Pancreatology最新文献

{"title":"A real-world analysis of second-line treatment option, gemcitabine plus anlotinib and anti-PD1, in advanced pancreatic cancer","authors":"Mengjiao Fan ,&nbsp;Yue Ma ,&nbsp;Guochao Deng ,&nbsp;Haiyan Si ,&nbsp;Ru Jia ,&nbsp;Zhikuan Wang ,&nbsp;Guanghai Dai","doi":"10.1016/j.pan.2024.03.017","DOIUrl":"10.1016/j.pan.2024.03.017","url":null,"abstract":"<div><h3>Background</h3><p>In the second-line treatment of advanced pancreatic cancer (APC), there is only one approved regimen based on the phase III NAPOLI-1 trial. However, for patients progressing after Nab-paclitaxel and Gemcitabine (Nab-P/Gem) or Nab-P combinations, second-line treatment were very limited.</p></div><div><h3>Methods</h3><p>This is a retrospective single-center analysis of patients. Our aim was to determine the effectiveness and tolerability of a novel regimen, gemcitabine plus Anlotinib and anti-PD1, in APC patients and to compare it with oxaliplatin, irinotecan, leucovorin, and fluorouracil (FOLFIRINOX) in the second-line setting who have failed on the first-line Nab-P combinations.</p></div><div><h3>Results</h3><p>In total, twenty-three patients received Gemcitabine plus Anlotinib and anti-PD1 in the second-line, 28 patients were treated with FOLFORINOX. There was no significant difference in overall survival (OS) or progression free survival (PFS) for either of the two sequences (p &gt; 0.05). Patients who received Gemcitabine plus Anlotinib and anti-PD1 had a median PFS of 4.0 months (95% CI: 1.1–6.9) versus 3.5 months (95% CI 1.8–5.2) in FOLFORINOX group (p = 0.953). The median OS of Gemcitabine plus Anlotinib and anti-PD1 was 9.0 months (95% CI: 4.0–13.7) and 8.0 months (95% CI: 5.5–10.5) in FOLFORINOX group (p = 0.373). Grade ≥3 treatment-emergent adverse events (AEs) occurred for 13% of patients with Gemcitabine plus Anlotinib and anti-PD1 and 40% for FOLFORINOX.</p></div><div><h3>Conclusion</h3><p>Our data confirms the effectiveness of Gemcitabine plus Anlotinib and anti-PD1 as a well-tolerated regimen in the second-line treatment of APC and extends available data on its use as a second-line treatment option when compared with FOLFIRINOX.</p></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1424390324000784/pdfft?md5=ab783284432ac1adc76e8f17afb9f7ac&pid=1-s2.0-S1424390324000784-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140326931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of acute pancreatitis in COVID-19 hospitalizations in the United States","authors":"Adishwar Rao,&nbsp;Akriti Agrawal,&nbsp;Hassam Ali,&nbsp;Manesh Kumar Gangwani,&nbsp;Saurabh Chandan,&nbsp;Dushyant Singh Dahiya","doi":"10.1016/j.pan.2024.04.002","DOIUrl":"10.1016/j.pan.2024.04.002","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140802466","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":"Impact of previous S-1 treatment on efficacy of liposomal irinotecan plus 5-fluorouracil and leucovorin in patients with metastatic pancreatic cancer","authors":"Cheng-Yu Tang ,&nbsp;Shih-Hung Yang ,&nbsp;Chung-Pin Li ,&nbsp;Yung-Yeh Su ,&nbsp;Sz-Chi Chiu ,&nbsp;Li-Yuan Bai ,&nbsp;Yan-Shen Shan ,&nbsp;Li-Tzong Chen ,&nbsp;Shih-Chang Chuang ,&nbsp;De-Chuan Chan ,&nbsp;Chia-Jui Yen ,&nbsp;Cheng-Ming Peng ,&nbsp;Tai-Jan Chiu ,&nbsp;Yen-Yang Chen ,&nbsp;Jen-Shi Chen ,&nbsp;Nai-Jung Chiang ,&nbsp;Wen-Chi Chou","doi":"10.1016/j.pan.2024.03.014","DOIUrl":"10.1016/j.pan.2024.03.014","url":null,"abstract":"<div><h3>Background/objectives</h3><p>Liposomal irinotecan plus 5-fluorouracil and leucovorin (nal-IRI + 5-FU/LV) provides survival benefits for metastatic pancreatic adenocarcinoma (mPDAC) refractory to gemcitabine-based treatment, mainly gemcitabine plus nab-paclitaxel (GA), in current practice. Gemcitabine plus S-1 (GS) is another commonly administered first-line regimen before nab-paclitaxel reimbursement; however, the efficacy and safety of nal-IRI + 5-FU/LV for mPDAC after failed GS treatment has not been reported and was therefore explored in this study.