Pancreatology最新文献

{"title":"Safety, tolerability and therapeutic efficacy of anti-inflammatory drug pirfenidone in acute pancreatitis patients: Protocol for a randomized pilot clinical trial","authors":"Ejas P. Bava ,&nbsp;Tejeshwar Jain ,&nbsp;Mustafa Al-Obaidi ,&nbsp;Zoe Evans ,&nbsp;Dureti Doto ,&nbsp;Santhi Swaroop Vege ,&nbsp;Vikas Dudeja","doi":"10.1016/j.pan.2025.01.004","DOIUrl":"10.1016/j.pan.2025.01.004","url":null,"abstract":"<div><h3>Background</h3><div>Acute Pancreatitis (AP) is a formidable disease with significant morbidity, mortality and healthcare expenditure. There is an emergent need to develop therapeutic agents for this disease as there are no targeted therapies available. We have recently demonstrated that pirfenidone can significantly decrease the severity of AP in animal models. Based on our preclinical findings, we decided to conduct a pilot trial to evaluate the safety, tolerability and efficacy of pirfenidone in patients with AP.</div></div><div><h3>Methods</h3><div>We have designed a multicenter, randomized, pilot clinical trial of 60 patients with blinded outcome assessment. All patients with AP<strong>,</strong> who present within 48 h of establishment of the diagnosis, will be screened for exclusion and inclusion criteria. Consenting patients will be randomized into pirfenidone or placebo within 48 h of the diagnosis of AP. The primary end points include decrease in PAN-PROMISE score after 72 h of initiation of drug, reduction in inflammatory markers, and development of serious adverse events. The secondary end points include changes in PAN-PROMISE score, discharge PASS score &lt;60, development of composite outcome of new or worsening necrotizing pancreatitis on CT scan performed 5–7 days after admission, major infection or death, and readmissions and/or ER visits within 30 days and within 6 months after discharge.</div></div><div><h3>Status</h3><div>Currently enrolling (NCT05350371).</div></div><div><h3>Conclusion</h3><div>There is an urgent need to identify novel therapies for AP. This pilot clinical trial may become the basis of a larger study to analyze the efficacy of pirfenidone in patients with AP.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 2","pages":"Pages 214-220"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047646","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":"Focal pancreatic parenchymal atrophy could be a precursor of pancreatic cancer","authors":"Masataka Kikuyama ,&nbsp;Jun Nakahodo ,&nbsp;Kazuro Chiba ,&nbsp;Goro Honda","doi":"10.1016/j.pan.2025.01.003","DOIUrl":"10.1016/j.pan.2025.01.003","url":null,"abstract":"<div><h3>Background/objectives</h3><div>We previously reported that focal pancreatic parenchymal atrophy (FPPA) indicates high-grade pancreatic intraepithelial neoplasia (HG-PanIN) or carcinoma in situ (CIS). Because HG-PanIN progresses into pancreatic ductal adenocarcinoma (PDAC), the relationship between FPPA and PDAC should be investigated.</div></div><div><h3>Methods</h3><div>We included 54 patients with PDAC, whose previous computed tomography or magnetic resonance imaging were reviewed. The existence, positional relationship between FPPA and PDAC, and time between FPPA recognition and PDAC diagnosis were all examined. Of the 54 patients, 28 underwent surgery. The remaining 26 patients were histopathologically diagnosed with PDAC using endoscopic ultrasonography-guided fine needle aspiration.</div></div><div><h3>Results</h3><div>Among the 54 patients included, 49 (83.3 %) had FPPA. The pancreatic head and body were the common sites of FPPA. In all patients with FPPA, PDAC developed near the FPPA, with an average distance of 7.93 mm between the edge of the FPPA and the center of the PDAC. The interval between FPPA recognition and PDAC diagnosis was 35.33 months, which was significantly shorter in the surgical group.</div></div><div><h3>Conclusions</h3><div>FPPA could be a precursor of PDAC and suggest the area at risk of PDAC.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 2","pages":"Pages 241-249"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080815","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":"Progression of resectable pancreatic ductal adenocarcinoma during surgical delay and effects on survival – A propensity score matched study","authors":"Bojan Kovacevic ,&nbsp;Caroline Ewertsen ,&nbsp;Thomas Skårup Kristensen ,&nbsp;Luit Penninga ,&nbsp;Carsten Palnæs Hansen","doi":"10.1016/j.pan.2024.11.015","DOIUrl":"10.1016/j.pan.2024.11.015","url":null,"abstract":"<div><h3>Background</h3><div>Surgery is the only curative treatment for pancreatic cancer, but less than 25 % of the patients present with a resectable tumor at the time of diagnosis. The aim of this study is to evaluate progression during surgical treatment delay and examine any associations between surgical treatment delay and survival.