Pancreatology最新文献

{"title":"Optimal indication of adding pancreatic juice cytology in the diagnosis of malignant intraductal papillary mucinous neoplasm of the pancreas","authors":"Takeshi Mori ,&nbsp;Yasutaka Ishii ,&nbsp;Yumiko Tatsukawa ,&nbsp;Shinya Nakamura ,&nbsp;Juri Ikemoto ,&nbsp;Sayaka Miyamoto ,&nbsp;Kazuki Nakamura ,&nbsp;Masaru Furukawa ,&nbsp;Yumiko Yamashita ,&nbsp;Noriaki Iijima ,&nbsp;Yasuhiro Okuda ,&nbsp;Risa Nomura ,&nbsp;Koji Arihiro ,&nbsp;Kenichiro Uemura ,&nbsp;Shinya Takahashi ,&nbsp;Hideki Ohdan ,&nbsp;Shiro Oka","doi":"10.1016/j.pan.2024.12.010","DOIUrl":"10.1016/j.pan.2024.12.010","url":null,"abstract":"<div><h3>Background/Objectives</h3><div>Positive pancreatic juice cytology (PJC) is an important finding when considering surgical resection in patients with intraductal papillary mucinous neoplasm (IPMN); however, guidelines do not recommend endoscopic retrograde cholangiopancreatography (ERCP) for PJC. This study aimed to clarify the findings worthy of adding PJC for diagnosing high-grade dysplasia (HGD) and invasive carcinoma (IC) in patients with IPMN.</div></div><div><h3>Methods</h3><div>Patients with IPMN who underwent preoperative PJC and surgical resection at Hiroshima University Hospital were enrolled, and the diagnostic yield of malignant IPMN based on PJC and clinical and imaging findings and the incidence of post-ERCP pancreatitis (PEP) were retrospectively analyzed.</div></div><div><h3>Results</h3><div>Of the 129 eligible patients, 61 (47%) had malignant tumors (29 HGD and 32 IC). The diagnostic yields of PJC were as follows: 33%, 97%, 91%, 62%, and 67% for sensitivity, specificity, and positive predictive value, and negative predictive value, respectively. Multivariate analysis revealed that an abrupt change in the pancreatic duct caliber was an independent predictive factor of true-positive PJC (hazard ratio: 15.81, <em>P</em> = 0.001), with a diagnostic sensitivity of 86% for PJC in these patients. The incidence rate of PEP was 19%, and the pancreatic body and tail lesions, main pancreatic duct diameter &lt;10 mm, and placement of a nasopancreatic drainage catheter were significant risk factors for PEP.</div></div><div><h3>Conclusions</h3><div>Although PJC is generally not recommended for patients with IPMN, it is worth considering for the determination of treatment strategies in patients with abrupt changes in the caliber of the pancreatic duct with distal pancreatic atrophy.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 1","pages":"Pages 118-124"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896690","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":"High prevalence of pancreatic steatosis in pancreatic cancer patients: A meta-analysis and systematic review","authors":"Cătălina Vlăduț ,&nbsp;Corinna Steiner ,&nbsp;Matthias Löhr ,&nbsp;Dilara Turan Gökçe ,&nbsp;Patrick Maisonneuve ,&nbsp;Thomas Hank ,&nbsp;Daniel Öhlund ,&nbsp;Malin Sund ,&nbsp;Sanne A. Hoogenboom","doi":"10.1016/j.pan.2024.11.010","DOIUrl":"10.1016/j.pan.2024.11.010","url":null,"abstract":"<div><h3>Objective</h3><div>In the last decade there has been increasing interest in defining pancreatic steatosis (PS) and establishing its association with pancreatic ductal adenocarcinoma (PDAC). However, no consensus guidelines have yet been published on the management of PS. In this systematic review and meta-analysis performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we investigated the association between PS and PDAC.</div></div><div><h3>Design</h3><div>Medical literature between 2007 and 2023 was reviewed for eligible trials investigating the prevalence of PS in patients with PDAC. Eligible studies reporting on PS, assessed via imaging or histology, were included. The primary objective was to determine the association between PDAC and PS by comparing the prevalence of PS in individuals with- and without PDAC. Secondary, an evaluation was conducted to establish whether the method of assessment correlated with the association of PDAC and PS, and the prevalence of PDAC in individuals with PS. Measures of effect size were determined using odds ratios (ORs) and corresponding 95 % confidence intervals (95 % CI).