</p></div><div><h3>Methods</h3><p>In total, 177 patients with mPDAC received first-line GS or GA treatment, followed by second-line nal-IRI + 5-FU/LV treatment (identified from a multicenter retrospective cohort in Taiwan from 2018 to 2020); 85 and 92 patients were allocated to the GS and GA groups, respectively. Overall survival (OS), time-to-treatment failure (TTF), and adverse events were compared between the two groups.</p></div><div><h3>Results</h3><p>The baseline characteristics of the two groups were generally similar; however, a higher median age (67 versus 62 years, <em>p</em> &lt; 0.001) and fewer liver metastases (52% versus 78%, <em>p</em> &lt; 0.001) were observed in the GS versus GA group. The median OS was 15.0 and 15.9 months in the GS and GA groups, respectively (<em>p</em> = 0.58). The TTF (3.1 versus 2.8 months, <em>p</em> = 0.36) and OS (7.6 versus 6.7 months, <em>p</em> = 0.83) after nal-IRI treatment were similar between the two groups. More patients in the GS group developed mucositis during nal-IRI treatment (15% versus 4%, <em>p</em> = 0.02).</p></div><div><h3>Conclusions</h3><p>The efficacy of second-line nal-IRI +5-FU/LV treatment was unaffected by prior S-1 exposure. GS followed by nal-IRI treatment is an alternative treatment sequence for patients with mPDAC.</p></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140600273","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 anastomosis training models: Current status and future directions","authors":"Kunal Joshi ,&nbsp;Daniel M. Espino ,&nbsp;Duncan ET. Shepherd ,&nbsp;Nasim Mahmoodi ,&nbsp;Keith J. Roberts ,&nbsp;Nikolaos Chatzizacharias ,&nbsp;Ravi Marudanayagam ,&nbsp;Robert P. Sutcliffe","doi":"10.1016/j.pan.2024.03.020","DOIUrl":"10.1016/j.pan.2024.03.020","url":null,"abstract":"<div><p>Postoperative pancreatic fistula (POPF) is a major cause of morbidity and mortality after pancreatoduodenectomy (PD), and previous research has focused on patient-related risk factors and comparisons between anastomotic techniques. However, it is recognized that surgeon experience is an important factor in POPF outcomes, and that there is a significant learning curve for the pancreatic anastomosis. The aim of this study was to review the current literature on training models for the pancreatic anastomosis, and to explore areas for future research. It is concluded that research is needed to understand the mechanical properties of the human pancreas in an effort to develop a synthetic model that closely mimics its mechanical properties. Virtual reality (VR) is an attractive alternative to synthetic models for surgical training, and further work is needed to develop a VR pancreatic anastomosis training module that provides both high fidelity and haptic feedback.</p></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1424390324000814/pdfft?md5=6ff6334fa63629f4820821af6570622c&pid=1-s2.0-S1424390324000814-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140600493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The epidemiology of acute pancreatitis in Tasmania over a 12-year period: Is this a disease of disadvantage?","authors":"Richard C. Turner ,&nbsp;Sauro Salomoni ,&nbsp;Rachel E. Neale ,&nbsp;Amanda Neil ,&nbsp;Savio G. Barreto ,&nbsp;Chee Y. Ooi ,&nbsp;Daniel Croagh ,&nbsp;Jeremy S. Wilson ,&nbsp;Tony Pang ,&nbsp;Minoti Apte","doi":"10.1016/j.pan.2024.04.010","DOIUrl":"10.1016/j.pan.2024.04.010","url":null,"abstract":"<div><h3>Background</h3><p>The global incidence of acute pancreatitis (AP) is increasing, but little information exists about trends in Australia. This study aimed to describe incidence trends, along with clinical and socio-demographic associations, in the state of Tasmania over a recent 12-year period.