Hepatobiliary & Pancreatic Diseases International最新文献

英文中文

Trajectories of prealbumin levels in the early phase of acute pancreatitis are associated with infected pancreatic necrosis 急性胰腺炎早期白蛋白水平的变化轨迹与感染性胰腺坏死有关。

IF 3.6 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hepatobiliary & Pancreatic Diseases International

Pub Date : 2025-06-07 DOI: 10.1016/j.hbpd.2025.06.002

Zi-Rui Liu , Yi-Zhe Chen , Yang Liu , Kang Li , Yi-Zhen Xu , Lin Gao , Lu Ke , Wei-Qin Li

Background

Infected pancreatic necrosis (IPN) is a highly morbid local complication following necrotizing pancreatitis. Early enteral nutrition has been proven to be effective in preventing IPN. This study aimed to assess the association between the trajectory of prealbumin (PAB) during the early phase of acute pancreatitis (AP) and the incidence of IPN and other clinical outcomes.

Methods

This retrospective, dual-centered study screened patients with AP admitted to the Center of Acute Pancreatitis, Jinling Hospital and the Affiliated Hospital of Zunyi Medical University from January 2018 to December 2022. The PAB levels during the first week after admission were collected. The primary outcome was the incidence of IPN within 90 days after AP onset. Group-based trajectory modelling was performed to describe the trajectory of PAB levels over time. A Cox proportional hazard model was used to facilitate the interpretation of the time-varying hazard ratio (HR) between PAB and outcomes. Fine-Gray sub-distribution hazard model was adopted for sensitivity analysis.

Results

A total of 373 patients were included, of whom 82 (22.0%) were diagnosed with IPN within 90 days. The trajectory model assigned 232 patients to the low-level PAB (L-PAB) group and 141 to the high-level PAB (H-PAB) group. The incidence of 90-day IPN in the L-PAB group was significantly higher than that in the H-PAB group (26.7% vs. 14.2%, P = 0.005). The multivariate Cox regression model showed that a high PAB trajectory was associated with a lower incidence of IPN (HR = 0.52, 95% CI: 0.30-0.89; P = 0.017) after adjustment for potential confounders. In the sensitivity analysis, taking death as a competing risk, high PAB trajectory remained significantly associated with a lower incidence of IPN in the Fine-Gray model (HR = 0.55, 95% CI: 0.33-0.92; P = 0.022).

Conclusions

A high PAB trajectory within the first week of AP was significantly associated with a lower incidence of IPN within 90 days after AP onset. Dynamic monitoring of PAB levels in the early phase of AP may play an important role in stratifying patients at high risk of developing IPN.

背景：感染性胰腺坏死（IPN）是坏死性胰腺炎后高度病态的局部并发症。早期肠内营养已被证明对预防IPN有效。本研究旨在评估急性胰腺炎（AP）早期前期白蛋白（PAB）轨迹与IPN发生率和其他临床结局之间的关系。方法：本回顾性双中心研究筛选2018年1月至2022年12月在金陵医院和遵义医科大学附属医院急性胰腺炎中心住院的AP患者。收集入院后第一周的PAB水平。主要终点是AP发病后90天内IPN的发生率。采用基于组的轨迹建模来描述PAB水平随时间的变化轨迹。采用Cox比例风险模型来解释PAB与预后之间的时变风险比（HR）。采用细灰色亚分布风险模型进行敏感性分析。结果：共纳入373例患者，其中82例（22.0%）在90天内诊断为IPN。轨迹模型将232例患者分配到低水平PAB （L-PAB）组，141例患者分配到高水平PAB （H-PAB）组。L-PAB组90天IPN发生率显著高于H-PAB组（26.7% vs. 14.2%, P = 0.005）。多因素Cox回归模型显示，高PAB轨迹与较低IPN发生率相关(HR = 0.52, 95% CI: 0.30-0.89；P = 0.017)，校正了潜在混杂因素。在敏感性分析中，将死亡作为竞争风险，在Fine-Gray模型中，高PAB轨迹仍然与较低的IPN发生率显著相关(HR = 0.55, 95% CI: 0.33-0.92；P = 0.022)。结论：AP第一周内较高的PAB轨迹与AP发病后90天内较低的IPN发生率显著相关。在AP早期动态监测PAB水平可能对IPN高危患者的分层起重要作用。

