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1. Benefits and barriers to accreditation of HPB center and fellowship programs in Europe: a strength-weakness-opportunity-and-threats (SWOT) analysis by an E-AHPBA-ESSO-UEMS ad hoc working committee

Author

Kerem, Mustafa, Sarıbeyoğlu, Kaya, Oliverius, Martin, Ndoma-Egba, Rowland, Dili, Alexandra, Glantzounis, Georgios K., Gulla, Aiste, Trotovšek, Blaž, Soreide, Kjetil, Berrevoet, Frederik, Frigerio, Isabella, Gallagher, Tom, Laukkarinen, Johanna, Gilg, Stefan, Schnitzbauer, Andreas, Stättner, Stefan, Taboada, Cristina D., Polak, Wojciech G., Siriwardena, Ajith K., and Besselink, Marc G.

Published
2024
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7. Is Perioperative COVID-19 Really Associated with Worse Surgical Outcomes? A Nationwide COVIDSurg Propensity-Matched Analysis

Author

Argandykov, Dias, Dorken-Gallastegi, Ander, El Moheb, Mohamad, Gebran, Anthony, Proaño-Zamudio, Jefferson A., Bokenkamp, Mary, Renne, Angela M., Nepogodiev, Dmitri, Bhangu, Aneel, Kaafarani, Haytham M.A., Siaw-Acheampong, Kwabena, Argus, Leah, Chaudhry, Daoud, Dawson, Brett E, Glasbey, James C., Gujjuri, Rohan R, Jones, Conor S, Kamarajah, Sivesh K, Khatri, Chetan, Keatley, James M, Lawday, Samuel, Li, Elizabeth, Mann, Harvinder, Marson, Ella J., Mclean, Kenneth A, Picciochi, Maria, Taylor, Elliott H, Tiwari, Abhinav, Simoes, Joana FF, Trout, Isobel M, Venn, Mary L, Wilkin, Richard JW, Bhangu, Aneel, Nepogodiev, Dmitri, Dajti, Irida, Gjata, Arben, Boccalatte, Luis, Modolo, Maria Marta, Cox, Daniel, Pockney, Peter, Townend, Philip, Aigner, Felix, Kronberger, Irmgard, Hossain, Kamral, VanRamshorst, Gabrielle, Lawani, Ismail, Ataide, Gustavo, Baiocchi, Glauco, Buarque, Igor, Gohar, Muhammad, Slavchev, Mihail, Agarwal, Arnav, Brar, Amanpreet, Martin, Janet, Modolo, Maria Marta, Olivos, Maricarmen, Calvache, Jose, Rivera, Carlos Jose Perez, Hadzibegovic, Ana Danic, Kopjar, Tomislav, Mihanovic, Jakov, Klat, Jaroslav, Novysedlak, René, Christensen, Peter, El-Hussuna, Alaa, Batista, Sylvia, Lincango, Eddy, Emile, Sameh H, Mengesha, Mengistu Gebreyohanes, Hailu, Samuel, Tamiru, Hailu, Kauppila, Joonas, Laukkarinen, Johanna, Arnaud, Alexis, Albertsmeiers, Markus, Lederhuber, Hans, Loffler, Markus, Tabiri, Stephen, Metallidis, Symeon, Tsoulfas, Georgios, Lorena, Maria Aguilera, Grecinos, Gustavo, Mersich, Tamas, Wettstein, Daniel, Ghosh, Dhruv, Kembuan, Gabriele, Brouk, Peiman, Khosravi, Mohammad, Mozafari, Masoud, Adil, Ahmed, Mohan, Helen M, Zmora, Oded, Fiore, Marco, Gallo, Gaetano, Pata, Francesco, Pellino, Gianluca, Satoi, Sohei, Ayasra, Faris, Chaar, Mohammad, Fakhradiyev, Ildar