Pub Date : 2025-12-05DOI: 10.1016/j.pan.2025.12.002
Nihal Ijaz Khan, Abdullah Javed, Syed Hamaad Rahman, Tareq Alsaleh, Nouman Shafique, Noor Fatima, Dawood Javed, Jeevin S Sandhu, Abu Hurairah, Nikhil Bush Jayaram, Mustafa Arain, Babu P Mohan, John George
{"title":"Efficacy and safety of pregabalin in managing pain of chronic pancreatitis: A systematic review and meta-analysis of randomized controlled trials.","authors":"Nihal Ijaz Khan, Abdullah Javed, Syed Hamaad Rahman, Tareq Alsaleh, Nouman Shafique, Noor Fatima, Dawood Javed, Jeevin S Sandhu, Abu Hurairah, Nikhil Bush Jayaram, Mustafa Arain, Babu P Mohan, John George","doi":"10.1016/j.pan.2025.12.002","DOIUrl":"https://doi.org/10.1016/j.pan.2025.12.002","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145757272","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}
Pub Date : 2025-12-05DOI: 10.1016/j.pan.2025.12.003
Morten Laksáfoss Lauritsen, Mikkel Parsberg Werge, Mirjana Cihoric, Henrik Løvendahl Jørgensen, Nicolai Bang Foss, John Gásdal Karstensen, Amer Hadi, Lise Lotte Gluud, Srdan Novovic
{"title":"Role of bioimpedance spectroscopy analysis to assess hydration status in the early phase of acute pancreatitis.","authors":"Morten Laksáfoss Lauritsen, Mikkel Parsberg Werge, Mirjana Cihoric, Henrik Løvendahl Jørgensen, Nicolai Bang Foss, John Gásdal Karstensen, Amer Hadi, Lise Lotte Gluud, Srdan Novovic","doi":"10.1016/j.pan.2025.12.003","DOIUrl":"https://doi.org/10.1016/j.pan.2025.12.003","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145782492","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}
Background and aims: We aimed to clarify the value of Contrast-enhanced harmonic EUS-guided tissue acquisition (C-EUS-TA) for pathological confirmation of liver metastases, particularly small metastases, derived from pancreatic cancer.
Methods: Fundamental B-mode EUS (B-EUS) and contrast-enhanced EUS (C-EUS) were compared in detection rates of liver metastases in patients with pancreatic cancer. We also assessed the ability of C-EUS-TA for the sensitivity, specificity, and accuracy of the pathological diagnosis of those liver metastases, and compared those values according to the size of the liver metastases (≤5 mm, 5 mm < size ≤10 mm, and size >10 mm in diameter).
Results: The accuracy of C-EUS for detection of liver metastases was significantly higher than that of B-EUS (91.3 % vs. 71.0 %, p = 0.001). In particular, the diagnostic accuracy of C-EUS for small liver metastases (≤5 mm in diameter) was significantly higher than that of B-EUS (93.9 % vs. 66.7 %, p = 0.016). The overall accuracy of C-EUS-TA for pathological diagnosis of liver metastases was 95.2 %. Interestingly, there was no significant difference in the accuracy of C-EUS-TA among the three lesions sizes (≤5 mm: 90.0 %, 5 mm < size ≤10 mm: 100 %, and size >10 mm in diameter: 95.5 %).
Conclusion: The present study demonstrates the usefulness and high accuracy of C-EUS-TA for diagnosis of suspected liver metastases, particularly small lesions measuring ≤5 mm. Thus, when confirmation of small liver metastases using conventional imaging is difficult, C-EUS-TA may be useful for histological diagnosis.