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引用次数: 0

Novel drug targets for the early treatment of acute pancreatitis: Focusing on calcium signaling 急性胰腺炎早期治疗的新药物靶点：关注钙信号。

IF 3.6 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hepatobiliary & Pancreatic Diseases International

Pub Date : 2025-06-06 DOI: 10.1016/j.hbpd.2025.06.001

Jin-Hao Chen , Robert Sutton , Li Wen

Acute pancreatitis (AP) is a common but potentially devastating disease characterized at onset pathophysiologically by premature activation of digestive enzymes within the pancreas. Despite an abundance of preclinical research and, until recently, a series of disappointing clinical trials, no specific disease modifying pharmacological treatment has yet been approved for this condition. Recent novel approaches to understanding the molecular pathogenesis of AP provide us with renewed optimism for translational drug discovery. Although digestive enzyme activation is the hallmark of AP, a critical mechanism that initiates AP is intracellular calcium (Ca²⁺) overload in pancreatic parenchymal cells, which triggers mitochondrial dysfunction, endoplasmic reticulum (ER) stress, and impairs autophagic flux. These processes are pivotal to the disease and present a range of drug targets, associated with the inflammatory responses that drive local and systemic inflammation in AP. Progress in translation has now been made, targeting the ORAI channel with the inhibitor zegocractin (Auxora) to reduce pancreatic injury and inflammatory responses in human AP. Herein we evaluated potential drug targets for the early treatment of AP, focused on intra-acinar mechanisms of injury central to the onset and severity of AP. Our analysis highlights the opportunities and progress in translating these molecular insights into clinical therapies.

急性胰腺炎（AP）是一种常见但具有潜在破坏性的疾病，其发病病理生理特征是胰腺内消化酶的过早激活。尽管有大量的临床前研究，直到最近，一系列令人失望的临床试验，还没有特定的疾病修饰药物治疗被批准用于这种情况。最近对AP分子发病机制的新认识为转化药物的发现提供了新的希望。虽然消化酶激活是AP的标志，但启动AP的一个关键机制是胰腺实质细胞内钙（Ca2+）超载，这会引发线粒体功能障碍，内质网（ER）应激，并损害自噬通量。这些过程是疾病的关键，并提出了一系列药物靶点，与驱动AP局部和全身炎症的炎症反应相关。现在已经取得了进展，用抑制剂zegocractin （Auxora）靶向ORAI通道，以减少人类AP的胰腺损伤和炎症反应。在这里，我们评估了AP早期治疗的潜在药物靶点。我们的分析强调了将这些分子见解转化为临床治疗的机会和进展。

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引用次数: 0

Autologous liver transplantation for right liver fragmentation and left lobe ischemia for 46 hours 自体肝移植治疗右肝碎裂左肝缺血46小时。

IF 3.6 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hepatobiliary & Pancreatic Diseases International

Pub Date : 2025-06-03 DOI: 10.1016/j.hbpd.2025.05.007

Xiao-Yan Hu , Zi-Biao Zhong , Wei Wang , Zhi-Ping Xia , Jun-Tao Liang , Zhong-Zhong Liu , Shao-Jun Ye , Qi-Fa Ye

引用次数: 0

Adjuvant chemotherapy improves post-transplant outcome in patients with hepatocellular carcinoma 辅助化疗改善肝细胞癌患者移植后的预后。

IF 4.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hepatobiliary & Pancreatic Diseases International

Pub Date : 2025-05-31 DOI: 10.1016/j.hbpd.2025.05.004

Heng-Kai Zhu , Hai-Bo Mou , Zhuo-Yi Wang , Wu Zhang , Dan Zhu , Si-Yi Zhong , Shu-Sen Zheng , Li Zhuang

Background

Hepatocellular carcinoma (HCC) recurrence following liver transplantation (LT) remains a major challenge. This study aimed to investigate the effect of adjuvant chemotherapy (ACT) with the modified FOLFOX-6 (mFOLFOX-6) regimen on the post-transplant prognosis of HCC patients.

