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Accelerated focused open necrosectomy-based step-cross versus conventional step-up approach in infected necrotizing pancreatitis 在感染性坏死性胰腺炎中，基于加速聚焦开放性坏死切除术的阶梯交叉与传统的阶梯交叉
IF 2.7 2区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Pancreatology
Pub Date : 2026-03-01 Epub Date: 2026-01-26 DOI: 10.1016/j.pan.2026.01.073
Shuai Li , Wutao Wang , Kaiming Li , Minchun Bu , Jing Zhou , Bo Ye , Lu Ke , Zhihui Tong , Weiqin Li , Gang Li

Background

Infected necrotizing pancreatitis (INP) patients requiring open necrosectomy (ON) as part of the step-up approach generally face high postoperative mortality. Our center proposed the step-cross approach as a supplement, but supporting evidence remains limited. This study aimed to compare clinical outcomes between the step-cross and step-up approaches in INP patients.

Methods

This retrospective cohort study included adult INP patients admitted to our center from 2017 to 2022. The step-cross approach consisted of percutaneous catheter drainage, followed by accelerated focused ON and personalized drainage or debridement as needed. Propensity score matching (PSM) was used to adjust for confounders.

Results

Of 509 included patients (median age 46 [34–55] years, 67.6 % male), 454 (89.2 %) and 55 (10.8 %) underwent the step-up and step-cross approach respectively. Overall, 180-day mortality was 20.2 % (103/509): 83 (18.3 %) in the step-up group and 20 (36.4 %) in step-cross group. After PSM (53 matched pairs), 180-day mortality did not differ significantly (35.9 %vs 49.1 %, relative risk [RR] and 95 % confidence interval [CI] with the step-cross approach = 0.73 [0.46–1.15], P = 0.169), but the step-cross group was associated with lower CRRT duration (2 [0, 16] vs 15 [3.5, 22] days, P = 0.005) and fewer minimally invasive necrosectomy procedures. Complications, hospital stays and costs were comparable between groups.