背景和目的：我们旨在阐明对比增强谐波eus引导下的组织采集（C-EUS-TA）在胰腺癌肝转移，特别是小转移的病理确认中的价值。方法：比较基础b型EUS （B-EUS）与增强造影EUS （C-EUS）对胰腺癌肝转移的检出率。我们还评估了C-EUS-TA对这些肝转移的病理诊断的敏感性、特异性和准确性，并根据肝转移的大小（≤5mm、5mm <≤10mm和直径> 10mm）对这些值进行了比较。结果：C-EUS对肝转移的检测准确率明显高于B-EUS（91.3%比71.0%,p = 0.001）。特别是C-EUS对小肝转移灶（直径≤5mm）的诊断准确率明显高于B-EUS （93.9% vs. 66.7%, p = 0.016）。C-EUS-TA对肝转移病理诊断的总体准确率为95.2%。有趣的是，C-EUS-TA在三种病变大小（≤5mm: 90.0%, 5mm <≤10mm: 100%，直径为> - 10mm: 95.5%）之间的准确性没有显著差异。结论：本研究证明了C-EUS-TA诊断疑似肝转移的有效性和准确性，特别是≤5mm的小病变。因此，当常规影像学难以确诊小肝转移时，C-EUS-TA可能有助于组织学诊断。
{"title":"Contrast-enhanced harmonic endoscopic ultrasonography (EUS)-guided tissue acquisition significantly improves diagnostic yield for small liver metastases derived from pancreatic cancer: a prospective study.","authors":"Tomoya Emori, Masahiro Itonaga, Reiko Ashida, Akiya Nakahata, Takaaki Tamura, Yuki Kawaji, Takashi Tamura, Yasunobu Yamashita, Kazuhiro Fukatsu, Toshio Shimokawa, Masayuki Kitano","doi":"10.1016/j.pan.2025.12.001","DOIUrl":"https://doi.org/10.1016/j.pan.2025.12.001","url":null,"abstract":"<p><strong>Background and aims: </strong>We aimed to clarify the value of Contrast-enhanced harmonic EUS-guided tissue acquisition (C-EUS-TA) for pathological confirmation of liver metastases, particularly small metastases, derived from pancreatic cancer.</p><p><strong>Methods: </strong>Fundamental B-mode EUS (B-EUS) and contrast-enhanced EUS (C-EUS) were compared in detection rates of liver metastases in patients with pancreatic cancer. We also assessed the ability of C-EUS-TA for the sensitivity, specificity, and accuracy of the pathological diagnosis of those liver metastases, and compared those values according to the size of the liver metastases (≤5 mm, 5 mm < size ≤10 mm, and size >10 mm in diameter).</p><p><strong>Results: </strong>The accuracy of C-EUS for detection of liver metastases was significantly higher than that of B-EUS (91.3 % vs. 71.0 %, p = 0.001). In particular, the diagnostic accuracy of C-EUS for small liver metastases (≤5 mm in diameter) was significantly higher than that of B-EUS (93.9 % vs. 66.7 %, p = 0.016). The overall accuracy of C-EUS-TA for pathological diagnosis of liver metastases was 95.2 %. Interestingly, there was no significant difference in the accuracy of C-EUS-TA among the three lesions sizes (≤5 mm: 90.0 %, 5 mm < size ≤10 mm: 100 %, and size >10 mm in diameter: 95.5 %).</p><p><strong>Conclusion: </strong>The present study demonstrates the usefulness and high accuracy of C-EUS-TA for diagnosis of suspected liver metastases, particularly small lesions measuring ≤5 mm. Thus, when confirmation of small liver metastases using conventional imaging is difficult, C-EUS-TA may be useful for histological diagnosis.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145757233","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}
Pub Date : 2025-12-01DOI: 10.1016/j.pan.2025.10.003
Rishi Das , Amir H. Davarpanah , Puneet Sharma , Steven Keilin , Preeti A. Reshamwala , Ram Subramanian , Field Willingham , Saurabh Chawla
{"title":"Association of pancreatic steatosis with Metabolic Dysfunction Associated Steatohepatitis using magnetic resonance imaging","authors":"Rishi Das , Amir H. Davarpanah , Puneet Sharma , Steven Keilin , Preeti A. Reshamwala , Ram Subramanian , Field Willingham , Saurabh Chawla","doi":"10.1016/j.pan.2025.10.003","DOIUrl":"10.1016/j.pan.2025.10.003","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 8","pages":"Pages 1489-1491"},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145368520","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}
Pub Date : 2025-12-01DOI: 10.1016/j.pan.2025.10.012
Tianyi Li , Chao Ling , Yinjie Gao , Xiaosen Ma , Qiang Xu , Ruichen Gao , Anli Tong , Yuxiu Li
Background
Von Hippel-Lindau (VHL) disease is a heritable syndrome with multiorgan involvement. In this study, we describe the phenotype of pancreatic lesions and the genetic mutational profile of patients with VHL.
Methods
We included 90 patients with VHL who were treated at a single center. Their clinical profile and types of pancreatic lesions were studied. In addition, genetic testing for mutations in the VHL gene was conducted using Sanger sequencing, covering all three exons and splicing sites of VHL. One patient with insulinoma underwent whole-exome sequencing (WES) and whole-genome sequencing (WGS).