R, Jamal, Mohammad, Elhadi, Muhammed, Gulla, Aiste, Roslani, April, Martinez, Laura, De La Medina, Antonio Ramos, Outani, Oumaima, Jonker, Pascal, Kruijff, Schelto, Noltes, Milou, Steinkamp, Pieter, van der Plas, Willemijn, Ademuyiwa, Adesoji, Osinaike, Babatunde, Seyi-olajide, Justina, Williams, Emmanuel, Pejkova, Sofija, Augestad, Knut Magne, Al Balushi, Zainab, Qureshi, Ahmad, Sayyed, Raza, Daraghmeh, Mustafa Abu Mohsen, Abukhalaf, Sadi, Cukier, Moises, Gomez, Hugo, Shu, Sebastian, Vasquez, Ximena, Parreno-Sacdalan, Marie Dione, Major, Piotr, Azevedo, José, Cunha, Miguel, Santos, Irene, Zarour, Ahmad, Bonci, Eduard-Alexandru, Negoi, Ionut, Efetov, Sergey, Litvin, Andrey, Ntirenganya, Faustin, AlAmeer, Ehab, Radenkovic, Dejan, Xiang, Frederick Koh Hong, Hoe, Chew Min, Yong, James Ngu Chi, Moore, Rachel, Nhlabathi, Ncamsile, Colino, Ruth Blanco, Bravo, Ana Minaya, Minaya-Bravo, Ana, Jayarajah, Umesh, Wickramasinghe, Dakshitha, Elmujtaba, Mohammed, Jebril, William, Rutegård, Martin, Sund, Malin, Isik, Arda, Leventoğlu, Sezai, Abbott, Tom EF, Benson, Ruth, Caruna, Ed, Chakrabortee, Sohini, Demetriades, Andreas, Desai, Anant, Drake, Thomas D, Edwards, John G, Evans, Jonathan P, Ford, Samuel, Fotopoulou, Christina, Griffiths, Ewen, Hutchinson, Peter, Jenkinson, Michael D, Khan, Tabassum, Knight, Stephen, Kolias, Angelos, Leung, Elaine, McKay, Siobhan, Norman, Lisa, Ots, Riinu, Raghavan, Vidya, Roberts, Keith, Schache, Andrew, Shaw, Richard, Shaw, Katie, Smart, Neil, Stewart, Grant, Sundar, Sudha, Vimalchandran, Dale, Wright, Naomi, Alshryda, Sattar, Alser, Osaid, Breen, Kerry, Ganly, Ian, Kaafarani, Haytham, Kendall, Brittany, Mashbari, Hassan, Al Naggar, Hamza, Mazingi, Dennis, Simoes, Joana FF, Wong, JJ, Napolitano, L, Hemmila, M, Amin, D, Abramowicz, S, Roser, SM, Olson, KA, Riley, C, Heron, C, Cardenas, T, Leede, E, Thornhill, M, Haynes, AB, McElhinney, K, Roward, S, Trust, MD, Hill, CE, Teixeira, PG, Etchill, E, Stevens, K, Ladd, MR, Long, C, Rose, J, Kent, A, Yesantharao, P, Vervoort, D, Jenny, H, Gabre-Kidan, A, Margalit, A, Tsai, L, Malapati, H, Yesantharao, L, Abdou, H, Diaz, J, Richmond, M, Clark, J, OʼMeara, L, Hanna, N, Ying, Y, Fleming, J, Ovaitt, A, Gigliotti, J, Fuson, A, Cooper, Z, Salim, A, Hirji, SA, Brown, A, Chung, C, Hansen, L, Okafor, BU, Roxo, V, Raut, CP, Jolissaint, JS, Mahvi, DA, Kaafarani, H, Breen, K, Bankhead-Kendall, B, Alser, O, Mashbari, H, Velmahos, G, Maurer, LR, El Moheb, M, Gaitanidis, A, Naar, L, Christensen, MA, Kapoen, C, Langeveld, K, El