Pancreatology最新文献

{"title":"Epidemiological time trends in acute pancreatitis – A 16-year experience from South Australia","authors":"Eleonora Dal Grande , Jacqueline H. Stephens , Mark E. Brooke-Smith , Minoti Apte , Daniel Croagh , Rachel E. Neale , Tony Pang , Chee (Keith) Y. Ooi , Jeremy Wilson , Ross A. McKinnon , Richard C. Turner , Savio George Barreto","doi":"10.1016/j.pan.2026.03.024","DOIUrl":"10.1016/j.pan.2026.03.024","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 4","pages":"Pages 635-637"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147654811","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":"Low-molecular-weight heparin and respiratory failure in hypertriglyceridemia-associated acute pancreatitis","authors":"Feng Deng ,&nbsp;Ling Ding ,&nbsp;Yuan-yuan Du ,&nbsp;Zhi-Guo Hu ,&nbsp;Tong-bang Zong ,&nbsp;Lu Ke ,&nbsp;Long-xiang Cao ,&nbsp;Jing-kang Zhu ,&nbsp;Zhen-guo Zeng","doi":"10.1016/j.pan.2026.03.020","DOIUrl":"10.1016/j.pan.2026.03.020","url":null,"abstract":"<div><h3>Background</h3><div>The role of low-molecular-weight heparin (LMWH) in preventing respiratory failure among patients with hypertriglyceridemia-associated acute pancreatitis (HTG-AP) remains uncertain. We aimed to examine the association between LMWH use and respiratory failure in HTG-AP.</div></div><div><h3>Methods</h3><div>This post-hoc analysis was based on a multicenter, prospective cohort. Adult patients with HTG-AP (plasma triglycerides &gt;11.3 mmol/L) admitted within 72 h of onset between February 2020 and July 2023 were included. Patients receiving LMWH during the first week were classified as the LMWH group, and those without LMWH served as controls. The primary outcome was defined as new-onset respiratory failure within 14 days of enrollment. Multivariate logistic regression and inverse probability of treatment weighting (IPTW) were applied to adjust for confounders.</div></div><div><h3>Results</h3><div>A total of 387 patients (287 [74.2%] male; median [IQR] age, 37 [32–44] years) were enrolled, including 326 in the LMWH group and 61 controls. Of the LMWH group, 260 (79.8%) received LMWH at baseline, and most (295 [90.5%]) received LMWH for &gt;2 days. LMWH use was associated with a reduced risk of respiratory failure (including baseline and post-enrollment cases) (adjusted OR 0.42, 95% CI 0.23–0.76; P = 0.004) and specifically new-onset respiratory failure (i.e., developed after enrollment, adjusted OR 0.46, 95% CI 0.23–0.94; P = 0.033). Longer time from onset to enrollment, higher total bilirubin, and higher APACHE II score were also predictors of respiratory failure. IPTW analysis confirmed these findings.</div></div><div><h3>Conclusions</h3><div>LMWH use may be associated with a lower incidence of respiratory failure in HTG-AP. These findings warrant confirmation in a randomized controlled trial.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 4","pages":"Pages 566-572"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147675379","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":"Healthcare resource use for acute pancreatitis in patients with familial chylomicronemia syndrome treated with olezarsen","authors":"Asia Sikora Kessler ,&nbsp;Montserrat Vera-Llonch ,&nbsp;Veronica J. Alexander ,&nbsp;Catrina Richards ,&nbsp;Quratul Ann ,&nbsp;Spyros Paparrodopoulos ,&nbsp;Shuting Xia ,&nbsp;Sotirios Tsimikas ,&nbsp;Seth J. Baum","doi":"10.1016/j.pan.2026.04.019","DOIUrl":"10.1016/j.pan.2026.04.019","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 4","pages":"Pages 644-646"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147819202","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 diagnostic technology to pathway design: what the Onomichi Method teaches us about early pancreatic cancer detection","authors":"Kentaro Yamao MD, PhD ,&nbsp;Toshifumi Kin MD, PhD ,&nbsp;Takao Ohtsuka MD, PhD","doi":"10.1016/j.pan.2026.04.021","DOIUrl":"10.1016/j.pan.2026.04.021","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 