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Acute venous thromboembolism in acute pancreatitis based on the severity:a retrospective cohort study

Journal of pancreatology 2022年第1期5卷 10-17页

作者： Hassam Ali Swethaa Manickam Rahul Pamarthy Muhamad Fahd Farooq William Leland department of Internal Medicine East Carolina University/Vidant Medical CenterGreenvilleNC department of Gastroenterology East Carolina University/Vidant Medical CenterGreenvilleNCUSA

Objective: Acute pancreatitis (AP) results in systemic inflammatory responses and activates coagulation pathways. We intend to investigate the risk and hospital outcomes of acute venous thromboembolisms (VTE) in patients with ***: We retrospectively analyzed patients with AP from 2016 to 2019 using the National Inpatient Sample database. Primary outcome was the effect of VTE on the length of stay, inpatient costs, and mortality. Hierarchical multivariate logistic regression models were built using univariate ***: The study included 909,354 weighted discharges with AP. 2.1% of cases had an acute VTE. The length of stay was 5.9 days longer in the hospital of AP patients with VTE compared to AP with no VTE (P <.001). Total hospital charge per patient was $71,914 in patients with VTE compared to AP with no VTE (P < .001). Mortality was higher in AP patients with VTE compared to AP with no VTE (adjusted odds ratio [AOR] 4.2, 95% confidence interval [CI]: 3.4-5.3,P <.001). AP was associated with an increased VTE risk during inpatient stay (AOR 1.06, 95% CI 1.04-1.1,P <.001) There was an increased association of lower and upper extremity deep venous thrombosis with AP without necrosis (AOR 6.9, 95% CI 6.4-7.4,P <.001) and AP with infected necrosis (AOR 12.2, 95% CI 10.6-14.1,P <.001) but not in AP without necrosis (AOR 0.77, 95% CI 0.74-0.81,P <.001).Conclusion: VTE in AP increases length of stay and inpatient costs. The prognosis is poor in such patients, with increased inpatient mortality compared to no VTE. AP with necrosis can increase chances of all VTE subtypes;however, AP without necrosis does not increase upper and lower extremity VTE risk.

关键词： Acute pancreatitis Deep venous thrombosis Necrosis Severity Venous thromboembolism

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An unrecognized undifferentiated tumor of the pancreas:a case report

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Journal of pancreatology 2023年第4期6卷 225-227页

作者： Chaoyu Pang Zhiyao Fan Peng Su Hanxiang Zhan Division of Pancreatic Surgery Department of General SurgeryQilu HospitalShandong UniversityJinan 250012China department of Pathology Qilu HospitalShandong UniversityJinan 250012China

SMARCA4-deficient tumors are gaining attention,and this type of tumor is highly malignant with a poor *** frequency of SMARCA4 deletion varies in different ***,it has never been identified in the pancreas.A 67-year-old woman pre-sented with upper abdominal pain lasting for half a *** tomography indicated a space-occupying lesion in the head of the pancreas,considered a malignant *** Endoscopic ultrasound fine-needle aspiration was performed and report-ed as SMARCA4-deficient undifferentiated pancreatic *** patient received no treatment and survived only two and a half months from diagnosis to *** are the first to report SMARCA4-deficient pancreatic undifferentiated tumor in which this new tumor entity presents with poorer overall *** also summarized the advances of SMARCA4 in oncology and treatment.

关键词： Immune checkpoint inhibitors Pancreatic undifferentiated tumor SMARCA4-deficient SWI/SNF

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Consensus of clinical diagnosis and treatment for non-functional pancreatic neuroendocrine neoplasms with diameter<2 cm

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Journal of pancreatology 2023年第3期6卷 87-95页

