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REVIEW
Toshiharu Ueki, Toru Maruo, Yoshinori Igarashi, Akira Yamamiya, Keiichi Tominaga, Atsushi Irisawa, Hitoshi Yoshida, Terumi Kamisawa, Mamoru Takenaka, Hiroyuki Isayama
The progress of endoscopic diagnosis and treatment for inflammatory diseases of the biliary tract and pancreas have been remarkable. Endoscopic ultrasonography (EUS) and EUS-elastography are used for the diagnosis of early chronic pancreatitis and evaluation of endocrine and exocrine function in chronic pancreatitis. Notably, extracorporeal shock wave lithotripsy and electrohydraulic shock wave lithotripsy have improved the endoscopic stone removal rate in patients for whom pancreatic stone removal is difficult...
March 12, 2024: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
#22
REVIEW
Alejandra Vargas, Priyata Dutta, Eileen S Carpenter, Jorge D Machicado
Pancreatic cancer is on the rise and expected to become the second leading cause of cancer-related death by 2030. Up to a one-fifth of pancreatic cancers may arise from mucinous pancreatic cysts, which are frequently present in the general population. Currently, surgical resection is the only curative approach for pancreatic cancer and its cystic precursors. However, only a dismal proportion of patients are eligible for surgery. Therefore, novel treatment approaches to treat pancreatic cancer and precancerous pancreatic cysts are needed...
March 6, 2024: Diagnostics
#23
JOURNAL ARTICLE
Tian Yang, Jing Feng, Ruchen Yao, Qi Feng, Jun Shen
OBJECTIVES: Predicting secondary loss of response (SLR) to infliximab (IFX) is paramount for tailoring personalized management regimens. Concurrent pancreatic manifestations in patients with Crohn's disease (CD) may correlate with SLR to anti-tumor necrosis factor treatment. This work aimed to evaluate the potential of pancreatic radiomics to predict SLR to IFX in biologic-naive individuals with CD. METHODS: Three models were developed by logistic regression analyses to identify high-risk subgroup prone to SLR...
March 13, 2024: Insights Into Imaging
#24
Rekha Patidar, Krishi Gowdra Revannasiddappa, Muniza Ghazanfer
Acute fatty liver of pregnancy (AFLP) is a rare, potentially fatal obstetric emergency. Due to its nonspecific signs and symptoms, there is often a delay in diagnosis and management which is associated with morbid complications and high mortality. We report a case of a 30-year-old female gravida 3 para 2 at 32 weeks gestation who presented with nausea and vomiting for two weeks, pruritis for three days, and upper abdomen pain for a day. A clinical diagnosis of HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome/obstetric cholestasis/AFLP was made...
February 2024: Curēus
#25
JOURNAL ARTICLE
Shehara Mendis, Lara Lipton, Yat Hang To, Sumitra Ananda, Michael Michael, Sue-Anne McLachlan, Benjamin Thomson, Benjamin Loveday, Brett Knowles, Adrian Fox, Mehrdad Nikfarjam, Val Usatoff, Julia Shapiro, Kate Clarke, Sharon Pattison, Cheng Ean Chee, Rob Zielinski, Rachel Wong, Peter Gibbs, Belinda Lee
BACKGROUND: Pancreatic cancer incidence is increasing in younger populations. Differences between early onset pancreatic cancer (EOPC) and later onset pancreatic cancer (LOPC), and how these should inform management warrant exploration in the contemporary setting. METHODS: A prospectively collected multi-site dataset on consecutive pancreatic adenocarcinoma patients was interrogated. Patient, tumour, treatment, and outcome data were extracted for EOPC (≤50 years old) vs LOPC (>50 years old)...
March 6, 2024: British Journal of Cancer
#26
Kazuna Matsutani, Yasuto Kinose, Mayuko Kato, Michiko Kodama, Kenjiro Sawada, Tadashi Kimura
Pancreatic fistulas are rare after gynecologic surgeries but are sometimes difficult to manage. A 62-year-old woman was admitted to a local hospital with acute abdominal pain. Computed tomography (CT) images showed subileus and an obstruction site in the transverse/descending colon, with invasion of peritoneal metastasis. A metal stent was placed in the bowel through colonoscopy. Suspecting advanced-stage ovarian cancer, the patient was referred to a tertiary hospital. Diagnostic laparoscopy was performed prior to neoadjuvant chemotherapy...
