Hepatobiliary&Pancreatic Diseases International

Copyright 2024,Hepatobiliary&Pancreatic Diseases International.All rights reserved.www.hbpdint.com.Aims and Scope.Hepatobiliary&Pancreatic Diseases International publishes peerreviewed original papers,reviews(meta-analysis,systematic review)and editorials concerned with clinical practice and research in the fields of hepatobiliary and pancreatic diseases.

Autophagy and its role in gastrointestinal diseases

Gastrointestinal disorders encompass a spectrum of conditions affecting various organs within the digestive system,such as the esophagus,stomach,colon,rectum,pancreas,liver,small intestine,and bile ducts.The role of autophagy in the etiology and progression of gastrointestinal diseases has garnered significant attention.This paper seeks to evaluate the impact and mechanisms of autophagy in gastrointestinal disorders by synthesizing recent research findings.Specifically,we delve into inflammation-related gastrointestinal conditions,including ulcerative colitis,Crohn’s disease,and pancreatitis,as well as gastrointestinal cancers such as esophageal,gastric,and colorectal cancers.Additionally,we provide commentary on a recent publication by Chang et al in the World Journal of Gastroenterology.Our objective is to offer fresh perspectives on the mechanisms and therapeutic approaches for these gastrointestinal ailments.This review aims to offer new perspectives on the mechanisms and therapeutic strategies for gastrointestinal disorders by critically analyzing relevant publications.As discussed,the role of autophagy in gastrointestinal diseases is complex and,at times,contentious.To harness the full therapeutic potential of autophagy in treating these conditions,more in-depth research is imperative.

Current considerations on intraductal papillary neoplasms of the bile duct and pancreatic duct

Pancreatobiliary intraductal papillary neoplasms(IPNs)represent precursors of pancreatic cancer or bile duct cholangiocarcinoma that can be detected and treated.Despite advances in diagnostic methods,identifying these premalignant lesions is still challenging for treatment providers.Modern imaging,biomarkers and molecular tests for genomic alterations can be used for diagnosis and follow-up.Surgical intervention in combination with new chemotherapeutic agents is considered the optimal treatment for malignant cases.The balance between the risk of malignancy and any risk of resection guides management policy;therefore,treatment should be individualized based on a meticulous preoperative assessment of high-risk stigmata.IPN of the bile duct is more aggressive;thus,early diagnosis and surgery are crucial.The conservative management of low-risk pancreatic branch-duct lesions is safe and effective.

A Study on Enhancing Pancreatic Islet Function in Type 2 Diabetes and Coronary Heart Disease Patients with Liraglutide and Metformin Combination Therapy

Objective:To investigate the impact of combining liraglutide with metformin on the enhancement of pancreatic islet function in patients with type 2 diabetes and coronary heart disease.Methods:60 patients with type 2 diabetes and coronary heart disease admitted from February 2022 to August 2023 were selected as research subjects.They were randomly assigned to either control or treatment groups,with 30 patients in each.The control group received metformin alone,while the treatment group received liraglutide in combination with metformin.Various indicators,including blood sugar levels,pancreatic islet function,and cardiac function between the two groups were compared.Results:The results of FPG,2hPG,HbA1c,HOMA-IR,NT-proBNP,and LVEDD in the treatment group were lower than those in the control group,whereas the values of FINS,HOMA-β,E/A,and LVEF in the treatment group were higher than those in the control group(P<0.05).Conclusion:The use of liraglutide in combination with metformin significantly benefits patients with type 2 diabetes and coronary heart disease.It leads to improved pancreatic islet function,better blood sugar control,and enhanced cardiac function.This combination therapy is recommended for clinical adoption.