</p></div><div><h3>Methods</h3><p>The study cohort was obtained by linking clinical and administrative datasets encompassing the whole Tasmanian population between 2007 and 2018, inclusive. Pancreatitis case definition was based on relevant ICD-10 hospitalization codes, or elevated serum lipase or amylase in pathology data.</p><p>Age-standardised incidence rates were estimated, overall and stratified by sex, aetiology, and Index of Relative Socio-economic Disadvantage (IRSD).</p></div><div><h3>Results</h3><p>In the study period, 4905 public hospital AP episodes were identified in 3503 people. The age-standardised person-based incidence rate across the entire period was 54 per 100,000 per year. Incidence was inversely related to IRSD score; 71 per 100,000 per year in the most disadvantaged quartile compared to 32 in the least disadvantaged. Biliary AP incidence was higher than that of alcohol-related AP, although the greatest incidence was in “unspecified” cases. There was an increase in incidence for the whole cohort (average annual percent change 3.23 %), largely driven by the two most disadvantaged IRSD quartiles; the least disadvantaged quartile saw a slight overall decrease.</p></div><div><h3>Conclusion</h3><p>This is the first Australian study providing robust evidence that AP incidence is increasing and is at the upper limit of population-based studies worldwide. This increased incidence is greatest in socio-economically disadvantaged areas, meriting further research to develop targeted, holistic management strategies.</p></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1424390324001091/pdfft?md5=bb50cbc6c08daf1d69cf11129451d999&pid=1-s2.0-S1424390324001091-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of pancreatic cancer risk factors from clinical notes using natural language processing","authors":"Dhruv Sarwal ,&nbsp;Liwei Wang ,&nbsp;Sonal Gandhi ,&nbsp;Elham Sagheb Hossein Pour ,&nbsp;Laurens P. Janssens ,&nbsp;Adriana M. Delgado ,&nbsp;Karen A. Doering ,&nbsp;Anup Kumar Mishra ,&nbsp;Jason D. Greenwood ,&nbsp;Hongfang Liu ,&nbsp;Shounak Majumder","doi":"10.1016/j.pan.2024.03.016","DOIUrl":"10.1016/j.pan.2024.03.016","url":null,"abstract":"<div><h3>Objectives</h3><p>Screening for pancreatic ductal adenocarcinoma (PDAC) is considered in high-risk individuals (HRIs) with established PDAC risk factors, such as family history and germline mutations in PDAC susceptibility genes. Accurate assessment of risk factor status is provider knowledge-dependent and requires extensive manual chart review by experts. Natural Language Processing (NLP) has shown promise in automated data extraction from the electronic health record (EHR). We aimed to use NLP for automated extraction of PDAC risk factors from unstructured clinical notes in the EHR.</p></div><div><h3>Methods</h3><p>We first developed rule-based NLP algorithms to extract PDAC risk factors at the document-level, using an annotated corpus of 2091 clinical notes. Next, we further improved the NLP algorithms using a cohort of 1138 patients through patient-level training, validation, and testing, with comparison against a pre-specified reference standard. To minimize false-negative results we prioritized algorithm recall.</p></div><div><h3>Results</h3><p>In the test set (n = 807), the NLP algorithms achieved a recall of 0.933, precision of 0.790, and F₁-score of 0.856 for family history of PDAC. For germline genetic mutations, the algorithm had a high recall of 0.851, while precision and F₁-score were lower at 0.350 and 0.496 respectively. Most false positives for germline mutations resulted from erroneous recognition of tissue mutations.</p></div><div><h3>Conclusions</h3><p>Rule-based NLP algorithms applied to unstructured clinical notes are highly sensitive for automated identification of PDAC risk factors. Further validation in a large primary-care patient population is warranted to assess real-world utility in identifying HRIs for pancreatic cancer screening.