March 2024: Case Reports in Women's Health
#27
REVIEW
Xiaorong Ye, Yue Yu, Xiaohu Zheng, Hongdi Ma
Pancreatic cancer remains a challenging disease with limited treatment options, resulting in high mortality rates. The predominant approach to managing pancreatic cancer patients continues to be systemic cytotoxic chemotherapy. Despite substantial advancements in immunotherapy strategies for various cancers, their clinical utility in pancreatic cancer has proven less effective and durable. Whether administered as monotherapy, employing immune checkpoint inhibitors, tumor vaccines, chimeric antigen receptors T cells, or in combination with conventional chemoradiotherapy, the clinical outcomes remain underwhelming...
March 2, 2024: Cancer Immunology, Immunotherapy: CII
#28
REVIEW
Thomas I Hirsch, Sarah Z Wang, Scott C Fligor, Mikayla Quigley, Kathleen M Gura, Mark Puder, Savas T Tsikis
Fat malabsorption is central to the pathophysiology of short bowel syndrome (SBS). It occurs in patients with insufficient intestinal surface area and/or function to maintain metabolic and growth demands. Rapid intestinal transit and impaired bile acid recycling further contribute to fat malabsorption. A significant portion of patients require parenteral nutrition (PN) for their survival but may develop sepsis and liver dysfunction as a result. Despite advancements in the treatment of SBS, fat malabsorption remains a chronic issue for this vulnerable patient population...
April 2024: Nutrition in Clinical Practice
#29
REVIEW
Catherine M McDonald, Elizabeth K Reid, John F Pohl, Tatiana K Yuzyuk, Laura M Padula, Kay Vavrina, Kimberly Altman
Cystic fibrosis (CF) is a progressive, genetic, multi-organ disease affecting the respiratory, digestive, endocrine, and reproductive systems. CF can affect any aspect of the gastrointestinal (GI) tract, including the esophagus, stomach, small intestine, colon, pancreas, liver, and gall bladder. GI pathophysiology associated with CF results from CF membrane conductance regulator (CFTR) dysfunction. The majority of people with CF (pwCF) experience exocrine pancreatic insufficiency resulting in malabsorption of nutrients and malnutrition...
April 2024: Nutrition in Clinical Practice
#30
REVIEW
Mengyuan Liu, Alice C Wei
A multimodality approach, which usually includes chemotherapy, surgery, and/or radiotherapy, is optimal for patients with localized pancreatic cancer. The timing and sequence of these interventions depend on anatomic resectability and the biological suitability of the tumor and the patient. Tumors with vascular involvement (ie, borderline resectable/locally advanced) require surgical reassessments after therapy and participation of surgeons familiar with advanced techniques. When indicated, venous reconstruction should be offered as standard of care because it has acceptable morbidity...
February 29, 2024: Hematology/oncology Clinics of North America
#31
JOURNAL ARTICLE
Juanjuan Zhu, Yangyang Wang, Yuting Li, Yingjie Chen, Fangyan Lu
BACKGROUND: Post-operative diarrhoea is a common adverse event after pancreatic surgery. While the risk factors for this condition have been identified, the increasing trend of administering chemotherapy before surgery might change these factors. This study aimed to identify the risk factors of post-operative diarrhoea in patients with pancreatic ductal adenocarcinoma (PDAC) who underwent neoadjuvant chemotherapy. DESIGN: A retrospective cohort study. METHODS: Patients who underwent neoadjuvant chemotherapy and pancreatectomy because of PDAC between 2021 and 2023 were included...
March 1, 2024: Journal of Clinical Nursing
#32
Dhruv Patel, Furqan A Bhullar, Ariana R Tagliaferri, Gabriel Melki, Matthew A Grossman
Pancreatic cancer is one of the most fatal malignancies due to its advanced stages at the time of presentation. Often, it is only diagnosed when patients present with late-stage complications, such as gastric outlet obstruction (GOO). Many patients experience a poor quality of life due to the side effects of GOO, such as persistent nausea, vomiting, and an inability to tolerate an oral diet, and as such, patients deteriorate quickly after their diagnosis. Because pancreatic cancer is diagnosed at advanced stages, many patients are not surgical candidates, and thus treatment is tailored for palliative measures...