4","pages":"Pages 523-524"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147932534","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":"Long-term disease progression in pediatric acute recurrent and chronic pancreatitis: A report from INSPPIRE","authors":"Elissa M. Downs ,&nbsp;Emily R. Perito ,&nbsp;Fuchenchu Wang ,&nbsp;Gretchen A. Cress ,&nbsp;Maisam Abu-El-Haija ,&nbsp;Ankur Chugh ,&nbsp;Reuven Zev Cohen ,&nbsp;Douglas S. Fishman ,&nbsp;A. Jay Freeman ,&nbsp;Cheryl E. Gariepy ,&nbsp;Matthew J. Giefer ,&nbsp;Tanja Y. Gonska ,&nbsp;Amit S. Grover ,&nbsp;Sohail Z. Husain ,&nbsp;Douglas Lindblad ,&nbsp;Quin Y. Liu ,&nbsp;Asim Maqbool ,&nbsp;Jacob A. Mark ,&nbsp;Brian A. McFerron ,&nbsp;Megha S. Mehta ,&nbsp;Aliye Uc","doi":"10.1016/j.pan.2026.01.076","DOIUrl":"10.1016/j.pan.2026.01.076","url":null,"abstract":"<div><h3>Background</h3><div>Acute recurrent pancreatitis (ARP) in childhood can rapidly progress to chronic pancreatitis (CP). Prospectively-collected data from the <u>IN</u>ternational <u>S</u>tudy group of <u>P</u>ediatric <u>P</u>ancreatitis: <u>I</u>n search for a cu<u>RE</u> (INSPPIRE) provides novel insight into disease progression.</div></div><div><h3>Methods</h3><div>INSPPIRE subjects were categorized as persistent ARP (pARP = remained ARP through last follow-up), incident CP (iCP = ARP at enrollment, developed CP), or prevalent CP (pCP = CP at enrollment). Time-to-sequelae and risk factors were analyzed.</div></div><div><h3>Results</h3><div>Of 626 total children, 384 (61%) were ARP at baseline; of these, 81 (21.1%) were iCP at follow-up.</div><div>iCP were more likely to have <em>PRSS1</em> mutations, obstructive risk factors, and more acute pancreatitis episodes (AP) vs. pARP, but didn't differ in age at first AP.</div><div>Exocrine pancreatic insufficiency (EPI) developed in 24% during follow-up, 10% of pARP, 32% of iCP. In all CP, 50% had EPI by 17.7yrs, median 10yrs after first AP.</div><div>Diabetes mellitus (DM) developed in 8% during follow-up, 6% of pARP, 5% of iCP. In all CP, median event-free survival from birth and after first AP was not reached.</div></div><div><h3>Conclusions</h3><div>Prospective follow-up of children with ARP revealed nearly 1 in 5 progressed to CP, with a subset developing irreversible sequelae, and highlighted risk factors associated with progression including genetics, obstructive disease, and episode frequency.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 4","pages":"Pages 525-531"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146166199","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 quantitative sensory testing (P-QST) for pain assessment in Indian patients with chronic pancreatitis","authors":"Misbah Unnisa ,&nbsp;Swapnil Chaudhary ,&nbsp;Ankit Agarwal ,&nbsp;Soumya Jagannath Mahapatra ,&nbsp;Søren Schou Olesen ,&nbsp;Abdul Rasheed ,&nbsp;Anas Khan ,&nbsp;Asbjørn Mohr Drewes ,&nbsp;Anna Evans Phillips ,&nbsp;D. Nageshwar Reddy ,&nbsp;Pramod Kumar Garg ,&nbsp;Rupjyoti Talukdar ,&nbsp;International Pancreatic Pain Consortium","doi":"10.1016/j.pan.2026.03.022","DOIUrl":"10.1016/j.pan.2026.03.022","url":null,"abstract":"<div><h3>Background</h3><div>Pain is the predominant symptom of chronic pancreatitis (CP). Pancreatic quantitative sensory testing (P-QST) provides a semi-objective assessment of pain processing, but has not been previously reported for Indian patients. This study aimed to evaluate pain characteristics using P-QST in Indian patients with CP.</div></div><div><h3>Methods</h3><div>Patients with painful CP and age- and sex-matched healthy controls (HCs) from two tertiary centers in northern (All India Institute of Medical Sciences, AIIMS) and southern India (Asian Institute of Gastroenterology, AIG) were included. P-QST assessed temporal summation (spinal hyperexcitability), pressure pain detection (pPDT), and tolerance thresholds (pPTT) across five dermatomes, tolerance to tonic cold pain, and conditioned pain modulation (descending pain inhibition). P-QST parameters were compared between CP and HC subgroups, stratified by center, and inter-center differences were evaluated.