Hechi, M, Mokhtari, A, Haqqani, MH, Drake, FT, Goldenberg-Sandau, A, Galbreath, B, Reinke, C, Ross, S, Thompson, K, Manning, D, Perkins, R, Eriksson, E, Evans, H, Masrur, M, Giulianotti, P, Benedetti, E, Chang, G, Ourieff, J, Dehart, D, Dorafshar, A, Price, T, Bhama, AR, Torquati, A, Cherullo, E, Kennedy, R, Myers, J, Rubin, K, Ban, VS, Aoun, SG, Batjer, HH, Caruso, J, Carmichael, H, Velopulos, CG, Wright, FL, Urban, S, McIntyre, RC, Jr, Schroeppel, TJ, Hennessy, EA, Dunn, J, Zier, L, Burlew, C, Coleman, J, Colling, KP, Hall, B, Rice, HE, Hwang, ES, Olson, SA, Moris, D, Verma, R, Hassan, R, Volpe, A, Merola, S, Flushing, OʼBanion, LA, Lilienstein, J, Dirks, R, Marwan, H, Almasri, M, Kulkarni, G, Mehdi, M, Abouassi, A, Abdallah, M, San Andrés, M, Eid, J, Aigbivbalu, E, Sundaresan, J, George, B, Ssentongo, A, Ssentongo, P, Oh, JS, Hazelton, J, Maines, J, Gusani, N, Garner, M, Horvath, S, Zheng, F, Ujiki, M, Kinnaman, G, Meagher, A, Sharma, I, Holler, E, McKenzie, K, Chan, J, Fretwell, K, Nugent, W, III, Khalil, A, Chen, D, Post, N, Rostkowski, T, Brahmbhatt, D, Huynh, K, Hibbard, ML, Schellenberg, M, Martin, RCG, Bhutiani, N, Giorgakis, E, Laryea, J, Bhavaraju, A, Sexton, K, Roberts, M, Kost, M, Kimbrough, M, Burdine, L, Kalkwarf, K, Gosain, A, Camp, L, Lewit, R, Kronenfeld, JP, Urrechaga, E, Goel, N, Rattan, R, Hart, V, Allen, M, Gilna, G, Cioci, A, Ruiz, G, Allen, M, Rakoczy, K, Pavlis, W, Saberi, R, Morris, R, Karam, BS, Brathwaite, CEM, Liu, H, Petrone, P, Hakmi, H, Sohail, AH, Baltazar, G, Heckburn, R, Nygaard, RM, Colonna, ET, Endorf, FW, Hill, MJ, Maiga, A, Dennis, B, Levin, JH, Lallemand, M, Choron, R, Peck, G, Soliman, F, Rehman, S, Glass, N, Juthani, B, Deisher, D, Ruzgar, NM, Ullrich, SJ, Sion, M, Paranjape, C, El Moheb, M, Kar, AR, Gillezeau, C, Rapp, J, Taioli, E, Miles, BA, Alpert, N, Podolsky, D, Coleman, NL, Callahan, MP, Ganly, I, Brown, L, Monson, JRT, Dehal, A, Abbas, A, Soliman, A, Kim, B, Jones, C, Dauer, MD E, Renza-Stingone, E, Hernandez, E, Gokcen, E, Kropf, E, Sufrin, H, Hirsch, H, Ross, H, Engel, J, Sewards, J, Diaz, J, Poggio, J, Sanserino, K, Rae, L, Philp, M, Metro, M, McNelis, P, Petrov, R, Rehman, S, Pazionis, T, Till, B, Lamm, R, Rios-Diaz, AJ, Palazzo, F, Rosengart, M, Nicholson, K, Carrick, MM, Rodkey, K, Suri, A, Callcut, R, Nicholson, S, Talathoti, N, Klaristenfeld, D, Biffl, W, Marsh, C, Schaffer, K, Berndtson, AE, Averbach, S, Curry, T, Kwan-Feinberg, R, Consorti, E, Gonzalez, R, Grolman, R, Liu, T, Merzlikin, O, Abel, MK, Ozgediz, D, Boeck, M, Kornblith, LZ, Nunez-Garcia, B, Robinson, B, Utria, AF, Rice-Townsend, SE, Javid, P, Hauptman, J, Kieran, K, Nehra, D, Walters, A, Cuschieri, J, Davidson, GH, Nunez, J, Cosker, R, Eckhouse, S, Choudhry, A, Marx, W, Jamil, T, Seegert, S, Al-Embideen, S, Quintana, M, Jackson, H, Wexner, SD, Kent, I, and Martins, PN

