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Clinical application of trans-sinus gastric stent placement and drainage in the management of persistent external pancreatic fistula after minimal access retroperitoneal pancreatic necrosectomy in severe acute pancreatitis patients

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Journal of pancreatology 2022年第4期5卷 146-150页

作者： Yuhui Chen Maosheng Su Xianlei Xin Zhiwei Liu Shouwang Cai department of General Surgery The First Medical CenterChinese PLA General HospitalBeijingChina department of Hepatobiliary and Pancreatic Surgery The First Medical CenterChinese PLA General HospitalBeijingChina

Background:Persistent external pancreatic fistula(EPF)in patients with pancreatic duct disruption or disconnection can result from minimal access to retroperitoneal pancreatic necrosectomy(MARPN)in severe acute pancreatitis patients,which is a difficult problem for clinicians and requires a long treatment *** study aimed to investigate the effectiveness and safety of trans-sinus gastric stent placement and drainage using interventional technology in the management of persistent EPF after MARPN in severe acute ***:From August 2018 to December 2020,the data of 9 patients with persistent EPF treated with trans-sinus gastric stent placement and drainage in our hospital were retrospectively *** main outcome measures were technical success rate,recurrence rate,new pancreatic fluid collection,morbidity,and *** patients were followed up after the procedure through clinic visits and imaging ***:The median age of the patients was 46 years(30-61 years).The median persistent EPF duration was 5 months(2-12 months).The median follow-up time was 41 months(range,20-47 months).The median operation time was 48 minutes(range,40-54 minutes),and the technical success rate was 100%.Seven days after treatment,the percutaneous drainage tubes of all patients were *** months after the procedure,2 patients lost the stents,and one of those patients suffered from a pseudocyst,which gradually increased to a maximum diameter of 7 cm over 9 ***,a double pigtail drainage tube was placed under the guidance of an *** second of these 2 patients had no recurrence or *** months after the procedure,another 3 patients lost the stents;18 months after the procedure,another 2 patients lost the *** patients had no recurrence as *** other adverse events or deaths occurred during the study ***:Trans-sinus tract gastric stent placement and drainage are safe and effective in the tr

关键词： Endoscopic technique Interventional technology Persistent external pancreatic fistula Trans-sinus gastric stent placement and drainage

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Primary tumor resection in colorectal cancer with unresectable synchronous metastases: A review

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世界胃肠肿瘤学杂志：英文版（电子版） 2014年第6期6卷 156-169页

作者： Louis de Mestier Gilles Manceau Cindy Neuzillet Jean Baptiste Bachet Jean Philippe Spano Reza Kianmanesh Jean Christophe Vaillant Olivier Bouché Laurent Han-noun Mehdi Karoui department of Gastroenterology and Digestive Oncology Robert-DebréUniversity Hospital Assistance Publique-Hopitaux de Paris Pitié-Salpêtrière HospitalDepartment of Digestive and Hepato-Pancreato-Biliary SurgeryUniversity Institute of Cancerology(ParisⅥ)Pierre and Marie Curie University Assistance Publique-Hopitaux de Paris Depart-ment of Gastroenterology and PancreatologyBeaujon University Hospital Assistance Publique-Hopitaux de Paris Pitié-Salpêtrière HospitalDepartment of GastroenterologyUniversity Institute of Cancerology(ParisⅥ)Pierre and Marie Curie University Assistance Publique-Hopitaux de Paris Pitié-Salpêtrière HospitalDepartment of Medical OncologyUniversity Institute of Cancerology(ParisⅥ)Pierre and Marie Curie University department of Digestive and Endocrine Sur-gery Robert-DebréUniversity Hospital

At the time of diagnosis, 25% of patients with colorectal cancer(CRC) present with synchronous metastases, which are unresectable in the majority of patients. Whether primary tumor resection(PTR) followed by chemotherapy or immediate chemotherapy without PTR is the best therapeutic option in patients with asymptomatic CRC and unresectable metastases is a major issue, although unanswered to date. The aim of this study was to review all published data on whether PTR should be performed in patients with CRC and unresectable synchronous metastases. All aspects of the management of CRC were taken into account, es-pecially prognostic factors in patients with CRC and un-resectable metastases. The impact of PTR on survival and quality of life were reviewed, in addition to the characteristics of patients that could benefit from PTR and the possible underlying mechanisms. The risks of both approaches are reported. As no randomized study has been performed to date, we finally discussed how a therapeutic strategy's trial should be designed to pro-vide answer to this issue.

