Pancreatology最新文献

{"title":"Reply to the Letter to the Editor regarding \"Early detection of pancreatic cancer: Study design and analytical considerations in biomarker discovery and early phase validation studies\".","authors":"Douglas M Mahoney, Lynette M Smith, Qiao-Li Wang, Grant Izmirlian, Gregory A Coté, Michael G Goggins, Randall Brand, Ann L Oberg","doi":"10.1016/j.pan.2025.04.017","DOIUrl":"https://doi.org/10.1016/j.pan.2025.04.017","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086446","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":"Chronic pancreatitis and extra pancreatic cancers- A systematic review and meta analysis.","authors":"Shauntelle Quammie, Colin John Crooks, Abdulsalam Aliyu, Guruprasad P Aithal, Aloysious D Aravinthan","doi":"10.1016/j.pan.2025.05.003","DOIUrl":"https://doi.org/10.1016/j.pan.2025.05.003","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic pancreatitis (CP) is a known risk factor for pancreatic cancer; however its association to extra pancreatic (EP) cancers remains inadequately explored. The aim of this systematic review is to investigate the evidence for CP as a risk factor for developing EP cancers.</p><p><strong>Method: </strong>Electronic search was conducted on Ovid Medline, EMBASE and Scopus from inception to January 27, 2024 to identify patients with CP who developed EP cancers. Prevalence and incidence of each cancer were calculated where possible from the reported numbers. A random effects meta-analysis was used to pool prevalence, incidence and hazard ratios (HR) of each EP cancer. Heterogeneity was assessed using I². PROSPERO registration: CRD42024543050.</p><p><strong>Results: </strong>Sixteen (16) studies consisting of 117,163 CP patients met the eligibility criteria. 4015 (3.4%) patients developed 4019 EP cancers. The overall annual prevalence and incidence of EP cancers were 7962 (95% CI 5044-10880) per 100,000 CP patients and 1039 (95% CI 649-1663) per 100,000 person years. Lung cancer had the highest annual prevalence - (1540 (95% CI 667-2413) per 100,000 CP patients) and incidence (260 (95% CI 120-390) per 100,000 person years). The pooled HR were 1.31 (95% CI 1.03-1.66) and 1.58 (95% CI 1.27-1.98) for adjusted lung cancer and crude liver cancer in patients with CP compared to patients without CP, respectively.</p><p><strong>Conclusion: </strong>Patients with CP have an increased risk of developing EP cancers compared to patients without CP, in particular lung and liver cancer which had the highest relative risk. Shared risk factor modifications, such as smoking cessation and alcohol reduction, could lower the risk of common EP cancers. Further, implementing non-invasive screening measures may aid in early diagnosis in this high-risk group.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094579","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":"Suboptimal adherence to surveillance in high-risk individuals for pancreatic cancer at a tertiary care academic center: Lessons from real-world surveillance patterns.","authors":"Alice A Lee, Abigail Twoy, Audrey Sutton, Naoko Fushimi, Walter G Park","doi":"10.1016/j.pan.2025.05.002","DOIUrl":"https://doi.org/10.1016/j.pan.2025.05.002","url":null,"abstract":"<p><strong>Background/objectives: </strong>Screening for pancreatic ductal adenocarcinoma alters the course of disease among high-risk individuals (HRIs) and is recommended by multiple societies including the International Cancer of the Pancreas Screening Consortium, American Gastroenterological Association, and American Society of Gastrointestinal Endoscopy. However, there are limited analyses on the screening rates and barriers to adherence among HRIs. This study aims to describe real-world longitudinal screening adherence of a HRI surveillance cohort and identify potential barriers to adherence.</p><p><strong>Methods: </strong>Patients followed by Stanford's Benign Pancreas Clinic were identified as HRIs if they met screening criteria per the latest abovementioned screening guidelines, and were included in our study if they underwent at least 1 screening exam. Data on HRIs were obtained retrospectively from our hospital's electronic health record system. Patient and screening characteristics were analyzed by adherence rates.</p><p><strong>Results: </strong>262 HRIs undergoing recommended screening were identified. The mean follow-up time per patient was 4.9 years and the mean successful annual screening rate within the entire cohort was 67%. HRIs in the lowest quartile of adherence were more likely to have more EUS rather than MRI surveillance exams compared to those who were completely adherent (p = 0.01). HRIs who were completely adherent were also an older cohort compared to those with non-complete adherence (p = 0.02) or in the lowest quartile of adherence (p = 0.01).