Risk of pancreatic cancer in individuals with celiac disease in the United States:A population-based matched cohort study

BACKGROUND Celiac disease(CD)has been associated with gastrointestinal malignancies.However,the magnitude of the risk of pancreatic cancer(PC)associated with CD is much less clear,and risks have not been estimated from large populations.AIM To assess the risk of PC in CD patients.METHODS We conducted a population-based,multicenter,propensity score-matched cohort study with consecutive patients diagnosed with CD using the TriNeTx research network platform.We examined the incidence of PC in patients with CD compared with a matched cohort of patients without CD(non-CD,controls).Each patient in the main group(CD)was matched to a patient in the control group using 1:1 propensity score matching to reduce confounding effects.The incidence of PC was estimated using a Cox proportional hazards model with a hazard ratio(HR)and 95%confidence interval(CI).RESULTS A total of 389980 patients were included in this study.Among them,155877 patients had a diagnosis of CD,and the remaining 234103 individuals without CD were considered a control cohort.The mean duration of follow-up for patients in the CD and control cohorts was 5.8±1.8 and 5.9±1.1 years,respectively.During the follow-up,309 patients with CD developed PC,whereas 240 patients developed PC in the control group(HR=1.29;95%CI:1.09-1.53).In the secondary analyses in the first year after diagnosis of CD,patients with CD were at a significant increase in risk for PC;151 patients with CD had an incidence of PC compared with 96 incidences of PC among the patients in the non-CD control group(HR=1.56;95%CI:1.20-2.01)and sensitivity analysis showed similar magnitude to the one generated in the primary and secondary analysis.CONCLUSION Patients with CD are at increased risk of PC.Risk elevation persists beyond the first year after diagnosis to reference individuals without CD from the general population.

Gemcitabine-induced peripheral vascular disease and prolonged response in a patient with metastatic pancreatic adenocarcinoma:A case report

BACKGROUND Gemcitabine is an antimetabolite used in the treatment of pancreatic cancer.One of the side effects of gemcitabine is vascular toxicity.Here,we report the case of a patient treated with gemcitabine who had peripheral vascular disease concomi-tant with a prolonged antitumor response.CASE SUMMARY A 75-year-old man was diagnosed with locally recurrent pancreatic cancer.Partial response was achieved after 9 mo of gemcitabine.At the same time,the patient reported peripheral vascular disease without necrosis.Chemotherapy was suspended,and after one month the Positron Emission Tomography(PET)scan showed locoregional tumor recurrence.Gemcitabine was resumed and partial response was obtained,but peripheral vascular disease occurred.CONCLUSION Our results suggest that the appearance of peripheral vascular disease may be related to a prolonged response to gemcitabine.

Role of endoscopic retrograde cholangiopancreatography in pancreatic diseases

Over the last 15 years,endoscopic retrograde cholangiopancreatography (ERCP) has evolved from a diagnostic tool to one that is primarily used to provide therapy. This development occurred f irst for biliary disorders and subsequently to a lesser extent for pancreatic diseases. Computed tomography, magnetic resonance imaging,magnetic resonance cholangiopancreatography and endoscopic ultrasonography suggest a diagnosis in the majority of patients with pancreatic diseases today and can help physicians and patients avoid unnecessary ERCP. However, a selected number of patients with pancreatic diseases may benef it from pancreatic endotherapy and avoid complex surgery and chronic use of medications. Pancreatic sphincterotomy, pancreatic stenting and pancreatic cyst drainage are some of the most effective and challenging endoscopic pancreatic interventions and should be performed with caution by expert therapeutic endoscopists.There has been a paucity of randomized studies investigating endoscopic techniques in comparison with surgery and medical therapy for the treatment of most benign and malignant pancreatic disorders due to the limited number of patients and the expertise required to attempt these procedures.