关键词： Colorectal cancer Colorectal surgery Chemotherapy Colorectal primary tumor Survival Livermetastases

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Survival outcomes of conversion surgery for metastatic pancreatic ductal adenocarcinoma after neoadjuvant therapy

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Journal of pancreatology 2023年第3期6卷 110-118页

作者： Lingyu Zhu Suizhi Gao Xinqian Wu Bo Li Xiaohan Shi Xiaoyi Yin Huan Wang Meilong Shi Penghao Li Yikai Li Chaoliang Zhong Chuanqi Teng Jiawei Han Yiwei Ren Jian Wang Zhendong Fua Xinyu Liu Kailian Zheng Shiwei Guo Gang Jin department of Pancreatic Hepatobiliary Surgery Changhai HospitalNaval Medical UniversityYangpu DistrictShanghaiChina

Objective:To evaluate the survival outcomes of patients who underwent conversion surgery for metastatic pancreatic ductal adenocarcinoma(mPDAC)after neoadjuvant therapy(NAT)and to identify potential candidates that may benefit from this treat-ment ***:The role and eligibility population of conversion surgery for mPDAC remains controversial in the era of ***:A consecutive cohort of patients diagnosed with mPDAC and treated with NAT followed by conversion surgery be-tween 2019 and 2021 were confirmed from a prospective database maintained by the department of Pancreatic Hepatobiliary Surgery of Changhai *** accordance with residual metastases and technical resectability after NAT,patients were classi-fied as the complete pathological response of metastases(ypM0)resection group,residual metastases(ypM1)resection group,and exploration *** overall survival(mOS)was calculated using the Kaplan-Meier method,uni-and multivariable cox regression was performed to identify clinicopathological predictors of ***:A total of 244 patients with mPDAC were identified from the prospective database,with 19(7.8%)patients who un-derwent ypM0 resection,22(9.0%)underwent ypM1 resection,and 23(9.4%)underwent explorative *** mOS was 32.6 months for ypM0 resected patients,15.1 months for ypM1 resected patients,and 13.4 months for those who underwent explorative laparotomy(P<.001).Univariable and multivariable Cox regression analyses confirmed that ypM0 resection,normal-ization of preoperative CA19-9 levels,and continued adjuvant therapy were independent prognostic factors of conversion surgery for mPDAC after *** analyses revealed that oligometastases and continued adjuvant therapy were associated with improved prognosis in the ypM1 resection ***:In patients with mPDAC who underwent NAT followed by conversion surgery,the complete pathological response of metastases,normalization of preoperative CA19-9 levels,and c

关键词： Conversion surgery Metastatic pancreatic ductal adenocarcinoma Neoadjuvant therapy Survival

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Correlative factor of death in patients with infected pancreatic necrosis after surgical intervention

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Journal of pancreatology 2022年第4期5卷 141-145页

作者： Yuhui Chen Zhiwei Liu Shouwang Cai department of General Surgery the First Medical CenterChinese PLA General HospitalHaidian DistrictBeijingChina department of Hepatobiliary and Pancreatic Surgery First Medical CenterChinese PLA General HospitalHaidian DistrictBeijingChina

Background:Acute pancreatitis(AP)was a potentially fatal disease with a variation in *** pancreatic necrosis was a common complication in AP which needed surgical *** present study was to study the correlative factors of death in patients with infected pancreatic necrosis after surgical ***:From January 2016 to October 2019,a total of 186 patients with infected pancreatic necrosis after surgical intervention in the First Medical Center,Chinese PLA General Hospital were retrospectively enrolled in this *** the 186 patients,22 who died in the hospital were defined as a mortality group and the others as a survival *** clinical characteristic of the 2 groups was compared and the relative risk of mortality in patients with infected pancreatic necrosis after the surgical intervention was ***:Acute fluid collection,acute kidney injury,acute lung injury,acute liver injury,multiple organ dysfunction syndromes,abdominal bleeding,abdominal Acinetobacter baumannii infection,pulmonary infection,pulmonary A baumannii infection,positive blood culture,A baumannii of blood culture,severe acute pancreatitis according to Atlanta 2012,the use of continuous renal replacement therapy,mechanical ventilation and minimally invasive retroperitoneal pancreatic necrosectomy was associated with death in *** age,longer acute kidney injury lasting time,longer acute lung injury lasting time,longer acute liver injury lasting time,and longer multiple organ dysfunction syndromes lasting time in predicting mortality in patients with infected pancreatic necrosis after surgical intervention were(0.635[95%confidence interval(CI):0.512-0.758],P=.040),(0.877[95%CI:0.788-0.965],P=.000),(0.932[95%CI:0.897-0.968],P=.000),(0.822[95%CI:0.708-0.935],P=.000),and(0.943[95%CI:0.887-0.998],P=.000).Due to the small number of death cases,the results of the multivariate analyses were not ***:In this single-center retrospectiv

