Pancreatology最新文献

{"title":"Presentation and management of pancreatic hydatid cyst: A comprehensive systematic review of the literature with meta-data","authors":"Berun A. Abdalla ,&nbsp;Aland S. Abdullah ,&nbsp;Deari A. Ismaeil ,&nbsp;Hemn H. Kaka Ali ,&nbsp;Omer H.G. Hawramy ,&nbsp;Dana T. Gharib ,&nbsp;Hoshmand A. Asaad ,&nbsp;Karokh F. HamaHussein ,&nbsp;Dlshad HamaSaeed Ahmed ,&nbsp;Soran H. Tahir ,&nbsp;Ali H. Hasan ,&nbsp;Muhammed Bag A. Ali ,&nbsp;Sasan M. Ahmed ,&nbsp;Fakher Abdullah ,&nbsp;Fahmi H. Kakamad","doi":"10.1016/j.pan.2024.11.019","DOIUrl":"10.1016/j.pan.2024.11.019","url":null,"abstract":"<div><h3>Introduction</h3><div>Hydatid cysts are among many cysts that can develop in the pancreas. Both the size and location of these cysts significantly influence clinical presentation and surgical approach required for management. This study aims to review the literature concerning pancreatic hydatic cysts, their presentations, and management strategies.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted across CINAHL, Pubmed/Medline, Cochrane Library, Web of Science, and EMBASE Databases to identify English-language studies published up to January 2nd, 2024.</div></div><div><h3>Results</h3><div>The mean age of the patients was 35.4 ± 17.4years, with females comprising 92 (59.0 %) of the cohort. Abdominal pain was the most common complaint, reported by 92 (59.0 %) patients. Serological testing for the echinococcal antigen demonstrated highest sensitivity at 67.0 %, whereas computed tomography exhibited a sensitivity of 34.1 %, and ultrasonography showed a sensitivity of 27.7 %. Among surgical interventions, laparotomy was the most frequently performed approach, utilized in 42(26.9 %) of the cases.</div></div><div><h3>Conclusion</h3><div>Although pancreatic hydatid cysts are rare and can be challenging to diagnose, their prognosis is generally favorable when appropriate therapeutic measures are employed. Surgical intervention, often combined with Albendazole, remains the mainstay of treatment.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 1","pages":"Pages 167-188"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771033","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":"Sequence analysis of the 5′ region of the chymotrypsin C (CTRC) gene in chronic pancreatitis","authors":"Zain A. Karamya ,&nbsp;Regina Stefanovics ,&nbsp;Máté Sándor ,&nbsp;Réka Madarász ,&nbsp;Adrienn Nagy ,&nbsp;Andrea Szentesi ,&nbsp;Péter Hegyi ,&nbsp;László Czakó ,&nbsp;Balázs Csaba Németh","doi":"10.1016/j.pan.2024.12.020","DOIUrl":"10.1016/j.pan.2024.12.020","url":null,"abstract":"<div><h3>Background/objectives</h3><div>Loss-of-function chymotrypsin C (<em>CTRC</em>) variants increase the risk for chronic pancreatitis (CP) by reducing protective pancreatic CTRC activity. Variants in the 5’ upstream region that includes the promoter might affect <em>CTRC</em> expression but have not been investigated to date. The aim of the present study was to address this knowledge gap.</div></div><div><h3>Methods</h3><div>We analyzed ∼1.4 kb of the 5’ region of the <em>CTRC</em> gene in 293 patients with chronic pancreatitis of alcoholic and non-alcoholic etiology and 402 controls from the Hungarian National Pancreas Registry by direct Sanger sequencing.</div></div><div><h3>Results</h3><div>We identified 14 gene variants, which included 11 novel variants and 3 previously reported variants. When allele frequencies were considered, none of the variants were significantly overrepresented in CP cases or controls. Genotype distribution of the frequently occurring variant c.-913A&gt;G showed a statistically significant enrichment of the homozygous GG genotype (versus the AA genotype) in CP cases versus controls (OR 1.67, 95 % CI 1.2–2.4, <em>P</em> 0.0053). However, the disease association was driven by the linkage disequilibrium with the known <em>CTRC</em> risk variant c.180C&gt;T.</div></div><div><h3>Conclusions</h3><div>We found no significant association between variants in the 5’ region of the <em>CTRC</em> gene and CP risk.