Results
Of the 90 patients, 55 (61.1 %) had VHL disease-related pancreatic lesions (male: female, 29:26; mean age at diagnosis, 34 years). The lesions included simple cysts (n = 31, 56.4 %), serous cystadenoma (n = 4, 7.3 %), and neuroendocrine tumors (NETs) (n = 32, 58.2 %). Among the 32 NETs, one was an insulinoma, and the others were nonfunctional tumors. Of the 55 patients, 44 patients with pancreatic lesions underwent genetic testing for the VHL gene. Mutations were missense in 38 cases, nonsense in 2 cases, deletion in 3 cases, and a splicing site mutation in 1 case. 23 patients had mutations in either codon 161 or 167. NETs were statistically more frequent in patients with missense mutations in codons 161 and 167 compared to mutations in the rest of the VHL gene (21/23 vs. 7/15; P = 0.006). An amplification pattern of copy-number variation was found on the WGS in the insulinoma patient.
Conclusion
Pancreatic lesions are common in VHL disease. Mutations in codons 161 and 167 are hotspots in patients with pancreatic lesions, particularly NETs.
{"title":"Types of pancreatic lesions and the mutational landscape of the VHL gene in patients with von Hippel-Lindau disease","authors":"Tianyi Li , Chao Ling , Yinjie Gao , Xiaosen Ma , Qiang Xu , Ruichen Gao , Anli Tong , Yuxiu Li","doi":"10.1016/j.pan.2025.10.012","DOIUrl":"10.1016/j.pan.2025.10.012","url":null,"abstract":"<div><h3>Background</h3><div>Von Hippel-Lindau (VHL) disease is a heritable syndrome with multiorgan involvement. In this study, we describe the phenotype of pancreatic lesions and the genetic mutational profile of patients with VHL.</div></div><div><h3>Methods</h3><div>We included 90 patients with VHL who were treated at a single center. Their clinical profile and types of pancreatic lesions were studied. In addition, genetic testing for mutations in the <em>VHL</em> gene was conducted using Sanger sequencing, covering all three exons and splicing sites of <em>VHL</em>. One patient with insulinoma underwent whole-exome sequencing (WES) and whole-genome sequencing (WGS).</div></div><div><h3>Results</h3><div>Of the 90 patients, 55 (61.1 %) had VHL disease-related pancreatic lesions (male: female, 29:26; mean age at diagnosis, 34 years). The lesions included simple cysts (n = 31, 56.4 %), serous cystadenoma (n = 4, 7.3 %), and neuroendocrine tumors (NETs) (n = 32, 58.2 %). Among the 32 NETs, one was an insulinoma, and the others were nonfunctional tumors. Of the 55 patients, 44 patients with pancreatic lesions underwent genetic testing for the <em>VHL</em> gene. Mutations were missense in 38 cases, nonsense in 2 cases, deletion in 3 cases, and a splicing site mutation in 1 case. 23 patients had mutations in either codon 161 or 167. NETs were statistically more frequent in patients with missense mutations in codons 161 and 167 compared to mutations in the rest of the <em>VHL</em> gene (21/23 vs. 7/15; P = 0.006). An amplification pattern of copy-number variation was found on the WGS in the insulinoma patient.</div></div><div><h3>Conclusion</h3><div>Pancreatic lesions are common in VHL disease. Mutations in codons 161 and 167 are hotspots in patients with pancreatic lesions, particularly NETs.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 8","pages":"Pages 1450-1455"},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145505680","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}
Pub Date : 2025-12-01DOI: 10.1016/j.pan.2025.11.020
Evangelia Florou, Yoh Zen, Parthi Srinivasan, Andreas Prachalias
{"title":"Can negative lymph node involvement and resection-free margins (ypT1-3N0R0) complete the disease-free survival benefit of a pathologic complete response (ypT0N0R0) in resected pancreatic cancer post neoadjuvant treatment?","authors":"Evangelia Florou, Yoh Zen, Parthi Srinivasan, Andreas Prachalias","doi":"10.1016/j.pan.2025.11.020","DOIUrl":"https://doi.org/10.1016/j.pan.2025.11.020","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145687716","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}
Pub Date : 2025-12-01DOI: 10.1016/j.pan.2025.07.415
Joerg M. Steiner , Hana Algül , Dietrich A. Ruess , Ihsan Ekin Demir , Rickmer Braren , Sabine Schwamberger , Marina Lesina , Judith Reiser , Julia Werner , Tanja Groll , Thomas Metzler , Katja Steiger
Background/objectives
Acute necrotizing pancreatitis is a common disease in humans and leads to significant and world-wide morbidity and mortality. Exploration of new pharmaceutical agents for the treatment of this disease frequently rests on rodent models that may not be relevant for spontaneous human disease and also preclude collecting multiple blood samples. Goal of this project was to establish an experimental model for acute necrotizing pancreatitis in pigs that mirrors the development of systemic complications of acute pancreatitis in humans as a prelude to clinical trials in humans.