</div></div><div><h3>Methods</h3><div>This is a retrospective, single center propensity score matched study including treatment naïve patients with pancreatic adenocarcinoma between 2018 and 2022. Outcomes included disease progression during surgical treatment delay in patients where follow-up imaging was performed as well as overall and recurrence-free survival for the entire cohort.</div></div><div><h3>Results</h3><div>The study cohort consisted of 290 patients of whom 129 (44.5 %) underwent follow-up imaging. Radiological progression to unresectable disease during surgical delay was seen in 14 cases (10.9 %), with another 17 cases (13.2 %) deemed unresectable during intended resection. Tumor size progression was observed in 29 patients (22.5 %) with an average tumor growth rate of 7.4 mm (95%CI 5.8–8.9, p &lt; 0.001). Median time to surgery was 37 days with no observed associations between treatment delay and overall survival (HR = 1.02, 95%CI 0.76–1.38, p = 0.996), or the risk of recurrence (HR = 1.06, 95%CI 0.77–1.48, p = 0.709).</div></div><div><h3>Conclusion</h3><div>Progression in tumor size does not seem to affect survival in our study population. In general, surgical treatment delay in up-front resectable patients does not seem to be associated with survival or the risk of recurrence, but the optimal and maximal time to surgery as well as the optimal timing of the follow-up scanning remain unclear.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 2","pages":"Pages 228-233"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771047","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 efficacy and safety profile of third-line treatment in patients with metastatic pancreatic adenocarcinoma","authors":"Chi-Chen Lan ,&nbsp;Tai-Jan Chiu ,&nbsp;Chia-Yen Hung ,&nbsp;Kun-Yun Yeh ,&nbsp;Chang-Hsien Lu ,&nbsp;Yen-Yang Chen ,&nbsp;Jen-Shi Chen ,&nbsp;Yu-Shin Hung ,&nbsp;Wen-Chi Chou","doi":"10.1016/j.pan.2025.01.012","DOIUrl":"10.1016/j.pan.2025.01.012","url":null,"abstract":"<div><h3>Background</h3><div>For metastatic pancreatic ductal adenocarcinoma (mPDAC), there are no established third-line chemotherapy options. We examined the efficacy and safety of third-line chemotherapy in patients with mPDAC in real-world practice.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 257 patients with mPDAC and progressive disease after first-line treatment with gemcitabine-based regimens and second-line treatment with liposomal irinotecan plus 5-fluorouracil and leucovorin at five Taiwanese medical centers from 2018 to 2022. Treatment efficacy and toxicity were analyzed in 77 of 257 patients receiving third-line treatment subsequently. We performed univariate and multivariate analyses to identify prognostic factors for overall survival (OS) in patients receiving third-line treatment.</div></div><div><h3>Results</h3><div>Patients receiving third-line treatment had a median OS of 4.5 months (95 % confidence interval [CI], 3.6–5.4), compared to 1.6 months (95 % CI, 1.3–1.9) for those who did not. Independent poor prognostic factors for OS included the absence of previous pancreatectomy (adjusted hazard ratio [aHR] 3.03, 95 % CI, 1.30–7.14, P = 0.001), an ECOG score of ≥2 ((aHR 9.81, 95 % CI 4.34–22.1, P &lt; 0.001), and progressive disease response during second-line treatment (aHR 1.90, 95 % CI 1.21–8.91, P = 0.020, P = 0.020). Median OS for patients with none, one, two, and three poor prognostic factors were 15.9 (95 % CI, 12.3–19.6), 7.0 (2.6–13.3), 4.4 (3.5–5.2), and 2.0 (1.7–2.2) months, respectively. 43 of 77 patients (56 %) experienced at least one grade 3 or 4 toxicity.</div></div><div><h3>Conclusion</h3><div>In real-world settings, patients with mPDAC receiving third-line chemotherapy may have a moderate survival advantage, although clinicians should carefully select patients owing to high incidence of grade 3/4 toxicities.