</div></div><div><h3>Results</h3><div>A total of 451 participants (251 CP, 200 HCs) were enrolled. TS scores were comparable between groups. Patients with CP had lower pPDT and pPTT sums than HCs at both centers (AIG: 2513 vs 2717 kPa, P = 0.006; 2966 vs 3337 kPa, P &lt; 0.001; AIIMS: 1666 vs 1870 kPa, P &lt; 0.001; 2355 vs 3033 kPa, P=&lt;0.001). Cold pressor endurance time was shorter in CP (AIG: 54 vs 74 s, P &lt; 0.001; AIIMS: 103 vs 114 s, P = 0.013). CPM responses were higher in CP (AIG: 5% vs 0%, P = 0.002; AIIMS: 5% vs 3%, P = 0.014)</div></div><div><h3>Conclusion</h3><div>P-QST showed consistent, widespread hyperalgesia in Indian patients with painful CP, providing a window of opportunity to identify central sensitization and validating its clinical utility in assessing central pain modulation across diverse populations.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 4","pages":"Pages 532-538"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639425","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":"Diabetes secondary to chronic pancreatitis and pancreatic cancer: Observations from the Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer (CPDPC)","authors":"Phil A. Hart ,&nbsp;Dana K. Andersen ,&nbsp;Melena D. Bellin ,&nbsp;Yogish C. Kudva ,&nbsp;Frederico G.S. Toledo ,&nbsp;Mark O. Goodarzi","doi":"10.1016/j.pan.2026.04.001","DOIUrl":"10.1016/j.pan.2026.04.001","url":null,"abstract":"<div><div>Diabetes secondary to diseases of the exocrine pancreas, including chronic pancreatitis (CP) and pancreatic cancer (PDAC), is easily confused with type 2 diabetes (T2D). Misdiagnosis as T2D is common due to poor understanding of the underlying pathophysiology of these diabetes subtypes. In this review, we highlight contributions from our research group to further characterize the distinctions between CP-DM and PDAC-DM as it relates to postprandial response to pancreatic polypeptide (PP) and key metabolic alterations compared to T2D. In general, the PP response is blunted, and there is relatively lower insulin secretion, higher insulin sensitivity, and alpha cell dysregulation in CP-DM and PDAC when compared to T2D. Additionally, we provide updates regarding ongoing work to use clinical and genetic data to model the prediction of incident CP-DM. Lastly, we identify remaining knowledge gaps to further improve the diagnosis and treatment of type 3c diabetes.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 4","pages":"Pages 581-586"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646173","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":"Optimizing nutritional support in acute pancreatitis: A systematic review and network meta-analysis of timing and route of feeding","authors":"Mahmoud M. Elhady ,&nbsp;Mohamed Rifai ,&nbsp;Eman Ayman Nada ,&nbsp;Abdel Rahman Feras AlSamhori ,&nbsp;Mohammad Alqudah ,&nbsp;Abdelrahman Elgendy ,&nbsp;Abdelrahman Awad ,&nbsp;Mohamed Abuelazm ,&nbsp;Ismail Elkhattib ,&nbsp;Mohamed Elnaggar","doi":"10.1016/j.pan.2026.04.004","DOIUrl":"10.1016/j.pan.2026.04.004","url":null,"abstract":"<div><h3>Background</h3><div>Acute pancreatitis (AP) is a common inflammatory condition with significant morbidity and mortality. Nutritional management is central to treatment, but uncertainties remain regarding the optimal timing and route of feeding.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and network meta-analysis of randomized controlled trials (RCTs) assessing feeding strategies in AP. Databases searched included PubMed, Embase, Scopus, Web of Science, and CENTRAL up to July 2025. Eligible interventions included very early oral feeding (VEOF), early oral feeding (EOF), delayed oral feeding (DOF), early enteral nutrition (EEN), delayed enteral nutrition (DEN), and parenteral nutrition (PN). Risk of bias was assessed using the Cochrane RoB 2 tool. The network and pairwise meta-analysis were conducted using R (version 4.4.3). PROSPERO (CRD420251152683).