作者： Wu Wenming Cai Shouwang Chen Rufu Fu Deliang Ge Chunlin Hao Chunyi Hao Jihui Huang Heguang Jian Zhixiang Jin Gang Li Fei Li Haimin Li Shengping Li Weiqin LiYixiong Liang Tingbo Liu Xubao Lou Wenhui Miao Yi Mou Yiping Peng Chenghong Qin Renyi Shao Chenghao Sun Bei Tan Guang Wang Huaizhi Wang Lei Wang Wei Wang Weilin Wei Junmin Wu Heshui Wu Zheng Yan Changqing Yang Yinmo Yin Xiaoyu Yu Xianjun Yuan Chunhui Zhao Yupei department of General Surgery State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100730China department of Hepatobiliary Surgery PLA General HospitalBeijing 100853China department of General Surgery Guangdong Provincial People’s HospitalGuangdong Academy of Medical SciencesGuangzhou 510080China department of Pancreatic Surgery Huashan HospitalShanghai Medical CollegeFudan UniversityShanghai 200040China department of Hepatobiliary and Pancreatic Surgery Hunnan Division of The First Hospital of China Medical UniversityShenyang 110167China department of Hepato-Pancreato-Biliary Surgery Peking University Cancer Hospital&InstituteBeijing 100142China department of Pancreatic Cancer Tianjin Medical University Cancer Institute and HospitalTianjin 300060China department of General Surgery Fujian Medical University Union HospitalFuzhou 350001China department of General Surgery Guangdong Provincial People’s HospitalGuangdong Academy of Medical SciencesGuangzhou 510000China department of Hepatobiliary Pancreatic Surgery Changhai Hospital Affiliated to Navy Medical University(Second Military Medical University)Shanghai 200433China department of General Surgery Xuanwu HospitalCapital Medical UniversityBeijing 100053China department of Hepatobiliary Surgery Xijing HospitalFourth Military Medical UniversityXi’an 710032China department of Hepatobiliary and Pancreatic Surgery Sun Yat-Sen University Cancer CenterState Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangzhou 510060China department of Critical Care Medicine Jinling HospitalMedical School of Nanjing UniversityNanjing 210002China department of General Surgery Xiangya HospitalCentral South UniversityChangsha 410008China department of Hepatobiliary and Pancreatic Surgery the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China department

In clinical practice,pancreatic neuroendocrine neoplasms(pNENs)with a diameter smaller than 2 cm are commonly referred to as small *** to their generally favorable biological characteristics,the diagnosis and treatment of small pNENs differ from other pNENs and are somewhat *** response to this,the Chinese Pancreatic Surgery Association,Chinese Society of Surgery,Chinese Medical Association have developed a consensus on the diagnosis and treatment of small pNENs,which is based on evidence-based medicine and expert *** consensus covers various topics,including concepts,disease assessment,treatment selection,follow-up,and other relevant aspects.

关键词： 2 cm Clinical diagnosis Non-functional pancreatic neuroendocrine neoplasms Treatment

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Real-world study of surgical treatment of pancreatic cancer in China: annual report of China Pancreas Data Center (2016-2020)

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Journal of pancreatology 2022年第1期5卷 1-9页

作者： Wenming Wu Yi Miao Yinmo Yang Wenhui Lou Yupei Zhao department of General Surgery State Key Laboratory of Complex and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science&Peking Union Medical CollegeBejing department of General Surgery Pancreas Centerthe First Afiliated Hospital of Nanjing Medical UniversityNanjingJiangsu Province department of General Surgery Peking University First HospitalBejing department of Pancreatic Surgery Zhongshan HospitalFudan UniversityShanghaiChina

Objective: In 2015, the Chinese Pancreatic Association of the Chinese Society of Surgery of the Chinese Medical Association launched a national multicenter online system for registration of surgical treatment of pancreatic cancer in China, called China Pancreas Data Center (CPDC). With continued effort, the CPDC has developed over time. Herein, we report the general results of the CPDC from January 2016 to January 2020 to present the real-world situation of surgical treatment of pancreatic cancer in ***: The data of the CPDC from January 2016 to January 2020 were retrieved and analyzed in this real-world study, including the data on patient demographics, comorbidities, diagnostic modalities, neoadjuvant treatment, surgical procedures, postoperative complications and treatment, pathological examinations, postoperative adjuvant treatment, survival, and risk ***: A total of 13,595 cases from 70 centers in 28 provinces were retrieved for analysis. This study reported the largest cohort of patients who underwent surgical treatment for pancreatic cancer in China to date. More cases were derived from the Eastern regions, among which Shanghai, Beijing, and Zhejiang ranked in the top three. The peak age of the patients ranged from 60 to 69 years. The ratio of males to females was 1.5:1. Overall, 64.3% of the tumors were located in the head and neck of the pancreas, and 35.7% in the body and tail of the pancreas. Of the patients, 23.0% underwent positron-emission tomography-computed tomography, 21.6% underwent endoscopic ultrasound, and 4.8% underwent preoperative biopsy. Two percent of the patients underwent neoadjuvant treatment, while 68.9% underwent R0 surgical resection (margin free of tumor cells). Of the latter, 78.6% of the operations were open procedures, 12.6% were laparoscopic procedures, 2.9% were robotic procedures, and 3.7% were converted to open procedures. The in-hospital mortality rate after surgery was 0.4%. The incidence of grade 2 and