</div></div><div><h3>Results</h3><div>The systematic review identified a total of 23 studies, of which seventeen studies examined PS prevalence among PDAC patients and were included in the meta-analysis. Overall, the pooled prevalence of PS in patients with PDAC was 53.6 % (95 % CI 40.9–66.2). No significant difference in PS prevalence was observed across various diagnostic methods or geographical regions. Overall, the pooled OR for PS in patients with PDAC compared to controls was 3.23 (95 % CI 1.86–5.60).</div></div><div><h3>Conclusions</h3><div>PDAC patients have a high prevalence of PS, and they are significantly more likely to have PS compared to controls. These findings emphasize the need to prioritize a standardized approach to the diagnosis, follow-up, and treatment of PS, with future studies focusing on identifying patients who would benefit from PDAC surveillance programs.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 1","pages":"Pages 98-107"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872783","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":"Associations between ABO, FUT2 and chronic pancreatitis: A comprehensive meta-analysis of multiple cohorts and public biobanks","authors":"Zeng-Kan Du ,&nbsp;Yuan-Chen Wang ,&nbsp;Ya-Hui Wang ,&nbsp;Xiao-Yu Li ,&nbsp;Yi-Zhou Zheng ,&nbsp;Di Wu ,&nbsp;Wei-Ming Qu ,&nbsp;Zhuan Liao ,&nbsp;Wen-Bin Zou","doi":"10.1016/j.pan.2024.12.016","DOIUrl":"10.1016/j.pan.2024.12.016","url":null,"abstract":"<div><h3>Objectives</h3><div>Associations of ABO blood group specifying transferases A/B (<em>ABO</em>) and fucosyltransferase 2 (<em>FUT2</em>) with CP remain inconclusive. We aimed to comprehensively investigate the associations by Chinese sequencing cohorts and external cohorts.</div></div><div><h3>Methods</h3><div>First, we analyzed the distributions of ABO blood groups and FUT2 status, along with lead single nucleotide polymorphisms (SNPs) at <em>ABO</em> (rs8176693 C/T) and <em>FUT2</em> (rs632111 A/G) gene loci in Chinese low-coverage whole-genome sequencing discovery cohort. Subsequently, we investigated the associations of CP with <em>ABO</em> and <em>FUT2</em> SNPs in Chinese whole-exome sequencing validation cohort and three public biobanks (FinnGen, UK Biobank, and BioBank Japan). Finally, comprehensive meta-analysis was performed by integrating data from two Chinese cohorts, reported cohorts and public biobanks.</div></div><div><h3>Results</h3><div>Firstly, in Chinese discovery cohort, the distribution of blood types in CP patients showed no significant difference compared to healthy controls, and similar results were observed in subgroup analyses and in meta-analysis with the reported cohorts. Secondly, results indicated no association between rs8176693 or rs632111 and CP in Chinese cohorts and meta-analysis of three biobanks, though <em>ABO</em> SNP was found to be significantly associated with CP in UK Biobank (odds ratio [OR] = 1.27, <em>P</em> = 0.04). Finally, no association was observed between rs8176693 (OR = 1.03, <em>P</em> = 0.29) or rs632111 (OR = 1.04, <em>P</em> = 0.10) and CP in comprehensive meta-analysis.</div></div><div><h3>Conclusions</h3><div>No association was found between lead SNPs of <em>ABO</em> or <em>FUT2</em> and CP in meta-analysis, nor was there an association between ABO blood group or FUT2 secretor status and CP in Chinese cohort. <em>ABO</em> and <em>FUT2</em> might play limited role in CP development.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 1","pages":"Pages 58-64"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896688","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":"Feasibility and clinical utility of endoscopic ultrasound-guided tissue acquisition for comprehensive genomic profiling in pancreatic cancer: A systematic review and meta-analysis","authors":"Sung Woo Ko ,&nbsp;Ik Hyun Jo ,&nbsp;Seung Bae Yoon","doi":"10.1016/j.pan.2024.12.012","DOIUrl":"10.1016/j.pan.2024.12.012","url":null,"abstract":"<div><h3>Background</h3><div>Endoscopic ultrasound-guided tissue acquisition (EUS-TA) has become essential for diagnosing pancreatic ductal adenocarcinoma (PDAC) and is increasingly utilized for comprehensive genome profiling (CGP) to advance precision medicine. This systematic review and meta-analysis assess the feasibility and clinical utility of EUS-TA samples for CGP in PDAC.