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 1","pages":"Pages 65-69"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143144916","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":"Tailoring endoscopy for infected pancreatic necrosis: DEN or PEN or combined?","authors":"Soumya Jagannath Mahapatra MD ,&nbsp;Raj Shah MD","doi":"10.1016/j.pan.2025.01.005","DOIUrl":"10.1016/j.pan.2025.01.005","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 1","pages":"Pages 3-4"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029248","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":"YKL-40 as a risk stratification marker in acute pancreatitis: A prospective study","authors":"Nina Blažević ,&nbsp;Vladimir Trkulja ,&nbsp;Dunja Rogić ,&nbsp;Stipe Pelajić ,&nbsp;Marijana Miler ,&nbsp;Goran Glavčić ,&nbsp;Zvonimir Misir ,&nbsp;Mario Živković ,&nbsp;Marko Nikolić ,&nbsp;Ivan Lerotić ,&nbsp;Neven Baršić ,&nbsp;Davor Hrabar ,&nbsp;Tajana Pavić","doi":"10.1016/j.pan.2024.11.024","DOIUrl":"10.1016/j.pan.2024.11.024","url":null,"abstract":"<div><h3>Background/objectives</h3><div>Increased systemic concentrations of YKL-40 are seen in various inflammatory conditions. We explored the relationship between the serum YKL-40 concentrations and subsequent disease severity in patients with acute pancreatitis (AP).</div></div><div><h3>Methods</h3><div>Consecutive adults with AP were prospectively enrolled, and classified as having mild, moderate or severe disease. On admission and 48 h later, C-reactive protein (CRP), YKL-40, interleukin-6 and 8 (IL-6, IL-8), and tumor necrosis factor alpha (TNF-α) concentrations were measured. Patients were also classified as those with low (&lt;50 ng/mL, in the range seen in 30 age and sex-matched non-AP subjects), high (≥190 ng/mL, seen in most of the other inflammatory conditions), and intermediate YKL-40 (50–189 ng/mL).</div></div><div><h3>Results</h3><div>Incidence of mild, moderate and severe AP among the 150 enrolled patients was 80 (53.3 %), 59 (39.3 %), and 11 (7.4 %), respectively. Both on admission and 48 h later, high YKL-40 (vs. intermediate or low) was strongly associated with higher odds of a more severe AP, independently of the concurrent IL-8 and TNF-α concentrations (OR around 3.5–4.0, or higher). On admission, the association was independent also of the concurrent CRP, whereas the association between the later concentrations and the outcome was conditional on CRP – uncertain at low, strong at high CRP. The high YKL-40 – outcome association at both time-points was conditional on concurrent IL-6: uncertain if IL-6 was low, strong if IL-6 was high.</div></div><div><h3>Conclusions</h3><div>Serum YKL-40 is a plausible candidate for further evaluation as an early biochemical indicator of subsequent AP severity, particularly if considered jointly with CRP and/or IL-6.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 1","pages":"Pages 48-57"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786436","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":"Significant projected savings with expansion of an emergency department observation protocol for mild acute pancreatitis","authors":"Nikhil Thiruvengadam ,&nbsp;Kelsey L. Anderson ,&nbsp;Sunil G. Sheth","doi":"10.1016/j.pan.2024.12.009","DOIUrl":"10.1016/j.pan.2024.12.009","url":null,"abstract":"<div><h3>Background</h3><div>Acute pancreatitis (AP) significantly contributes to healthcare costs, but not all patients require hospitalization. A novel, validated Emergency Department (ED) pathway for mild AP (MAP) at our tertiary care center reduced hospitalizations and resource utilization, without affecting outcomes.</div></div><div><h3>Methods</h3><div>A decision-analytic model was constructed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist and methodologic recommendations by the Second Panel on Cost-Effectiveness in Health and Medicine to predict healthcare costs based on whether an ED discharge protocol for MAP was utilized.</div></div><div><h3>Results</h3><div>Average savings for one MAP discharged from the ED were $1720.5 compared to the standard of care hospitalization. Assuming that 67.7 % of cases are mild and that there are 288,820 hospitalizations for AP annually, the ED discharge pathway would result in $98.6 million direct healthcare savings.</div></div><div><h3>Conclusions</h3><div>Implementation of an evidence-based, protocoled ED pathway for MAP could result in over $100 million in direct healthcare savings.