</p></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140406148","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":"Development of a novel CT-based index for predicting the number of extracorporeal shockwave lithotripsy (ESWL) sessions required for successful fragmentation of obstructing pancreatic duct stones","authors":"Nikhil Bush ,&nbsp;Praneeth Chandragiri ,&nbsp;Nitish Ashok Gaurav ,&nbsp;Sneh Sonaiya ,&nbsp;Ila Lahooti ,&nbsp;Anmol Singh ,&nbsp;Abhinav Gupta ,&nbsp;Elham Afghani ,&nbsp;Georgios Papachristou ,&nbsp;Mouen A. Khashab ,&nbsp;Peter J. Lee ,&nbsp;Rupjyoti Talukdar ,&nbsp;Sundeep Lakhtakia ,&nbsp;Vikesh K. Singh ,&nbsp;Samuel Han ,&nbsp;Manu Tandan ,&nbsp;Venkata S. Akshintala","doi":"10.1016/j.pan.2024.03.018","DOIUrl":"10.1016/j.pan.2024.03.018","url":null,"abstract":"<div><h3>Background &amp; aim</h3><p>Extracorporeal shock wave lithotripsy (ESWL) is used for the treatment of pancreatic duct stones (PDS) in patients with chronic pancreatitis (CP). We aimed to develop a CT based index to predict the required number of ESWL sessions for technical success.</p></div><div><h3>Methods</h3><p>We retrospectively evaluated patients with PDS secondary to CP who underwent ESWL. Technical success was defined as the complete fragmentation of stones to &lt;3 mm. CT features including PDS size, number, location, and density in Hounsfield units (HU) were noted. We analyzed the relationship between PDS characteristics and the number of ESWL sessions required for technical success. A multiple linear regression model was used to combine size and density into the pancreatic duct stone (PDS) index that was translated into a web-based calculator.</p></div><div><h3>Results</h3><p>There were 206 subjects (mean age 38.6 ± 13.7 years, 59.2% male) who underwent ESWL. PDS size showed a moderate correlation with the number of ESWL sessions (r = 0.42, p &lt; 0.01). PDS in the head required a fewer number of sessions in comparison to those in the body (1.4 ± 0.6 vs. 1.6 ± 0.7, p = 0.01). There was a strong correlation between PDS density and the number of ESWL sessions (r = 0.617, p-value &lt;0.01). The PDS index {0.3793 + [0.0009755 x PDS density (HU)] + [0.02549 x PDS size (mm)]} could accurately predict the required number of ESWL sessions with an AUC of 0.872 (p &lt; 0.01).</p></div><div><h3>Conclusion</h3><p>The PDS index is a useful predictor of the number of ESWL sessions needed for technical success that can help in planning and patient counseling.</p></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140399298","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":"Revealing the role of early peripancreatic bacterial contamination and Enterococcus faecalis in pancreatic fistula development after pancreaticoduodenectomy: Implications for useful antibiotic prophylaxis–An observational cohort study","authors":"Norihisa Kimura,&nbsp;Keinosuke Ishido,&nbsp;Taiichi Wakiya,&nbsp;Hayato Nagase,&nbsp;Tadashi Odagiri,&nbsp;Yusuke Wakasa,&nbsp;Kenichi Hakamada","doi":"10.1016/j.pan.2024.03.008","DOIUrl":"10.1016/j.pan.2024.03.008","url":null,"abstract":"<div><h3>Background</h3><p>Peripancreatic bacterial contamination (PBC) is a critical factor contributing to the development of clinically relevant postoperative pancreatic fistula (CR-POPF) following pancreaticoduodenectomy (PD). Controlling pathogenic bacteria is essential in preventing CR-POPF; however, the precise relationship between specific bacteria and CR-POPF remains unclear. This study aimed to investigate the relationship between PBC and CR-POPF after PD, with a focus on identifying potentially causative bacteria.