Pancreatology最新文献

英文中文

Prevalence, clinicopathological features, and prognosis of diabetes in pancreatic cancer: A single-center retrospective cohort study of 1620 patients 糖尿病在胰腺癌中的患病率、临床病理特征和预后：一项1620例患者的单中心回顾性队列研究

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2025-12-01 DOI: 10.1016/j.pan.2025.11.004

Yunlong Li , Shuai Xiang , Wenhui Zhong , Shunda Wang , Shuisheng Zhang , Jianwei Zhang , Yongxing Du , Chengfeng Wang , Xu Che

Background

The interplay between pancreatic cancer (PC) and diabetes mellitus (DM) is complex, and may differ between new-onset DM (NODM) and long-standing DM (LSDM). We compared clinical features and prognosis across non-DM, NODM, and LSDM groups.

Methods

We retrospectively analyzed 1620 PC patients treated at the National Cancer Center (2008–2018). Patients were classified as non-DM, NODM (≤2 years), and LSDM (>2 years). Survival outcomes were assessed by Kaplan–Meier and Cox regression analyses, and mediation analysis was applied to evaluate indirect effects.

Results

Of 1620 patients, 536 (33.1 %) had DM, including 287 (53.4 % of DM) with NODM. NODM was associated with higher jaundice prevalence and elevated liver function markers; LSDM patients were older, had a greater prevalence of hypertension, and showed lower M stage. Non-DM patients had lower CA19-9, CA242, and CEA than both DM groups. Overall survival was significantly worse in NODM than in LSDM and non-DM. In curatively resected patients, DM status (non-DM/NODM/LSDM) independently predicted OS in multivariable models. Mediation analysis indicated total bilirubin accounted for 9.8 % of the adverse association between NODM and OS (ACME −0.46, 95 % CI −1.04 to −0.09; p = 0.008).

Conclusion

DM is common in PC and associates with distinct clinicopathological profiles. NODM is linked to jaundice and poorer survival, while DM status serves as an independent prognostic factor in the curative-surgery subgroup, with part of NODM's adverse effect operating through bilirubin.

背景：胰腺癌（PC）与糖尿病（DM）之间的相互作用是复杂的，并且在新发糖尿病（NODM）和长期糖尿病（LSDM）之间可能存在差异。我们比较了非dm、NODM和LSDM组的临床特征和预后。方法：回顾性分析2008-2018年在国家癌症中心治疗的1620例PC患者。患者分为非dm、NODM（≤2年）和LSDM（≤2年）。生存结局采用Kaplan-Meier和Cox回归分析评估，间接影响采用中介分析评估。结果：1620例患者中，536例（33.1%）为DM，其中287例（53.4%）为NODM。NODM与较高的黄疸患病率和肝功能指标升高有关；LSDM患者年龄较大，高血压患病率较高，M期较低。非糖尿病患者的CA19-9、CA242和CEA均低于两组。NODM患者的总生存率明显低于LSDM和非dm患者。在治疗性切除的患者中，在多变量模型中，DM状态（非DM/NODM/LSDM）独立预测OS。中介分析表明，总胆红素占NODM和OS之间不良关联的9.8% （ACME -0.46, 95% CI -1.04 ~ -0.09; p = 0.008）。结论：糖尿病在PC中很常见，且具有独特的临床病理特征。NODM与黄疸和较差的生存率有关，而在治疗手术亚组中，DM状态是一个独立的预后因素，部分NODM的不良反应通过胆红素起作用。

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引用次数: 0

Cost-effectiveness of biodegradable pancreatic stents in post-ERCP pancreatitis prophylaxis. 可生物降解胰腺支架在ercp后胰腺炎预防中的成本-效果。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2025-12-01 DOI: 10.1016/j.pan.2025.11.022

Abdullah Abbasi, Raheel Anjum, Pavit Tewatia, Shyam Menon

Background: Biodegradable biliopancreatic stents (BDS) are commercially available alternatives to conventional stents. While these offer potential economic benefits-such as eliminating the need for follow-up imaging or endoscopic procedures to retrieve retained stents-they have not been evaluated in a cost-effectiveness model. We aimed to develop a health economic model comparing conventional pancreatic stents (PS) with BDS for the prophylaxis of post-ERCP pancreatitis (PEP).

