Pub Date : 2022-06-01DOI: 10.1097/JP9.0000000000000095
A. Tan-Garcia, S. Lee, Jen-San Wong, T. Ho, K. Ng, K. H. Tony Lim
Pancreatic lymphangiomas are very rare benign cystic lesions that pose a diagnostic dilemma due to their resemblance to other non-neoplastic and neoplastic pancreatic cystic lesions. As such, pancreatic lymphangiomas are frequently diagnosed only after histological examination of the excised lesion. We present 2 cases of pancreatic lymphangioma, determine its prevalence at our institution and perform a detailed review of published literature since 2010. Case 1 is a 36-year-old male and case 2 is a 35-year-old female, both of which presented with abdominal pain. These were the only cases of pancreatic lymphangiomas reported at our institution since 2010. We reviewed 69 cases of pancreatic lymphangiomas from 52 publications. It affects predominantly females with a median age of 43 and such patients typically present with abdominal pain (58.8%) or are asymptomatic (27.9%). The median size is 8.6 cm, the most common location is the head of pancreas and the most common imaging finding is that of a multilocular cyst. Majority of patients underwent surgical resection (69.6%). Endoscopic ultrasound-guided fine-needle aspiration features of pancreatic lymphangiomas include chylous cyst fluid, elevated fluid triglyceride levels (15/16 cases) and numerous lymphocytes on cytology. The majority of patients with elevated fluid triglyceride levels (13/15 cases) were managed conservatively. Pancreatic lymphangiomas are rare pancreatic cystic lesions that may be diagnosed preoperatively using a multidisciplinary and multimodal approach involving clinical, radiological, biochemical and cytological features, allowing greater confidence in the selection of patients who can be managed conservatively.
{"title":"Pancreatic lymphangioma: two case reports from an institutional experience with a rare entity and review of literature","authors":"A. Tan-Garcia, S. Lee, Jen-San Wong, T. Ho, K. Ng, K. H. Tony Lim","doi":"10.1097/JP9.0000000000000095","DOIUrl":"https://doi.org/10.1097/JP9.0000000000000095","url":null,"abstract":"Pancreatic lymphangiomas are very rare benign cystic lesions that pose a diagnostic dilemma due to their resemblance to other non-neoplastic and neoplastic pancreatic cystic lesions. As such, pancreatic lymphangiomas are frequently diagnosed only after histological examination of the excised lesion. We present 2 cases of pancreatic lymphangioma, determine its prevalence at our institution and perform a detailed review of published literature since 2010. Case 1 is a 36-year-old male and case 2 is a 35-year-old female, both of which presented with abdominal pain. These were the only cases of pancreatic lymphangiomas reported at our institution since 2010. We reviewed 69 cases of pancreatic lymphangiomas from 52 publications. It affects predominantly females with a median age of 43 and such patients typically present with abdominal pain (58.8%) or are asymptomatic (27.9%). The median size is 8.6 cm, the most common location is the head of pancreas and the most common imaging finding is that of a multilocular cyst. Majority of patients underwent surgical resection (69.6%). Endoscopic ultrasound-guided fine-needle aspiration features of pancreatic lymphangiomas include chylous cyst fluid, elevated fluid triglyceride levels (15/16 cases) and numerous lymphocytes on cytology. The majority of patients with elevated fluid triglyceride levels (13/15 cases) were managed conservatively. Pancreatic lymphangiomas are rare pancreatic cystic lesions that may be diagnosed preoperatively using a multidisciplinary and multimodal approach involving clinical, radiological, biochemical and cytological features, allowing greater confidence in the selection of patients who can be managed conservatively.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"5 1","pages":"98 - 109"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41516108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-01Epub Date: 2021-06-15DOI: 10.1097/jp9.0000000000000083
Georgios Antonios Margonis, Nikolaos Andreatos, Jane Wang, Matthew J Weiss, Christopher L Wolfgang
Although the natural history of recurrence/progression in patients with intraductal papillary mucinous neoplasms (IPMN) of the pancreas has not been studied thoroughly, the three principal mechanisms have been identified: (a) presence of residual disease at the transection margin, (b) presence of intraductal/intraparenchymal metastases and (c) development of new primary lesions. Mechanisms (a) and (b) result in metastatic lesions that are genetically related to the primary, while new primary lesions (mechanism c) are genetically distinct. Interestingly, recurrence/progression in IPMN displays conceptual parallels with the well-established paradigm of disease recurrence in patients with hepatocellular carcinoma (HCC). Specifically, patients with HCC may also develop recurrent tumors due to microscopic residual disease/intrahepatic metastasis which are genetically similar to the primary while the development of genetically unrelated, de novo HCC after curative-intent resection is also common. The latter has been attributed to the presence of a widespread genetic abnormality ("field defect") in the liver (ie, cirrhosis). Given the conceptual similarities between IPMN and HCC, a pancreatic "field defect"may also be hypothesized to exist. This review does not suggest that HCC and IPMN have identical pathogeneses, but rather that they have conceptual similarities in tumor recurrence/progression; thus, lessons learned from HCC could be applied to IPMN research and subsequent management. Conceptual similarities in tumor progression and recurrence may also be observed between IPMN and other malignancies. However, HCC was selected because it is well studied and can serve as a paradigm.