Methods

HCC patients who underwent LT at our institution from June 2017 to December 2019 were enrolled. The cohort was divided into the ACT group (n = 57) and the non-ACT group (n = 93). The median post-transplant follow-up period was 54.0 months. The study endpoints were HCC recurrence and patient mortality following LT. The association between ACT and recurrence/mortality were evaluated through univariate and multivariate analyses utilizing a Cox proportional hazards model, propensity score adjustment, propensity score matching, and inverse probability of treatment weighting (IPTW) analyses. A stratification analysis was performed to determine the interaction effects.

Results

The ACT group was younger and had worse tumor characteristics including tumor number, tumor size, portal vein tumor thrombosis, pathological differentiation and microvascular invasion (MVI). The ACT group also demonstrated a lower risk of mortality than the non-ACT group (hazard ratio = 0.36, P = 0.017). It was consistent across sensitivity analyses utilizing propensity score adjustment and matching. There was a significant stronger association between ACT and recurrence-free benefit in patients with grade M2 of MVI compared to patients with grade M0/1 (P for interaction = 0.002).

Conclusions

ACT with mFOLFOX-6 regimen decreased the recurrence and mortality risks following LT for HCC patients. ACT may be considered in HCC patients with high risk of recurrence and mortality after LT.

背景：肝移植（LT）后肝细胞癌（HCC）复发仍然是一个主要挑战。本研究旨在探讨改良FOLFOX-6 （mFOLFOX-6）方案的辅助化疗（ACT）对HCC患者移植后预后的影响。方法：纳入2017年6月至2019年12月在我院接受肝移植的HCC患者。该队列分为ACT组（n = 57）和非ACT组（n = 93）。移植后中位随访时间为54.0个月。研究终点是肝细胞癌复发和lt后患者死亡率。通过单因素和多因素分析评估ACT与复发/死亡率之间的关系，利用Cox比例风险模型、倾向评分调整、倾向评分匹配和治疗加权逆概率（IPTW）分析。进行分层分析以确定相互作用效应。结果：ACT组患者年龄更轻，肿瘤特征更差，包括肿瘤数量、肿瘤大小、门静脉肿瘤血栓形成、病理分化、微血管侵袭（MVI）等。ACT组的死亡风险也低于非ACT组（风险比= 0.36,P = 0.017）。使用倾向评分调整和匹配的敏感性分析结果是一致的。与M0/1级患者相比，M2级MVI患者的ACT与无复发获益之间的相关性更强（相互作用P = 0.002）。结论：ACT联合mFOLFOX-6方案降低了HCC患者肝移植后的复发和死亡风险。肝移植后复发和死亡风险高的HCC患者可考虑ACT。

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引用次数: 0

Nursing factors in patients with hepatocellular carcinoma after transarterial chemoembolization 肝癌经动脉化疗栓塞后护理因素分析。

IF 3.6 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hepatobiliary & Pancreatic Diseases International

Pub Date : 2025-05-31 DOI: 10.1016/j.hbpd.2025.05.006

Yan Zheng , Fei-Yan Huang , Li-Xia Cai , Chong Peng , Tong-Yin Zhu

引用次数: 0

Exosome-mediated regulation of macrophage polarization: A novel therapeutic strategy for diabetic wound healing 外泌体介导的巨噬细胞极化调节：糖尿病伤口愈合的新治疗策略。

IF 4.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hepatobiliary & Pancreatic Diseases International

Pub Date : 2025-05-30 DOI: 10.1016/j.hbpd.2025.05.005

Jia-Le Ma , Ling-Xiao Wang , Hao Yu , Zhi-Kang Zhu , Jia-Hong Xu , Jia-Qi Lou , Shou-Jie Wang

引用次数: 0

Treatment of large pancreatic radiolucent stone 大胰腺放射性结石的治疗。

IF 3.6 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hepatobiliary & Pancreatic Diseases International

Pub Date : 2025-05-24 DOI: 10.1016/j.hbpd.2025.05.003

Dan Wang , Wei An , Jin-Hui Yi , Fan Wang, Zhao-Shen Li, Liang-Hao Hu

Background

Previous studies have not clarified the treatment of large pancreatic radiolucent stones (≥ 5 mm). The primary objective of this study was to assess the clinical features and therapeutic efficacy in patients with chronic pancreatitis who have large radiolucent stones, and to propose a treatment strategy.