Conclusions

The step-cross approach is a safe complementary strategy to the step-up approach, demonstrating trends toward lower mortality and reduced organ support requirements in selected INP patients. Nevertheless, these findings require validation through large-scale prospective studies.
背景：感染性坏死性胰腺炎（INP）患者需要开放性坏死性切除术（ON）作为升级方法的一部分，通常面临较高的术后死亡率。本中心建议采用阶梯交叉法作为补充，但支持证据仍然有限。本研究旨在比较INP患者的阶梯交叉和阶梯上升方法的临床结果。方法：本回顾性队列研究纳入了2017年至2022年在本中心就诊的成人INP患者。阶梯交叉入路包括经皮导管引流，随后加速聚焦ON和个性化引流或根据需要清创。倾向评分匹配（PSM）用于调整混杂因素。结果：509例纳入的患者（中位年龄46[34-55]岁，67.6%为男性）中，分别有454例（89.2%）和55例（10.8%）采用阶梯入路和阶梯交叉入路。总体而言，180天死亡率为20.2%(103/509)：阶梯组为83(18.3%)，阶梯交叉组为20（36.4%）。经PSM（53对配对）后，180天死亡率无显著差异（35.9% vs 49.1%，相对危险度[RR]和95%可信区间[CI]，阶梯交叉入路= 0.73 [0.46-1.15],P = 0.169），但阶梯交叉组CRRT持续时间较短（2 [0,16]vs 15[3.5, 22]天，P = 0.005），微创坏死切除手术较少。两组之间的并发症、住院时间和费用具有可比性。结论：阶梯式交叉方法是一种安全的补充策略，在选择的INP患者中显示出降低死亡率和减少器官支持需求的趋势。然而，这些发现需要通过大规模的前瞻性研究来验证。
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引用次数: 0
Reply to the Letter to Editor regarding the role of circular RNA circ0001415 in acute pancreatitis 回复关于环状RNA circ0001415在急性胰腺炎中的作用的致编辑信。
IF 2.7 2区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Pancreatology
Pub Date : 2026-03-01 Epub Date: 2026-01-24 DOI: 10.1016/j.pan.2026.01.003
Yan Zhang , Shaolong Hao , Fang Nie , Hao Sun , Wenxiu Zhang , Lang Ji , Jiahui Qi , Ziyu Zhang , Wei Han
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引用次数: 0
Chronological vs Physiological age: Surgical outcomes in elderly PDAC 年龄与生理年龄：老年PDAC的手术结果
IF 2.7 2区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Pancreatology
Pub Date : 2026-03-01 Epub Date: 2026-03-02 DOI: 10.1016/j.pan.2026.01.043
D. de la Iglesia, B. Agudo Castillo, A. Ruiz Casado
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引用次数: 0
Improving ongoing care for patients with biliopancreatic diseases: Do we know how our hospital monographic medical consultations work? 改善对胆道胰腺疾病患者的持续护理：我们知道我们医院的专题医学咨询是如何工作的吗？
IF 2.7 2区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Pancreatology
Pub Date : 2026-03-01 Epub Date: 2026-03-02 DOI: 10.1016/j.pan.2026.01.021
R. Cuevas Algaba , J.X. Wu Wu , L. Ballesteros de Diego , P. Hernán Ocaña , T. Álvarez-Nava Torrego , S. Sáenz-López Pérez , R. Narro Bravo , M. Pérez-Carreras
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引用次数: 0
Impact of age and etiology on complications of acute pancreatitis: A real-world cohort study 年龄和病因对急性胰腺炎并发症的影响：一项真实世界队列研究
IF 2.7 2区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Pancreatology
Pub Date : 2026-03-01 Epub Date: 2026-03-02 DOI: 10.1016/j.pan.2026.01.028
I. Santamaría Vicario, M. Durá Gil, A. de la Fuente Gaztañaga, E. Martínez Moneo, A. Bausela Sainz, R. Fernández Bezanilla, C. Ibarra Ponce de León, N. Gendive Martín, C. Gil García Ollauri, I. Casado Morentin
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引用次数: 0
Thermal liquid biopsy (TLB): A promising diagnostic and screening tool for pancreatic ductal adenocarcinoma (PDAC) 热液活检（TLB）：一种有前途的胰腺导管腺癌（PDAC）诊断和筛查工具
IF 2.7 2区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Pancreatology
Pub Date : 2026-03-01 Epub Date: 2026-03-02 DOI: 10.1016/j.pan.2026.01.029
J. Millastre Bocos , S. Hermoso Durán , F.J. Falcó Martí , M. Ortiz de Solórzano , E. Ceamanos Ibarra , G. García Rayado , R. Velamazán Sandalinas , M. Galochino Ballano , P.F. Garrido , O. Abián Franco
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引用次数: 0
New advanced imaging techniques associated with endoscopic ultrasound (EUS) in the differential diagnosis of solid pancreatic tumors 新的先进成像技术与内镜超声（EUS）在胰腺实体瘤鉴别诊断中的应用
IF 2.7 2区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Pancreatology
Pub Date : 2026-03-01 Epub Date: 2026-03-02 DOI: 10.1016/j.pan.2026.01.068
Y. Domínguez Novoa , J. Iglesias García , J. Lariño Noia , H. Lazare Iglesias , I. Abdulkader Nallib , J.E. Domínguez Muñoz
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引用次数: 0
Pancreatic mucinous cystic neoplasms (MCN) during pregnancy grow rapidly and undergo malignant transformation: A series of 69 operated cases 妊娠期胰腺粘液囊性肿瘤（MCN）生长迅速并发生恶性转化：69例手术分析
IF 2.7 2区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Pancreatology
Pub Date : 2026-03-01 Epub Date: 2026-03-02 DOI: 10.1016/j.pan.2026.01.066
C. Verdejo Gil , O. Korhonen , J. Millastre Bocos , M.G. Keane , A. Antila , L.N. Nilsson , A. Shamali , M. Marijinissen-van Zanten , M. Del Chiaro , J. Laukkarinen
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引用次数: 0
Impact of failed ERCP on complications after EUS-guided choledochoduodenostomy with lumen-apposing metal stents in pancreatic cancer eus引导下胆总管十二指肠吻合置管金属支架对胰腺癌并发症的影响
IF 2.7 2区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Pancreatology
Pub Date : 2026-03-01 Epub Date: 2026-03-02 DOI: 10.1016/j.pan.2026.01.071
A.M. Hernández Pérez, A. Sánchez Yagüe, R. Rivera Irigoin, J.K. Bisso Zein, C. Verdejo Gil, A. Pérez Aisa
{"title":"Impact of failed ERCP on complications after EUS-guided choledochoduodenostomy with lumen-apposing metal stents in pancreatic cancer","authors":"A.M. Hernández Pérez,&nbsp;A. Sánchez Yagüe,&nbsp;R. Rivera Irigoin,&nbsp;J.K. Bisso Zein,&nbsp;C. Verdejo Gil,&nbsp;A. Pérez Aisa","doi":"10.1016/j.pan.2026.01.071","DOIUrl":"10.1016/j.pan.2026.01.071","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 2","pages":"Page 334"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147412841","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}
引用次数: 0
Validation and clinical usefulness of the patient-reported outcome measure PEI-Q for assessing symptoms and therapeutic response to pancreatic enzyme replacement therapy in pancreatic exocrine insufficiency of different etiologies: Results from a European registry 对不同病因的胰腺外分泌功能不全患者报告的结果测量指标PEI-Q的有效性和临床应用：来自欧洲登记的结果
IF 2.7 2区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Pancreatology
Pub Date : 2026-03-01 Epub Date: 2026-03-02 DOI: 10.1016/j.pan.2026.01.058
J.E. Domínguez Muñoz , Y. Domínguez Novoa , P. Hegyi , G. Capurso , X. Martínez-Seara , O. Eperjesi , G. Lauri , J. Iglesias García
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引用次数: 0
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