{"title":"Lessons learned from hepatocellular carcinoma may cause a paradigm shift in intraductal papillary mucinous neoplasms: a narrative review and discussion of conceptual similarities in tumor progression and recurrence.","authors":"Georgios Antonios Margonis, Nikolaos Andreatos, Jane Wang, Matthew J Weiss, Christopher L Wolfgang","doi":"10.1097/jp9.0000000000000083","DOIUrl":"10.1097/jp9.0000000000000083","url":null,"abstract":"<p><p>Although the natural history of recurrence/progression in patients with intraductal papillary mucinous neoplasms (IPMN) of the pancreas has not been studied thoroughly, the three principal mechanisms have been identified: (a) presence of residual disease at the transection margin, (b) presence of intraductal/intraparenchymal metastases and (c) development of new primary lesions. Mechanisms (a) and (b) result in metastatic lesions that are genetically related to the primary, while new primary lesions (mechanism c) are genetically distinct. Interestingly, recurrence/progression in IPMN displays conceptual parallels with the well-established paradigm of disease recurrence in patients with hepatocellular carcinoma (HCC). Specifically, patients with HCC may also develop recurrent tumors due to microscopic residual disease/intrahepatic metastasis which are genetically similar to the primary while the development of genetically unrelated, de novo HCC after curative-intent resection is also common. The latter has been attributed to the presence of a widespread genetic abnormality (\"field defect\") in the liver (ie, cirrhosis). Given the conceptual similarities between IPMN and HCC, a pancreatic \"field defect\"may also be hypothesized to exist. This review does not suggest that HCC and IPMN have identical pathogeneses, but rather that they have conceptual similarities in tumor recurrence/progression; thus, lessons learned from HCC could be applied to IPMN research and subsequent management. Conceptual similarities in tumor progression and recurrence may also be observed between IPMN and other malignancies. However, HCC was selected because it is well studied and can serve as a paradigm.</p>","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"5 1","pages":"36-40"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44626312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Objective: Pancreatic cancer is one of the most aggressive digestive system malignant tumors, and its clinical diagnosis and treatment are still challenging. To further understand the current status and improve the multidisciplinary collaboration for diagnosis and treatment of pancreatic cancer in China, we conducted an online questionnaire survey on the diagnosis and treatment status of pancreatic cancer in public tertiary hospitals of China in 2021. Methods: In this cross-sectional questionnaire-based, observational study, online questionnaires with real-name authentication were used to gather data from 500 clinicians, 50 pharmacists, and 1000 pancreatic cancer patients in tertiary general hospitals or cancer hospitals nationwide. Results: A total of 485 valid questionnaires were obtained from the clinicians, majority of whom were from economically better developed regions or cities of China. There were multi-disciplinary team treatment (MDT) clinics for pancreatic cancer patients in 60% of the hospitals. Minimally invasive surgeries could be performed in all the surveyed hospitals. However, open surgery was still the mainstream choice in most cases. Gemcitabine-based chemotherapy was the most popular first-line adjuvant regimen for pancreatic cancer. A total of 50 valid questionnaires were collected from pharmacists, 48% of them are not satisfactory with the efficacy of the chemotherapeutic drugs, and myelosuppression, liver, and renal damage were the most concerning side effects. In total, 1011 valid questionnaires were collected from the patients. Approximately, 48.4% of the patients did not know about pancreatic cancer before becoming ill. Over 80% of pancreatic cancer patients reported poor to very poor health-related quality of life, and the estimated overall medical expenses were within ¥400,000 ($58823.53) in 80% of the patients. Clinicians, pharmacists, and patients believe that popularizing scientific knowledge of pancreatic cancer, constructing MDT clinics and fast-lane system, and conducting clinical research will help further improve the diagnosis and treatment of pancreatic cancer. Conclusions: The MDT clinics for pancreatic cancer have been well developed in most of the public tertiary hospitals. Minimally invasive pancreatic surgery has developed rapidly in China; however, open surgery is still the mainstream choice for pancreatic cancer. The proportion of adjuvant treatment has been significantly improved, and the gemcitabine-based regimen is the most commonly used first-line regimen. Most of the public still lacks the general knowledge of pancreatic cancer, needing further popularization. The construction of a fast-lane treatment system and conducting of high-level clinical studies are the warm expectations of the clinicians and patients. The real-world situation of the diagnosis and treatment of pancreatic cancer in the other types of hospitals of China needs further exploration.