</div></div><div><h3>Results</h3><div>Twenty-three RCTs involving 2095 patients were analyzed. EOF demonstrated the most significant mortality reduction compared with PN (RR 0.06, 95% CI 0.00–0.68; SUCRA 92%). DOF (RR 0.19, 95% CI 0.06–0.58) and EEN (RR 0.31, 95% CI 0.17–0.58) also reduced mortality. MOF risk was significantly reduced with DOF (RR 0.25, 95% CI 0.08–0.79) and EEN (RR 0.32, 95% CI 0.20–0.51). No intervention significantly affected sepsis, necrosis, or overall complications. VEOF reduced C-reactive protein (MD −47.3 mg/L, 95% CI −89.8 to −4.8) and LOHS (MD −4.3 days, 95% CI −8.1 to −0.4).</div></div><div><h3>Conclusion</h3><div>EOF should be prioritized in AP as it offers the most substantial mortality benefit while preserving gut integrity and reducing inflammation. DOF and EEN strategies remain effective alternatives, and rhubarb-supplemented EEN may further reduce the length of hospital stay.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 4","pages":"Pages 539-551"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147819156","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":"Microbiome–genetic interplay in intraductal papillary mucinous neoplasms: A critical appraisal of emerging evidence","authors":"Zain Mazhar ,&nbsp;Husnain Bashir","doi":"10.1016/j.pan.2025.10.001","DOIUrl":"10.1016/j.pan.2025.10.001","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 4","pages":"Pages 647-648"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280940","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":"Fibromodulin promotes PDAC progression through multifaceted regulation of tumor growth pathways: Implications for therapeutic targeting","authors":"Xin Wang ,&nbsp;Chao Liu ,&nbsp;Qi Zhang,&nbsp;Yi Ren,&nbsp;Kunzheng Fan,&nbsp;Yuntao Zhang,&nbsp;Huijie Gao","doi":"10.1016/j.pan.2026.04.015","DOIUrl":"10.1016/j.pan.2026.04.015","url":null,"abstract":"<div><h3>Background</h3><div>Therapeutic progress in pancreatic ductal adenocarcinoma (PDAC) has been slow. A key factor contributing to this lethal disease's progression is excessive extracellular matrix (ECM) deposition, as highlighted in numerous studies. Fibromodulin (FMOD), a significant ECM component, is speculated to play a crucial role in PDAC, however detailed studies on this are lacking. As such, our study evaluated the functional importance of FMOD in the context of PDAC to understand its mechanistic role.</div></div><div><h3>Methods</h3><div>Through systematic bioinformatics analysis and tissue microarray analysis, the expression of FMOD in PDAC was investigated. Further, the study delved into the specific roles FMOD plays in PDAC development both in vitro and in vivo using loss-of-function and gain-of-function strategies. Additionally, the influence of FMOD on the differential metabolites in the serum of PDAC mice was analyzed using metabolomics.</div></div><div><h3>Results</h3><div>FMOD is highly expressed in PDAC (fold change = 7.7, <em>p</em> &lt; 0.05) and is associated with poor clinical outcomes. FMOD significantly promotes the proliferation, migration, and invasion of PDAC cells while inhibiting apoptosis. Mechanistically, FMOD expression is associated with activation of the TGFβ/SMAD2/3 and EGFR-mediated PI3K/AKT/mTOR signaling pathways. Additionally, Metabolomic analysis demonstrated that FMOD elevates prostaglandin levels by upregulating key arachidonic acid-metabolizing enzymes (cPLA2 and COX-2).</div></div><div><h3>Conclusions</h3><div>FMOD plays critical roles in the development and progression of PDAC. These findings highlight FMOD as a candidate prognostic marker and suggest that targeting FMOD merits further exploration in PDAC.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 4","pages":"Pages 594-606"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147932411","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}