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 2","pages":"Pages 266-274"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364829","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":"Contrast agent dispersion visualized by CE-EUS may be a prediction tool for FOLFIRINOX chemotherapy effectiveness in patients with pancreatic adenocarcinoma","authors":"Mike J.P. de Jong ,&nbsp;Foke van Delft ,&nbsp;Fer D.W. Radstake ,&nbsp;Tom H. Perik ,&nbsp;Geke Litjens ,&nbsp;Tanya M. Bisseling ,&nbsp;Fons van der Sommen ,&nbsp;Erwin-Jan M. van Geenen ,&nbsp;John J. Hermans ,&nbsp;Peter D. Siersema","doi":"10.1016/j.pan.2025.01.011","DOIUrl":"10.1016/j.pan.2025.01.011","url":null,"abstract":"<div><h3>Background</h3><div>Pancreatic ductal adenocarcinoma (PDAC) still has a dismal 5-year overall survival of 13 %. Chemotherapy is increasingly used as treatment in both (neo-) adjuvant and palliative conditions. However, the overall survival benefits of chemotherapy must be weighed against significant side effects leading to a reduction in quality of life. CE-EUS and elastography could provide additional information about the vascularization and elasticity of the pancreatic tumor. The aim of this study was to investigate if contrast-enhanced endoscopic ultrasound and/or elastography could be suitable to predict the effectiveness of FOLFIRINOX.</div></div><div><h3>Methods</h3><div>Single center, prospective proof-of-concept study in which intravenous contrast agent was administered and strain ratio was calculated in patients undergoing EUS in their regular diagnostic work-up. Directly after contrast administration, a video of 120 s was recorded and afterwards tracked and fitted by a Modified Local Density Random Walk (mLDRW) model.</div></div><div><h3>Results</h3><div>We included 17 patients. Based on cross-sectional imaging based RECIST criteria, chemotherapy treatment was effective in 11 patients and not effective in 6 patients. The contrast dispersion parameter (κ1) differed significantly between both groups in favor of the responders: 2.994 (IQR 1.670–5.170) vs 1.203 (IQR 0.953–1.756), p = 0.005. The elastography strain ratio was higher in the effectively treated group (20.9 vs 13.6, p = 0.138).</div></div><div><h3>Conclusion</h3><div>This proof-of-concept study showed that the dispersion parameter of the first wave of contrast was 2.5 times higher in patients in whom FOLFIRINOX was effective, suggesting that this parameter could possibly be a reliable prediction tool.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 2","pages":"Pages 258-265"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256141","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":"Time between pancreatic cancer diagnosis and treatment initiation and survival in the U.S. Military Health System","authors":"Yvonne L. Eaglehouse ,&nbsp;Sarah Darmon ,&nbsp;Amie B. Park ,&nbsp;Craig D. Shriver ,&nbsp;Kangmin Zhu","doi":"10.1016/j.pan.2024.12.015","DOIUrl":"10.1016/j.pan.2024.12.015","url":null,"abstract":"<div><h3>Background</h3><div>Pancreatic cancer has a high case fatality and treatment is known to improve survival. It is unknown whether the time between diagnosis and treatment initiation (time-to-treatment) is related to survival. Access to medical care may influence both treatment receipt and timing. We examined the relationship between time-to-treatment and survival among patients with pancreatic adenocarcinoma treated in the equal access Military Health System.</div></div><div><h3>Methods</h3><div>We used the MilCanEpi database to study a cohort of 806 men and women who were diagnosed with stage I-IV pancreatic adenocarcinoma between 1998 and 2014 and received either surgery or chemotherapy as primary treatment. Time-to-treatment in relation to overall survival was examined in multivariable time-dependent Cox regression models.</div></div><div><h3>Results</h3><div>Overall, median time-to-treatment was 3 weeks and 95 % of patients received treatment within 12 weeks. Time-to-treatment &gt;6 weeks was associated with a statistically significant lower risk of death (AHR = 0.77, 95 % CI = 0.61–0.98) compared to time-to-treatment &lt;3 weeks. Analysis by the first treatment type showed that time-to-surgery was not associated with survival among those receiving upfront surgery. Time-to-chemotherapy of &gt;6 weeks was associated with reduced risks of death compared to &lt;3 weeks (AHR = 0.62, 95 % CI = 0.48–0.80) for patients receiving primary chemotherapy.