Methods

This analysis examined the data of patients with large pancreatic ductal stones (≥ 5 mm) from March 2011 to June 2018. Patients with radiolucent stones were classified as the radiolucent stones group, while those with pancreatic radiopaque stones presented at the same time were randomly selected as controls in a 1:2 ratio. Data on demographics, disease courses and treatment details were retrieved, and stone clearance and pain relief during the follow-up were compared between the two groups.

Results

A total of 52 patients with large radiolucent stones and 104 patients with large radiopaque stones were included in the study. Pancreatic extracorporeal shock wave lithotripsy (ESWL) was the initial treatment for large radiopaque stone. Endoscopic retrograde cholangiopancreatography (ERCP) was the first-step treatment for all patients in the radiolucent stones group, of which one patient received medication after failed ERCP cannulation, and four who failed stone extraction were treated with ESWL following the placement of a nasopancreatic catheter. There was no significant difference in the complete stone clearance rate (75.0% vs. 78.8%; P = 0.553) between the two groups. Among the 51 patients in the large radiolucent stones group who were followed up for 5.8 years (range 2.1-12.6), complete pain relief was achieved in 42 patients (82.4%), with no significant difference compared with the radiopaque group (82.4% vs. 76.4%; P = 0.409).

Conclusions

ERCP is an effective endotherapy for large radiolucent stone and should be considered the first-step treatment. When stone extraction failed during ERCP, ESWL is recommended following the placement of a nasopancreatic catheter.

背景：先前的研究尚未明确胰腺大放射性结石（≥5mm）的治疗方法。本研究的主要目的是评估慢性胰腺炎伴大放射性结石患者的临床特征和治疗效果，并提出治疗策略。方法：分析2011年3月至2018年6月胰管结石（≥5mm）患者的资料。结石透光组为透光组，同时出现胰腺不透光组按1:2的比例随机选择为对照组。检索人口统计学、病程和治疗细节数据，比较两组随访期间结石清除和疼痛缓解情况。结果：共纳入52例大透光性结石和104例大透光性结石。胰腺体外冲击波碎石术（ESWL）是治疗大型不透射线结石的首选方法。内镜逆行胆管造影（ERCP）是所有放射性结石组患者的第一步治疗，其中1例患者在ERCP插管失败后接受药物治疗，4例结石取出失败的患者在放置鼻胰导管后进行ESWL治疗。两组结石完全清除率无显著差异(75.0% vs 78.8%；P = 0.553)。大透光结石组51例患者随访5.8年（范围2.1-12.6），有42例（82.4%）患者疼痛完全缓解，与不透光结石组(82.4 vs 76.4%；P = 0.409)。结论：ERCP是一种有效的治疗大放射性结石的方法，应考虑作为第一步治疗。当ERCP期间结石取出失败时，建议在放置鼻胰导管后进行ESWL。

