Pancreatology最新文献

{"title":"The duodenum-preserving head resections for chronic pancreatitis: Beger, Livocado and Pottakkat.","authors":"Andrea R G Sheel, Ryan D Baron, John P Neoptolemos","doi":"10.1016/j.pan.2025.02.011","DOIUrl":"https://doi.org/10.1016/j.pan.2025.02.011","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605959","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":"Vascular stent graft for the treatment of post-pancreaticoduodenectomy hemorrhage and risk factors for rebleeding.","authors":"Xiaowei Li, Zhigang Fu, Kunkun Cao, Dianqiang Lu, Jiaming Zhong, Xiaoxia Chen, Ning Ding, Li Liu, Xiaoli Zhang, Zengqiang Qu, Jian Zhai","doi":"10.1016/j.pan.2025.02.009","DOIUrl":"https://doi.org/10.1016/j.pan.2025.02.009","url":null,"abstract":"<p><strong>Background: </strong>To investigate the effectiveness and safety of vascular stent graft in the treatment of post-pancreaticoduodenectomy hemorrhage (PPH) and to determine independent risk factors for rebleeding.</p><p><strong>Methods: </strong>A retrospective review of 24 patients who received a vascular stent graft for the treatment of PPH between April 2016 and April 2021 was conducted. The site(s) and time of onset of hemorrhage, angiographic findings, endovascular treatment techniques, and risk factors for rebleeding after stent graft placement in these patients were analyzed.</p><p><strong>Results: </strong>The vascular stent grafts were successfully placed in 22 of the 24 patients, indicating a technical success rate of 91.7 %. The median time of hemorrhage onset was 18.5 days (range 0.25-37 days). Bleeding sites included the gastroduodenal artery (GDA) stump (n = 12) and the common and proper hepatic arteries CHA-PHA (n = 10). Nineteen patients had available imaging follow-up data for 12-2521 days, and the stent grafts were patent in 94.7 % of patients (18/19). The clinical success rate was 68.2 % (15/22). Rebleeding occurred after 31.8 % (7/22) interventions at a median interval of 6 days (range 2-27 days). In multivariate analysis, body mass index (BMI) ≥24.8 (OR = 6.159, 95 % CI: 1.020-37.181; P = 0.048) and pancreatic fistula (OR = 23.391, 95 % CI: 1.078-507.769; P = 0.045) were independent risk factors for rebleeding after stent graft placement.</p><p><strong>Conclusions: </strong>Vascular stent graft is effective and safe for PPH, especially at the site of the GDA stump and the CHA-PHA. Recurrent bleeding is not rare with such treatment, and BMI and pancreatic fistula are independent risk factors for rebleeding.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542956","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 evolving landscape of EUS utilization in the management of pancreatic cystic neoplasms.","authors":"Daniel Marino, Tamas A Gonda","doi":"10.1016/j.pan.2025.02.010","DOIUrl":"https://doi.org/10.1016/j.pan.2025.02.010","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537521","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":"\"Harnessing the power of organoids for improved outcomes in pancreatic cancer\".","authors":"Laxmi Kirola, Saurabh Kedia, Sujata Mohanty","doi":"10.1016/j.pan.2025.02.008","DOIUrl":"https://doi.org/10.1016/j.pan.2025.02.008","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537518","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":"Letter to the editor: Risk score to predict inpatient mortality of acute pancreatitis patients admitted to the intensive care unit.","authors":"Hiba Thasleem, Saad Khan, Fatima Sohail, Maryam Adnan, Junai'd Imran","doi":"10.1016/j.pan.2025.02.003","DOIUrl":"https://doi.org/10.1016/j.pan.2025.02.003","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458955","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":"Albumin ratio-based indicator for predicting inpatient mortality in acute pancreatitis patients admitted to the intensive care unit.","authors":"Guangyao Yang, Qifang Shi, Ying Xu","doi":"10.1016/j.pan.2025.02.002","DOIUrl":"https://doi.org/10.1016/j.pan.2025.02.002","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374507","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":"Why is the rectal route for NSAIDS favorable for preventing post-ERCP pancreatitis?","authors":"Gayathri Swaminathan, Yu-Chu Lin, Jianbo Ni, Asna Khalid, Cheng-Yu Tsai, Ying Ding, Na Bo, Judy-April Murayi, Thottala Jayaraman, Ronald