</div></div><div><h3>Methods</h3><div>We conducted a thorough systematic literature search in PubMed, EMBASE, and the Cochrane Library up to October 2023. Key outcomes included sequencing success rates, detection rates of four major driver genes and actionable genes, and concordance rates with other sample types or methodologies.</div></div><div><h3>Results</h3><div>A total of 23 studies met the inclusion criteria. The pooled sequencing success rate was 83.9 % [95 % confidence interval (CI): 75.8–89.7 %]. No significant difference was observed in sequencing success rates between fine needle aspiration and biopsy (odds ratio 1.77, 95 % CI 0.70–4.47). Meta-regression analysis revealed that the minimum DNA requirement for CGP significantly influenced sequencing success rates. The pooled mutation rate for K-ras was 86.4 % (95 % CI 83.6–88.8), while potentially actionable mutations had a pooled rate of 17.7 % (95 % CI 12.8–23.8). The concordance rate between CGP results from EUS-guided samples and surgical specimens was 81.6 % (95 % CI 68.2–90.1).</div></div><div><h3>Conclusion</h3><div>Comprehensive genomic profiling of PDAC using EUS-TA-derived samples demonstrated feasibility in clinical settings. Approximately 18 % of patients undergoing CGP exhibited potentially actionable mutations, highlighting the potential for personalized therapeutic approaches.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 1","pages":"Pages 89-97"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896689","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":"Genotype-based prognosis prediction for MEN1-Related pancreatic neuroendocrine tumors in Korean patients a single-center retrospective study","authors":"Juwan Kim ,&nbsp;Seung Soo Hong ,&nbsp;Sung Hyun Kim ,&nbsp;Ho Kyoung Hwang ,&nbsp;Namki Hong ,&nbsp;Yumie Rhee ,&nbsp;Chang Moo Kang","doi":"10.1016/j.pan.2024.11.020","DOIUrl":"10.1016/j.pan.2024.11.020","url":null,"abstract":"<div><h3>Background</h3><div>Pancreatic neuroendocrine tumors (PNETs) are the leading cause of death related to multiple endocrine neoplasia type 1 (MEN1). Previous studies have linked certain mutations in the MEN1 gene and loss of interactions with MENIN's functional partners to the mortality or aggressiveness of PNETs. This study aimed to evaluate the genotype-phenotype correlations of MEN1-related PNETs in Korean patients and to summarize the treatment outcomes comprehensively.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 72 patients diagnosed with MEN1 at a tertiary care center in Korea between January 2003 and September 2022. MEN1 mutations were analyzed using direct or next-generation sequencing.</div></div><div><h3>Results</h3><div>Among 40 families with MEN1, 10 had exon 2 mutations, which were the most frequently observed. Of these, 50 (69.4 %) were diagnosed with PNETs; 20 underwent pancreatic resection. Patients with truncating mutations showed a significant difference in age-related penetrance of PNET (p = 0.029). No distinct genotype was associated with malignant transformation (lymph node or distant metastasis) in MEN1-related PNETs. In the subgroup Cox model, mutations in exons 3 or 10 showed significant differences in tumor progression in the observation group (adjusted hazard ratio: 8.164,(95 % CI: 1.648–40.436), p = 0.010, HR: 8.300, (95 % CI: 1.808–38.113), p = 0.007).</div></div><div><h3>Conclusion</h3><div>PNETs in Korean patients with MEN1 exhibit a stable prognosis. An individualized follow-up strategy may be necessary, particularly for young patients with truncating mutation in the MEN1 gene. In addition, those with mutations in exons 3 or 10 may require more active surveillance to decrease the risk of progression.