{"title":"Survey on the current status of the diagnosis and treatment of pancreatic cancer in public tertiary hospitals in China: a cross-sectional questionnaire-based, observational study","authors":"Wenming Wu, Qiaofei Liu, Jingcheng Zhang, Yupei Zhao","doi":"10.1097/JP9.0000000000000079","DOIUrl":"https://doi.org/10.1097/JP9.0000000000000079","url":null,"abstract":"Abstract Objective: Pancreatic cancer is one of the most aggressive digestive system malignant tumors, and its clinical diagnosis and treatment are still challenging. To further understand the current status and improve the multidisciplinary collaboration for diagnosis and treatment of pancreatic cancer in China, we conducted an online questionnaire survey on the diagnosis and treatment status of pancreatic cancer in public tertiary hospitals of China in 2021. Methods: In this cross-sectional questionnaire-based, observational study, online questionnaires with real-name authentication were used to gather data from 500 clinicians, 50 pharmacists, and 1000 pancreatic cancer patients in tertiary general hospitals or cancer hospitals nationwide. Results: A total of 485 valid questionnaires were obtained from the clinicians, majority of whom were from economically better developed regions or cities of China. There were multi-disciplinary team treatment (MDT) clinics for pancreatic cancer patients in 60% of the hospitals. Minimally invasive surgeries could be performed in all the surveyed hospitals. However, open surgery was still the mainstream choice in most cases. Gemcitabine-based chemotherapy was the most popular first-line adjuvant regimen for pancreatic cancer. A total of 50 valid questionnaires were collected from pharmacists, 48% of them are not satisfactory with the efficacy of the chemotherapeutic drugs, and myelosuppression, liver, and renal damage were the most concerning side effects. In total, 1011 valid questionnaires were collected from the patients. Approximately, 48.4% of the patients did not know about pancreatic cancer before becoming ill. Over 80% of pancreatic cancer patients reported poor to very poor health-related quality of life, and the estimated overall medical expenses were within ¥400,000 ($58823.53) in 80% of the patients. Clinicians, pharmacists, and patients believe that popularizing scientific knowledge of pancreatic cancer, constructing MDT clinics and fast-lane system, and conducting clinical research will help further improve the diagnosis and treatment of pancreatic cancer. Conclusions: The MDT clinics for pancreatic cancer have been well developed in most of the public tertiary hospitals. Minimally invasive pancreatic surgery has developed rapidly in China; however, open surgery is still the mainstream choice for pancreatic cancer. The proportion of adjuvant treatment has been significantly improved, and the gemcitabine-based regimen is the most commonly used first-line regimen. Most of the public still lacks the general knowledge of pancreatic cancer, needing further popularization. The construction of a fast-lane treatment system and conducting of high-level clinical studies are the warm expectations of the clinicians and patients. The real-world situation of the diagnosis and treatment of pancreatic cancer in the other types of hospitals of China needs further exploration.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"4 1","pages":"164 - 169"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48342185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-01DOI: 10.1097/JP9.0000000000000081
Dipesh Kumar Yadav, Xing Huang, Qi Zhang, Gang Zhang, X. Bai, T. Liang
Supplemental Digital Content is available in the text Abstract To analyze a long-term survival outcome of an auto-intestine transplantation (aINTx) for the patients with locally advanced pancreatic tumor and identify the potential prognostic factors, databases were carefully searched for the studies reporting the patients with a locally advanced pancreatic tumor which typically underwent aINTx. We performed a database search using PubMed, the Cochrane Library, EMBASE, and MEDLINE to identify multiple case series of the patients who had pancreatic tumors with mesenteric root involvement and underwent aINTx, to evaluate the treatment outcomes, and calculated the patient survival using the Kaplan–Meier method and Cox proportional hazard regression analysis to properly identify an independent predictor of the survival. A total of 9 retrospective studies with a total of 29 patients were included in our study. The calculated 