关键词： Infected pancreatic necrosis Mortality Risk factors Surgical intervention

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Pancreatic cancer with ovarian metastasis: cases report and literature review

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Journal of pancreatology 2023年第1期6卷 34-39页

作者： Zeru Li Xingtong Zhou Bangbo Zhao Zhibo Zheng Cheng Qin Xudong Liu Huadan Xue Weibin Wang department of General Surgery Peking Union Medical College HospitalChinese Academy of Medical SciencesBeijingChina department of Breast Surgery Peking Union Medical College HospitalChinese Academy of Medical SciencesBeijingChina department of International Medical Services Peking Union Medical College HospitalChinese Academy of Medical SciencesBeijingChina Medical Science Research Center Peking Union Medical College HospitalChinese Academy of Medical SciencesBeijingChina department of radiology Peking Union Medical College HospitalChinese Academy of Medical SciencesBeijingChina

Background: Pancreatic cancer with ovarian metastases is rare and easily misdiagnosed. Patients with ovarian metastases are first diagnosed with ovarian cancer and may miss the opportunity to receive surgical operation. We report 7 rare cases of ovarian metastases secondary to pancreatic adenocarcinoma and review the literature to analyze clinical characteristics, diagnostic methods, and potential therapeutic strategies for the rare *** Summary: We retrospectively analyzed the clinical data of 7 female patients with ovarian metastases of primary pancreatic cancer who were admitted to our hospital from January 01, 1985, to April 1, 2020. These 7 patients were diagnosed with ovarian metastasis at an average age of 52.28 (38-69) years. The reason for the patient’s visit was generally a mass in the lower abdomen and/or abdominal pain. Six of them had significantly higher serum Carbohydrate antigen19-9 (CA19-9) levels, 6 patients had pancreatic tumors located in the body or tail, and 1 patient had one in the head of the pancreas. All patients underwent excision of ovarian tumors and resection or biopsy of pancreatic tumors. Five patients had pancreatic ductal adenocarcinoma (PDAC), and 2 had pancreatic cystadenocarcinoma (PCC), all of which were revealed by the pathological results. Ovarian tumors were assessed by pathology and were consistent with pancreatic metastasis. Currently, all 7 patients have died (follow-up to January 2, 2021). The median survival time for all patients was 13.7 months (2.9-27 months).Conclusions: For this rare tumor, elevated serum CA19-9 may indicate that the primary lesion is in the pancreas. Enhanced pancreatic Computed Tomography (CT) can facilitate diagnostic localization. In addition, if the pancreatic tumor cannot be removed, the ovarian tumor should still be resected to reduce the tumor load and improve the quality of life.

关键词： Case report Outcome Ovarian metastases Pancreatic cancer Prognosis

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Natural Chinese herbs for the prevention and treatment of acute pancreatitis:a narrative review

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Journal of pancreatology 2022年第4期5卷 186-197页

作者： Jiaqi Cui Di Wu Huimin Zhou Haiyan Chen Zhixia Dong Jun Yang department of General Surgery Wuxi Institute of Hepatobiliary SurgeryAffiliated Hospital of Jiangnan UniversityWuxi 214000China

