Objectives: Pancreatic carcinoid tumor (PCT) is described as a malignant form of carcinoid tumors. However, the epidemiology and prognostic factors for PCT are poorly understood.
Materials and methods: The data of 2447 PCT patients were included in this study from the Surveillance, Epidemiology, and End Results database and randomly divided into a training cohort (1959) and a validation cohort (488). The epidemiology of PCT was calculated, and independent prognostic factors were identified to construct a prognostic nomogram for predicting long-term disease-specific survival (DSS) among PCT patients.
Results: The incidence of PCT increased remarkably from 2000 to 2018. The 1-, 5-, and 10-year DSS rates were 96.4%, 90.3%, and 86.5%, respectively. Age at diagnosis, stage, surgery, radiotherapy, and chemotherapy were identified as independent prognostic factors to construct a prognostic nomogram. The C -indices; area under the receiver operating characteristic curves for predicting 1-, 5-, and 10-year DSS, and calibration plots of the nomogram in both cohorts indicated a high discriminatory accuracy, preferable survival predictive ability, and optimal concordances, respectively.
Conclusions: The incidence of PCT has increased rapidly since 2000. In addition, we established a practical, effective, and accurate prognostic nomogram for predicting the long-term DSS of PCT patients.
{"title":"Epidemiology and Prognostic Nomogram for Predicting Long-Term Disease-Specific Survival in Patients With Pancreatic Carcinoid Tumor: A SEER-Based Study.","authors":"Hai Lin, Yufang Li, Yutong Chen, Linjuan Zeng, Bixiang Li, Shili Chen","doi":"10.1097/MPA.0000000000002320","DOIUrl":"10.1097/MPA.0000000000002320","url":null,"abstract":"<p><strong>Objectives: </strong>Pancreatic carcinoid tumor (PCT) is described as a malignant form of carcinoid tumors. However, the epidemiology and prognostic factors for PCT are poorly understood.</p><p><strong>Materials and methods: </strong>The data of 2447 PCT patients were included in this study from the Surveillance, Epidemiology, and End Results database and randomly divided into a training cohort (1959) and a validation cohort (488). The epidemiology of PCT was calculated, and independent prognostic factors were identified to construct a prognostic nomogram for predicting long-term disease-specific survival (DSS) among PCT patients.</p><p><strong>Results: </strong>The incidence of PCT increased remarkably from 2000 to 2018. The 1-, 5-, and 10-year DSS rates were 96.4%, 90.3%, and 86.5%, respectively. Age at diagnosis, stage, surgery, radiotherapy, and chemotherapy were identified as independent prognostic factors to construct a prognostic nomogram. The C -indices; area under the receiver operating characteristic curves for predicting 1-, 5-, and 10-year DSS, and calibration plots of the nomogram in both cohorts indicated a high discriminatory accuracy, preferable survival predictive ability, and optimal concordances, respectively.</p><p><strong>Conclusions: </strong>The incidence of PCT has increased rapidly since 2000. In addition, we established a practical, effective, and accurate prognostic nomogram for predicting the long-term DSS of PCT patients.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e424-e433"},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140294220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study primarily aimed to assess the expression of MUC-4 in patients with Pancreatic Ductal Adenocarcinoma (PDAC) as compared with controls and assess its clinical relevance.
{"title":"Clinical significance of MUC-4 and associated proteins in Pancreatic and Periampullary Cancers.","authors":"Sumaira Rashid, Nidhi Singh, Safoora Rashid, Prasenjit Das, Surabhi Gupta, Shyam S Chauhan, Hem Chandra Sati, Nihar Ranjan Dash, Atul Sharma, Sharmistha Dey, Anoop Saraya","doi":"10.1097/mpa.0000000000002340","DOIUrl":"https://doi.org/10.1097/mpa.0000000000002340","url":null,"abstract":"This study primarily aimed to assess the expression of MUC-4 in patients with Pancreatic Ductal Adenocarcinoma (PDAC) as compared with controls and assess its clinical relevance.","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":"44 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140836397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The incidence rate of hypertriglyceridemia pancreatitis (HTGP) has experienced a notable increase in recent years, with eclipsing alcohol as the second leading cause of acute pancreatitis (AP). HTGP is often associated with more severe local and systemic complications. Recognized as a metabolic disorder hypertriglyceridemia (HTG), holds significant relevance in the pathogenesis of HTGP, yet its mechanisms are not fully understood. Both primary (genetic) and secondary (acquired) factors contribute to elevated triglyceride (TG) levels, which concurrently influence the progression of HTGP. This article presents a comprehensive review of the evolving research on HTGP pathogenesis, encompassing lipid synthesis and metabolism, calcium signal transduction, inflammatory mediators, endoplasmic reticulum stress, autophagy, mitochondrial injury by fatty acids, oxidative stress response, genetic factors, and gene mutations. By unraveling the intricate mechanisms underlying HTGP, this article aims to enhance physicians' understanding of the disease and facilitate the development of potential targeted pharmacological interventions for patients.