January 2024: Curēus
#33
JOURNAL ARTICLE
T Enzler, A Nguyen, J Misleh, V J Cline, M Johns, N Shumway, S Paulson, R Siegel, T Larson, W Messersmith, D Richards, J Chaves, E Pierce, M Zalupski, V Sahai, D Orr, S A Ruste, A Haun, T Kawabe
BACKGROUND: There is no standard of care for ≥ 3rd-line treatment of metastatic pancreatic adenocarcinoma (PDAC). CBP501 is a novel calmodulin-binding peptide that has been shown to enhance the influx of platinum agents into tumor cells and tumor immunogenicity. This study aimed to (1) confirm efficacy of CBP501/cisplatin/nivolumab for metastatic PDAC observed in a previous phase 1 study, (2) identify combinations that yield 35% 3-month progression-free survival rate (3MPFS) and (3) define the contribution of CBP501 to the effects of combination therapy...
February 22, 2024: European Journal of Cancer
#34
REVIEW
J Boustani, F Huguet, V Vendrely
Gastrointestinal cancers are one of the most frequent cancers and a leading cause of cancer deaths worldwide. We provide an overview of the most important practice-changing trials that were either published or presented at the international scientific meetings in 2021-2023. Highlights included reports on three phase III trials (CONCORDE/PRODIGE 26, ARTDECO, and a study by Xu et al.) that evaluated dose escalation in the definitive setting for locally advanced oesophageal cancers, as well as two phase III trials that evaluated the role of chemotherapy (neo-AEGIS) and targeted therapy (NRG/RTOG 1010) in the neoadjuvant setting for adenocarcinoma oesophageal cancers or gastroesophageal junction cancer...
December 2023: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
#35
REVIEW
O Joe Hines, Stephen J Pandol
Chronic pancreatitis results from repeated episodes of pancreatic inflammation and associated fibrosis leading to the loss of functional exocrine and endocrine pancreatic function. The disease is manifested by abdominal pain, deterioration in quality of life, food maldigestion and malabsorption, diabetes, and an increased risk for pancreatic adenocarcinoma. This review summarizes the latest evidence on the diagnosis and management of chronic pancreatitis and its manifestations. In particular, this review discusses advances in understanding of the role of genetic disorders in the mechanisms of the disease and surgical options for patients refractory to medical therapy...
February 26, 2024: BMJ: British Medical Journal
#36
JOURNAL ARTICLE
Ugo Boggi, Emanuele Kauffmann, Niccolò Napoli, S George Barreto, Marc G Besselink, Giuseppe K Fusai, Thilo Hackert, Mohammad Abu Hilal, Giovanni Marchegiani, Roberto Salvia, Shailesh Shrikhande, Mark Truty, Jens Werner, Christopher Wolfgang, Elisa Bannone, Giovanni Capretti, Alice Cattelani, Alessandro Coppola, Alessandro Cucchetti, Davide De Sio, Armando Di Dato, Giovanna Di Meo, Claudio Fiorillo, Cesare Gianfaldoni, Michael Ginesini, Camila Hidalgo Salinas, Quirino Lai, Mario Miccoli, Roberto Montorsi, Michele Pagnanelli, Andrea Poli, Claudio Ricci, Francesco Sucameli, Domenico Tamburrino, Virginia Viti, Pietro F Addeo, Sergio Alfieri, Philippe Bachellier, Gianluca Baiocchi, Gianpaolo Balzano, Linda Barbarello, Alberto Brolese, Juli Busquets, Giovanni Butturini, Fabio Caniglia, Damiano Caputo, Riccardo Casadei, Xi Chunhua, Ettore Colangelo, Andrea Coratti, Francesca Costa, Francesco Crafa, Raffaele Dalla Valle, Luciano De Carlis, Roeland F de Wilde, Marco Del Chiaro, Fabrizio Di Benedetto, Pierluigi Di Sebastiano, Safi Domak, Melissa Hogg, Vyacheslav I Egorov, Giorgio Ercolani, Giuseppe Maria Ettorre, Massimo Falconi, Giovanni Ferrari, Alessandro Ferrero, Marco Filauro, Alessandro Giardino, Gian Luca Grazi, Salvatore Gruttaduaria, Jakob R Izbicki, Elio Jovine, Matthew Katz, Tobias Keck, Igor Khatkov, Gozo Kiguchi, David Kooby, Hauke Lang, Carlo Lombardo, Giuseppe Malleo, Marco Massani, Vincenzo Mazzaferro, Riccardo Memeo, Yi Miao, Kohei Mishima, Carlo Molino, Yuichi Nagakawa, Masafumi Nakamura, Bruno Nardo, Fabrizio Panaro, Claudio Pasquali, Vittorio Perrone, Elena Rangelova, Long Riu, Renato Romagnoli, Raffaele Romito, Edoardo Rosso, Richard Schulick, Ajith Siriwardena, Marcello Spampinato, Oliver Strobel, Mario Testini, Roberto Troisi, Faik G Uzunoglo, Roberto Valente, Luigi Veneroni, Alessandro Zerbi, Emilio Vicente, Fabio Vistoli, Marco Vivarelli, Go Wakabayashi, Giacomo Zanus, Amer Zureikat, Nicholas J Zyromski, Roberto Coppola, Vito D'Andrea, José Davide, Christos Dervenis, Isabella Frigerio, Kevin C Konlon, Fabrizio Michelassi, Marco Montorsi, William Nealon, Nazario Portolani, Donzília Sousa Silva, Giuseppe Bozzi, Viviana Ferrari, Maria G Trivella, John Cameron, Pierre-Alain Clavien, Horacio J Asbun
OBJECTIVE: The REDISCOVER consensus conference aimed at developing and validate guidelines on the perioperative care of patients with borderline resectable (BR-) and locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC). SUMMARY BACKGROUND DATA: Coupled with improvements in chemotherapy and radiation, the contemporary approach to pancreatic surgery supports resection of BR-PDAC and, to a lesser extent, LA-PDAC. Guidelines outlining the selection and perioperative care for these patients are lacking...