Novel serum tumor marker, RCASl, in pancreatic diseases

AIM： As tumor markers for pancreatic carcinoma, carcinoembryonic antigen （CEA） and carbohydrate antigen （CA） 19-9 have been used, but the sensitivity and specificity are not enough for the diagnosis of pancreatic carcinoma. METHODS： A novel serum tumor marker, RCAS1, was compared with two conventional serum tumor markers, CEA （highly specific for pancreatic cancer） and CA 19-9 （highly sensitive for pancreatic cancer）, in 48 patients with pancreatic exocrine tumors. RESULTS： When the diagnosis of benign or malignant conditions was examined by one tumor marker, the sensitivity of RCAS1 alone （55%） was higher than that of CEA alone （27%） and the specificity of RCAS1 alone （92%） was greater than that of CA19-9 alone （78%）. When examined by a combination of two markers, the sensitivity of a combination of RCAS1 and CA19-9 （95%） was superior to those of CA19-9 alone （78%）, RCAS1 alone （55%, P = 0.002）, CEA alone （27%） （P〈0.001）, RCAS1 and CEA （59%） and CA19-9 and CEA （82%）. CONCLUSION： These results suggest that the combination of RCAS1 and CA19-9 is highly sensitive for pancreatic carcinoma.

Applications of endoscopic ultrasound elastography in pancreatic diseases: From literature to real life

Elastography is a non-invasive method widely used to measure the stiffness of the tissues,and it is available in most endoscopic ultrasound machines,using either qualitative or quantitative techniques.Endoscopic ultrasound elastography is a tool that should be applied to obtain a complementary evaluation of pancreatic diseases,together with other imaging tests and clinical data.Elastography can be informative,especially when studying pancreatic masses and help the clinician in the differential diagnosis between benign or malignant lesions.However,further studies are necessary to standardize the method,increase the reproducibility and establish definitive cut-offs to distinguish between benign and malignant pancreatic masses.Moreover,even if promising,elastography still provides little information in the evaluation of benign conditions.

Natural orifice transluminal endoscopic surgery in pancreatic diseases

Natural orifice transluminal endoscopic surgery (NOTES) is a surgical technique that has received considerable interest in recent years. Although minimal access surgery has increasingly replaced traditional open abdominal surgical approaches for a wide spectrum of indications, in pancreatic diseases its widespread use is limited to few indications because of the challenging and demanding nature of major pancreatic operations. Nonetheless, there have been attempts in animal models as well as in the clinical setting to perform diag- nostic and resectional NOTES for pancreatic diseases. Here, we review and comment upon the available data regarding currently analyzed and performed pancreatic NOTES procedures. Potential indications for NOTES include peritoneoscopy, cyst drainage, and necrosectomy, palliative procedures such as gastroenterostomy, as well as resections such as distal pancreatectomy or enucleation. These procedures have already been shown to be technically feasible in several studies in animal models and a few clinical trials. In conclusion, NOTES is a rapidly developing concept/technique that could potentially become an integral part of the armamentarium dealing with surgical approaches to pancreatic diseases.

Progress in endoscopic management of pancreatic diseases

ＰｒｏｇｒｅｓｓｉｎｅｎｄｏｓｃｏｐｉｃｍａｎａｇｅｍｅｎｔｏｆｐａｎｃｒｅａｔｉｃｄｉｓｅａｓｅｓＬＩＺｈａｏＳｈｅｎＳｕｂｊｅｃｔｈｅａｄｉｎｇｓｐａｎｃｒｅａｔｉｃｄｉｓｅａｓｅｓ／ｔｈｅｒａｐｙ；ｃｈｏｌａｎｇｉｏｐａｎｃｒｅａｔｏｇｒａｐ...

Hepatobiliary & Pancreatic Diseases International(HBPD INT)

Hepatobiliary & Pancreatic Diseases International (HBPD INT) is a journal published bimonthly in English language by the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China. We welcome original

Hepatobiliary & Pancreatic Diseases International (HBPD Int)

Hepatobiliary & Pancreatic Diseases International(HBPD Int) is a journal published quarterly inEnglish language by the First Affiliated Hospital,Zhejiang University School of Medicine, Hang-zhou, China. We welcome original articles fromany part of the world; no charge is made for re-view. The papers are reviewed by members of theEditorial Board and our international panel of ex-pert peer reviewers, then either accepted for publi-cation or rejected by the Editor. Please send allsubmissions to:

Hepatobiliary & Pancreatic Diseases International (HBPD Int)

Hepatobiliary & Pancreatic Diseases International(HBPD Int) is a journal published quarterly inEnglish language by the First Affiliated Hospital,Zhejiang University School of Medicine, Hang-zhou, China. We welcome original articles fromany part of the world; no charge is made for re-view. The papers are reviewed by members of theEditorial Board and our international panel of ex-pert peer reviewers, then either accepted for publi-cation or rejected by the Editor. Please send allsubmissions to:The EditorHopatobiliary & Pancreatic Diseases International(HBPD Int), First Affiliated Hospital, Zhejiang

Hepatobiliary & Pancreatic Diseases International (HBPD Int)

Hepatobiliary & Pancreatic Diseases International(HBPD Int)is a journal published quarterly inEnglish language by the First Affiliated Hospital,Zhejiang University School of Medicine,Hang-zhou,China.We welcome original articles fromany part of the world;no charge is made for re-view.The papers are reviewed by members of theEditorial Board and our international panel of ex-pert peer reviewers,then either accepted for publi-cation or rejected by the Editor.Please send allsubmissions to:The EditorHepatobiliary & Pancreatic Diseases International(HBPD Int),First Affiliated Hospital,ZhejiangUniversity School of Medicine,79 Qingchun Road,

Hepatobiliary & Pancreatic Diseases International (HBPD Int)

Hepatobiliary & Pancreatic Diseases International(HBPD Int) is a journal published quarterly inEnglish language by the First Affiliated Hospital,Zhejiang University School of Medicine, Hang-zhou, China. We welcome original articles fromany part of the world; no charge is made for re-view. The papers are reviewed by members of theEditorial Board and our international panel of ex-pert peer reviewers, then either accepted for publi-cation or rejected by the Editor. Please send allsubmissions to:

Hepatobiliary & Pancreatic Diseases International (HBPD Int)

Aims and ScopeHBPD Int publishes peer-reviewed original papers,reviews and editorials concerned with clinical prac-tice and research in the fields of hepatobiliary andpancreatic diseases. Papers cover the medical,surgical, radiological, pathological, biochemical,physiological and historical aspects of the subjectareas under the headings Liver, Biliary, Pancreas,Transplantation, Research, Special Reports, Edi-torials, Reviews, Brief Communications and CaseReports. The journal also deals with the basic sci-ences and experimental work. All submitted papersare reviewed by at least two referees expert in thefield of the submitted paper. For detailed instruc-tions concerning the submission of manuscripts,

Hepatobiliary & Pancreatic Diseases International (HBPD Int)

Aims and ScopeHBPD Int publishes peer-reviewed original papers,reviews and editorials concerned with clinical prac-tice and research in the fields of hepatobiliary andpancreatic diseases. Papers cover the medical,surgical, radiological, pathological, biochemical,physiological and historical aspects of the subjectareas under the headings Liver, Biliary, Pancreas,Transplantation, Research, Special Reports, Edi-torias, Reviews , Brief Communications and CaseReports. The journal also deals with the basic sci-ences and experimental work. All submitted papersare reviewed by at least two referees expert in the

Hepatobiliary & Pancreatic Diseases International

Chief Editor:Shu-Sen Zheng,MD,PhD Ihdexed/abstracted by SCI-E,IM/MEDLINE,CA,EM Impact factor:1.649(ISI 2016 JCR)Manuscript Online Submission to:http://mc03.manuscriptcentral.com/hbpdint Look for HBPD INT both in print and online.Available in a variety of disciplines,this journal keeps busy professionals up to date on information that will affect their practice.

Hepatobiliary & Pancreatic Diseases International

General information Hepatobiliary & Pancreatic Diseases International is a journal published bimonthly in the English language by the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China. We welcome original research articles, review articles, editorials, and others from any part of the world. Manuscripts are reviewed by members of the international editorial board and our expert peer reviewers, then either accepted for publication or rejected by the chief editor.