{"title":"Research progress on the mechanism of acute hypertriglyceridemic pancreatitis.","authors":"Yiteng Meng, Peiyu Han, Xiaoyu Ma, Yiting He, Hetian Chen, Hongbo Ren","doi":"10.1097/mpa.0000000000002364","DOIUrl":"https://doi.org/10.1097/mpa.0000000000002364","url":null,"abstract":"The incidence rate of hypertriglyceridemia pancreatitis (HTGP) has experienced a notable increase in recent years, with eclipsing alcohol as the second leading cause of acute pancreatitis (AP). HTGP is often associated with more severe local and systemic complications. Recognized as a metabolic disorder hypertriglyceridemia (HTG), holds significant relevance in the pathogenesis of HTGP, yet its mechanisms are not fully understood. Both primary (genetic) and secondary (acquired) factors contribute to elevated triglyceride (TG) levels, which concurrently influence the progression of HTGP. This article presents a comprehensive review of the evolving research on HTGP pathogenesis, encompassing lipid synthesis and metabolism, calcium signal transduction, inflammatory mediators, endoplasmic reticulum stress, autophagy, mitochondrial injury by fatty acids, oxidative stress response, genetic factors, and gene mutations. By unraveling the intricate mechanisms underlying HTGP, this article aims to enhance physicians' understanding of the disease and facilitate the development of potential targeted pharmacological interventions for patients.","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":"90 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140828886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1097/mpa.0000000000002353
Laura Barthold, Kerrington D Smith, Sushela S Chaidarun, Dawn A Fischer, Timothy B Gardner
Total pancreatectomy with islet autotransplantation (TPIAT) is performed to improve the quality of life (QOL) of patients with chronic pancreatitis. Few reports have documented QOL following TPIAT, with none using the pancreatitis-specific Pancreatitis Quality of Life Instrument (PANQOLI). We surveyed patients at our center who underwent TPIAT to document postoperative QOL.
{"title":"Quality of Life Following TPIAT: A Patient Experience Survey.","authors":"Laura Barthold, Kerrington D Smith, Sushela S Chaidarun, Dawn A Fischer, Timothy B Gardner","doi":"10.1097/mpa.0000000000002353","DOIUrl":"https://doi.org/10.1097/mpa.0000000000002353","url":null,"abstract":"Total pancreatectomy with islet autotransplantation (TPIAT) is performed to improve the quality of life (QOL) of patients with chronic pancreatitis. Few reports have documented QOL following TPIAT, with none using the pancreatitis-specific Pancreatitis Quality of Life Instrument (PANQOLI). We surveyed patients at our center who underwent TPIAT to document postoperative QOL.","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":"59 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140828954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01Epub Date: 2024-03-14DOI: 10.1097/MPA.0000000000002316
Tony Zibo Zhuang, Chris Bergstrom, Bassel F El-Rayes, Walid L Shaib
Abstract: Neuroendocrine tumors (NETs) are rare cancers with heterogeneous histologies, response to treatments, and prognoses. Majority of these cancers originate in the gastrointestinal tract and metastasize to the liver. We report the cases of 5 patients with low-grade NET disease with rare metastases to the choroids. Two of the patients were treated with peptide receptor radionuclide therapy (lutetium 177 [ 177 Lu]). This is the first report confirming peptide radionuclide therapy safety in patients with low-grade NET with ocular metastases.