February 26, 2024: Annals of Surgery
#37
REVIEW
Chao Han, Yan-Wei Lv, Liang-Hao Hu
As a progressive fibroinflammatory disease, chronic pancreatitis (CP) often manifests as recurrent bouts of abdominal pain with or without complications, causing a heavy burden of health care. In recent years, some meaningful insights into the management of CP have been obtained from randomized controlled trials, systematic reviews, and meta-analyses, which were of great importance. Based on this research, it is shown that there are various treatments for CP. Therefore, it is of great importance to choose a suitable strategy for patients with CP individually...
2024: Therapeutic Advances in Gastroenterology
#38
JOURNAL ARTICLE
Hiroo Imai, Yasuhiro Sakamoto, Shin Takahashi, Hiroyuki Shibata, Atsushi Sato, Kazunori Otsuka, Kenji Amagai, Masanobu Takahashi, Takuhiro Yamaguchi, Chikashi Ishioka
BACKGROUND: Advanced pancreatic cancer is one of the leading causes of cancer-related deaths. For patients with advanced pancreatic cancer, gemcitabine and nanoparticle albumin-binding paclitaxel (nabPTX) combination (GEM/nabPTX) therapy is one of the recommended first-line treatments. Several retrospective studies have suggested that the addition of levofloxacin improves the efficacy of GEM/nabPTX therapy in patients with advanced pancreatic cancer. This prospective study aims to evaluate whether the addition of antibiotics improves the treatment efficacy of GEM/nabPTX as a first-line chemotherapy in patients with advanced pancreatic cancer...
February 24, 2024: BMC Cancer
#39
JOURNAL ARTICLE
Francesca Spada, Massimo Milione, Patrick Maisonneuve, Natalie Prinzi, Valeria Smiroldo, Elena Bolzacchini, Sara Pusceddu, Carlo Carnaghi, Fausto Sessa, Stefano La Rosa, Silvia Uccella, Nicola Fazio
PURPOSE: The aim of this study is to describe the clinical management of an Italian series of patients with advanced gastro-entero-pancreatic (GEP) MiNENs treated in clinical practice. METHODS: Clinical records of patients from four Italian referral Centers were retrospectively analyzed to correlate clinical/biological data with clinical outcomes. All the surgical specimens were centrally reviewed. RESULTS: Clinical data and surgical samples of 51 patients during 1995-2015 were analyzed...
February 24, 2024: Journal of Endocrinological Investigation
#40
REVIEW
Julianne M Szczepanski, Mark A Rudolf, Jiaqi Shi
Advances in our understanding of pancreatic ductal adenocarcinoma (PDAC) and its tumor microenvironment (TME) have the potential to transform treatment for the hundreds of thousands of patients who are diagnosed each year. Whereas the clinical assessment of cancer cell genetics has grown increasingly sophisticated and personalized, current protocols to evaluate the TME have lagged, despite evidence that the TME can be heterogeneous within and between patients. Here, we outline current protocols for PDAC diagnosis and management, review novel biomarkers, and highlight potential opportunities and challenges when evaluating the PDAC TME as we prepare to translate emerging TME-directed therapies to the clinic...
February 15, 2024: Cancers
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