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 1","pages":"Pages 35-38"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896691","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":"Onset of pancreatic cancer before and after acute pancreatitis: A multicenter longitudinal cohort study","authors":"Tamás Hussein ,&nbsp;Péter Mátrai ,&nbsp;Vivien Vass ,&nbsp;Andrea Szentesi ,&nbsp;Péter Hegyi","doi":"10.1016/j.pan.2024.12.007","DOIUrl":"10.1016/j.pan.2024.12.007","url":null,"abstract":"<div><h3>Background</h3><div>Pancreatic cancer (PC) is a leading cause of cancer mortality, often diagnosed at advanced stages. Acute pancreatitis (AP), particularly idiopathic cases, may serve as an early indicator of PC.</div></div><div><h3>Objective</h3><div>This multicenter cohort study investigated the incidence of PC before and after an AP episode, focusing on idiopathic AP and the role of pseudocysts as potential early markers for PC development.</div></div><div><h3>Methods</h3><div>We analyzed data from 2356 AP patients across 25 centers, with a median follow-up of 4.1 years (IQR: 1.6–6.8 years). Patients were categorized into 'PC before AP' and 'PC after AP' groups, and relative risk (RR) and adjusted odds ratios (OR) were calculated for idiopathic AP cases to quantify PC risk.</div></div><div><h3>Results</h3><div>Among all cases, 69 patients (2.9 %) developed PC: 1.4 % (n = 34) before and 1.5 % (n = 35) after AP. Idiopathic AP cases had a fourfold higher risk of PC (OR = 4.46, [2.25–8.85]). Notably, pseudocysts were five times more prevalent in the PC group (14 %) compared to controls (3 %) (RR = 5.66; p &lt; 0.01), often located at the tumor site. PC developed in 3 % of idiopathic AP cases versus 1.0 % in non-idiopathic cases. The median time to PC diagnosis post-AP was 373 days.</div></div><div><h3>Conclusion</h3><div>Idiopathic AP and pseudocyst formation significantly elevate the risk of PC, particularly within two years. These findings underscore the need for structured follow-up and early screening in idiopathic AP cases to improve PC detection and survival outcomes.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 1","pages":"Pages 29-34"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903362","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":"Repeated pancreatic juice cytology via endoscopic nasopancreatic drainage catheter combined with clinical findings improves diagnostic ability for malignant cases of suspected pancreatic cancer with non-identifiable tumors","authors":"Tatsunori Satoh ,&nbsp;Junichi Kaneko ,&nbsp;Eiji Nakatani ,&nbsp;Hirotoshi Ishiwatari ,&nbsp;Junya Sato ,&nbsp;Akihiko Ohata ,&nbsp;Reiko Yamada ,&nbsp;Tetsuro Miwata ,&nbsp;Kazuma Ishikawa ,&nbsp;Fumitaka Niiya ,&nbsp;Yosuke Kobayashi ,&nbsp;Yasushi Hamaya ,&nbsp;Jun Ito ,&nbsp;Kazuhito Kawata ,&nbsp;Azumi Suzuki ,&nbsp;Yasunari Sakamoto ,&nbsp;Yuya Ishiguro ,&nbsp;Haruna Takahashi ,&nbsp;Shinya Kawaguchi","doi":"10.1016/j.pan.2024.11.022","DOIUrl":"10.1016/j.pan.2024.11.022","url":null,"abstract":"<div><h3>Background/objectives</h3><div>The detection of pancreatic cancer (PC) often depends on indirect indicators such as parenchyma atrophy (PPA), main pancreatic duct stenosis, and low echoic areas, particularly when no mass is evident on imaging. While pathological evaluation is the gold standard for differentiating malignant from benign conditions, endoscopic ultrasound-guided fine-needle aspiration/biopsy is not always feasible in such cases. Serial pancreatic juice aspiration cytologic examination (SPACE) via endoscopic nasopancreatic drainage (NPD) has emerged as an alternative diagnostic method, though its accuracy remains underevaluated. This study aimed to evaluate the diagnostic performance of SPACE and explore strategies to enhance its accuracy in diagnosing PC.</div></div><div><h3>Methods</h3><div>This multicenter, retrospective study analyzed patients who underwent SPACE between January 2015 and September 2023. The inclusion criteria focused on cases lacking a clear pancreatic mass but exhibiting indirect signs suggestive of PC. Diagnostic accuracy was determined using surgical pathology or a minimum follow-up period of 12 months as the reference standard.