Pancreatology最新文献

{"title":"Efficiency evaluation of dual-energy CT to predict the postoperative early recurrence of pancreatic ductal adenocarcinoma","authors":"Si-Yao Yu ,&nbsp;Yu-Ping Shu ,&nbsp;Xiao-Han Bai ,&nbsp;Jing Yu ,&nbsp;Zi-Peng Lu ,&nbsp;Kui-Rong Jiang ,&nbsp;Qing Xu","doi":"10.1016/j.pan.2024.09.012","DOIUrl":"10.1016/j.pan.2024.09.012","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the efficacy of quantitative parameters from dual-energy CT (DECT) and basic CT features in predicting the postoperative early recurrence (ER) of pancreatic ductal adenocarcinoma (PDAC).</div></div><div><h3>Methods</h3><div>In this study, patients with PDAC who underwent radical resection and DECT from 2018 to 2022 were enrolled and categorised into ER and non-ER groups. The clinical data, basic CT features and DECT parameters of all patients were analyzed. Independent predictors of ER were identified with Logistic regression analyses. Three models (model A: basic CT features; model B: DECT parameters; model C: basic CT features + DECT parameters) were established. Receiver operating characteristic curve analysis was utilized to evaluate predictive performance.</div></div><div><h3>Results</h3><div>A total of 150 patients were enrolled (ER group: n = 63; non-ER group: n = 87). Rim enhancement (odds ratio [OR], 3.32), peripancreatic strands appearance (OR, 2.68), electron density in the pancreatic parenchymal phase (P-Rho; OR, 0.90), arterial enhancement fraction (AEF; OR, 0.05) and pancreatic parenchyma fat fraction in the delayed phase (OR, 1.25) were identified as independent predictors of ER. Model C showed the highest area under the curve of 0.898. In addition, the corresponding ER risk factors were identified separately for resectable and borderline resectable PDAC subgroups.</div></div><div><h3>Conclusions</h3><div>DECT quantitative parameters allow for the noninvasive prediction of postoperative ER in patients with PDAC, and the combination of DECT parameters and basic CT features shows a high prediction efficiency. Our model can help to identify patients with high-risk factors to guide preoperative decision making.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"24 7","pages":"Pages 1123-1132"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351776","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":"Molecular aspects of BRAF and HER2 in prognosis of periampullary carcinoma","authors":"Apurva ,&nbsp;Nimisha ,&nbsp;Abhay Kumar Sharma ,&nbsp;Arun Kumar ,&nbsp;Ejaj Ahmad ,&nbsp;Seneha Santoshi ,&nbsp;Sundeep Singh Saluja","doi":"10.1016/j.pan.2024.08.009","DOIUrl":"10.1016/j.pan.2024.08.009","url":null,"abstract":"<div><h3>Background</h3><div>Biological behaviour of Periampullary cancers (PACS) differs from pancreatic head cancer, and analysis of molecular alteration is needed. BRAF and HER2 are keys members of the RAS/RAF and EGFR pathway, playing roles in prognostic markers and therapeutic targets.</div></div><div><h3>Methods</h3><div>A study on 89 PACS patients, undergoing Whipple Pancreaticoduodenectomy, PCR-RFLP, and qPCR methods used for SNP and mRNA expression studies. Clinicopathological and survival data collected. Molecular changes were correlated with Clinicopathological parameters. Survival outcomes were assessed by Kaplan Meir Log rank test.</div></div><div><h3>Results</h3><div>The study revealed that homozygous mutant BRAF V600E was significantly higher in PAC compared to a healthy control (p = 0.0012). Whereas the genotype frequency of HER2 I1655V was similar among PAC and healthy control. The A &gt; G change in HER2 was associated with tumor arising from duodenum (p = 0.004) and showed poor survival outcome (p = 0.001). Upregulation of BRAF and HER2 was found in 43 % of patients with synergistic effect, the median overall survival (OS) being 50.5 ± 13 months. The increased expression of HER2 was higher in early stage (p = 0.04) PAC. The gene expression did not impact the OS, whereas female gender, G3 tumors, T3-T4 depth of tumour, advanced stage, LN metastasis, LVI and PNI were poor predictors of OS.