Published
2023
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8. Exocrine pancreas insufficiency in chronic pancreatitis – Risk factors and associations with complications. A multicentre study of 1869 patients

Author

Erchinger, Friedemann, Engjom, Trond, Dimcevski, Georg, Drewes, Asbjørn M., Olesen, Søren Schou, Vujasinovic, Miroslav, Löhr, Johannes-Matthias, Nøjgaard, Camilla, Novovic, Srdan, Laukkarinen, Johanna, Parhiala, Mikael, Björn, Lindkvist, Waage, Anne, Hauge, Truls, Pukitis, Aldis, Ozola-Zalite, Imanta, Kalaitzakis, Evangelos, Okhlobystin, Alexey, Barauskas, Giederius, Eva Efsen, Dahl, and Tjora, Erling

Published
2022
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9. Surveillance after surgery for pancreatic cancer: a global scoping review of guidelines and a nordic Survey of contemporary practice.

Author

Ansari, Daniel, Søreide, Kjetil, Andersson, Bodil, Hansen, Carsten Palnæs, Seppänen, Hanna, Sparrelid, Ernesto, Labori, Knut Jørgen, Kirkegård, Jakob, Kauhanen, Saila, Månsson, Christopher, Nymo, Linn Såve, Nortunen, Minna, Björnsson, Bergthor, Kivivuori, Antti, Tingstedt, Bobby, Bratlie, Svein-Olav, Waardal, Kim, Laukkarinen, Johanna, Halimi, Asif, and Lindberg, Hannes

Subjects
CA 19-9 test, PANCREATIC cancer, WATCHFUL waiting, ONCOLOGIC surgery, SURGICAL excision
Abstract

Objectives: Most patients with pancreatic cancer who have undergone surgical resection eventually develop disease recurrence. ‍This study aimed to investigate whether there is evidence to support routine surveillance after pancreatic cancer surgery, with a secondary aim of analyzing the implementation of surveillance strategies in the Nordic countries. Materials and Methods: A scoping review was conducted to identify clinical practice guidelines globally and research studies relating to surveillance after pancreatic cancer resection. This was followed by a survey among 20 pancreatic units from four Nordic countries to assess their current practice of follow-up for operated patients. Results: Altogether 16 clinical practice guidelines and 17 research studies were included. The guidelines provided inconsistent recommendations regarding postoperative surveillance of pancreatic cancer. The clinical research data were mainly based on retrospective cohort studies with low level of evidence and lead-time bias was not addressed. Active surveillance was recommended in Sweden and Denmark, but not in Norway beyond the post-operative/adjuvant period. Finland had no national recommendations for surveillance. The Nordic survey revealed a wide variation in reported practice among the different units. About 75% (15 of 20 units) performed routine postoperative surveillance. Routine CA 19-9 testing was used by 80% and routine CT by 67% as part of surveillance. About 73% of centers continued follow-up until 5 years postoperatively. Conclusion: Evidence for routine long-term (i.e. 5 years) surveillance after pancreatic cancer surgery remains limited. Most pancreatic units in the Nordic countries conduct regular follow-up, but protocols vary. [ABSTRACT FROM AUTHOR]

Published
2024
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10. Margin clearance greater than 1 mm in nodal-positive pancreatic adenocarcinoma patients: multicentre retrospective analysis.