Poropatich, Rita Bottino, Georgios I Papachristou, Sunil G Sheth, Li Wen, Monique T Barakat, Adam R Frymoyer, Mang Yu, Sohail Z Husain","doi":"10.1016/j.pan.2025.02.004","DOIUrl":"https://doi.org/10.1016/j.pan.2025.02.004","url":null,"abstract":"<p><strong>Objective: </strong>Acute pancreatitis is a frequent, burdensome adverse event of endoscopic retrograde cholangiography (ERCP). Rectal nonsteroidal anti-inflammatory drugs (NSAIDs) have reduced post-ERCP pancreatitis (PEP) risk by about 50 % and show greater efficacy over parenteral or oral administration, although the mechanism for its superiority remains unclear. To probe this question, we investigated in a preclinical model, the pharmacokinetics in the blood, pancreas and other tissues of the NSAID diclofenac given via the rectal, intravenous, or intragastric routes.</p><p><strong>Methods: </strong>The data on diclofenac was extracted from a larger study that examined a combination of diclofenac and tacrolimus. 20.8 mg diclofenac/kg body weight, which is the mouse equivalent dosing used in clinical practice for PEP prophylaxis, was administered to C57BL/6J mice via the rectal, intravenous and intragastric (oral) routes. Cross-collection of blood and tissues was done at various timepoints after administration for the evaluation of drug levels and pharmacokinetic parameters.</p><p><strong>Results: </strong>Rectal diclofenac demonstrated favorable blood pharmacokinetics and systemic bioavailability as well as sustained pancreas penetration. The total pancreas exposure to diclofenac over 24 h following rectal dosing was not significantly different as compared to intravenous and oral dosing.</p><p><strong>Conclusion: </strong>Our findings suggest that the efficacy of rectal diclofenac in PEP prevention relates more to its higher and consistent systemic exposure than its absolute pancreas levels. The implications are that the rectal route provides both systemic and pancreas exposure for the full duration of PEP vulnerability.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374514","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 extracellular volume fraction on routine contrast-enhanced computed tomography can predict pancreatic fibrosis and postoperative pancreatic fistula","authors":"Takahide Sasaki ,&nbsp;Yukihisa Takayama ,&nbsp;Shinji Tanaka ,&nbsp;Yoshihiro Hamada ,&nbsp;Ryo Nakashima ,&nbsp;Shigetoshi Naito ,&nbsp;Masatoshi Kajiwara ,&nbsp;Suguru Hasegawa","doi":"10.1016/j.pan.2024.12.003","DOIUrl":"10.1016/j.pan.2024.12.003","url":null,"abstract":"<div><h3>Background/objectives</h3><div>Postoperative pancreatic fistula (POPF) is a critical complication of pancreatectomy, with a higher risk associated with the absence of pancreatic fibrosis. We investigated whether pancreatic extracellular volume fraction (ECV) calculated from preoperative contrast-enhanced computed tomography (CE-CT) images can be used to predict pancreatic fibrosis and POPF.</div></div><div><h3>Methods</h3><div>This retrospective study included patients who underwent CE-CT before pancreatectomy. ECV map was created by subtracting unenhanced from equilibrium-phase images. We assessed the relationship between pancreatic ECV, the histopathological grade of fibrosis at the pancreatic resection margin, and the occurrence of POPF.</div></div><div><h3>Results</h3><div>Among the 107 patients included, 66 underwent pancreaticoduodenectomy (PD) and 41 underwent distal pancreatectomy (DP). The median ECV at the pancreatic resection margin was 22.5 %. Pancreatic ECV significantly correlated with the histopathological grade of pancreatic fibrosis (ρ = 0.689; <em>p</em> &lt; 0.001). In PD cases, the ECV was an independent risk factor for all-grade POPF (odds ratio, 0.852; 95 % confidence interval, 0.755−0.934), with excellent predictive capability (area under the curve, 0.912; 95 % confidence interval, 0.842−0.983). In DP cases, pancreatic thickness was the only factor associated with all-grade POPF.</div></div><div><h3>Conclusions</h3><div>Pancreatic ECV obtained from routine CE-CT images accurately predicted the histopathological grade of pancreatic fibrosis and was an independent risk factor for POPF after PD.