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 1","pages":"Pages 134-141"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786435","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":"Misfolding PRSS1 variant p.Ala61Val in a case of suspected intrauterine pancreatitis","authors":"Máté Sándor ,&nbsp;David S. Vitale ,&nbsp;Zoltán Attila Nagy ,&nbsp;Sherif Y. Ibrahim ,&nbsp;Maisam Abu-El-Haija ,&nbsp;Maria Lazou ,&nbsp;Sandor Vajda ,&nbsp;Miklós Sahin-Tóth","doi":"10.1016/j.pan.2024.12.013","DOIUrl":"10.1016/j.pan.2024.12.013","url":null,"abstract":"<div><h3>Background/objectives</h3><div>Genetic variants in <em>PRSS1</em> encoding human cationic trypsinogen are associated with hereditary pancreatitis. The clinically frequent variants exert their pathogenic effect by increasing intrapancreatic trypsin activity, while a distinct subset of variants causes disease via mutation-induced trypsinogen misfolding and endoplasmic reticulum (ER) stress. Here, we report a novel misfolding <em>PRSS1</em> variant.</div></div><div><h3>Methods</h3><div>We used next-generation and Sanger sequencing to screen the index patient. We performed structural modeling and analyzed the functional effects of the <em>PRSS1</em> variant.</div></div><div><h3>Results</h3><div>A heterozygous c.182C&gt;T (p.Ala61Val) <em>PRSS1</em> variant was identified in a case of suspected intrauterine pancreatitis with pseudocyst formation. Recombinant p.Ala61Val trypsinogen autoactivated to lower trypsin levels, but activity of p.Ala61Val trypsin was similar to wild type. In cell culture experiments, the variant exhibited reduced secretion and intracellular retention. Cells expressing the p.Ala61Val variant showed signs of ER stress, as judged by elevated mRNA expression of <em>Hspa5</em> encoding the chaperone BiP, and increased mRNA splicing of the transcription factor <em>XBP1</em>. <strong>Conclusions</strong>: Taken together, the observations expand the repertoire of misfolding <em>PRSS1</em> variants and highlight the need for functional analysis to identify this rare form of genetic etiology.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 1","pages":"Pages 70-81"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903349","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":"Serum IgG4-negative and IgG4-positive type 1 autoimmune pancreatitis present with different clinicopathological features: An analysis of a nationwide survey in Japan","authors":"Takanori Sano ,&nbsp;Kazuhiro Kikuta ,&nbsp;Tetsuya Takikawa ,&nbsp;Ryotaro Matsumoto ,&nbsp;Kazuichi Okazaki ,&nbsp;Yoshifumi Takeyama ,&nbsp;Atsushi Masamune","doi":"10.1016/j.pan.2024.11.018","DOIUrl":"10.1016/j.pan.2024.11.018","url":null,"abstract":"<div><h3>Background/Objective</h3><div>Elevated serum IgG4 (sIgG4) is a useful diagnostic marker of type 1 autoimmune pancreatitis (AIP). This study aimed to clarify the clinicopathological characteristics of the type 1 AIP patients without elevated sIgG4 levels.</div></div><div><h3>Methods</h3><div>We analyzed the clinical data of patients registered in a nationwide epidemiological survey in Japan. AIP was diagnosed according to the International Consensus Diagnostic Criteria. Patients with sIgG4 levels ≥135 mg/dl at the diagnosis were classified as sIgG4-positive AIP, and those with sIgG4 levels &lt;135 mg/dl were as sIgG4-negative AIP.</div></div><div><h3>Results</h3><div>A total of 1285 patients with AIP were enrolled in this study; 1128 (87.8 %) had sIgG4-positive AIP and 157 (12.2 %) had sIgG4-negative AIP. Compared to patients with sIgG4-positive AIP, those with sIgG4-negative AIP more frequently experienced inflammatory bowel diseases (3.8 % vs. 0.4 %), and less frequently developed extrapancreatic lesions (53.5 % vs. 72.3 %), including sclerosing cholangitis (30.6 % vs. 40.7 %) and sialadenitis/dacryoadenitis (5.1 % vs. 24.7 %). Histopathological examinations were performed more frequently in patients with sIgG4-negative AIP. The criterion of abundant IgG4-positive plasma cells was less frequently fulfilled by patients with sIgG4-negative AIP (28.0 % vs. 43.1 %). A Kaplan-Meier analysis showed that relapse occurred less frequently in patients with sIgG4-negative AIP (<em>P</em> = 0.006). Results were similar even if the patients with AIP-not otherwise specified (n = 45) were excluded.