</p></div><div><h3>Methods</h3><p>This prospective observational study enrolled 370 patients who underwent PD. Microbial cultures were routinely collected from peripancreatic drain fluid on postoperative days (PODs) 1, 3, and 6. Predictive factors for CR-POPF and the bacteria involved in PBC were investigated.</p></div><div><h3>Results</h3><p>CR-POPF occurred in 86 (23.2%) patients. In multivariate analysis, PBC on POD1 (Odds ratio [OR] = 3.59; <em>P</em> = 0.005) was one of the main independent predictive factors for CR-POPF, while prophylactic use of antibiotics other than piperacillin/tazobactam independently influenced PBC on POD1 (OR = 2.95; <em>P</em> = 0.010). Notably, <em>Enterococcus</em> spp., particularly <em>Enterococcus faecalis</em>, were significantly isolated from PBC in patients with CR-POPF compared to those without CR-POPF on PODs 1 and 3 (<em>P</em> &lt; 0.001), and they displayed high resistance to all cephalosporins.</p></div><div><h3>Conclusions</h3><p>Early PBC plays a pivotal role in the development of CR-POPF following PD. Prophylactic antibiotic administration, specifically targeting <em>Enterococcus faecalis</em>, may effectively mitigate early PBC and subsequently reduce the risk of CR-POPF. This research sheds light on the importance of bacterial control strategies in preventing CR-POPF after PD.</p></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140166422","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":"Treatment outcomes of gemcitabine plus nab-paclitaxel in pancreatic cancer patients with malignant ascites","authors":"Kanae Inoue ,&nbsp;Koh Fukushi ,&nbsp;Shota Yamaguchi ,&nbsp;Tomonao Taira ,&nbsp;Taro Shibuki ,&nbsp;Tomoyuki Satake ,&nbsp;Kazuo Watanabe ,&nbsp;Mitsuhito Sasaki ,&nbsp;Hiroshi Imaoka ,&nbsp;Shuichi Mitsunaga ,&nbsp;Masafumi Ikeda","doi":"10.1016/j.pan.2024.03.015","DOIUrl":"10.1016/j.pan.2024.03.015","url":null,"abstract":"<div><h3>Background</h3><p>Gemcitabine plus nab-paclitaxel (GnP) therapy has been shown to improve the prognosis in patients with metastatic pancreatic cancer (PC); however, the efficacy and safety of GnP in PC patients with malignant ascites (MA) remains unknown.</p></div><div><h3>Methods</h3><p>We retrospectively investigated PC patients with peritoneal dissemination who had received GnP as first-line chemotherapy at our institution between March 2015 and August 2021. The following patient data were reviewed: patient characteristics, overall survival (OS), progression-free survival (PFS), objective response rate (ORR), adverse events (AEs), and relative dose intensity (RDI). The severity of MA was categorized based on the CT findings as grade 1 (small), grade 2 (moderate), or grade 3 (massive).</p></div><div><h3>Results</h3><p>A total of 189 patients were included; the study endpoints were compared between patients with each ascites grade and 41 patients without MA. The MA was classified as grade 1 in 85 patients, grade 2 in 41 patients, and grade 3 in 22 patients. In the patients with MA, the median OS, PFS and ORR were 11.2 months, 5.7 months and 24.3%, respectively. The OS and PFS decreased with increasing the severity of MA; in particular, patients with grade 2 and 3 showed a poorer prognosis. There were no differences in AEs, except for anorexia, or the RDI according to the severity of MA.</p></div><div><h3>Conclusion</h3><p>GnP showed moderate efficacy with manageable safety profile in PC patients with MA. However, PC patients with moderate to massive ascites still have a dismal prognosis, and further development of effective treatments is needed.</p></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140600408","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 timing of endoscopic necrosectomy: More questions than answers","authors":"Avinash Tiwari","doi":"10.1016/j.pan.2024.05.528","DOIUrl":"10.1016/j.pan.2024.05.528","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141284450","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}