{"title":"A Case Series of Choroidal and Orbital Neuroendocrine Tumors: Metastasis: Two Patients Treated With Peptide Radionuclide Therapy.","authors":"Tony Zibo Zhuang, Chris Bergstrom, Bassel F El-Rayes, Walid L Shaib","doi":"10.1097/MPA.0000000000002316","DOIUrl":"10.1097/MPA.0000000000002316","url":null,"abstract":"<p><strong>Abstract: </strong>Neuroendocrine tumors (NETs) are rare cancers with heterogeneous histologies, response to treatments, and prognoses. Majority of these cancers originate in the gastrointestinal tract and metastasize to the liver. We report the cases of 5 patients with low-grade NET disease with rare metastases to the choroids. Two of the patients were treated with peptide receptor radionuclide therapy (lutetium 177 [ 177 Lu]). This is the first report confirming peptide radionuclide therapy safety in patients with low-grade NET with ocular metastases.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e445-e449"},"PeriodicalIF":1.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140294217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1097/mpa.0000000000002359
Oyedotun Babajide, Aakash Desai, Chinelo Eruchalu, Mary Sedarous, Deborah Adekunle, Michael Youssef, Muftah Mahmud, Philip N Okafor
To study the prevalence of exocrine pancreas insufficiency (EPI) at a population level and the subsequent risk of pancreatic ductal adenocarcinoma (PDAC).
研究人群中胰腺外分泌功能不全(EPI)的发病率及其胰腺导管腺癌(PDAC)的发病风险。
{"title":"The Population-level Prevalence of Exocrine Pancreas Insufficiency and the Subsequent Risk of Pancreatic Cancer.","authors":"Oyedotun Babajide, Aakash Desai, Chinelo Eruchalu, Mary Sedarous, Deborah Adekunle, Michael Youssef, Muftah Mahmud, Philip N Okafor","doi":"10.1097/mpa.0000000000002359","DOIUrl":"https://doi.org/10.1097/mpa.0000000000002359","url":null,"abstract":"To study the prevalence of exocrine pancreas insufficiency (EPI) at a population level and the subsequent risk of pancreatic ductal adenocarcinoma (PDAC).","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":"12 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140842414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-10DOI: 10.1097/mpa.0000000000002335
Aleksander M Bogdanski, Anke M Onnekink, Akin Inderson, Bas Boekestijn, Bert A Bonsing, Hans F A Vasen, Jeanin E van Hooft, Jurjen J Boonstra, J Sven D Mieog, Martin N J M Wasser, Shirin Feshtali, Thomas P Potjer, Derk C F Klatte, Monique E van Leerdam
The study aimed to investigate the added value of blood glucose monitoring in high-risk individuals (HRIs) participating in pancreatic cancer surveillance.
该研究旨在调查血糖监测对参与胰腺癌监测的高危人群(HRIs)的附加价值。
{"title":"THE ADDED VALUE OF BLOOD GLUCOSE MONITORING IN HIGH-RISK INDIVIDUALS UNDERGOING PANCREATIC CANCER SURVEILLANCE.","authors":"Aleksander M Bogdanski, Anke M Onnekink, Akin Inderson, Bas Boekestijn, Bert A Bonsing, Hans F A Vasen, Jeanin E van Hooft, Jurjen J Boonstra, J Sven D Mieog, Martin N J M Wasser, Shirin Feshtali, Thomas P Potjer, Derk C F Klatte, Monique E van Leerdam","doi":"10.1097/mpa.0000000000002335","DOIUrl":"https://doi.org/10.1097/mpa.0000000000002335","url":null,"abstract":"The study aimed to investigate the added value of blood glucose monitoring in high-risk individuals (HRIs) participating in pancreatic cancer surveillance.","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":"41 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140576796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-10DOI: 10.1097/mpa.0000000000002317
Shyam Varadarajulu, Michael J Cangelosi, Geri R Cramer, Kevin Kuipers, Stacey Reimer, Ann K Roy
To compare clinical and economic implications of percutaneous and endoscopic treatment approaches in patients with pancreatic fluid collections (PFCs).