Methods: Data on pancreatic stents used for PEP and follow-up outcomes were extracted from the endoscopy database at The Royal Wolverhampton NHS Trust, United Kingdom, to develop a cost-benefit decision analysis model. Healthcare-associated quality of life data were sourced from the literature to derive utility values for the model. Complications related to retained stents were incorporated. Deterministic and probabilistic sensitivity analyses were performed. Incremental cost-effectiveness ratios (ICERs) were calculated using a willingness-to-pay (WTP) threshold of £30,000.

Results: Deterministic analysis demonstrated that using BDS for PEP prophylaxis was cost-effective compared to conventional PS (£656.12, 0.98 QALY for BDS vs. £377.59, 0.95 QALY for PS), yielding an ICER of £9316.70. Probabilistic sensitivity analysis similarly confirmed the cost-effectiveness of BDS over PS, with BDS being cost-effective at £666.67 for 0.98 QALY versus £373.68 for 0.95 QALY for PS. Threshold analysis identified a cost threshold of £353.37 for BDS to remain cost-effective.

Conclusion: BDS for PEP prophylaxis is cost effective compared to conventional PS, avoiding the need for follow-up imaging and repeat procedures for stent removal.

背景：生物可降解胆管支架（BDS）是传统支架的商业替代品。虽然这些技术提供了潜在的经济效益，例如无需后续成像或内窥镜手术来取出保留的支架，但它们尚未在成本效益模型中进行评估。我们的目的是建立一个健康经济模型，比较传统胰腺支架（PS）和BDS对ercp后胰腺炎（PEP）的预防作用。方法：从英国皇家伍尔弗汉普顿NHS信托基金会的内窥镜数据库中提取用于PEP的胰腺支架数据和随访结果，以建立成本效益决策分析模型。从文献中获取与医疗保健相关的生活质量数据，以得出模型的实用价值。留置支架相关并发症纳入研究。进行了确定性和概率敏感性分析。增量成本效益比（ICERs）是使用支付意愿（WTP）阈值30,000英镑来计算的。结果：确定性分析表明，与传统PS相比，使用BDS进行PEP预防具有成本效益（BDS为656.12英镑，质量aly为0.98；BDS为377.59英镑，质量aly为0.95），ICER为9316.70英镑。概率敏感性分析同样证实了BDS相对于PS的成本效益，BDS的成本效益为0.98 QALY为666.67英镑，而PS的成本效益为0.95 QALY为373.68英镑。阈值分析确定了BDS保持成本效益的成本阈值为353.37英镑。结论：与传统PS相比，BDS预防PEP具有成本效益，避免了后续影像学检查和重复支架取出手术的需要。

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引用次数: 0

Reevaluating rifaximin prophylaxis in severe acute pancreatitis: A call for methodological refinement and microbiome-centric endpoints. 重新评估利福昔明预防严重急性胰腺炎：呼吁改进方法和以微生物组为中心的终点。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2025-11-21 DOI: 10.1016/j.pan.2025.11.012

Parth Aphale, Himanshu Shekhar, Shashank Dokania

引用次数: 0

Methodological Considerations Regarding "Prognostic impact of serum triglycerides in acute pancreatitis". 关于“血清甘油三酯对急性胰腺炎预后的影响”的方法学考虑。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2025-11-12 DOI: 10.1016/j.pan.2025.11.008

Wenhua Zhou, Liuying Li, Xia Zhou

引用次数: 0

Event timing inaccuracies in a retrospective study of low-dose aspirin and acute pancreatitis. 低剂量阿司匹林与急性胰腺炎回顾性研究中的事件时间不准确。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2025-11-12 DOI: 10.1016/j.pan.2025.11.006

Hung-Da Chen, Joshua Wang

引用次数: 0

Prognostic impact of serum triglycerides in acute pancreatitis: Evidence from multi-center cohort study using a common data model 血清甘油三酯对急性胰腺炎预后的影响：来自使用通用数据模型的多中心队列研究的证据。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2025-11-01 DOI: 10.1016/j.pan.2025.09.032

Da Hee Park , Seung In Seo , Jin Gu Kang , Woon Geon Shin , Jinseob Kim , Kyong Joo Lee , Se Woo Park

Background and aims

Hypertriglyceridemia (HTG) is a risk factor for acute pancreatitis (AP); however its association with increased AP severity remains unclear. This study aimed to investigate the association between HTG levels and severity of AP.

Design

This study analyzed data from 10 Korean hospital databases converted to a common data model from 2004 to 2019. Hospitalized patients with AP were divided into two groups based on their serum triglyceride (TG) levels: a high TG (HiTG) group (serum TG: >500 mg/dL) and a low TG (LoTG) group (TG: ≤500 mg/dL). Subgroup analyses were performed based on age and sex.