Author

Ahola, Reea P, Zwart, Eline S, Kurlinkus, Benediktas, Halimi, Asif, Yilmaz, Bengi S, Belfiori, Giulio, Roberts, Keith, Pande, Rupaly, Al-Saffar, Hasan A, Maisonneuve, Patrick, Ceyhan, Güralp O, and Laukkarinen, Johanna

Subjects
MESENTERIC veins, PANCREATIC duct, PROGRESSION-free survival, OVERALL survival, SURGICAL margin
Abstract

Background The introduction of the 1 mm cut-off for resection margin according to the Leeds Pathology Protocol has transformed the concept of surgical radicality. Its impact on nodal-positive resected pancreatic ductal adenocarcinoma patients is unclear. The aim of this study was to analyse the effect of margin clearance on survival among resected, nodal-positive pancreatic ductal adenocarcinoma patients whose specimens were analysed according to the Leeds Pathology Protocol. Methods Data were collected retrospectively from multicentre clinical databases. Resected patients with nodal involvement were included. Overall survival and disease-free survival were analysed according to minimum reported margin clearances of 0, 0.5, 1, and 2 mm. The results are reported separately for patients who had not undergone venous resection and for patients for whom data were available regarding the superior mesenteric vein-facing margin or the vein specimen. The eighth edition of TNM classification by the AJCC was used. Results The study comprised 290 stage IIB patients and 215 stage III patients without venous resection. The superior mesenteric vein margin analysis comprised 127 stage IIB patients and 198 stage III patients. The different resection margin distances were not associated with overall survival and disease-free survival among patients without venous resection (P > 0.050). Receiving adjuvant therapy was associated with longer overall survival among stage IIB patients (P = 0.034) and stage III patients (P = 0.003) and with longer disease-free survival among stage III patients (P < 0.001). Conclusions In this study, a margin clearance greater than 1 mm showed no clear effect on overall survival in pancreatic ductal adenocarcinoma patients with nodal involvement, whereas adjuvant therapy was confirmed to be essential to ensure longer overall survival. [ABSTRACT FROM AUTHOR]

Published
2024
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13. Three-Year Outcomes of Oral Antibiotics vs Intravenous and Oral Antibiotics for Uncomplicated Acute Appendicitis

Author

Selänne, Liisa, primary, Haijanen, Jussi, additional, Sippola, Suvi, additional, Hurme, Saija, additional, Rautio, Tero, additional, Nordström, Pia, additional, Rantanen, Tuomo, additional, Pinta, Tarja, additional, Ilves, Imre, additional, Mattila, Anne, additional, Rintala, Jukka, additional, Marttila, Harri, additional, Meriläinen, Sanna, additional, Laukkarinen, Johanna, additional, Sävelä, Eeva-Liisa, additional, Paajanen, Hannu, additional, Grönroos, Juha, additional, and Salminen, Paulina, additional

Published
2024
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20. Management of the pancreatic transection plane after left (distal) pancreatectomy: Expert consensus guidelines by the International Study Group of Pancreatic Surgery (ISGPS)

Author

Miao, Yi, Büchler, Markus W., Fernandez-del Castillo, Carlos, Neoptolemos, John P., Dervenis, Christos, Ghaneh, Paula, Kleeff, Jörg, Shrikhande, Shailesh V., Falconi, Massimo, Takaori, Kyoichi, Tanaka, Masao, Shimosegawa, Tooru, Peng, Yunpeng, Wang, Guangfu, Huang, Xumin, Lu, Zipeng, Yeo, Charles J., Vollmer, Charles M., Jr., Halloran, Christopher M., de Rooij, Thijs, Werner, Jens, Friess, Helmut, Zeh, Herbert J., Izbicki, Jakob R., He, Jin, Laukkarinen, Johanna, Dejong, Cees H., Lillemoe, Keith D., Conlon, Kevin, Gianotti, Luca, Besselink, Marc G., Del Chiaro, Marco, Montorsi, Marco, Bockhorn, Maximilian, Adham, Mustapha, Oláh, Attila, Salvia, Roberto, Hackert, Thilo, Zureikat, Amer H., Ceyhan, Güralp O., and Bassi, Claudio