</p><p><strong>Conclusions: </strong>It is difficult to achieve high adherence rates for annual pancreatic cancer screening of HRIs as recommended by the latest guidelines. Age and screening modality may be factors that contribute to adherence difficulty.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094590","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":"Performance of a novel three-prong asymmetric tip needle in EUS-guided tissue sampling of pancreatic solid Lesions: Implications for diagnosis and molecular profiling.","authors":"Alberto Busatto, Livia Zornetta, Elisa Pinto, Vittorio Storer, Barbara Perini, Alessandro Borsato, Matteo Ghisa, Francesco Ferrara","doi":"10.1016/j.pan.2025.04.015","DOIUrl":"https://doi.org/10.1016/j.pan.2025.04.015","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079435","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":"Reply to the letter to editor regarding critical appraisal of the study on postoperative pancreatic enzyme replacement therapy after total pancreatectomy.","authors":"Ryuta Shintakuya, Kenichiro Uemura, Tatsuaki Sumiyoshi, Kenjiro Okada, Kenta Baba, Takumi Harada, Yasutaka Ishii, Shiro Oka, Koji Arihiro, Yoshiaki Murakami, Shinya Takahashi","doi":"10.1016/j.pan.2025.05.001","DOIUrl":"https://doi.org/10.1016/j.pan.2025.05.001","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111622","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":"Comparison of thrombosis risk in patients undergoing purified and non-purified islet cell transplantation.","authors":"Victoria Ruvkun, Kerrington D Smith, Sushela S Chaidarun, Dawn A Fischer, Timothy B Gardner","doi":"10.1016/j.pan.2025.04.018","DOIUrl":"https://doi.org/10.1016/j.pan.2025.04.018","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the thrombosis risk and adverse bleeding events in patients who received purified vs. non-purified islet cell autotransplants (IAT).</p><p><strong>Methods: </strong>We performed a retrospective cohort study evaluating the rate of portal vein thrombosis (PVT), adverse bleeding events, and premature heparin discontinuation in purified and non-purified IAT patients at our center between 2013 and 2022.</p><p><strong>Results: </strong>The incidence of PVT formation was 0 % in the purified group (23 patients) and 4.2 % in the non-purified group (48 patients). Patients in the purified islet group received lower intra-operative heparin dosing compared to patients in the non-purified group (3157units vs 2657units, p = 0.03), but both groups received similar post-operative heparin dosing (505units vs. 437units, p = 0.55). Non-purified patients were on heparin for significantly fewer days than purified patients (1.6 days vs. 3.2 days, p < 0.01). There was no difference in adverse bleeding events that resulted in premature heparin discontinuation (39.1 % vs. 62.5 %, p = 0.08) nor blood transfusion requirements (34.8 % vs. 41.7 %, p = 0.58) between the purified and non-purified groups. However, patients in the purified group had higher rates of reoperation due to rebleeding compared with the non-purified group (17.4 % vs 0 %, p < 0.01).</p><p><strong>Conclusions: </strong>While PVT is a relatively rare event in both purified and non-purified IAT when peri-operative and post-operative full-dose heparinization is administered, there remains a clinical difference in PVT formation between purified and non-purified IATs. Although bleeding risk may potentially be mitigated by a reduction in the duration of full dose heparinization without a corresponding risk in PVT rate, further investigation is warranted.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079431","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 impact of delayed graft function after pancreas transplantation on clinical outcomes and survival.","authors":"Ruben Bellotti, Michael Brugger, Rupert Oberhuber, Benno Cardini, Thomas Resch, Manuel Maglione, Christian Margreiter, Annemarie Weißenbacher, Gerald Brandacher, Stefan Schneeberger, Franka Messner","doi":"10.1016/j.pan.2025.04.019","DOIUrl":"https://doi.org/10.1016/j.pan.2025.04.019","url":null,"abstract":"<p><strong>Introduction: </strong>Delayed graft function after pancreas transplantation (pDGF) is still lacking of a homogenous definition. So, its incidence and clinical impact are poorly understood.</p><p><strong>Methods: </strong>151 consecutive pancreas transplants (PTx) performed at the Medical University of Innsbruck between January 2011 and December 2021. 142 were finally evaluated analyzed after excluding those with early graft loss due to surgical or infectious problems.