比较经皮和内窥镜治疗方法对胰腺积液(PFC)患者的临床和经济影响。
{"title":"Clinical and Economic Implications of Interventions in Pancreatic Fluid Collections: An Assessment From a National Claims Database.","authors":"Shyam Varadarajulu, Michael J Cangelosi, Geri R Cramer, Kevin Kuipers, Stacey Reimer, Ann K Roy","doi":"10.1097/mpa.0000000000002317","DOIUrl":"https://doi.org/10.1097/mpa.0000000000002317","url":null,"abstract":"To compare clinical and economic implications of percutaneous and endoscopic treatment approaches in patients with pancreatic fluid collections (PFCs).","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":"84 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140577061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: The elemental diet (ED) is a formula to support nutritional status without increasing chylous burden. This study evaluates the efficacy of early ED feeding after pancreatoduodenectomy (PD).
Materials and methods: A prospective phase II study of consecutive patients who underwent PD with early ED feeding was conducted. Patient backgrounds, surgical outcomes, and ED feeding tolerability were compared with a historical cohort of 74 PD patients with early enteral feeding of a low residue diet (LRD).
Results: The ED group comprised 104 patients. No patient in the ED group discontinued enteral feeding because of chylous ascites (CAs), whereas 17.6% of the LRD group experienced refractory CAs that disrupted further enteral feeding. The CAs rate was significantly decreased in the ED group compared with the LRD group (3.9% and 48.7%, respectively; P < 0.001). There was no significant difference in the incidence of major complications (ED: 17.3%, LRD: 18.9%; P = 0.844). Postoperative prognostic nutritional index was similar between the 2 groups ( P = 0.764). In multivariate analysis, enteral feeding formula, and sex were independent risk factors for CAs (LRD: P < 0.001, odds ratio, 22.87; female: P = 0.019, odds ratio, 2.78).
Conclusions: An ED reduces postoperative CAs of patients undergoing PD in the setting of early enteral feeding.
目的:元素饮食(ED)是一种在不增加胆汁负担的情况下支持营养状况的配方。本研究评估了胰十二指肠切除术(PD)后早期 ED 喂养的疗效:对连续接受胰十二指肠切除术并进行早期 ED 喂养的患者进行了一项前瞻性 II 期研究。将患者背景、手术结果和 ED 喂养耐受性与 74 例早期低渣饮食(LRD)肠道喂养的胰腺十二指肠切除术患者进行比较:ED 组有 104 名患者。ED 组中没有患者因乳糜腹水(CAs)而中断肠内喂养,而 LRD 组中有 17.6% 的患者因难治性 CAs 而中断进一步肠内喂养。与 LRD 组相比,ED 组的 CAs 发生率明显降低(分别为 3.9% 和 48.7%;P <0.001)。主要并发症的发生率没有明显差异(ED:17.3%,LRD:18.9%;P = 0.844)。两组患者的术后预后营养指数相似(P = 0.764)。在多变量分析中,肠内喂养配方和性别是 CAs 的独立风险因素(LRD:P < 0.001,几率为 22.87;女性:P = 0.019,几率为 2.78):结论:在早期肠内喂养的情况下,ED可减少腹腔镜手术患者术后CA的发生。
{"title":"An Elemental Diet Reduces Chylous Ascites of Patients Undergoing Pancreatoduodenectomy in the Setting of Early Enteral Feeding.","authors":"Masaru Matsumura, Yoshihiro Mise, Nobuyuki Takemura, Yoshihiro Ono, Takafumi Sato, Hiromichi Ito, Yosuke Inoue, Yu Takahashi, Akio Saiura","doi":"10.1097/MPA.0000000000002309","DOIUrl":"10.1097/MPA.0000000000002309","url":null,"abstract":"<p><strong>Objectives: </strong>The elemental diet (ED) is a formula to support nutritional status without increasing chylous burden. This study evaluates the efficacy of early ED feeding after pancreatoduodenectomy (PD).</p><p><strong>Materials and methods: </strong>A prospective phase II study of consecutive patients who underwent PD with early ED feeding was conducted. Patient backgrounds, surgical outcomes, and ED feeding tolerability were compared with a historical cohort of 74 PD patients with early enteral feeding of a low residue diet (LRD).</p><p><strong>Results: </strong>The ED group comprised 104 patients. No patient in the ED group discontinued enteral feeding because of chylous ascites (CAs), whereas 17.6% of the LRD group experienced refractory CAs that disrupted further enteral feeding. The CAs rate was significantly decreased in the ED group compared with the LRD group (3.9% and 48.7%, respectively; P < 0.001). There was no significant difference in the incidence of major complications (ED: 17.3%, LRD: 18.9%; P = 0.844). Postoperative prognostic nutritional index was similar between the 2 groups ( P = 0.764). In multivariate analysis, enteral feeding formula, and sex were independent risk factors for CAs (LRD: P < 0.001, odds ratio, 22.87; female: P = 0.019, odds ratio, 2.78).</p><p><strong>Conclusions: </strong>An ED reduces postoperative CAs of patients undergoing PD in the setting of early enteral feeding.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e343-e349"},"PeriodicalIF":2.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139735806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01Epub Date: 2024-03-13DOI: 10.1097/MPA.0000000000002311
David Nicolás-Pérez, Antonio Zebenzuy Gimeno-García, Rafael Joaquín Romero-García, Iván Castilla-Rodríguez, Manuel Hernandez-Guerra
Objectives: Secondary infections due to transmission via the duodenoscope have been reported in up to 3% of endoscopic retrograde cholangiopancreatographies. The use of single-use duodenoscopes has been suggested. We investigate the cost-effectiveness of these duodenoscopes use in cholangiopancreatography.