Published
2020
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21. The role of total pancreatectomy with islet autotransplantation in the treatment of chronic pancreatitis: A report from the International Consensus Guidelines in chronic pancreatitis

Author

Abu-El-Haija, Maisam, Anazawa, Takayuki, Beilman, Gregory J., Besselink, Marc G., Del Chiaro, Marco, Demir, Ihsan Ekin, Dennison, Ashley R., Dudeja, Vikas, Freeman, Martin L., Friess, Helmut, Hackert, Thilo, Kleeff, Jorg, Laukkarinen, Johanna, Levy, Marlon F., Nathan, Jaimie D., Werner, Jens, Windsor, John A., Neoptolemos, John P., Sheel, Andrea R.G., Shimosegawa, Tooru, Whitcomb, David C., and Bellin, Melena D.

Published
2020
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25. Small cyst size and slow growth rate are soothing features in individuals with pancreatic cysts undergoing surveillance

Author

Levink, Iris, primary, Koopmann, Brechtje, additional, Jaarsma, Sanne, additional, van Riet, Priscilla, additional, Overbeek, Kasper, additional, Meziani, Jihane, additional, Sprij, Marloes, additional, Gorris, Myrte, additional, Van Hooft, Jeanin, additional, Casadei, Riccardo, additional, Ingaldi, Carlo, additional, Wallace, Michael, additional, Hoogenboom, Sanne, additional, Honkoop, Pieter, additional, Polkowski, Marcin, additional, Carrara, Silvia, additional, Schoon, Erik, additional, Gemma, Rossi, additional, van der Waaij, Laurens, additional, Beyer, Georg, additional, Bergmann, Jilling, additional, Pando, Elizabeth, additional, Venneman, Niels, additional, Laukkarinen, Johanna, additional, Berkel, Anne-Marie van, additional, Van Vilsteren, Frederike, additional, Schwartz, Thijs, additional, Azopardi, Neville, additional, Hoge, Chantal, additional, van Soest, Ellert, additional, Smits, Marianne, additional, Quispel, Rutger, additional, Vos, Patrick, additional, Tan, Adriaan, additional, Czacko, Laszlo, additional, Leeuwenburgh, Ivonne, additional, Bruno, Marco, additional, and Cahen, Djuna, additional

Published
2023
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31. Pancreatic calcifications associate with diverse aetiological risk factors in patients with chronic pancreatitis: A multicentre study of 1500 cases

Author

Olesen, Søren S., Lisitskaya, Maria Valeryevna, Drewes, Asbjørn M., Novovic, Srdan, Nøjgaard, Camilla, Kalaitzakis, Evangelos, Jensen, Nanna M., Engjom, Trond, Erchinger, Friedemann, Waage, Anne, Hauge, Truls, Haas, Stephan L., Vujasinovic, Miroslav, Lindkvist, Björn, Zviniene, Kristina, Pukitis, Aldis, Ozola-Zālīte, Imanta, Okhlobystin, Alexey, Parhiala, Mikael, Laukkarinen, Johanna, and Frøkjær, Jens B.

Published
2019
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38. Wait-and-see strategy is justified after ERCP and endoscopic sphincterotomy in elderly patients with common biliary duct stones

Author

Kivivuori, Antti, Mattila, Laura, Siiki, Antti, Laukkarinen, Johanna, Rantanen, Tuomo, and Ukkonen, Mika