1-, 2-, and 3-year survival rates for the patients with pancreatic cancer and benign or low grade pancreatic tumors were 49.64%, 22.06%, and 0% versus 100%, 100%, and 80%, respectively. The corresponding median survival time was 13.4 months and 84 months, respectively. Moreover, when stratifying the pancreatic cancer patients undergoing aINTx on the basis of neoadjuvant chemotherapy (aINTx + neoadjuvant vs aINTx - neoadjuvant) there was a significant difference in the survival (P = .01). The 1- and 2-year survival rates were 75% and 75% versus 34.1% and 0%, respectively. Corresponding median survival times were 24 months and 10 months, respectively. Our analysis shows the long-term survival benefit with acceptable morbidity and mortality of pancreatoduodenectomy and aINTx for the pancreatic tumors with the mesenteric root involvement that are otherwise unresectable by the conventional surgical techniques. However, from an oncological point of view, a larger study with the control group is required to determine its safety compared to less aggressive surgical treatment.
{"title":"Auto-intestine transplantation for pancreatic tumors with mesenteric root involvement: a systematic review and survival-based analysis","authors":"Dipesh Kumar Yadav, Xing Huang, Qi Zhang, Gang Zhang, X. Bai, T. Liang","doi":"10.1097/JP9.0000000000000081","DOIUrl":"https://doi.org/10.1097/JP9.0000000000000081","url":null,"abstract":"Supplemental Digital Content is available in the text Abstract To analyze a long-term survival outcome of an auto-intestine transplantation (aINTx) for the patients with locally advanced pancreatic tumor and identify the potential prognostic factors, databases were carefully searched for the studies reporting the patients with a locally advanced pancreatic tumor which typically underwent aINTx. We performed a database search using PubMed, the Cochrane Library, EMBASE, and MEDLINE to identify multiple case series of the patients who had pancreatic tumors with mesenteric root involvement and underwent aINTx, to evaluate the treatment outcomes, and calculated the patient survival using the Kaplan–Meier method and Cox proportional hazard regression analysis to properly identify an independent predictor of the survival. A total of 9 retrospective studies with a total of 29 patients were included in our study. The calculated 1-, 2-, and 3-year survival rates for the patients with pancreatic cancer and benign or low grade pancreatic tumors were 49.64%, 22.06%, and 0% versus 100%, 100%, and 80%, respectively. The corresponding median survival time was 13.4 months and 84 months, respectively. Moreover, when stratifying the pancreatic cancer patients undergoing aINTx on the basis of neoadjuvant chemotherapy (aINTx + neoadjuvant vs aINTx - neoadjuvant) there was a significant difference in the survival (P = .01). The 1- and 2-year survival rates were 75% and 75% versus 34.1% and 0%, respectively. Corresponding median survival times were 24 months and 10 months, respectively. Our analysis shows the long-term survival benefit with acceptable morbidity and mortality of pancreatoduodenectomy and aINTx for the pancreatic tumors with the mesenteric root involvement that are otherwise unresectable by the conventional surgical techniques. However, from an oncological point of view, a larger study with the control group is required to determine its safety compared to less aggressive surgical treatment.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"4 1","pages":"153 - 163"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46070402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-01DOI: 10.1097/JP9.0000000000000077
Taiping Zhang, Wenming Wu, Yinmo Yang, Yupei Zhao
Abstract Aiming to keep pace with the renewal of international guidelines and refine the domestic treatment system of pancreatic cancer, the Chinese Pancreatic Surgery Association, Chinese Medical Association and Pancreatic Disease Committee of China Research Hospital Association launched this Chinese guidelines for neoadjuvant therapy of pancreatic cancer (2020 edition). Based on the Grading of Recommendations Assessment, Development, and Evaluation system, the guidelines have conducted a discussion on the indication, regimen selection, therapeutic effect evaluation, pathological diagnosis, surgery strategy, etc. The guidelines have quantified the evidence level of the current clinical researches and provided recommendations for the clinical practice in neoadjuvant therapy of pancreatic cancer. The guidelines have highlighted the role of multiple disciplinary team and represented the conversion of treatment concepts in pancreatic cancer. Neoadjuvant therapy has prolonged the survival of part of pancreatic cancer patients. However, more high-quality clinical researches are in urgent need to improve the level of evidence, optimize the clinical practice, and improve the survival of patients.