Methods
The accessory pancreatic duct was surgically isolated in domestic pigs and 8 μmol/kg glycodeoxycholic acid were slowly injected into the duct, followed by ligation and cutting the duct. Pigs were repeatedly evaluated clinically and multiple blood samples were collected before the pigs were sacrificed and their organs histopathologically assessed after 1, 5, or 7 days.
Results
All pigs showed clinical and clinical pathological evidence of pancreatitis after induction of pancreatitis. Pigs showed histopathological evidence of acute necrotizing pancreatitis one day after induction of pancreatitis. At 7 days after induction of pancreatitis, dramatic regeneration could be observed in the pancreas. At 5 days after induction of pancreatitis, evidence of necrotizing pancreatitis was present with less evidence of regeneration.
Conclusions
The porcine model for acute necrotizing pancreatitis described here shows many parallels to spontaneous human disease and its systemic complications and may thus serve as a good model to assess the efficacy of novel pharmaceutical agents for the treatment of acute pancreatitis in humans.
{"title":"A porcine model of acute necrotizing pancreatitis","authors":"Joerg M. Steiner , Hana Algül , Dietrich A. Ruess , Ihsan Ekin Demir , Rickmer Braren , Sabine Schwamberger , Marina Lesina , Judith Reiser , Julia Werner , Tanja Groll , Thomas Metzler , Katja Steiger","doi":"10.1016/j.pan.2025.07.415","DOIUrl":"10.1016/j.pan.2025.07.415","url":null,"abstract":"<div><h3>Background/objectives</h3><div>Acute necrotizing pancreatitis is a common disease in humans and leads to significant and world-wide morbidity and mortality. Exploration of new pharmaceutical agents for the treatment of this disease frequently rests on rodent models that may not be relevant for spontaneous human disease and also preclude collecting multiple blood samples. Goal of this project was to establish an experimental model for acute necrotizing pancreatitis in pigs that mirrors the development of systemic complications of acute pancreatitis in humans as a prelude to clinical trials in humans.</div></div><div><h3>Methods</h3><div>The accessory pancreatic duct was surgically isolated in domestic pigs and 8 μmol/kg glycodeoxycholic acid were slowly injected into the duct, followed by ligation and cutting the duct. Pigs were repeatedly evaluated clinically and multiple blood samples were collected before the pigs were sacrificed and their organs histopathologically assessed after 1, 5, or 7 days.</div></div><div><h3>Results</h3><div>All pigs showed clinical and clinical pathological evidence of pancreatitis after induction of pancreatitis. Pigs showed histopathological evidence of acute necrotizing pancreatitis one day after induction of pancreatitis. At 7 days after induction of pancreatitis, dramatic regeneration could be observed in the pancreas. At 5 days after induction of pancreatitis, evidence of necrotizing pancreatitis was present with less evidence of regeneration.</div></div><div><h3>Conclusions</h3><div>The porcine model for acute necrotizing pancreatitis described here shows many parallels to spontaneous human disease and its systemic complications and may thus serve as a good model to assess the efficacy of novel pharmaceutical agents for the treatment of acute pancreatitis in humans.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 8","pages":"Pages 1426-1433"},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812274","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 cross-sectional study of liver dysfunction using transient elastography among patients with chronic pancreatitis","authors":"Anirudh Gupta, Arun S. Sankannavar, Namit Gupta, Kamlesh Kumar Sharma, Sudhir Maharshi, Rupesh Pokharna","doi":"10.1016/j.pan.2025.10.004","DOIUrl":"10.1016/j.pan.2025.10.004","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 8","pages":"Pages 1483-1485"},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145346526","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}
Pub Date : 2025-12-01DOI: 10.1016/j.pan.2025.11.002
Yassine Kilani , Mahmoud Y. Madi , Ayah Obeid , Farah Heis , Park Jiwon , Daniel Alejandro Gonzalez Mosquera , Tarek Nammour , Asbjørn M. Drewes , Søren S. Olesen , Adam D. Farmer
Background
Chronic pancreatitis is a progressive inflammatory disease causing exocrine and endocrine dysfunction, frequently leading to severe, recurrent pain necessitating treatment with opioid analgesics. The impact of opioid use on chronic pancreatitis outcomes is poorly understood.