关键词： Chemotherapy China Pancreas Data Center Overall survival Pancreatic cancer Pancreatic surgery Registration study

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Pancreatic steatosis and its correlation with clinicopathological features in patients with pancreatic neuroendocrine neoplasms

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Journal of pancreatology 2023年第2期6卷 48-54页

作者： Yongzheng Li Jian Yang Zhiyao Fan Peng Dong Jingjuan Hu Shujie Liu Yufan Meng Changhao Gao Xin Gao Chaoyu Pang Hanxiang Zhan Division of Pancreatic Surgery Department of General SurgeryQilu Hospital of Shandong UniversityJinanShandong ProvinceChina department of Nephrology Shouguang Hospital of Traditional Chinese MedicineWeifangShandong ProvinceChina

Background and objective:The incidence of pancreatic neuroendocrine neoplasms(pNENs)has been increasing year by year,and pancreatic steatosis has been paid more and more attention to by *** study aims to reveal the correlation between pancreatic steatosis,clinicopathological parameters,and the prognosis of patients with ***:The clinicopathological data of patients with pNENs who underwent surgical resections in our institution from January 2013 to May 2022 were retrospectively *** mean computed tomography(CT)values of the pancreas and spleen were used to assess the severity of the pancreatic *** Chi-square test,T test,Mann Whitney U test,Univariate Cox re-gression,and Multivariate Cox regression were used to explore the relationship between pancreatic steatosis and age,sex,body mass index,tumor type,tumor location,tumor stage,blood lipid,prognosis,and other ***:A total of 122 patients were included in our study,and 19.67%have pancreatic *** incidence of pancreatic steatosis was significantly higher in patients with fatty liver than in patients without fatty liver(36.8%vs 16.5%,P=.04).In insu-linoma,the incidence of pancreatic steatosis in elderly patients was significantly higher than in young and middle-aged patients(41.7%vs 9.3%,P=.025).There was no significant difference in lipid levels between the pancreatic steatosis group and the non-pancreatic steatosis group(P>.05).Kaplan-Meier curves show that the prognosis of stage III/IV patients was significantly worse than that of stage I/II patients(P<.001).However,there was no significant difference in prognosis between patients with and without pancreatic steatosis(P=.404).Conclusion:The incidence of pancreatic steatosis was significantly higher in those with fatty liver than those without fatty *** is a high incidence of pancreatic steatosis in elderly patients with *** Joint Committee on Cancer(AJCC)stage,but not pancreatic st

关键词： Blood lipid Fatty liver Pancreatic neuroendocrine neoplasms Pancreatic steatosis Prognosis

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Clinical impact of artificial intelligence-based solutions on imaging of the pancreas and liver

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World Journal of Gastroenterology 2023年第9期29卷 1427-1445页

作者： M Alvaro Berbís Felix Paulano Godino Javier Royuela del Val Lidia AlcaláMata Antonio Luna department of Radiology HT MédicaSan Juan de Dios HospitalCórdoba 14960Spain Faculty of Medicine Autonomous University of MadridMadrid 28049Spain department of Radiology HT MédicaClínica las NievesJaén 23007Spain