{"title":"Treatment of large pancreatic radiolucent stone","authors":"Dan Wang , Wei An , Jin-Hui Yi , Fan Wang, Zhao-Shen Li, Liang-Hao Hu","doi":"10.1016/j.hbpd.2025.05.003","DOIUrl":"10.1016/j.hbpd.2025.05.003","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies have not clarified the treatment of large pancreatic radiolucent stones (≥ 5 mm). The primary objective of this study was to assess the clinical features and therapeutic efficacy in patients with chronic pancreatitis who have large radiolucent stones, and to propose a treatment strategy.</div></div><div><h3>Methods</h3><div>This analysis examined the data of patients with large pancreatic ductal stones (≥ 5 mm) from March 2011 to June 2018. Patients with radiolucent stones were classified as the radiolucent stones group, while those with pancreatic radiopaque stones presented at the same time were randomly selected as controls in a 1:2 ratio. Data on demographics, disease courses and treatment details were retrieved, and stone clearance and pain relief during the follow-up were compared between the two groups.</div></div><div><h3>Results</h3><div>A total of 52 patients with large radiolucent stones and 104 patients with large radiopaque stones were included in the study. Pancreatic extracorporeal shock wave lithotripsy (ESWL) was the initial treatment for large radiopaque stone. Endoscopic retrograde cholangiopancreatography (ERCP) was the first-step treatment for all patients in the radiolucent stones group, of which one patient received medication after failed ERCP cannulation, and four who failed stone extraction were treated with ESWL following the placement of a nasopancreatic catheter. There was no significant difference in the complete stone clearance rate (75.0% vs. 78.8%; <em>P</em> = 0.553) between the two groups. Among the 51 patients in the large radiolucent stones group who were followed up for 5.8 years (range 2.1-12.6), complete pain relief was achieved in 42 patients (82.4%), with no significant difference compared with the radiopaque group (82.4% vs. 76.4%; <em>P</em> = 0.409).</div></div><div><h3>Conclusions</h3><div>ERCP is an effective endotherapy for large radiolucent stone and should be considered the first-step treatment. When stone extraction failed during ERCP, ESWL is recommended following the placement of a nasopancreatic catheter.</div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"24 4","pages":"Pages 404-411"},"PeriodicalIF":3.6,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Prevalence and risk factors of skeletal muscle loss and sarcopenia in patients with autoimmune pancreatitis 自身免疫性胰腺炎患者骨骼肌损失和肌肉减少的患病率及危险因素

IF 3.6 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hepatobiliary & Pancreatic Diseases International

Pub Date : 2025-05-23 DOI: 10.1016/j.hbpd.2025.05.002

Takanori Sano, Kazuhiro Kikuta, Ryotaro Matsumoto, Tetsuya Takikawa, Shin Hamada, Shin Miura, Kiyoshi Kume, Atsushi Masamune

Background

Previous studies have highlighted the frequent occurrence of sarcopenia in patients with pancreatic diseases, including chronic pancreatitis. We aimed to clarify the prevalence of skeletal muscle (SM) loss and sarcopenia, and their associations with clinical characteristics, bone mineral density, and pancreatic imaging findings in patients with autoimmune pancreatitis (AIP).

Methods

This study included 114 patients with AIP treated at Tohoku University Hospital. The SM index was assessed using a bioelectrical impedance analysis device, grip strength was measured using a hand dynamometer, and bone mineral density was evaluated using dual-energy X-ray absorptiometry. Univariate and multivariate logistic regression analyses were used to analyze factors associated with SM loss and sarcopenia.

Results

Among 114 patients, 57 (50.0%) had SM loss, 31 (27.2%) had reduced grip strength, and 27 (23.7%) had both. Patients with SM loss were older and had a lower body mass index, weaker grip strength, higher Controlling Nutritional Status scores, and lower serum lipase and albumin levels compared to those without SM loss. Computed tomography scans revealed a higher prevalence of pancreatic parenchymal atrophy in patients with SM loss. Similar differences were observed between patients with sarcopenia and those without. Osteopathy was observed in 35.6% of patients with SM loss and 38.1% of those with sarcopenia, whereas only 4.1% of patients without SM loss had osteopathy. Low BMI (< 21.0 kg/m²) was also found to be an independent risk factor for SM loss in multivariate analysis. Age > 72 years, low BMI (< 20.0 kg/m²), and low serum lipase levels (< 13 U/L) were independent risk factors for sarcopenia in multivariate analysis.

Conclusions

SM loss and sarcopenia are prevalent in patients with AIP and are associated with aging, poor nutritional status, low serum lipase levels, and pancreatic parenchymal atrophy. In addition to the high risk of osteopathy, careful attention should be paid to maintain muscle health in AIP patients.