Acute pancreatitis(AP)is a disease characterized by local inflammation in the pancreas,followed by trypsin activation,and may result from multiple *** 20%of AP can progress to severe acute pancreatitis(SAP),which can lead to systemic inflammatory response syndrome(SIRS)and multiple organ dysfunction syndromes(MODS).SAP mortality rates have remained high in recent years,but there are currently no specific drugs designed to reduce these *** studies have shown that patients can reduce the symptoms of the disease and slow down the development of the disease after taking the Chinese medicine *** studies have shown that in AP or SAP disease models,the use of Chinese medicine monomers can improve the condition of *** natural Chinese herbal products can improve pancreatitis,given their ability to act on multiple ***,they have not been widely employed clinically and studied sufficiently and ***,this review aimed to summarize the pathophysiological mechanisms underlying pancreatitis and review the potential role of natural Chinese herbs(monomers and decoctions)in clinical and basic research.

关键词： Acute pancreatitis Chinese herbs Natural product

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Comparison of regional arterial chemotherapy and systemic intravenous chemotherapy for advanced pancreatic cancer:a systematic review and meta-analysis

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Journal of pancreatology 2022年第2期5卷 49-57页

作者： Chengqing Li Wenyi Guo Shihong Chen Jianwei Xu Feng Li Lei Wang department of Pancreatic Surgery General SurgeryQilu Hospital of Shandong UniversityJinanPeople’s Republic of China

Chemotherapy is the mainstay of treatment for advanced pancreatic cancer(stageⅢ/Ⅳ).However,conventional systemic intravenous chemotherapy(SIC)has been unsatisfactory for pancreatic *** recent years,regional arterial infusion chemotherapy(RAIC)has been clinically used as a new chemotherapy regimen for the treatment of advanced pancreatic cancer,but its efficacy is *** purpose of this study was to evaluate the clinical efficacy and safety of *** searched literatures in databases such as PubMed,EMBASE,Cochrane Library,Web of Science,and *** screening,this meta-analysis finally included 9 randomized controlled trials(RCTs)with 444 patients(230 RAIC and 214 SIC).We used the Cochrane Risk of Bias 2.0 tool to assess risk of bias for included *** were overall survival(OS),overall response rate(ORR),adverse events rate(AER),and pain remission *** indicators used relative risk(RR)and its 95%confidence interval(CI)as effect analysis *** results showed that RAIC had some advantages over SIC in terms of ORR,OS,incidence of leukopenia,and pain *** conclusion,compared with SIC,RAIC has better clinical efficacy and lower toxicity in the treatment of advanced pancreatic cancer.

关键词： Advanced pancreatic cancer Adverse events rate Clinical efficacy Meta-analysis Regional arterial infusion chemo-therapy Systemic intravenous chemotherapy

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Initial chemotherapy option for pancreatic ductal adenocarcinoma in patients with adequate performance status

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Journal of pancreatology 2023年第4期6卷 196-201页

作者： Jiazhang Xing Yuping Ge Xiaolei Gong Yuan Liu Yuejuan Cheng department of Medical Oncology Peking Union Medical College HospitalChinese Academy of Medical SciencesBeijingChina

Pancreatic ductal adenocarcinoma(PDAC)is a highly progressive lethal malignancy,with chemotherapy being the primary treatment *** article provides a review of the initial chemotherapy options for PDAC patients with adequate performance status,comparing FOLFIRINOX(oxaliplatin,irinotecan,5-fluorouracil,and leucovorin)or modified FOLFIRINOX and gemcitabine plus nab-paclitaxel(GEM-NabP)*** availability of limited evidence from randomized trials restricts a direct comparison between the 2 *** on our review,(m)FOLFIRINOX yields superior survival outcomes compared to GEM-NabP in metastatic *** locally advanced PDAC,either(m)FOLFIRINOX or GEM-NabP can be considered initial *** the neoadjuvant setting for borderline resectable PDAC,both regimens have demonstrated promising results in achieving feasible resection ***,mFOLFIRINOX remains the preferred choice for adjuvant *** selection of initial chemotherapy for PDAC depends on the disease stage,patients’performance status,and tumor molecular *** research and clinical trials are necessary to optimize treatment approaches for PDAC patients.