</div></div><div><h3>Conclusions</h3><div>Our data suggests that longer time-to-treatment, especially among patients with chemotherapy, was associated with lower risk of death among patients with pancreatic adenocarcinoma who received treatment. Further research is needed to understand the association of intervals along the whole cancer spectrum (e.g., presentation, diagnosis, treatment) and longer treatment intervals (i.e., &gt;12 weeks) with survival.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 2","pages":"Pages 234-240"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903414","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":"Effect of plasmapheresis versus standard medical treatment in patients with hypertriglyceridemia-associated acute pancreatitis complicated by early organ failure (PERFORM-R): Study design and rationale of a multicenter, pragmatic, registry-based randomized controlled trial","authors":"Jing Zhou ,&nbsp;Lanting Wang ,&nbsp;Tao Chen ,&nbsp;Chao Li ,&nbsp;Yue Long ,&nbsp;Xinsen Zou ,&nbsp;Zhouzhou Dong ,&nbsp;Yun Sun ,&nbsp;Guoxiu Zhang ,&nbsp;Zhenguo Zeng ,&nbsp;Gang Li ,&nbsp;Bo Ye ,&nbsp;Longxiang Cao ,&nbsp;Lu Ke ,&nbsp;Yuxiu Liu ,&nbsp;Zhihui Tong ,&nbsp;Weiqin Li ,&nbsp;for the Chinese Acute Pancreatitis Clinical Trials Group (CAPCTG)","doi":"10.1016/j.pan.2025.01.008","DOIUrl":"10.1016/j.pan.2025.01.008","url":null,"abstract":"<div><h3>Background</h3><div>The prevalence of hypertriglyceridemia-associated acute pancreatitis (HTG-AP) is increasing. Studies have demonstrated the association between higher initial plasma triglyceride (TG) levels and worse clinical prognosis; therefore, lowering plasma TG has been the mainstay when managing HTG-AP. For TG-lowering therapy, plasmapheresis, which is costly and of potential complications, is currently widely used to clear TG from plasma, but whether it confers clinical benefits is unclear. In this trial, we aimed to evaluate the effect of plasmapheresis versus standard medical treatment on the duration of organ failure in HTG-AP patients with early organ failure.</div></div><div><h3>Methods</h3><div>This is a multicenter, pragmatic, registry-based, randomized controlled trial. Based on previous studies, up to 236 HTG-AP patients with early organ failure are projected to be randomly assigned to either the plasmapheresis group or the standard medical treatment group (insulin plus low molecular weight heparin therapy). The PERFORM registry will be used as the platform for patient enrollment. The primary outcome is organ failure-free days to 14 days of enrollment. Organ failure in this trial is defined as an individual sequential organ failure assessment (SOFA) score of two or more for the respiratory, cardiovascular, or renal system. Patients who died before day 14 will be assigned zero organ failure-free days.</div></div><div><h3>Discussion</h3><div>This trial will provide top-class evidence regarding the clinical impact of plasmapheresis in HTG-AP patients with early organ failure. The findings of this trial will have a direct influence on the current clinical practice concerning the management of HTG-AP.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 2","pages":"Pages 221-227"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075230","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":"Early prediction of post-pancreatectomy acute pancreatitis after pancreaticoduodenectomy based on serum C-reactive protein","authors":"Haoda Chen ,&nbsp;Chao Wang ,&nbsp;Wentao Xia ,&nbsp;Ningzhen Fu ,&nbsp;Yiran Zhou,&nbsp;Rui Ding,&nbsp;Weishen Wang,&nbsp;Zhiwei Xu,&nbsp;Xiaxing Deng,&nbsp;Yuanchi Weng,&nbsp;Baiyong Shen","doi":"10.1016/j.pan.2025.01.002","DOIUrl":"10.1016/j.pan.2025.01.002","url":null,"abstract":"<div><h3>Background</h3><div>Post-pancreatectomy acute pancreatitis (PPAP) is an early acute inflammatory process of the pancreatic remnant that is associated with a series of downstream pancreas-specific complications. This study aimed to investigate the relationship between postoperative serum C-reactive protein (CRP) levels and the occurrence of PPAP after pancreaticoduodenectomy (PD).</div></div><div><h3>Methods</h3><div>Consecutive patients who underwent PD between January 1, 2020, and May 31, 2022, were retrospectively analyzed. PPAP was defined according to the International Study Group for Pancreatic Surgery (ISGPS) definitions. A Sankey diagram incorporating Fistula Risk Score (FRS), serum amylase levels, and serum CRP levels was further performed for the early iterative risk stratification of PPAP.