</div></div><div><h3>Conclusions</h3><div>BRAF V600E SNP was associated with disease susceptibility, and had increased mRNA expression while HER2 I1655V SNP was associated with poor survival outcome in PAC. The increased expression of BRAF and HER2 in early tumors and their co-expression in PAC exhibit cross talk between RAS/RAF and EGFR pathway in PAC.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"24 7","pages":"Pages 1084-1096"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142081196","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":"Pancreatitis pain quality changes at year 1 follow-up, but GP130 remains a biomarker for pain","authors":"Jami L Saloman ,&nbsp;Kristofer Jennings ,&nbsp;Kimberly Stello ,&nbsp;Shuang Li ,&nbsp;Anna Evans Phillips ,&nbsp;Kristen Hall ,&nbsp;Evan L. Fogel ,&nbsp;Santhi Swaroop Vege ,&nbsp;Dana K. Andersen ,&nbsp;William E. Fisher ,&nbsp;Christopher E. Forsmark ,&nbsp;Phil A. Hart ,&nbsp;Stephen J. Pandol ,&nbsp;Walter G. Park ,&nbsp;Mark D. Topazian ,&nbsp;Stephen K. Van Den Eeden ,&nbsp;Jose Serrano ,&nbsp;Darwin L. Conwell ,&nbsp;Liang Li ,&nbsp;Dhiraj Yadav","doi":"10.1016/j.pan.2024.09.016","DOIUrl":"10.1016/j.pan.2024.09.016","url":null,"abstract":"<div><h3>Background/objectives</h3><div>Debilitating abdominal pain is a common symptom affecting patients with chronic pancreatitis (CP). CP pain is dynamic due to multiple underlying mechanisms. <em>The objective of this study was to 1) evaluate changes in pain phenotype at one year follow-up and 2) validate putative pain biomarkers in a prospective cohort study</em>.</div></div><div><h3>Methods</h3><div>The Neuropathic and Nociceptive PROMIS-PQ questionnaires were used to classify pain for participants with in the PROCEED study. Putative serum biomarkers were measured via immunoassay.</div></div><div><h3>Results</h3><div>At enrollment, 17.6 % (120/681) subjects with CP reported no pain in the previous year. Of those, 29 % experienced pain during the 1 yr follow-up whereas 18 % of those with pain prior to enrollment reported no pain during the 1 yr follow-up period. Of the 393 subjects with PROMIS-PQ data at enrollment, 212 also had follow-up data at 1 yr. Approximately half (53.3 %) of those individuals changed pain phenotype between baseline and follow-up. At 1 yr, serum TGFβ1 level was negatively correlated with nociceptive T-scores (p = 0.006). GP130 was significantly correlated with both nociceptive (p = 0.012) and neuropathic T-scores (p = 0.043) at 1 yr, which is consistent with the previously published findings.</div></div><div><h3>Conclusions</h3><div>The positive association between TGFβ1 and pain is not maintained over time, suggesting it is a poor pain biomarker. However, serum GP130 is a consistent biomarker for mixed-type pain in CP. Preclinical studies show that targeting TGFβ1 or IL-6 (ligand for GP130) is sufficient to inhibit CP pain supporting further investigation of this as a potential therapeutic target.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"24 7","pages":"Pages 993-1002"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351777","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":"Imbalance in the vWF – ADAMTS13 axis exists early in acute pancreatitis and predicts persistent organ failure and pancreatic necrosis-a prospective study","authors":"P.S. Sairam ,&nbsp;Sudipta Dhar Chowdhury ,&nbsp;Ajith Thomas ,&nbsp;Anoop John ,&nbsp;Rajeeb Jaleel ,&nbsp;Reuben Thomas Kurien ,&nbsp;Amit Kumar Dutta ,&nbsp;Ebby George Simon ,&nbsp;Tulasi Geevar ,&nbsp;Sukesh Chandran Nair ,&nbsp;Reka Karuppusami ,&nbsp;C.E. Eapen ,&nbsp;Anjilivelil Joseph Joseph","doi":"10.1016/j.pan.2024.06.011","DOIUrl":"10.1016/j.pan.2024.06.011","url":null,"abstract":"<div><h3>Background</h3><div><span>The pathophysiology<span> of Acute Pancreatitis (AP) may be complicated by endothelial activation. </span></span>von Willebrand Factor<span><span> (vWF)- ADAMTS13 axis is a marker of endothelial activation. The study aimed to investigate the axis in AP, comparing it in patients with and without persistent organ failure (OF), with and without </span>pancreatic necrosis, and correlating it with the standard severity scores (CRP, APACHE II, BISAP, SOFA, and qSOFA)</span></div></div><div><h3>Methods</h3><div>vWF-Antigen (vWF:Ag), vWF-Collagen-Binding-Assay (vWF:CBA), and ADAMTS13 activity (ADAMTS13:act) levels were measured within 5 days of symptom onset in consecutive patients (n = 98), who were admitted with a first episode of AP (Dec 2021–May 2023).