Artificial intelligence(AI)has experienced substantial progress over the last ten years in many fields of application,including *** hepatology and pancreatology,major attention to date has been paid to its application to the assisted or even automated interpretation of radiological images,where AI can generate accurate and reproducible imaging diagnosis,reducing the physicians’*** can provide automatic or semi-automatic segmentation and registration of the liver and pancreatic glands and ***,using radiomics,AI can introduce new quantitative information which is not visible to the human eye to radiological *** has been applied in the detection and characterization of focal lesions and diffuse diseases of the liver and pancreas,such as neoplasms,chronic hepatic disease,or acute or chronic pancreatitis,among *** solutions have been applied to different imaging techniques commonly used to diagnose liver and pancreatic diseases,such as ultrasound,endoscopic ultrasonography,computerized tomography(CT),magnetic resonance imaging,and positron emission tomography/***,AI is also applied in this context to many other relevant steps involved in a comprehensive clinical scenario to manage a gastroenterological *** can also be applied to choose the most convenient test prescription,to improve image quality or accelerate its acquisition,and to predict patient prognosis and treatment *** this review,we summarize the current evidence on the application of AI to hepatic and pancreatic radiology,not only in regard to the interpretation of images,but also to all the steps involved in the radiological workflow in a broader ***,we discuss the challenges and future directions of the clinical application of AI methods.

关键词： Artificial intelligence Machine learning Deep learning Imaging Liver Pancreas

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KCNH2 regulates the growth and metastasis of pancreatic cancer

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Journal of pancreatology 2023年第3期6卷 101-109页

作者： Jinghao Lei Qiang Wang Tengfei Qu Lichao Cha Hanxiang Zhan Jianwei Xu Shanglong Liu Lantian Tian Chuandong Sun Jingyu Cao Fabo Qiu Weidong Guo Bin Zhou department of Hepatobiliary and Pancreatic Surgery the Affiliated Hospital of Qingdao UniversityQingdaoShandong ProvinceChina department of Anesthesiology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina department of General Surgery Qilu HospitalShandong UniversityJinanShandong ProvinceChina department of General Surgery the Affiliated Hospital of Qingdao UniversityQingdaoShandong ProvinceChina

Objective:Due to the characteristics of insidious onset and early metastasis of pancreatic cancer(PC),patients are often diag-nosed at an advanced stage and often delayed in completing surgical resection timely,resulting in poor ***,this study aims to explore the expression of potassium voltage-gated channel subfamily H member 2(KCNH2)in PC and its relation-ship with clinicopathological parameters and the related ***:GEPIA database and immunohistochemical staining were used to analyze the difference in KCNH2 expression be-tween PC and adjacent tissue in RNA and protein ***-squared test was used to evaluate the relationship between KCNH2 expression and clinicopathological *** Cox regression model was used for multivariate analysis and univariate *** diagnosis was performed according to World Health Organization(WHO)criteria to evaluate the relationship between KCNH2 expression and clinicopathological ***:KCNH2 expression was upregulated in PC compared with normal pancreatic *** addition,the knockdown of KCNH2 inhibits PC cell proliferation,migration,invasion,and epithelial-mesenchymal transformation and promotes their *** addition,clinical data showed that the abnormal expression of KCNH2 in PC was related to the tumor *** with high expression of KCNH2 had a poor ***:KCNH2 is expected to be a novel targeted molecule in treating PC.

关键词： Epithelial-mesenchymal transition Metastasis Pancreatic cancer Potassium voltage-gated channel subfamily H member 2(KCNH2) Proliferation

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Pancreatic lymphangioma:two case reports from an institutional experience with a rare entity and review of literature

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Journal of pancreatology 2022年第2期5卷 98-109页

作者： Alfonso Tan-Garcia Ser Yee Lee Jen San Wong Thomas W.T.Ho Keng Sin Ng Kiat Hon Tony Lim Division of Pathology Department of Anatomical PathologySingapore General HospitalSingapore Surgical Associates Mount Elizabeth Medical CentreSingapore department of Hepatopancreatobiliary and Transplant Surgery Singapore General HospitalSingapore Hepatobiliary and Pancreatic Surgery Centre Mount Elizabeth Medical CentreSingapore Digestive Surgical Oncology department of Diagnostic Imaging Mount Alvernia HospitalSingapore

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 *** such,pancreatic lymphangiomas are frequently diagnosed only after histological examination of the excised *** present 2 cases of pancreatic lymphangioma,determine its prevalence at our institution and perform a detailed review of published literature since *** 1 is a 36-year-old male and case 2 is a 35-year-old female,both of which presented with abdominal *** were the only cases of pancreatic lymphangiomas reported at our institution since *** reviewed 69 cases of pancreatic lymphangiomas from 52 *** 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 *** 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 *** majority of patients with elevated fluid triglyceride levels(13/15 cases)were managed *** 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.