</div></div><div><h3>Results</h3><div>Among 164 patients, 85 (51.8 %) were diagnosed with malignancy. The sensitivity and specificity of SPACE were 74.1 % and 87.3 %, respectively, with a area under the receiver operating characteristic curve (ROC-AUC) of 0.807 (95%CI: 0.748–0.867). Incorporating patient age, CEA and PPA with SPACE results further improved diagnostic performance, yielding a ROC-AUC of 0.828 (95%CI: 0.76–0.897, p = 0.013).</div></div><div><h3>Conclusions</h3><div>Combining SPACE with clinical and imaging findings significantly enhances diagnostic accuracy in suspected PC cases where conventional imaging fails to detect tumors. This integrated approach has the potential to enhance clinical outcomes by facilitating more accurate patient management.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 1","pages":"Pages 125-133"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792165","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":"Impact of islet autotransplantation on 30-day post-operative outcomes in patients undergoing total pancreatectomy: A NSQIP retrospective cohort analysis of 584 patients","authors":"Armin Rouhi,&nbsp;Kevin Verhoeff,&nbsp;Blaire Anderson,&nbsp;Khaled Dajani,&nbsp;David L. Bigam,&nbsp;A.M James Shapiro","doi":"10.1016/j.pan.2024.12.002","DOIUrl":"10.1016/j.pan.2024.12.002","url":null,"abstract":"<div><h3>Background</h3><div>Total pancreatectomy (TP) offers a surgical option for refractory pancreatitis, yet confers substantial long-term morbidity associated with resultant diabetes. While total pancreatectomy with islet autotransplantation (TPIAT) offers an intuitive solution, data evaluating its safety have been limited to single-center studies. The aim of this study is to evaluate whether the addition of islet autotransplantation to TP confers additional post-operative morbidity within the 30-day post-operative period.</div></div><div><h3>Methods</h3><div>This is a retrospective cohort study of prospectively collected cases from the National Surgical Quality Improvement Program (NSQIP) database. Cases of TP with or without islet autotransplantation from 2016 to 2021 were included. Baseline demographics, and a comprehensive list of 30-day postoperative outcomes were evaluated. Multivariable logistic regression models were constructed to evaluate the impact of each factor on 30-day complications.</div></div><div><h3>Results</h3><div>A total of 584 cases were included with 171 (29.2 %) patients undergoing TPIAT. TPIAT patients were younger (58.8 vs. 39.5; p &lt; 0.0001), and had lower incidences of pre-existing diabetes (41.4 % vs. 19.9 %; p &lt; 0.0001) and hypertension (48.2 % vs. 24.6 %; p &lt; 0.0001). TPIAT cohort had longer length of stay (10.3 days vs.12.2 days; p = 0.0006). There was no difference in overall rates of serious complications between the two cohorts (50.1 % vs. 45.0 %; p = 0.263). After adjusting for demographic differences between cohorts using multivariable logistic regression models, TPIAT was not associated with serious complications (OR 0.71; p = 0.168) compared to TP alone.</div></div><div><h3>Conclusion</h3><div>The results from this study suggest that TPIAT does not appear to be associated with increased 30-day morbidity, and should be considered in patients to mitigate the long-term morbidity associated with diabetes mellitus post TP.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 1","pages":"Pages 147-152"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854756","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":"Author’s reply to the Letter to Editor regarding “Exploring the Role of Neoadjuvant Therapy for Resectable Pancreatic Cancer”","authors":"S. Yamada,&nbsp;D. Hashimoto,&nbsp;S. Satoi","doi":"10.1016/j.pan.2024.11.017","DOIUrl":"10.1016/j.pan.2024.11.017","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 1","pages":"Page 189"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771006","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 Editor regarding “Autoimmune pancreatitis associated with severe postoperative pneumonia”","authors":"Gyula Farkas Jr.,&nbsp;Gábor Demeter,&nbsp;György Lázár","doi":"10.1016/j.pan.2024.12.004","DOIUrl":"10.1016/j.pan.2024.12.004","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 1","pages":"Page 190"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818883","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}