</p><p><strong>Results: </strong>pDGF was defined as a total mean insulin requirement of 2.5 UI or greater within postoperative day 10. Of the 142 recipients, 52 (36.6 %) developed pDGF. By multivariate analysis, pDGF was found to be associated with a donor age (odds ratio, 1.05; 95 % CI: 1.01-1.09; p = 0.010) and the continuous postoperative administration of unfractioned heparin (odds ratio, 2.52; 95 % CI: 1.12-5.64; p = 0.025). The occurrence of pDGF lead to longer hospital stay (23 vs 20 days, p = 0.049), intensive care unit stay (5 vs 3 days, p < 0.003) and impaired glycemia at day 10 postoperative (146.0 vs 126.4 mg/dl, p < 0.001). Also, pDGF was found to be associated with a greater risk of pancreas graft failure at 5 years (p = 0.047) in the univariable analysis, while in the multivariable this trend was not statistically significant (p = 0.076). Of note, in the multivariable analysis pDGF showed a strong trend towards worse graft survival without reaching statistical significance (HR:2.33, 95 % CI: 0.95-5.82; p = 0.069) CONCLUSION: pDGF represents a common condition, depending both from donor and recipient conditions. Its clinical impact concerns the early postoperative stay and the long-term graft survival as well.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079437","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":"Technical success of double-balloon enteroscopy - Endoscopic retrograde cholangiopancreatography in patients with pancreaticojejunostomy anastomotic strictures post-pancreatoduodenectomy.","authors":"Katina Zheng, Kareem Khalaf, Huaqi Li, Jeffrey D Mosko, Gary R May, Natalia Causada Calo","doi":"10.1016/j.pan.2025.04.013","DOIUrl":"https://doi.org/10.1016/j.pan.2025.04.013","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007195","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 and validation of a novel chronic pancreatitis pathological grade based on artificial intelligence.","authors":"Chengwei Chen, Jian Zhou, Shaojia Mo, Jing Li, Xu Fang, Fang Liu, Tiegong Wang, Li Wang, Jianping Lu, Hui Jiang, Chengwei Shao, Yun Bian","doi":"10.1016/j.pan.2025.04.011","DOIUrl":"https://doi.org/10.1016/j.pan.2025.04.011","url":null,"abstract":"<p><strong>Background: </strong>Effective chronic pancreatitis (CP) treatment requires accurate severity evaluation, but no histopathology grading system exists. This study aimed to develop and validate a novel CP pathological grade (Histopathology-derived CPpG) using quantified pathological and radiological characteristics through deep learning.</p><p><strong>Methods: </strong>Patients with pathologically/clinically confirmed CP or recurrent acute pancreatitis were retrospectively enrolled (2011-2023). Whole-slide CP images were automatically segmented and quantified via DeeplabV3+, followed by latent class analysis to develop Histopathology-derived CPpG. A deep learning radiomics score (DLRS) was created to predict Histopathology-derived CPpG using preoperative CT scans of patients with pathologically confirmed CP. CT-predicted CPpG was then validated in an independent group of patients with clinically confirmed CP and recurrent acute pancreatitis.</p><p><strong>Results: </strong>The study included 2054 patients with CP and recurrent acute pancreatitis, with 181 cases of pathologically confirmed CP. Histopathology-derived CPpG I had a higher proportion of acini, acinus-to-stroma ratio, acinus-to-islet ratio, islet-to-stroma ratio, and (acinus + islet)-to-stroma ratio, and a lower proportion of stroma and lymphocytes compared to CPpG II. The DLRS demonstrated high performance in the validation (AUC, 0.84; 95 % CI: 0.75-0.92) and test (AUC, 0.76; 95 % CI: 0.65-0.87) sets. In a large-scale clinical validation, CT-predicted grades were significantly associated with endocrine and exocrine function, as well as prognosis (P < .05).</p><p><strong>Conclusion: </strong>This study developed a novel pathological classification, Histopathology-derived CPpG, which accurately reflects disease severity. Additionally, the non-invasive DLRS shows great potential for dynamically monitoring CP severity and evaluating pancreatic endocrine and exocrine function, as well as prognosis.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976003","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":"Reply to letters to editors regarding risk scores to predict inpatient mortality of acute pancreatitis.","authors":"Hassam Ali, Douglas G Adler","doi":"10.1016/j.pan.2025.04.016","DOIUrl":"https://doi.org/10.1016/j.pan.2025.04.016","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977464","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}