</div></div><div><h3>Results</h3><div><span>Of the 98 patients admitted with AP, 78(79.6 %) had no or transient OF; 20(20.4 %) had persistent OF. Age was comparable (43.73 ± 15.36 vs 38.65 ± 13.69) [mean ± SD](years), and males were predominant in both groups (70.5 % vs 80 %). Patientswith persistent OF had higher vWF:CBA(%)[323(279–486.5) vs 199.5(159.1–295.75)] and lower ADAMTS13:act(%)[35.4(23.8–56.85) vs 56.35(44.1–71.9)][median (25th – 75th percentile)](P = 0.001) than those with no or transient OF. Patients with </span>pancreatic necrosis (n = 19) had lower ADAMTS13:act(%)[42.79 ± 18.69] than those without pancreatic necrosis (n = 18) [62.49 ± 22.64] (P &lt; 0.01). ADAMTS13:act had a negative correlation(r = −0.2), whereas vWF:Ag and vWF:CBA had a positive correlation (r = 0.2) with the standard severity scores (P &lt; 0.05). ADAMTS13:act could predict pancreatic necrosis [AUROC-0.737, P &lt; 0.05] and persistent OF [AUROC–0.746, P &lt; 0.001], while vWF:CBA could predict persistent OF [AUROC– 0.73, P &lt; 0.001].</div></div><div><h3>Conclusion</h3><div>vWF-ADAMTS13 axis helps to predict severe disease and is associated with poor outcomes in acute pancreatitis.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"24 7","pages":"Pages 986-992"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141498712","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":"vWF-ADAMTS13 axis in acute pancreatitis: Unveiling the hidden player or a mere bystander?","authors":"Deepak Gunjan,&nbsp;Venkata S. Akshintala","doi":"10.1016/j.pan.2024.09.005","DOIUrl":"10.1016/j.pan.2024.09.005","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"24 7","pages":"Pages 983-985"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252012","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":"Prediction of pancreatic cancer in patients with new onset hyperglycemia: A modified ENDPAC model","authors":"Wansu Chen ,&nbsp;Botao Zhou ,&nbsp;Tiffany Q. Luong ,&nbsp;Eva Lustigova ,&nbsp;Fagen Xie ,&nbsp;Lynn M. Matrisian ,&nbsp;Bechien U. Wu","doi":"10.1016/j.pan.2024.09.015","DOIUrl":"10.1016/j.pan.2024.09.015","url":null,"abstract":"<div><h3>Background/Objectives</h3><div>The Enriching New-Onset Diabetes for Pancreatic Cancer (ENDPAC) model relies primarily on fasting glucose values. Health systems have increasingly shifted practice towards use of glycated hemoglobin (HbA1c) measurement. We modified the ENDPAC model using patients with new onset hyperglycemia.</div></div><div><h3>Methods</h3><div>Four cohorts of patients 50–84 years of age with HbA1c results ≥6.2–6.5 % in 2011–2018 were identified. A combine cohort was formed. A widened eligibility criterion was applied to form additional four individual cohorts and one combined cohort. The primary outcome was the diagnosis of pancreatic cancer within 3 years after the first elevated HbA1c testing. The performance of the modified ENDPAC model was evaluated by AUC, sensitivity, positive predictive value, cases detected, and total number of patients screened.</div></div><div><h3>Results</h3><div>The individual and combined cohorts consisted of 39,001–79,060 and 69,334–92,818 patients, respectively (mean age 63.5–65.0 years). The three-year PC incidence rates were 0.47%–0.54 %. The AUC measures were in the range of 0.75–0.77 for the individual cohorts and 0.75 for the combined cohorts. When the four individual cohorts were combined, more PC cases can be identified (149 by the combined vs. 113–116 by individual cohorts when risk score was 5+). Performance measures were compromised in nonwhites. Asian and Pacific islanders had lower sensitivity compared to other racial and ethnic groups (29 % vs. 50–60 %) when risk score was 5+.