背景：以往的研究强调，肌肉减少症在包括慢性胰腺炎在内的胰腺疾病患者中经常发生。我们旨在阐明自身免疫性胰腺炎（AIP）患者骨骼肌（SM）损失和肌肉减少的患病率，以及它们与临床特征、骨矿物质密度和胰腺影像学表现的关系。方法：选取东北大学附属医院收治的114例AIP患者为研究对象。使用生物电阻抗分析装置评估SM指数，使用手部测力仪测量握力，使用双能x线吸收仪评估骨密度。采用单因素和多因素logistic回归分析分析与SM丧失和肌肉减少症相关的因素。结果：114例患者中，57例（50.0%）有握力丧失，31例（27.2%）有握力下降，27例（23.7%）两者兼有。与没有SM丧失的患者相比，SM丧失的患者年龄较大，体重指数较低，握力较弱，控制营养状态评分较高，血清脂肪酶和白蛋白水平较低。计算机断层扫描显示，SM丧失患者胰腺实质萎缩的发生率较高。在肌肉减少症患者和非肌肉减少症患者之间观察到类似的差异。35.6%的SM丢失患者和38.1%的肌肉减少患者出现了骨病，而没有SM丢失的患者中只有4.1%出现了骨病。在多因素分析中，低BMI （< 21.0 kg/m2）也被发现是SM丧失的独立危险因素。多因素分析显示，年龄bb0 ~ 72岁、低BMI （< 20.0 kg/m2）、低血清脂肪酶水平（< 13 U/L）是肌少症的独立危险因素。结论：SM丢失和肌肉减少在AIP患者中普遍存在，并与衰老、营养状况不佳、血清脂肪酶水平低和胰腺实质萎缩有关。除了患骨病的高风险外，还应注意保持AIP患者的肌肉健康。

{"title":"Prevalence and risk factors of skeletal muscle loss and sarcopenia in patients with autoimmune pancreatitis","authors":"Takanori Sano, Kazuhiro Kikuta, Ryotaro Matsumoto, Tetsuya Takikawa, Shin Hamada, Shin Miura, Kiyoshi Kume, Atsushi Masamune","doi":"10.1016/j.hbpd.2025.05.002","DOIUrl":"10.1016/j.hbpd.2025.05.002","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies have highlighted the frequent occurrence of sarcopenia in patients with pancreatic diseases, including chronic pancreatitis. We aimed to clarify the prevalence of skeletal muscle (SM) loss and sarcopenia, and their associations with clinical characteristics, bone mineral density, and pancreatic imaging findings in patients with autoimmune pancreatitis (AIP).</div></div><div><h3>Methods</h3><div>This study included 114 patients with AIP treated at Tohoku University Hospital. The SM index was assessed using a bioelectrical impedance analysis device, grip strength was measured using a hand dynamometer, and bone mineral density was evaluated using dual-energy X-ray absorptiometry. Univariate and multivariate logistic regression analyses were used to analyze factors associated with SM loss and sarcopenia.</div></div><div><h3>Results</h3><div>Among 114 patients, 57 (50.0%) had SM loss, 31 (27.2%) had reduced grip strength, and 27 (23.7%) had both. Patients with SM loss were older and had a lower body mass index, weaker grip strength, higher Controlling Nutritional Status scores, and lower serum lipase and albumin levels compared to those without SM loss. Computed tomography scans revealed a higher prevalence of pancreatic parenchymal atrophy in patients with SM loss. Similar differences were observed between patients with sarcopenia and those without. Osteopathy was observed in 35.6% of patients with SM loss and 38.1% of those with sarcopenia, whereas only 4.1% of patients without SM loss had osteopathy. Low BMI (< 21.0 kg/m<sup>2</sup>) was also found to be an independent risk factor for SM loss in multivariate analysis. Age > 72 years, low BMI (< 20.0 kg/m<sup>2</sup>), and low serum lipase levels (< 13 U/L) were independent risk factors for sarcopenia in multivariate analysis.</div></div><div><h3>Conclusions</h3><div>SM loss and sarcopenia are prevalent in patients with AIP and are associated with aging, poor nutritional status, low serum lipase levels, and pancreatic parenchymal atrophy. In addition to the high risk of osteopathy, careful attention should be paid to maintain muscle health in AIP patients.</div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"24 4","pages":"Pages 396-403"},"PeriodicalIF":3.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Meetings and Courses 会议及课程