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 1","pages":"Pages 153-159"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of percutaneous endoscopic versus endoscopic transmural necrosectomy for necrotizing pancreatitis: A propensity score-matched study","authors":"Ling Ding ,&nbsp;Lei Li ,&nbsp;Jingwen Rao ,&nbsp;Yong Zhu,&nbsp;Liang Xia,&nbsp;Pi Liu,&nbsp;Lingyu Luo,&nbsp;Huifang Xiong,&nbsp;Yang Hu,&nbsp;Yao Wu,&nbsp;Huajing Ke,&nbsp;Xin Huang,&nbsp;Yupeng Lei,&nbsp;Xu Shu,&nbsp;Zhijian Liu,&nbsp;Youxiang Chen,&nbsp;Nonghua Lu,&nbsp;Yin Zhu ,&nbsp;Wenhua He","doi":"10.1016/j.pan.2024.11.004","DOIUrl":"10.1016/j.pan.2024.11.004","url":null,"abstract":"<div><h3>Background</h3><div>Few published studies exist that compare the outcomes of different endoscopic necrosectomy methods for necrotizing pancreatitis (NP). We compared the safety and efficacy of percutaneous versus transmural endoscopic necrosectomy for NP patients.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, we analyzed adult NP patients who underwent either percutaneous endoscopic necrosectomy (PEN) or endoscopic transmural necrosectomy (ETN), and compared safety and efficacy between the two groups. Propensity score-matched analysis and multivariable logistic regression analysis were conducted.</div></div><div><h3>Results</h3><div>A total of 280 patients were enrolled, among which 142 underwent PEN and 138 underwent ETN. There were differences in baseline characteristics between the two groups, including body mass index, C-reactive protein, systemic inflammatory response syndrome score. The incidences of sepsis, respiratory failure, and intensive care unit stay were higher among patients who underwent PEN than those who underwent ETN (all P &lt; 0.01). Ninety-one pairs were matched with comparable baseline characteristics and severity. The incidence of postoperative complications, open surgery, clinical success, radiological success, collection recurrence, and reintervention were not significantly different between the ETN group and PEN group (all P &gt; 0.05). Multivariate analysis also showed that the approaches (PEN vs ETN) was not associated with postoperative complications or mortality.</div></div><div><h3>Conclusions</h3><div>In real world setting, sicker patients tend to be more effectively managed through PEN compared to ETN. PEN demonstrates comparable efficacy and safety to ETN in the treatment of NP patients.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 1","pages":"Pages 5-11"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frozen section analysis of pancreatic resection margins during pancreaticoduodenectomy for pancreatic adenocarcinoma is not affected by neoadjuvant therapy","authors":"Patricia A. Repollet Otero,&nbsp;Elsayed Ibrahim,&nbsp;Saverio Ligato","doi":"10.1016/j.pan.2024.12.008","DOIUrl":"10.1016/j.pan.2024.12.008","url":null,"abstract":"<div><h3>Background/objectives</h3><div>The aim of our study was to evaluate if the histopathological changes occurring in the pancreas post neoadjuvant-therapy (PNAT) for pancreatic ductal adenocarcinoma (PDAC) may negatively affect the assessment of intra-operative frozen section (FS) analysis of pancreatic resection margins (PRMs).</div></div><div><h3>Methods</h3><div>The clinicopathological data of patients who underwent pancreatoduodenectomy for PDAC between 2015 and 2022 were analyzed. Comparison of the accuracy of the FS analysis in treatment naïve (TN) and PNAT patients for all pancreatic margins was performed.</div></div><div><h3>Results</h3><div>We identified 81 patients with PDAC (40 female, 41 male) of which 47 (58.0 %) were TN and 34 (42.0 %) PNAT. Including FSs performed for re-excisions of initially positive PRMs, we identified 2/103 discrepancies for the pancreatic neck margin, one in a TN patient and one in a PNAT patient; one discrepancy for the common bile duct margin (1/47) in a TN patient; and 2/14 discrepancies for the uncinate margin, both in TN patients. In summary, accuracy of FS analysis was similar in the PNAT and TN groups (98.8 % vs. 96.7 %).</div></div><div><h3>Conclusions</h3><div>The histopathological changes occurring in the pancreas PNAT for PDAC do not affect the histopathological interpretation of FS analysis of PRMs, and the accuracy of FS analysis is similar in the PNAT and TN patients.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 1","pages":"Pages 142-146"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903344","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}