Materials and methods: A cost-effectiveness analysis was implemented to compare the performance of cholangiopancreatographies with reusable duodenoscopes versus single-use duodenoscopes. Effectiveness was analyzed by calculating quality-adjusted life years (QALY) from the perspective of the National Health System. Possibility of crossover from single-use to reusable duodenoscopes was considered. A willingness-to-pay of €25,000/QALY was set, the incremental cost-effectiveness ratio (ICER) was calculated, and deterministic and probabilistic sensitivity analyses were performed.
Results: Considering cholangiopancreatographies with single-use and reusable duodenoscopes at a cost of €2900 and €1333, respectively, and a 10% rate of single-use duodenoscopes, ICER was greater than €3,000,000/QALY. A lower single-use duodenoscope cost of €1211 resulted in an ICER of €23,583/QALY. When the unit cost of the single-use duodenoscope was €1211, a crossover rate of more than 9.5% made the use of the single-use duodenoscope inefficient.
Conclusions: Single-use duodenoscopes are cost-effective in a proportion of cholangiopancreatographies if its cost is reduced. Increased crossover rate makes single-use duodenoscope use not cost-effective.
{"title":"Cost-effectiveness Analysis of Single-Use Duodenoscope Applied to Endoscopic Retrograde Cholangiopancreatography.","authors":"David Nicolás-Pérez, Antonio Zebenzuy Gimeno-García, Rafael Joaquín Romero-García, Iván Castilla-Rodríguez, Manuel Hernandez-Guerra","doi":"10.1097/MPA.0000000000002311","DOIUrl":"10.1097/MPA.0000000000002311","url":null,"abstract":"<p><strong>Objectives: </strong>Secondary infections due to transmission via the duodenoscope have been reported in up to 3% of endoscopic retrograde cholangiopancreatographies. The use of single-use duodenoscopes has been suggested. We investigate the cost-effectiveness of these duodenoscopes use in cholangiopancreatography.</p><p><strong>Materials and methods: </strong>A cost-effectiveness analysis was implemented to compare the performance of cholangiopancreatographies with reusable duodenoscopes versus single-use duodenoscopes. Effectiveness was analyzed by calculating quality-adjusted life years (QALY) from the perspective of the National Health System. Possibility of crossover from single-use to reusable duodenoscopes was considered. A willingness-to-pay of €25,000/QALY was set, the incremental cost-effectiveness ratio (ICER) was calculated, and deterministic and probabilistic sensitivity analyses were performed.</p><p><strong>Results: </strong>Considering cholangiopancreatographies with single-use and reusable duodenoscopes at a cost of €2900 and €1333, respectively, and a 10% rate of single-use duodenoscopes, ICER was greater than €3,000,000/QALY. A lower single-use duodenoscope cost of €1211 resulted in an ICER of €23,583/QALY. When the unit cost of the single-use duodenoscope was €1211, a crossover rate of more than 9.5% made the use of the single-use duodenoscope inefficient.</p><p><strong>Conclusions: </strong>Single-use duodenoscopes are cost-effective in a proportion of cholangiopancreatographies if its cost is reduced. Increased crossover rate makes single-use duodenoscope use not cost-effective.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":"53 4","pages":"e357-e367"},"PeriodicalIF":2.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140189924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}