</div></div><div><h3>Conclusions</h3><div>The modified ENDPAC model targets a broader population and thus identifies more high-risk patients for cancer screening. The differential performance needs to be considered when the model is applied to non-white population.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"24 7","pages":"Pages 1115-1122"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366204","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 regarding ‘EUS guided cyst Ablation of intraductal papillary mucinous neoplasm of the pancreas’","authors":"Matthew T. Moyer,&nbsp;Charles E. Dye,&nbsp;Brandon Rodgers","doi":"10.1016/j.pan.2024.07.010","DOIUrl":"10.1016/j.pan.2024.07.010","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"24 7","pages":"Pages 1199-1200"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996267","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":"Prognostic significance of involvement of the circumferential resection margin/surface in patients with pancreatic head cancer: A prospective evaluation of pancreatoduodenectomy specimens using the 0 and 1 mm rules","authors":"Moonhwan Kim ,&nbsp;Jun Suh Lee ,&nbsp;Boram Lee ,&nbsp;Yeongsoo Jo ,&nbsp;Haeryoung Kim ,&nbsp;Hee Young Na ,&nbsp;Yangkyu Lee ,&nbsp;Soomin Ahn ,&nbsp;Ji-Young Choe ,&nbsp;Ho-seong Han ,&nbsp;Yoo-Seok Yoon","doi":"10.1016/j.pan.2024.09.003","DOIUrl":"10.1016/j.pan.2024.09.003","url":null,"abstract":"<div><h3>Background/Objectives</h3><div>The prognostic significance of circumferential resection margin (CRM) or circumferential surface (CS) in pancreatic head cancer is controversial. We investigated the survival outcomes according to CRM or CS involvement in pancreatoduodenectomy specimens of pancreatic ductal adenocarcinoma (PDAC).</div></div><div><h3>Methods</h3><div>A total of 102 pancreatoduodenectomy specimens after upfront surgery for PDAC between 2014 and 2018 were prospectively collected. The superior mesenteric vein/portal vein or superior mesenteric artery margins were classified as CRM, and the anterior or posterior surfaces as CS. Survival outcomes and recurrence were compared according to the CRM/CS status, which was categorized into R1_0mm, R1_1mm, and R0 (≥1 mm) by the 0 and 1 mm rules.</div></div><div><h3>Results</h3><div>For CRM, R1_0mm had significantly lower overall survival (OS) (<em>P</em> &lt; 0.001) and disease-free survival (<em>P</em> &lt; 0.001) rates than R1_1mm and R0, with no difference between R1_1mm and R0. For CS, R0 had a significantly higher OS rate (<em>P</em> &lt; 0.001) than R1_0mm and R1_1mm, with no difference between R1_0mm and R1_1mm. In multivariable analysis, R1_0mm CRM was an independent risk factor for OS (hazard ratio 2.410, <em>P</em> = 0.003) and DFS (hazard ratio 5.019, <em>P</em> &lt; 0.001). When CRM/CS were analyzed separately, only the R1_0mm superior mesenteric artery margin was significantly associated with local recurrence (<em>P</em> = 0.012).</div></div><div><h3>Conclusions</h3><div>The results suggest that CRM involvement defined by the 0 mm rule is more appropriate than the 1 mm rule for predicting survival outcomes, but CS involvement defined by the 0 or 1 mm rules is not prognostically significant.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"24 7","pages":"Pages 1040-1048"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142178149","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":"A pilot study of chlorambucil in pre-treated metastatic pancreatic adenocarcinoma patients bearing germline BRCA or other DNA damage repair system variants","authors":"Catia Carconi ,&nbsp;Carlo Bosi ,&nbsp;Mario Scartozzi ,&nbsp;Massimiliano Cergnul ,&nbsp;Marika Cinausero ,&nbsp;Luca Faloppi ,&nbsp;Ingrid Garajova ,&nbsp;Sara Lonardi ,&nbsp;Irene Pecora ,&nbsp;Laura Pisanu ,&nbsp;Rosella Spadi ,&nbsp;Andrea Spallanzani ,&nbsp;Umberto Peretti ,&nbsp;Marina Macchini ,&nbsp;Giulia Orsi ,&nbsp;Michele Reni","doi":"10.1016/j.pan.2024.09.006","DOIUrl":"10.1016/j.pan.2024.09.006","url":null,"abstract":"<div><h3>Backgorund</h3><div>Pancreatic adenocarcinoma remains a malignancy with a grim prognosis and scarce personalized treatment options. Pathogenic variants of DNA damage repair (DDR) genes are emerging as molecular targets, as they confer a higher sensitivity to DNA-damaging agents. This study aimed at assessing the activity of chlorambucil as salvage therapy in metastatic pancreatic cancer patients bearing a germline pathogenetic variant or variant of uncertain significance on a DDR-related gene.