{"title":"The Chinese guidelines for neoadjuvant therapy of pancreatic cancer (2020)","authors":"Taiping Zhang, Wenming Wu, Yinmo Yang, Yupei Zhao","doi":"10.1097/JP9.0000000000000077","DOIUrl":"https://doi.org/10.1097/JP9.0000000000000077","url":null,"abstract":"Abstract Aiming to keep pace with the renewal of international guidelines and refine the domestic treatment system of pancreatic cancer, the Chinese Pancreatic Surgery Association, Chinese Medical Association and Pancreatic Disease Committee of China Research Hospital Association launched this Chinese guidelines for neoadjuvant therapy of pancreatic cancer (2020 edition). Based on the Grading of Recommendations Assessment, Development, and Evaluation system, the guidelines have conducted a discussion on the indication, regimen selection, therapeutic effect evaluation, pathological diagnosis, surgery strategy, etc. The guidelines have quantified the evidence level of the current clinical researches and provided recommendations for the clinical practice in neoadjuvant therapy of pancreatic cancer. The guidelines have highlighted the role of multiple disciplinary team and represented the conversion of treatment concepts in pancreatic cancer. Neoadjuvant therapy has prolonged the survival of part of pancreatic cancer patients. However, more high-quality clinical researches are in urgent need to improve the level of evidence, optimize the clinical practice, and improve the survival of patients.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"4 1","pages":"135 - 145"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47057749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-01DOI: 10.1097/JP9.0000000000000080
Nuerabula Wujimaimaiti, Yi Wu, J. Yuan, Jikuan Jin, Hebin Wang, Shizhen Li, Hang Zhang, Min Wang, R. Qin
Abstract Pancreatic surgery is one of the most complex and challenging fields in abdominal surgery associated with extensive surgical trauma, damage to adjacent organs, a long operation time and a high incidence of postoperative complications. Since the early 1990s, laparoscopic techniques have been applied to a growing number of pancreas surgeries, and great progress has been achieved in laparoscopic pancreaticoduodenectomy. As surgeons become proficient in laparoscopic pancreaticoduodenectomy techniques, laparoscopic techniques are gradually used in other pancreatic surgeries, such as laparoscopic distal pancreatectomies and laparoscopic duodenum-preserving pancreatic head resection (LDPPHR), which may benefit patients by reducing postoperative pain and hospital stays and providing a quick recovery to normal activity. Recently, a great number of literature have introduced LDPPHR. It is a good surgical method for benign and low-grade malignant tumors of the pancreatic head. Although LDPPHR is technically feasible, it is not yet generally practicable and limited to highly skilled endoscopic surgeons, and the long-term results after LDPPHR are still not well defined. This article aims to provide a literature review of LDPPHR to assess its feasibility, safety, postoperative recovery, and future outlook according to early experiences of this technique.