关键词： FOLFIRINOX Gemcitabine plus nab-paclitaxel Pancreatic ductal adenocarcinoma

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Overall survival,late mortality,and cancer-directed surgery among children and adolescents with ultra-rare pediatric pancreatoblastoma in the United States,1975-2018

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Journal of pancreatology 2023年第2期6卷 61-66页

作者： Peiyi Li Yujia Kong Lin Wan Jing Guo Weimin Li Hui Zhang Guang Yang Bo Zhang department of Anesthesiology West China HospitalSichuan UniversityChengduSichuanChina Laboratory of Anesthesia and Critical Care Medicine National-Local Joint Engineering Research Centre of Translational Medicine of AnesthesiologyWest China HospitalSichuan UniversityChengduSichuanChina department of Public Health Weifang Medical UniversityWeifangShandongChina department of Pediatrics First Medical CenterChinese PLA General HospitalBeijingChina Senior department of Pediatrics Seventh MedicalCenterPLA General HospitalBeijingChina department of Health Policy and Management School of Public HealthPeking UniversityBeijingChina department of Respiratory and Critical Care Medicine West China HospitalSichuan UniversityChengduSichuanChina Institute of Respiratory Health Frontiers Science Center for Disease-related Molecular NetworkWest China HospitalSichuan UniversityChengduSichuanChina department of Preventive Medicine Feinberg School of MedicineNorthwestern UniversityChicagoIL The Second School of Clinical Medicine Southern Medical UniversityGuangzhouChina department of Neurology Boston Children’s HospitalHarvard Medical SchoolBostonMA Biostatistics and Research Design Center Institutional Centers for Clinical and Translational ResearchBoston Children’s HospitalHarvard Medical SchoolBostonMA

Background:Pediatric pancreatoblastoma is an extremely rare malignant tumor,posing diagnostic and treatment difficulties for pediatric *** the Surveillance,Epidemiology,and End Results(SEER)database,we present an up-to-date report of the epidemiology,clinicopathological features,survival rates,and prognosis of pancreatoblastoma in pediatric ***:All pediatric patients diagnosed with pancreatoblastoma between 1975 and 2018 were identified in the SEER regis-tries(SEER 8 registries and SEER 17 registries).We conducted a survival analysis to assess overall survival and 1-and 5-year late mortality *** statistics and log-rank test were ***:A total of 22 children and adolescents with pancreatoblastoma were *** this cohort,12 of 22 were male(54.55%),14 were White(63.64%),and 11 were diagnosed between the ages of 1 and 4 years(50.0%).Among the 22 patients,11(50.0%)had distant metastases,whereas 7(31.82%)had localized,and 4(18.18%)had a regional disease.A total of 5 children and adolescents died during the study period,with cumulative survival rates of 14 of 17(82.35%)and 10 of 11(90.95%)among 1-and 5-year survivors,***-directed surgery was significantly associated with an increased life expectancy(log-rank test,P=.018).Conclusion:Pediatric pancreatoblastoma is a rare *** that underwent surgery had a greater likelihood of overall survival and reduced late mortality.

关键词： Mortality Overall survival Pancreatic cancer surgery Pancreatoblastoma Pediatric pancreatic cancer

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Emerging roles of circular RNAs in cancer:a narrative review

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Journal of pancreatology 2022年第1期5卷 41-48页

作者： Shixiang Guo Junfeng Zhang Junyu Tao Jinfeng Zhu Ruixin Zheng Huaizhi Wang department of Hepatopancreatobiliary Surgery Chongqing General HospitalChongqing Chongqing School University of Chinese Academy SciencesChongqingChina

Circular RNAs (circRNAs) constitute a novel class of endogenous noncoding RNAs characterized by a covalently closed structure and involved in multiple biological processes. The main biological functions and properties of circRNAs can be defined by five features: a "sponging" effect on other RNA species, post-transcriptional regulation, rolling circle translation, generation of pseudogenes, and splicing interference. Although circRNAs were first detected decades ago, the role of circRNAs and the mechanisms underlying their actions remain incompletely characterized. Recently, circRNAs were reported to play indispensable roles in regulating metabolic and signal transduction events controlling the proliferation, migration, and survival of cells. Importantly, many studies demonstrated that dysregulated circRNA expression is associated with the development of multiple diseases, including cancer. In this review, we summarize current knowledge on the roles and mechanisms of circRNAs in cancer and discuss their functions as oncogenes or tumor suppressors in different tumor types.

关键词： Cancer circRNA Oncogene Review Tumor suppressor

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