Subjects
Surgery, Critical Care and Intensive Care Medicine
Abstract

Older patients with simultaneous main bile duct and gallbladder stones, especially those with high-surgical risks, create a common clinical dilemma. After successful endoscopic removal of main bile duct stones, should these patients undergo laparoscopic cholecystectomy to reduce risk of recurrent biliary events?In this population-based cohort study, we report long-term outcomes of a wait-and-see strategy after successful endoscopic extraction of main bile duct stones.Consecutive patients aged ≥75 years undergoing endoscopic stone extraction without subsequent cholecystectomy in two tertiary academic centers between January 2010 and December 2018 were included. Primary outcome measure was recurrence of biliary events. Secondary outcome measures were operation-related morbidity and mortality.A total of 450 patients (median age 85 years, 61% female) were included, with a median follow-up time of 36 (0-120) months. Recurrent biliary events occurred in 51 patients (11%), with a median time from index hospital admission to recurrence of 307 (12-1993) days. The most biliary event common was acute cholecystitis (7.1%). Twelve patients had cholangitis (2.7%) and two biliary pancreatitis (0.4%). Only one patient (0.4%) underwent surgery due to later gallstone-related symptoms. Eighteen patients (4.0%) required endoscopic intervention and 16 (3.5%) underwent surgery. There were no operation-associated deaths or morbidity among those undergoing later surgical or endoscopic interventions.In elderly patients, it is relatively safe to leave gallbladder in situ after successful sphincterotomy and endoscopic common bile duct stone removal. In elderly and frail patients a wait-and see strategy without routine cholecystectomy rarely leads to clinically significant consequences.Study type: therapeutic/care management.Level III, Therapeutic study.

Published
2022

47. The additive value of CA19.9 monitoring in a pancreatic cyst surveillance program

Author

Levink, Iris J.M., Jaarsma, Sanne C., Koopmann, Brechtje D.M., van Riet, Priscilla A., Overbeek, Kasper A., Meziani, Jihane, Sprij, Marloes L.J.A., Casadei, Riccardo, Ingaldi, Carlo, Polkowski, Marcin, Engels, Megan M.L., van der Waaij, Laurens A., Carrara, Silvia, Pando, Elizabeth, Vornhülz, Marlies, Honkoop, Pieter, Schoon, Erik J., Laukkarinen, Johanna, Bergmann, Jilling F., Rossi, Gemma, van Vilsteren, Frederike G.I., van Berkel, Anne Marie, Tabone, Trevor, Schwartz, Matthijs P., Tan, Adriaan C.I.T.L., van Hooft, Jeanin E., Quispel, Rutger, van Soest, Ellert, Czacko, Laszlo, Bruno, Marco J., Cahen, Djuna L., Levink, Iris J.M., Jaarsma, Sanne C., Koopmann, Brechtje D.M., van Riet, Priscilla A., Overbeek, Kasper A., Meziani, Jihane, Sprij, Marloes L.J.A., Casadei, Riccardo, Ingaldi, Carlo, Polkowski, Marcin, Engels, Megan M.L., van der Waaij, Laurens A., Carrara, Silvia, Pando, Elizabeth, Vornhülz, Marlies, Honkoop, Pieter, Schoon, Erik J., Laukkarinen, Johanna, Bergmann, Jilling F., Rossi, Gemma, van Vilsteren, Frederike G.I., van Berkel, Anne Marie, Tabone, Trevor, Schwartz, Matthijs P., Tan, Adriaan C.I.T.L., van Hooft, Jeanin E., Quispel, Rutger, van Soest, Ellert, Czacko, Laszlo, Bruno, Marco J., and Cahen, Djuna L.

Abstract

Background:Surveillance of pancreatic cysts focuses on the detection of (mostly morphologic) features warranting surgery. European guidelines consider elevated CA19.9 as a relative indication for surgery. We aimed to evaluate the role of CA19.9 monitoring for early detection and management in a cyst surveillance population. Methods: The PACYFIC-registry is a prospective collaboration that investigates the yield of pancreatic cyst surveillance performed at the discretion of the treating physician. We included participants for whom at least one serum CA19.9 value was determined by a minimum follow-up of 12 months.Results: Of 1865 PACYFIC participants, 685 met the inclusion criteria for this study (mean age 67 years, SD 10; 61% female). During a median follow-up of 25 months (IQR 24, 1966 visits), 29 participants developed high-grade dysplasia (HGD) or pancreatic cancer. At baseline, CA19.9 ranged from 1 to 591 kU/L (median 10 kU/L [IQR 14]), and was elevated (≥37 kU/L) in 64 participants (9%). During 191 of 1966 visits (10%), an elevated CA19.9 was detected, and these visits more often led to an intensified follow-up (42%) than those without an elevated CA19.9 (27%; p < 0.001). An elevated CA19.9 was the sole reason for surgery in five participants with benign disease (10%). The baseline CA19.9 value was (as continuous or dichotomous variable at the 37 kU/L threshold) not independently associated with HGD or pancreatic cancer development, whilst a CA19.9 of ≥ 133 kU/L was (HR 3.8, 95% CI 1.1–13, p = 0.03). Conclusions: In this pancreatic cyst surveillance cohort, CA19.9 monitoring caused substantial harm by shortening surveillance intervals (and performance of unnecessary surgery). The current CA19.9 cutoff was not predictive of HGD and pancreatic cancer, whereas a higher cutoff may decrease false-positive values. The role of CA19.9 monitoring should be critically appraised prior to imp