</div></div><div><h3>Results</h3><div>A total of 601 patients were included in the analysis. Postoperative serum hyperamylasemia (POH) was observed in 268 patients (44.6 %), of whom 136 (16.7 %) developed PPAP after PD. Patients with serum CRP &gt;100 mg/L on postoperative day (POD) 2 had a significantly higher incidence of PPAP (27.2 % vs. 2.3 %, p &lt; 0.001). The highest Youden index was achieved with the cut-off value of 100 mg/L, with the area under the curve (AUC) value of 0.754 for predicting PPAP (sensitivity 91.8 %, specificity 59.0 %). Multivariate analysis revealed that body mass index (BMI) ≥24 (OR 2.09), estimated blood loss &gt;200 mL (OR 1.70), and elevated serum CRP levels (OR 13.01) were independent risk factors for PPAP. Notably, patients with both POH and elevated serum CRP levels on POD 2 were classified as the high-risk group, exhibiting a remarkably high PPAP rate of 41.8 %.</div></div><div><h3>Conclusions</h3><div>Serum CRP levels on POD 2 are strongly associated with the development of PPAP after PD. This finding has the potential to enable tailored postoperative management and pave the way for the anti-inflammation strategies targeting the early postoperative period.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 2","pages":"Pages 208-213"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009886","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":"From Misdiagnosis to Management of Pancreatic Cystic Tumors Initially Identified as Pseudocysts and Treated with Cystogastrostomy: Experience from a Tertiary Care Center","authors":"Oğuzhan Şal ,&nbsp;Beslen Göksoy ,&nbsp;Görkem Uzunyolcu ,&nbsp;Celal Caner Ercan ,&nbsp;Neslihan Berker ,&nbsp;Feza Ekiz ,&nbsp;Kürşat Rahmi Serin","doi":"10.1016/j.pan.2025.02.001","DOIUrl":"10.1016/j.pan.2025.02.001","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 2","pages":"Pages 286-288"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483880","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":"Pancreatectomies with vein resection: Two large institutions’ experience of East and West","authors":"Atsushi Oba ,&nbsp;Kimitaka Tanaka ,&nbsp;Yosuke Inoue ,&nbsp;Roberto Valente ,&nbsp;Elena Rangelova ,&nbsp;Urban Arnelo ,&nbsp;Yoshihiro Ono ,&nbsp;Takafumi Sato ,&nbsp;Robert J. Torphy ,&nbsp;Hiromichi Ito ,&nbsp;Matthias Löhr ,&nbsp;Yu Takahashi ,&nbsp;Richard D. Schulick ,&nbsp;Akio Saiura ,&nbsp;Ernesto Sparrelid ,&nbsp;Marco Del Chiaro","doi":"10.1016/j.pan.2025.01.007","DOIUrl":"10.1016/j.pan.2025.01.007","url":null,"abstract":"<div><h3>Background</h3><div>The effectiveness and preferred reconstruction methods of pancreatectomy associated with vein resection (PAVR) for pancreatic cancer, especially for the extensive portal vein/superior mesenteric vein (PV/SMV) resections (more than 4 cm), are still subjects of debate. The aim of this study is to evaluate the safety and feasibility of PAVR by analyzing data from two large institutions from different regions.</div></div><div><h3>Methods</h3><div>From 2008 to 2018, we identified consecutive series of patients with pancreatic cancer who underwent PAVR at Karolinska University Hospital (KUH), Sweden, and Cancer Institute Hospital, Japanese Foundation of Cancer Research (JFCR), Japan. Both institutions adopted the artery-first approach to enhance surgical precision. This study compared the short- and long-term outcomes, vein resection types, and reconstruction methods between the two centers.</div></div><div><h3>Results</h3><div>A total of 506 patients who underwent PAVR were identified, 211 patients were from KUH and 295 patients were from JFCR. A higher incidence of total pancreatectomy was identified at KUH (24.6 % vs 0.3 %). There were no significant differences in intraoperative estimated blood loss (KUH: 630 ml, JFCR: 600 ml), severe complications rate (8.5 %, 5.1 %), and mortality (2.4 %, 0.7 %). Primary end-to-end anastomosis was primarily performed even if the length of PV/SMV resection was 5 cm or more and achieved successfully with acceptable patency (No thrombus rate: overall cases, 98.0 %; 5 cm or more, 93.5 %).</div></div><div><h3>Conclusions</h3><div>We report favorable outcomes of PAVR for pancreatic cancer from two high-volume centers in the east and west. Primary end-to-end anastomosis was safe and feasible even if the length of PV/SMV resection was 5 cm or more.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 2","pages":"Pages 250-257"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067171","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}