</div></div><div><h3>Methods</h3><div>Platinum-pretreated metastatic pancreatic cancer patients harbouring a germline variant on a DDR gene received chlorambucil at a daily oral dose of 6 mg/m² for 42 every 56 days for the first cycle and for 14 every 28 days for the following cycles, until disease progression or unacceptable toxicity. The primary endpoint was 6-month progression-free survival rate (PFS-6). Median progression-free survival (PFS) and overall survival (OS) were secondarily described.</div></div><div><h3>Results</h3><div>Twenty patients were enrolled between December 2020 and September 2022. PFS-6 was 5%, median PFS and OS were 1.6 months and 3.0 months, respectively. Grade-3 adverse events were observed in 25% of patients, while no Grade-4 toxicity was reported.</div></div><div><h3>Conclusions</h3><div>Single agent chlorambucil did not show sufficient signal of activity to warrant its further investigation in metastatic pancreatic cancer patients bearing a DDR-related germline alteration.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"24 7","pages":"Pages 1066-1072"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142268451","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":"Increased kidney stone risk following total pancreatectomy with islet autotransplantation","authors":"Nandini Avula ,&nbsp;James S. Hodges ,&nbsp;Gregory Beilman ,&nbsp;Srinath Chinnakotla ,&nbsp;Martin L. Freeman ,&nbsp;Karthik Ramanathan ,&nbsp;Sarah Jane Schwarzenberg ,&nbsp;Guru Trikudanathan ,&nbsp;Melena D. Bellin ,&nbsp;Elissa M. Downs","doi":"10.1016/j.pan.2024.09.004","DOIUrl":"10.1016/j.pan.2024.09.004","url":null,"abstract":"<div><h3>Background/objectives</h3><div>Chronic pancreatitis (CP) is associated with increased risk of calcium-oxalate kidney stones, likely due to enteric hyperoxaluria. However, the risk of kidney stones for patients with CP after total pancreatectomy with islet autotransplantation (TPIAT) is unknown. We aimed to evaluate kidney stone risk in patients with CP after TPIAT.</div></div><div><h3>Methods</h3><div>A retrospective analysis of 629 patients who underwent TPIAT was conducted to identify patients who developed kidney stones post-TPIAT. Kaplan-Meier analysis estimated time to first event. An Anderson-Gill proportional-hazards analysis of all kidney stone events described key clinical associations.</div></div><div><h3>Results</h3><div>Mean age at TPIAT was 33 years (SD 15.3, range 3–69); 69.8 % (n = 439) were female. The estimated chance of any kidney stone episodes by 5 years post-TPIAT was 12.8 % (95 % CI: 8.8–16.6 %); by 10 years, 23.2 % (CI: 17.5–28.6 %); by 15 years, 29.4 % (CI: 21.8–36.2 %). Significant associations with kidney stones post-TPIAT included older age (HR 1.25 per 10 years), smoking history (HR 1.72), mild chronic kidney disease (HR 1.96), renal cysts (HR 3.67), pre-TPIAT kidney stones (HR 4.06), family history of kidney stones (HR 4.10), and Roux-en-Y reconstruction (HR 2.68). Of the 77 patients who developed kidney stones, 34 (44.1 %) had recurrent episodes. Of 143 total kidney stone events, 35 (24.5 %) required stone removal, 79 (55.2 %) resolved spontaneously, and 29 (20.3 %) were missing this data.</div></div><div><h3>Conclusions</h3><div>Patients with CP post-TPIAT commonly have kidney stones: nearly 3 in 10 have ≥1 kidney stone episodes within 15 years. Clinicians should be aware of this risk and counsel patients on prevention.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"24 7","pages":"Pages 1167-1173"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293111","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}