Published
2023

49. Quality of life after endoscopic procedures for chronic pancreatitis: A multicentre study

Author

Parhiala, Mikael, Nøjgaard, Camilla, Bartholdy, Andreas, Waage, Anne, Ignatavičius, Povilas, Engjom, Trond, Dimcevski, Georg, Nordaas, Ingrid Kvåle, Kalaitzakis, Evangelos, Drewes, Asbjørn M., Hadi, Amer, Olesen, Søren S., Poulsen, Jakob L., and Laukkarinen, Johanna

Abstract

Chronic Pancreatitis (CP) causes morphological changes in the pancreatic tissue, leading to complications and pain, which may require endoscopic interventions. Our aim was to determine the frequency of endoscopic procedures (EP) in CP patients and to analyse pain and quality of life (QoL) in these patients after their EP. This study included 1327 CP patients from the Scandinavian Baltic Pancreatic Club (SBPC) database including four countries and eight centres. We analysed patients undergoing EPs and gathered information on the EP, pancreatic function, pain, disease and duration. The EORTC C‐30 QoL questionnaire was gathered prospectively and multivariable analysis was conducted on independent parameters between the groups. The reference population had no interventions (n= 870). 260 CP patients (22%) underwent EPs, median one year (range 0–39 years) after CP diagnosis. 68% were males. The median age was 59 (20–90) years. Most common aetiological factors were alcohol in 65% and smoking in 71%. Extracorporeal shock wave lithotripsy (ESWL) was used in 6% of the CP population and in 21% of the EP group. Biliary duct stenting was performed on 37% and pancreatic stenting was performed on 56% of the patients. There was no difference in pain patterns between patients who had pancreatic stenting and the reference population. The EP group had slightly better QoL (p= 0.047), functioning and fewer symptoms than the reference population, in the multivariable analysis there was no interaction effect analysis between the groups. The pancreatic stent group had better QoL and the same amount of pain than the reference group. The patients who needed later surgery (23%) had more pain (p= 0.043) and fatigue (p= 0.021). One in five of the CP patients underwent EP. These patients scored higher on QoL responses and had better symptom scores. CP patients who had pancreatic stenting performed had the same pain patterns as the reference population. Randomised prospective trials are needed to determine the effect of endoscopy procedures on CP patients.

Published
2023
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50. Real-world costs and dynamics of surveillance in patients who underwent surgery for low-risk branch duct intraductal papillary mucinous neoplasms

Author

Tamburrino, Domenico, primary, Cortesi, Paolo, additional, Facchetti, Rita, additional, de Pretis, Nicolò, additional, Pérez-Cuadrado-Robles, Enrique, additional, Uribarri-Gonzalez, Laura, additional, Ateeb, Zeeshan, additional, Belfiori, Giulio, additional, Arcidiacono, Paolo Giorgio, additional, Mantovani, Lorenzo Giovanni, additional, Del Chiaro, Marco, additional, Laukkarinen, Johanna, additional, Falconi, Massimo, additional, Crippa, Stefano, additional, and Capurso, Gabriele, additional

Published
2023
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