</div></div><div><h3>Conclusions</h3><div>Patients with sIgG4-negative type 1 AIP and those with sIgG4-positive type 1 AIP present with different clinicopathological features which suggests heterogeneity of patients with type 1 AIP. Low serum IgG4 levels could indicate low disease activity in type 1 AIP.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 1","pages":"Pages 82-88"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792097","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":"Methionine restriction inhibits pancreatic cancer proliferation while suppressing JAK2/STAT3 pathway","authors":"Manabu Maebashi ,&nbsp;Kentaro Miyake ,&nbsp;Jun Yamamoto ,&nbsp;Kota Sahara ,&nbsp;Tomoko Akiyama ,&nbsp;Yayoi Kimura ,&nbsp;Itaru Endo","doi":"10.1016/j.pan.2024.11.023","DOIUrl":"10.1016/j.pan.2024.11.023","url":null,"abstract":"<div><h3>Background</h3><div>Methionine restriction (MR) has been demonstrated to exhibit anti-tumor effects in various types of cancer, including pancreatic cancer (PC). However, the detailed mechanism induced by MR remains still unclear. This study aims to reveal the underlying mechanism of MR on PC by proteomic analysis.</div></div><div><h3>Material &amp; methods</h3><div>Human PC cell lines were cultured in both standard and MR media to evaluate the effect of MR. The differences in protein expression were evaluated through proteomic analysis. Ingenuity Pathway Analysis (IPA) was performed to identify proteins potentially associated with tumor growth in vitro. The proteins associated with the anti-tumor effect were validated using western blotting, real-time PCR, and ELISA. An experimental model involving subcutaneous PC mice was established for the assessment of the effectiveness of the MR diet and the expression of target proteins through immunohistochemical staining.</div></div><div><h3>Results</h3><div>Cell proliferation was suppressed in the MR media compared to the standard media. IPA analysis showed that STAT3 was decreased in the Apoptotic Pathway of Pancreatic Cancer Cell lines in the MR group. Western blotting showed MR decreased STAT3 expression. Real-time PCR showed that MR decreased JAK2 and STAT3 mRNA expression in Panc-1 and Mia-PaCa 2, but not in Capan-1. ELISA revealed that NF-kB expression was decreased in the MR group. In the in vivo study, the final estimated tumor volume in the MR group was significantly lower than the control group (p &lt; 0.01). Immunostaining of resected specimens showed that STAT3 expression was suppressed in the MR group.</div></div><div><h3>Conclusion</h3><div>MR suppressed the JAK2/STAT3 pathway and decreased NF-kB in some PC cell lines.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 1","pages":"Pages 108-117"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818885","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":"Concomitant virus infection increases mortality and worsens outcome of acute pancreatitis: A systematic review and meta-analysis","authors":"Gefu Cai ,&nbsp;Eszter Ágnes Szalai ,&nbsp;Petrana Martinekova ,&nbsp;Ximeng Li ,&nbsp;Xinyi Qian ,&nbsp;Dániel Sándor Veres ,&nbsp;Zoltán Péterfi ,&nbsp;Jaishree Biswakarma ,&nbsp;Rita Nagy ,&nbsp;Alexandra Mikó ,&nbsp;Szabolcs Ábrahám ,&nbsp;Bálint Erőss ,&nbsp;Péter Hegyi ,&nbsp;Andrea Szentesi","doi":"10.1016/j.pan.2024.12.005","DOIUrl":"10.1016/j.pan.2024.12.005","url":null,"abstract":"<div><h3>Background</h3><div>Acute pancreatitis (AP) is a major health threat, with a high mortality rate in severe forms. Though alcohol and bile-induced factors are the most common causes, increasing evidence suggests that viral infections such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and human immunodeficiency virus (HIV) may also trigger AP development. Our study aims to explore this association in greater detail.