Results

A total of 5644 AP patients were included in the study, with 534 and 5110 patients in the HiTG and LoTG groups, respectively. An increasing trend was observed in the number of patients with pancreatitis (p < 0.001 for trend), including those with HTG-associated pancreatitis. The HiTG group showed a male predominance (74.9 %), and 34.4 % of patients were between the ages of 30 and 39 years. The HiTG group showed significantly higher C-reactive protein (CRP) elevation rates (30.8 % vs. 10.6 %, P < 0.001) requiring intensive care unit (ICU) admission (12.8 % vs. 9.3 %, P = 0.050) than the LoTG group. Age-based subgroup analysis revealed that the HiTG group had significantly higher CRP levels, ICU management, and 30-day mortality in patients aged <60 years.

Conclusion

HTG is associated with a higher risk of developing severe AP. Younger patients (<60 years) with HTG may be vulnerable to a more severe disease course.

背景和目的：高甘油三酯血症（HTG）是急性胰腺炎（AP）的危险因素；然而，其与急性脑卒中严重程度增加的关系尚不清楚。本研究旨在探讨HTG水平与ap严重程度之间的关系。设计：本研究分析了从2004年至2019年转换为通用数据模型的10家韩国医院数据库的数据。根据住院AP患者的血清甘油三酯（TG）水平分为两组：高TG （HiTG）组（血清TG: bb0 500 mg/dL）和低TG （LoTG）组（TG:≤500 mg/dL）。根据年龄和性别进行亚组分析。结果：共纳入AP患者5644例，其中HiTG组534例，LoTG组5110例。胰腺炎患者数量呈增加趋势（p < 0.001），包括htg相关性胰腺炎患者。HiTG组以男性为主（74.9%），34.4%的患者年龄在30 ~ 39岁之间。HiTG组c -反应蛋白（CRP）升高率（30.8%比10.6%,P < 0.001）需要入住重症监护病房（ICU）（12.8%比9.3%,P = 0.050）显著高于LoTG组。基于年龄的亚组分析显示，HiTG组在老年患者中CRP水平、ICU管理和30天死亡率均显著升高。结论：HTG与发生严重AP的风险较高相关。

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引用次数: 0

Low-dose aspirin use is associated with reduced 30- and 90-day mortality and overall improved outcomes in patients with acute pancreatitis: A multinational multicenter analysis 低剂量阿司匹林与急性胰腺炎患者30天和90天死亡率降低以及总体预后改善相关：一项多国多中心分析

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2025-11-01 DOI: 10.1016/j.pan.2025.09.022

Do Han Kim , Donghyun Ko , Carlos Elizondo Alatorre , Frank J. Lukens , Jose A. Porres , Pedro Palacios Argueta , Massimo Raimondo , Baoan Ji , Yan Bi , Paul T. Kröner

Introduction

Studies regarding outcomes in patients with acute pancreatitis (AP) on aspirin (ASA) have shown conflicting results. This study aims to evaluate the association between low-dose ASA and clinical outcomes in patients with AP at 30 and 90 days.

Methods

This retrospective cohort study used Global Research Network from TriNetX. Patients with AP on low-dose ASA were matched 1:1 with non-ASA users by demographics and comorbidities. Outcomes included mortality, shock, intensive care unit (ICU) admission, mechanical ventilation, venous thromboembolism (VTE), acute kidney injury (AKI), pancreatic pseudocyst formation, development of necrotizing pancreatitis, and recurrent AP. Hazard ratios (HR) and 95 % confidence intervals (CI) were calculated at 30 and 90 days.

Results

A total of 240 720 patients with AP were identified of which 12 634 were ASA users. 12 389 ASA users (mean age 60.4 years, 48.8 % female) were matched with 12 389 non-users (mean age 60.7 years, 48.4 % female). ASA users had lower risk of 30-day mortality (HR: 0.53, 95 %CI: 0.43–0.64), shock (HR: 0.57, 95 %CI: 0.37–0.88), ICU admission (HR: 0.71, 95 %CI: 0.56–0.89), VTE (HR: 0.38, 95 %CI: 0.24–0.60), AKI (HR: 0.69, 95 %CI: 0.59–0.80), and recurrent AP (HR: 0.64, 95 %CI: 0.60–0.67). Similar trends were observed at 90 days.

Conclusion

Low-dose ASA was associated with lower mortality, fewer complications, and lower recurrence in patients with AP, as compared to patients without ASA use at 30- and 90-days. These findings may suggest that ASA's anti-inflammatory and antiplatelet properties could potentially mitigate the inflammatory cascade in AP pathophysiology. Further studies are warranted to explore the direct impact of ASA on AP.