IF 3.6 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hepatobiliary & Pancreatic Diseases International

Pub Date : 2025-05-16 DOI: 10.1016/S1499-3872(25)00069-4

引用次数: 0

New-onset diabetes worsens prognosis of patients with pancreatic ductal adenocarcinoma after R0 resection: A multicenter study 一项多中心研究表明，新发糖尿病恶化了胰腺导管腺癌患者R0切除术后的预后。

IF 4.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hepatobiliary & Pancreatic Diseases International

Pub Date : 2025-05-02 DOI: 10.1016/j.hbpd.2025.04.008

Peng-Jiong Liu , Zhi-Peng Zhou , Guan-Yu Wang , Shuai Xu , Wei Wang , Xiong Chen , Xiao-Dong Tan , Zhong-Hua Liu , Zhi-Ming Zhao , Yuan-Xing Gao , Xiu-Ping Zhang , Rong Liu

Background

The risk of pancreatic ductal adenocarcinoma (PDAC) is increased in patients with diabetes mellitus (DM), particularly in new-onset diabetes (NOD). This study aimed to analyze the effect of NOD on the outcomes of patients with PDAC after R0 resection.

Methods

PDAC patients from six centers in China undergoing R0 resection from 2015 to 2022 were included. Patients were categorized as long-term diabetes (LTD), NOD, or non-diabetes mellitus (non-DM) based on the timing of diagnosis relative to pancreatic resection. We compared the effects of diabetes status on perioperative and oncological outcomes of PDAC.

Results

Of 1211 patients, 602 (49.7%), 127 (10.5%), and 482 (39.8%) were in the non-DM, LTD, and NOD groups, respectively. Patients with NOD suffered from higher rates of fatty pancreas and postoperative pancreatic fistula (POPF) (both P < 0.05). When compared with the non-DM group, the NOD group had worse median overall survival (OS) (24.6 vs. 29.4 months, P < 0.001) and recurrence-free survival (RFS) (13.3 vs. 15.8 months, P < 0.001); and the LTD group also had worse median OS (25.2 vs. 29.4 months, P = 0.041) and RFS (13.8 vs. 15.8 months, P = 0.007) compared with non-DM group. However, there were no significant differences in survival between the NOD and the LTD groups. Multivariate analysis indicated that NOD, LTD, largest tumor size, and poor tumor differentiation were independently associated with worse OS and RFS (all P < 0.05).

Conclusions

Patients with PDAC undergoing R0 resection experienced a higher probability of POPF in the presence of concurrent NOD. Long-term survival prognosis was worse in NOD or LTD patients than in non-DM patients.

背景：糖尿病（DM）患者，特别是新发糖尿病（NOD）患者发生胰导管腺癌（PDAC）的风险增加。本研究旨在分析NOD对PDAC患者R0切除术后预后的影响。方法：纳入2015 - 2022年中国6个中心接受R0切除术的PDAC患者。根据与胰腺切除术相关的诊断时间，将患者分为长期糖尿病（LTD）、NOD或非糖尿病（non-DM）。我们比较了糖尿病状况对PDAC围手术期和肿瘤预后的影响。结果：1211例患者中，非dm组602例（49.7%），LTD组127例（10.5%），NOD组482例（39.8%）。NOD患者的脂肪性胰腺和术后胰瘘（POPF）发生率较高（P < 0.05）。与非dm组相比，NOD组的中位总生存期（OS）（24.6个月vs 29.4个月，P < 0.001）和无复发生存期（RFS）（13.3个月vs 15.8个月，P < 0.001）较差；与非dm组相比，LTD组的中位OS（25.2个月vs 29.4个月，P = 0.041）和RFS（13.8个月vs 15.8个月，P = 0.007）也较差。然而，NOD组和LTD组的生存率没有显著差异。多因素分析显示，NOD、LTD、最大肿瘤大小、肿瘤分化差与较差的OS和RFS独立相关（均P < 0.05）。结论：接受R0切除术的PDAC患者在并发NOD的情况下发生POPF的可能性更高。NOD或LTD患者的长期生存预后较非dm患者差。

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