{"title":"Laparoscopic duodenum-preserving pancreatic head resection: a narrative review","authors":"Nuerabula Wujimaimaiti, Yi Wu, J. Yuan, Jikuan Jin, Hebin Wang, Shizhen Li, Hang Zhang, Min Wang, R. Qin","doi":"10.1097/JP9.0000000000000080","DOIUrl":"https://doi.org/10.1097/JP9.0000000000000080","url":null,"abstract":"Abstract Pancreatic surgery is one of the most complex and challenging fields in abdominal surgery associated with extensive surgical trauma, damage to adjacent organs, a long operation time and a high incidence of postoperative complications. Since the early 1990s, laparoscopic techniques have been applied to a growing number of pancreas surgeries, and great progress has been achieved in laparoscopic pancreaticoduodenectomy. As surgeons become proficient in laparoscopic pancreaticoduodenectomy techniques, laparoscopic techniques are gradually used in other pancreatic surgeries, such as laparoscopic distal pancreatectomies and laparoscopic duodenum-preserving pancreatic head resection (LDPPHR), which may benefit patients by reducing postoperative pain and hospital stays and providing a quick recovery to normal activity. Recently, a great number of literature have introduced LDPPHR. It is a good surgical method for benign and low-grade malignant tumors of the pancreatic head. Although LDPPHR is technically feasible, it is not yet generally practicable and limited to highly skilled endoscopic surgeons, and the long-term results after LDPPHR are still not well defined. This article aims to provide a literature review of LDPPHR to assess its feasibility, safety, postoperative recovery, and future outlook according to early experiences of this technique.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"4 1","pages":"146 - 152"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42289442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-01DOI: 10.1097/JP9.0000000000000082
Amon B. Hackney, W. Chung, J. Isherwood, A. Dennison, N. Martin
Abstract Objective: Pancreatic cancer (PC) is an aggressive cancer with ineffective treatment. Inhibition of stearoyl-CoA desaturase 1 (SCD1) suppresses cancer proliferation and might act as a novel chemotherapy supplement, but this has not been investigated in PC. Here, the effects of SCD1 inhibitor CAY10566 supplemented with gemcitabine treatment (gemcitabine+CAY10566) on PC cell viability, apoptosis, phenotype, fatty acid content, platelet-derived growth factor release, and cell size were investigated. Methods: Human PC cell line (PANC-1) was treated with SCD1 inhibitor CAY10566 with or without gemcitabine. Cell viability was assayed using 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide and apoptosis and phenotype were determined using flow cytometry. Fatty acid content and platelet-derived growth factor release were measured by enzyme-linked immunosorbent assay. Cell size was determined using scanning electron microscopy. Results: Half-maximal inhibitory concentration of gemcitabine or CAY10566 significantly reduced PANC-1 viability compared to gemcitabine alone (P < .0001). No significant differences in the phenotype of phosphatidylserine, tissue factor or basigin expression were detected at therapeutic doses (P > .05). Apoptosis was significantly increased following incubation with CAY10566 (P < .05). Fatty acid content of cells was significantly higher following gemcitabine treatment compared to CAY10566 alone or gemcitabine+CAY10566 (P < .05). Platelet-derived growth factor released by gemcitabine-treated cells was significantly increased compared to 142 nM CAY10566 alone or gemcitabine+CAY10566 (P < .01). CAY10566 did not affect the size of isolated tumor cells but gemcitabine+CAY10566 significantly increased the size compared to the control (P < .05). Cell viability decreased significantly after the treatment with gemcitabine+CAY10566 compared with CAY10566 alone (P < .05) and gemcitabine alone (P < .01). However, when cycles of chemotherapy were mimicked and treatment was removed, the number of cell viability was significantly reduced (P < .05). Conclusion: This study suggests that CAY10566 may be a suitable supplement for gemcitabine chemotherapy for PC.