</div></div><div><h3>Methods</h3><div>After the PROSPERO registration, we systematically searched PubMed, Embase, Cochrane Library, China Science and Technology Journal Database, China National Knowledge Infrastructure, and Wanfang Data Knowledge Service Platform in February 2023. We included studies with the following PECO framework: Population: AP patients, Exposure/Comparison: with/without virus infection, Outcome: mortality, severity, and complications of AP. Pooled odds ratios (OR) were calculated with 95 % confidence intervals (CIs).</div></div><div><h3>Results</h3><div>Altogether, 29 cohorts with 2,295,172 patients were identified for the meta-analysis and 858 cases for the qualitative synthesis. Patients with concurrent SARS-CoV-2 infection and AP exhibited heightened odds of in-hospital mortality (OR: 3.15, CI: 2.08–4.76), and necrosis (OR: 1.83, CI: 1.13–2.97). Mild AP was less prevalent in the SARS-CoV-2 group (OR: 0.37, CI: 0.14–0.97) compared to moderately severe and severe AP together. Contrarily, no evidence was found that concomitant HIV infection elevated in-hospital mortality (OR: 1.12, CI: 0.92–1.37) or sepsis occurrence (OR:1.21, CI: 0.41–3.59).</div></div><div><h3>Conclusion</h3><div>Patients co-diagnosed with AP and SARS-CoV-2 infection require heightened attention due to an increased risk of mortality and complications. No evidence was found that HIV infection elevated the risk of a more severe outcome.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 1","pages":"Pages 20-28"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847158","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":"Significance of administering postoperative pancreatic enzyme replacement therapy for fat digestion and absorption functions in patients who underwent initial total pancreatectomy","authors":"Ryuta Shintakuya ,&nbsp;Kenichiro Uemura ,&nbsp;Tatsuaki Sumiyoshi ,&nbsp;Kenjiro Okada ,&nbsp;Kenta Baba ,&nbsp;Takumi Harada ,&nbsp;Yasutaka Ishii ,&nbsp;Shiro Oka ,&nbsp;Koji Arihiro ,&nbsp;Yoshiaki Murakami ,&nbsp;Shinya Takahashi","doi":"10.1016/j.pan.2024.12.011","DOIUrl":"10.1016/j.pan.2024.12.011","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the effects of postoperative pancreatic enzyme replacement therapy on fat digestion and absorption in patients following initial total pancreatectomy.</div></div><div><h3>Methods</h3><div>Data were retrospectively collected from patients who underwent initial total pancreatectomy at our department between 2012 and 2020. Fat digestion, absorption functions, serum nutritional markers, HbA1c levels, and hepatic steatosis before and after the initial total pancreatectomy were evaluated. The rate of change in these parameters pre- and 1-year postoperatively were compared between patients with initial total pancreatectomy and pancreaticoduodenectomy. Patients underwent the ¹³C-labeled mixed triglyceride breath test to evaluate fat digestion and absorption functions. Hepatic steatosis was assessed using computed tomography.</div></div><div><h3>Results</h3><div>Of 17 consecutive patients who underwent initial total pancreatectomy, 12 were men, and the median age was 70 years. All 17 patients received 1800 mg pancrelipase when food intake was resumed after surgery. The pre- and 1-year postoperative median % dose ¹³C cum 7 h (%), serum nutritional markers, HbA1c levels, and liver computed tomography findings did not differ significantly. Two patients had nonalcoholic fatty liver disease after surgery, without serious disease progression. In total, 48 patients who underwent pancreaticoduodenectomy were found eligible. The median change in % dose ¹³C cum 7 h (%), serum nutritional markers, HbA1c levels, and liver computed tomography findings pre and 1-year postoperatively showed no significant differences between the initial total pancreatectomy and pancreaticoduodenectomy groups.</div></div><div><h3>Conclusions</h3><div>High-dose pancreatic enzyme replacement therapy after initial total pancreatectomy might maintain fat digestion and absorption functions and nutritional status and prevent hepatic steatosis.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 1","pages":"Pages 160-166"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927139","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}