergistic anti-tumor effect. The combination of hypoxia activation and radiotherapy sensitization is a promising strategy for the treatment of pancreatic cancer.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of percutaneous versus endoscopic transmural necrosectomy for necrotizing pancreatitis: A propensity score-matched study.","authors":"Ling Ding, Lei Li, Jingwen Rao, Yong Zhu, Liang Xia, Pi Liu, Lingyu Luo, Huifang Xiong, Yang Hu, Yao Wu, Huajing Ke, Xin Huang, Yupeng Lei, Xu Shu, Zhijian Liu, Youxiang Chen, Nonghua Lu, Yin Zhu, Wenhua He","doi":"10.1016/j.pan.2024.11.004","DOIUrl":"https://doi.org/10.1016/j.pan.2024.11.004","url":null,"abstract":"<p><strong>Background: </strong>Few published studies exist that compare the outcomes of different endoscopic necrosectomy methods for necrotizing pancreatitis (NP). We compared the safety and efficacy of percutaneous versus transmural endoscopic necrosectomy for NP patients.</p><p><strong>Methods: </strong>In this retrospective cohort study, we analyzed adult NP patients who underwent either percutaneous endoscopic necrosectomy (PEN) or endoscopic transmural necrosectomy (ETN), and compared safety and efficacy between the two groups. Propensity score-matched analysis and multivariable logistic regression analysis were conducted.</p><p><strong>Results: </strong>A total of 280 patients were enrolled, among which 142 underwent PEN and 138 underwent ETN. There were differences in baseline characteristics between the two groups, including body mass index, C-reactive protein, systemic inflammatory response syndrome score. The incidences of sepsis, respiratory failure, and intensive care unit stay were higher among patients who underwent PEN than those who underwent ETN (all P < 0.01). Ninety-one pairs were matched with comparable baseline characteristics and severity. The incidence of postoperative complications, open surgery, clinical success, radiological success, collection recurrence, and reintervention were not significantly different between the ETN group and PEN group (all P > 0.05). Multivariate analysis also showed that the approaches (PEN vs ETN) was not associated with postoperative complications or mortality.</p><p><strong>Conclusions: </strong>In real world setting, sicker patients tend to be more effectively managed through PEN compared to ETN. PEN demonstrates comparable efficacy and safety to ETN in the treatment of NP patients.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}