关于急性胰腺炎（AP）患者服用阿司匹林（ASA）的结局的研究显示了相互矛盾的结果。本研究旨在评估低剂量ASA与AP患者30天和90天临床结局之间的关系。方法：采用TriNetX的全球研究网络进行回顾性队列研究。低剂量ASA的AP患者与非ASA使用者按人口统计学和合并症进行1:1匹配。结果包括死亡率、休克、重症监护病房（ICU）入院、机械通气、静脉血栓栓塞（VTE）、急性肾损伤（AKI）、胰腺假囊肿形成、坏死性胰腺炎的发展和复发性AP。在30天和90天计算风险比（HR）和95%置信区间（CI）。结果：共发现240720例AP患者，其中12634例为ASA使用者。12389名ASA使用者（平均年龄60.4岁，48.8%为女性）与12389名非ASA使用者（平均年龄60.7岁，48.4%为女性）相匹配。ASA使用者的30天死亡率（HR: 0.53, 95% CI: 0.43-0.64）、休克（HR: 0.57, 95% CI: 0.37-0.88）、ICU入院（HR: 0.71, 95% CI: 0.56-0.89）、静脉血栓栓塞（HR: 0.38, 95% CI: 0.24-0.60）、AKI （HR: 0.69, 95% CI: 0.59-0.80）和复发性AP （HR: 0.64, 95% CI: 0.60-0.67）的风险较低。在第90天观察到类似的趋势。结论：与未使用ASA的患者相比，低剂量ASA在30天和90天的AP患者中具有更低的死亡率、更少的并发症和更低的复发率。这些发现可能提示ASA的抗炎和抗血小板特性可能潜在地减轻AP病理生理中的炎症级联反应。ASA对AP的直接影响有待进一步研究。

{"title":"Low-dose aspirin use is associated with reduced 30- and 90-day mortality and overall improved outcomes in patients with acute pancreatitis: A multinational multicenter analysis","authors":"Do Han Kim , Donghyun Ko , Carlos Elizondo Alatorre , Frank J. Lukens , Jose A. Porres , Pedro Palacios Argueta , Massimo Raimondo , Baoan Ji , Yan Bi , Paul T. Kröner","doi":"10.1016/j.pan.2025.09.022","DOIUrl":"10.1016/j.pan.2025.09.022","url":null,"abstract":"<div><h3>Introduction</h3><div>Studies regarding outcomes in patients with acute pancreatitis (AP) on aspirin (ASA) have shown conflicting results. This study aims to evaluate the association between low-dose ASA and clinical outcomes in patients with AP at 30 and 90 days.</div></div><div><h3>Methods</h3><div>This retrospective cohort study used Global Research Network from TriNetX. Patients with AP on low-dose ASA were matched 1:1 with non-ASA users by demographics and comorbidities. Outcomes included mortality, shock, intensive care unit (ICU) admission, mechanical ventilation, venous thromboembolism (VTE), acute kidney injury (AKI), pancreatic pseudocyst formation, development of necrotizing pancreatitis, and recurrent AP. Hazard ratios (HR) and 95 % confidence intervals (CI) were calculated at 30 and 90 days.</div></div><div><h3>Results</h3><div>A total of 240 720 patients with AP were identified of which 12 634 were ASA users. 12 389 ASA users (mean age 60.4 years, 48.8 % female) were matched with 12 389 non-users (mean age 60.7 years, 48.4 % female). ASA users had lower risk of 30-day mortality (HR: 0.53, 95 %CI: 0.43–0.64), shock (HR: 0.57, 95 %CI: 0.37–0.88), ICU admission (HR: 0.71, 95 %CI: 0.56–0.89), VTE (HR: 0.38, 95 %CI: 0.24–0.60), AKI (HR: 0.69, 95 %CI: 0.59–0.80), and recurrent AP (HR: 0.64, 95 %CI: 0.60–0.67). Similar trends were observed at 90 days.</div></div><div><h3>Conclusion</h3><div>Low-dose ASA was associated with lower mortality, fewer complications, and lower recurrence in patients with AP, as compared to patients without ASA use at 30- and 90-days. These findings may suggest that ASA's anti-inflammatory and antiplatelet properties could potentially mitigate the inflammatory cascade in AP pathophysiology. Further studies are warranted to explore the direct impact of ASA on AP.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 7","pages":"Pages 1080-1085"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145293128","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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