{"title":"Stearoyl-CoA desaturase 1 inhibitor supplemented with gemcitabine treatment reduces the viability and fatty acid content of pancreatic cancer cells in vitro","authors":"Amon B. Hackney, W. Chung, J. Isherwood, A. Dennison, N. Martin","doi":"10.1097/JP9.0000000000000082","DOIUrl":"https://doi.org/10.1097/JP9.0000000000000082","url":null,"abstract":"Abstract Objective: Pancreatic cancer (PC) is an aggressive cancer with ineffective treatment. Inhibition of stearoyl-CoA desaturase 1 (SCD1) suppresses cancer proliferation and might act as a novel chemotherapy supplement, but this has not been investigated in PC. Here, the effects of SCD1 inhibitor CAY10566 supplemented with gemcitabine treatment (gemcitabine+CAY10566) on PC cell viability, apoptosis, phenotype, fatty acid content, platelet-derived growth factor release, and cell size were investigated. Methods: Human PC cell line (PANC-1) was treated with SCD1 inhibitor CAY10566 with or without gemcitabine. Cell viability was assayed using 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide and apoptosis and phenotype were determined using flow cytometry. Fatty acid content and platelet-derived growth factor release were measured by enzyme-linked immunosorbent assay. Cell size was determined using scanning electron microscopy. Results: Half-maximal inhibitory concentration of gemcitabine or CAY10566 significantly reduced PANC-1 viability compared to gemcitabine alone (P < .0001). No significant differences in the phenotype of phosphatidylserine, tissue factor or basigin expression were detected at therapeutic doses (P > .05). Apoptosis was significantly increased following incubation with CAY10566 (P < .05). Fatty acid content of cells was significantly higher following gemcitabine treatment compared to CAY10566 alone or gemcitabine+CAY10566 (P < .05). Platelet-derived growth factor released by gemcitabine-treated cells was significantly increased compared to 142 nM CAY10566 alone or gemcitabine+CAY10566 (P < .01). CAY10566 did not affect the size of isolated tumor cells but gemcitabine+CAY10566 significantly increased the size compared to the control (P < .05). Cell viability decreased significantly after the treatment with gemcitabine+CAY10566 compared with CAY10566 alone (P < .05) and gemcitabine alone (P < .01). However, when cycles of chemotherapy were mimicked and treatment was removed, the number of cell viability was significantly reduced (P < .05). Conclusion: This study suggests that CAY10566 may be a suitable supplement for gemcitabine chemotherapy for PC.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"4 1","pages":"170 - 177"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42478623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-17DOI: 10.1097/jp9.0000000000000076
Xiaofan Guo, S. Gao, Zekun Li, J. Hao
{"title":"The role of biomarker in pancreatic neuroendocrine tumor","authors":"Xiaofan Guo, S. Gao, Zekun Li, J. Hao","doi":"10.1097/jp9.0000000000000076","DOIUrl":"https://doi.org/10.1097/jp9.0000000000000076","url":null,"abstract":"","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48871601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-16DOI: 10.1097/jp9.0000000000000074
Wen Xie, Huaiyu Liang, Yan Guo, S. Xiao
{"title":"Update on mucinous cystic neoplasm of the pancreas","authors":"Wen Xie, Huaiyu Liang, Yan Guo, S. Xiao","doi":"10.1097/jp9.0000000000000074","DOIUrl":"https://doi.org/10.1097/jp9.0000000000000074","url":null,"abstract":"","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47679073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-01DOI: 10.1097/JP9.0000000000000075
G. Krishnamurthy, P. Radhakrishna, Aswin Khanna, K. Damodaran
Abstract Severe acute pancreatitis is commonly associated with pancreatic and extrapancreatic necrosis (EPN). Progressive EPN leading to necrotizing fasciitis of the retroperitoneum and abdominal wall has been reported. However, extension of retroperitoneal necrosis to the scrotum causing Fournier's gangrene is uncommon. We present a case of 39-year-old male admitted with severe acute pancreatitis requiring prolonged mechanical ventilation. He was managed with percutaneous drainage and culture specific antibiotics during the 1st month of hospital stay. During the 3rd month of hospital stay, the patient started developing pain and ulceration over the scrotum. He was diagnosed with Fournier's gangrene based on clinical examination and was planned for debridement. During surgery, the track extending up to the deep inguinal ring was widened and drain was placed into the right lateral pelvic wall through the deep ring via a separate stab incision to reduce further scrotal wound contamination. The case highlights a rare but potentially fatal complication of Fournier's gangrene following severe acute necrotizing pancreatitis and the importance of measures to prevent further contamination of scrotum after surgical debridement. Concomitant management of two potentially fatal conditions poses numerous challenges.
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