关键词： Case report Cystic Diagnostic features Literature review Lymphangioma management Pancreas Prevalence

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Perioperative risk factors for delayed gastric emptying after pancreaticoduodenectomy:a meta-analysis of the complications

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Journal of pancreatology 2023年第2期6卷 67-73页

作者： Xiaowei Deng Ting Niu Zhaolong Han Xing Liang Zhiping Fu Liang Tang Guang Yang Judong Li An’an Liu Junfeng Peng Minghui Zheng Chenghao Shao department of Pancreatic-biliary Surgery Changzheng HospitalNaval Medical UniversityShanghai 200003

Objective:To evaluate the correlation between the incidence of delayed gastric emptying(DGE)in pancreaticoduodenectomy(PD)and the perioperative possible risk ***:We searched PubMed,Embase,Cochrane Library,and Medline for studies describing complications related to PD from 2018 to *** analysis was performed using Stata/SE16.0 ***:In 6 retrospective studies,1 systematic review,and 1 randomized controlled trial(RCT)experiment,12,419 patients(2174 and 10,245 patients,respectively,in DGE and no delayed gastric emptying[NDGE]groups).The preoperative American Society of Anesthesiologists(ASA)score between DGE and NDGE groups(log odds ratio[OR]=0.23,95%credible interval[CI]:0.11-0.35,P.05).Conclusion:The incidence of DGE is significantly correlated with the operation time,preoperative ASA score,POPF,and EIBL,which suggests that the surgeon should thoroughly evaluate the patient through adequate preoperative examination before the ***,standardized practice and perfect technology are undoubtedly necessary to reduce complications.

关键词： Complications Delayed gastric emptying Pancreaticoduodenectomy Perioperative period Risk factors

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Chinese expert consensus on multidisciplinary diagnosis and treatment of pancreatic neuroendocrine liver metastases

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Journal of pancreatology 2023年第4期6卷 139-150页

作者： Yihebali Chi Liming Jiang Susheng Shi Shun He Chunmei Bai Dan Cao Jianqiang Cai Qichen Chen Xiao Chen Yiqiao Deng Shunda Du Zhen Huang Li Huo Yuan Ji Jie Li Wenhui Lou Jie Luo Xueying Shi Lijie Song Bei Sun Huangying Tan Feng Wang Xuan Wang Zhewen Wei Wenming Wu Dianrong Xiu Jianming Xu Huadan Xue Yi Yang Fei Yin Chunhui Yuan Yefan Zhang Weixun Zhou Dongbing Zhao Hong Zhao department of Medical Oncology National Cancer Centre/National Clinical Research Centre for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina department of Diagnostic Radiology National Cancer Center Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina department of Pathology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina department of Endoscopy National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina department of Medical Oncology Peking Union Medical College HospitalBeijingChina department of Abdominal Oncology Cancer CenterWest China HospitalSichuan UniversityChengduChina department of Hepatobiliary Surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina department of Liver Surgery Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine Department of Nuclear MedicinePeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina department of Pathology Zhongshan HospitalFudan UniversityShanghaiChina department of Gastrointestinal Oncology Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing)Peking University Cancer Hospital&InstituteBeijingChina department of General Surgery Zhongshan HospitalFudan UniversityShanghaiChina department of Pathology China-Japan Friendship HospitalBeijingChinan Department of PathologyPeking University Third HospitalSchool of Basic Medical SciencePeking University Health Scienc

Many management strategies are available for pancreatic neuroendocrine neoplasms with liver ***,a lack of biological,molecular,and genomic information and an absence of data from rigorous trials limit the validity of these *** review presents the viewpoints from an international conference consisting of several expert working *** working groups reviewed a series of questions of particular interest to clinicians taking care of patients with pancreatic neuroendocrine neoplasms with liver metastases by reviewing the existing management strategies and literature,evaluating the evidence on which management decisions were based,developing internationally acceptable recommendations for clinical practice,and making recommendations for clinical and research *** review for each question will be followed by recommendations from the panel.

关键词： pancreatic neuroendocrine neoplasms liver metastases clinical diagnosis treatment

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