Objective
This study's objective was to evaluate the effect of opioid use on mortality and healthcare utilization in patients with chronic pancreatitis using real-world data.
Design
We conducted a retrospective cohort study using the TriNetX research network, identifying U.S. adults (≥18 years) with chronic pancreatitis from a 121-million-patient database (2005–2025). Patients were stratified into opioid users and non-users (controls) and propensity score matched (1:1) for demographics, body mass index, comorbidities, laboratory parameters, and treatments. Primary outcomes included acute-on-chronic pancreatitis, all-cause mortality, emergency department (ED) visits and hospitalizations. Outcomes were analyzed using Cox regression and time-stratified methods, reported as adjusted hazard ratios (aHR).
Results
Of 252,130 patients with chronic pancreatitis, 143,758 opioid users and 108,372 non-users were propensity-matched. Opioid users were older, with higher rates of alcohol use, pancreatitis risk factors, psychiatric disorders, substance use disorder, malnutrition, and analgesic use (all p < 0.0001). Opioids were associated with increased risks of acute-on-chronic pancreatitis (aHR = 1.45, 95 % CI: 1.36–1.54), all-cause mortality (aHR = 1.90, 95 % CI: 1.80–2.00), and ED visits (aHR = 1.28, 95 % CI: 1.22–1.36).
Conclusion
Opioid use in chronic pancreatitis is associated with higher morbidity, mortality, and healthcare utilization, likely reflecting underlying disease severity and complications. These patients represent a high-risk group warranting greater attention, and prospective studies are needed to clarify causal relationships and guide optimized pain management strategies.
{"title":"The impact of opioid use in chronic pancreatitis from 2004–2024: A propensity-matched analysis of 183,214 individuals","authors":"Yassine Kilani , Mahmoud Y. Madi , Ayah Obeid , Farah Heis , Park Jiwon , Daniel Alejandro Gonzalez Mosquera , Tarek Nammour , Asbjørn M. Drewes , Søren S. Olesen , Adam D. Farmer","doi":"10.1016/j.pan.2025.11.002","DOIUrl":"10.1016/j.pan.2025.11.002","url":null,"abstract":"<div><h3>Background</h3><div>Chronic pancreatitis is a progressive inflammatory disease causing exocrine and endocrine dysfunction, frequently leading to severe, recurrent pain necessitating treatment with opioid analgesics. The impact of opioid use on chronic pancreatitis outcomes is poorly understood.</div></div><div><h3>Objective</h3><div>This study's objective was to evaluate the effect of opioid use on mortality and healthcare utilization in patients with chronic pancreatitis using real-world data.</div></div><div><h3>Design</h3><div>We conducted a retrospective cohort study using the TriNetX research network, identifying U.S. adults (≥18 years) with chronic pancreatitis from a 121-million-patient database (2005–2025). Patients were stratified into opioid users and non-users (controls) and propensity score matched (1:1) for demographics, body mass index, comorbidities, laboratory parameters, and treatments. Primary outcomes included acute-on-chronic pancreatitis, all-cause mortality, emergency department (ED) visits and hospitalizations. Outcomes were analyzed using Cox regression and time-stratified methods, reported as adjusted hazard ratios (aHR).</div></div><div><h3>Results</h3><div>Of 252,130 patients with chronic pancreatitis, 143,758 opioid users and 108,372 non-users were propensity-matched. Opioid users were older, with higher rates of alcohol use, pancreatitis risk factors, psychiatric disorders, substance use disorder, malnutrition, and analgesic use (all p < 0.0001). Opioids were associated with increased risks of acute-on-chronic pancreatitis (aHR = 1.45, 95 % CI: 1.36–1.54), all-cause mortality (aHR = 1.90, 95 % CI: 1.80–2.00), and ED visits (aHR = 1.28, 95 % CI: 1.22–1.36).</div></div><div><h3>Conclusion</h3><div>Opioid use in chronic pancreatitis is associated with higher morbidity, mortality, and healthcare utilization, likely reflecting underlying disease severity and complications. These patients represent a high-risk group warranting greater attention, and prospective studies are needed to clarify causal relationships and guide optimized pain management strategies.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 8","pages":"Pages 1407-1417"},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145574208","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}
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