Article
Gastroenterology & Hepatology
Lillian Wang, Sherif Elhanafi, Andrew C. Storm, Mark D. Topazian, Shounak Majumder, Barham K. Abu Dayyeh, Michael J. Levy, Bret T. Petersen, John A. Martin, Suresh T. Chari, Santhi S. Vege, Vinay Chandrasekhara
Summary: DPDS is frequently seen in patients with PFCs, but does not impact successful resolution. Patients with DPDS have an increased risk of PFC recurrence after stent removal.
Article
Gastroenterology & Hepatology
Nikhil R. Thiruvengadam, Kimberly A. Forde, Janille Miranda, Christopher Kim, Spencer Behr, Umesh Masharani, Mustafa A. Arain
Summary: This study found that DPDS-P occurred in 16% of patients with necrotizing pancreatitis, and it was associated with a higher rate of new-onset diabetes after pancreatitis compared to other manifestations of DPDS and patients without DPDS.
CLINICAL AND TRANSLATIONAL GASTROENTEROLOGY
(2022)
Review
Gastroenterology & Hepatology
Daniel Llwyd Hughes, Michael A. A. Silva
Summary: Disconnected duct syndrome is an adverse consequence of acute necrotizing pancreatitis, resulting in a failure to deliver pancreatic secretions into the duodenum. The diagnosis of this syndrome may be delayed, and there is no definitive consensus on the optimal treatment strategy. Treatment should be tailored to each individual patient.
Review
Gastroenterology & Hepatology
Zhi-Jie Wang, Yi-Hang Song, Shi-Yu Li, Zi-Xuan He, Zhao-Shen Li, Shu-Ling Wang, Yu Bai
Summary: Disconnected pancreatic duct syndrome (DPDS) is a common and important complication of acute necrotizing pancreatitis. The endoscopic approach, including transpapillary and transmural drainage, has become the preferred treatment for pancreatic fluid collections (PFCs) with DPDS. However, there is no standardized treatment for DPDS and the existing literature reports inconsistent and confusing results. This article summarizes the latest evidence to explore the optimal endoscopic management of PFC with DPDS.
ENDOSCOPIC ULTRASOUND
(2023)
Article
Gastroenterology & Hepatology
Safi Dokmak, Auriana Tetart, Beatrice Aussilhou, Anais Choquet, Vinciane Rebours, Marie Pierre Vullierme, Olivier Soubrane, Philippe Ruszniewski, Philippe Levy, Alain Sauvanet
Summary: The French reconnection procedure, as an alternative to distal splenopancreatectomy for the treatment of DPDS, provides good control of symptoms and decreases the risk of pancreatic insufficiency.
Article
Gastroenterology & Hepatology
Radhika Chavan, Zaheer Nabi, Sundeep Lakhtakia, Rajesh Gupta, Basha Jahangeer, Rupjyoti Talukdar, Aniruddha Pratap Singh, Arun Karyampudi, Raghavendra Yarlagadda, Mohan Ramchandani, Rakesh Kalapala, Nitin Jagtap, Manohar Reddy, Manu Tandan, Guduru Venkat Rao, Nageshwar D. Reddy
Summary: In this study, plastic stents were compared to no stents in patients with DPD to evaluate the recurrence of PFC. The results showed that the deployment of plastic stents after LCMS removal did not reduce the recurrence of PFC.
Article
Gastroenterology & Hepatology
Paraskevas Gkolfakis, Arnaud Bourguignon, Marianna Arvanitakis, Arthur Baudewyns, Pierre Eisendrath, Daniel Blero, Arnaud Lemmers, Myriam Delhaye, Jacques Deviere
Summary: Long-term transmural double-pigtail stent placement is a safe and effective treatment for patients with DPDS-associated peri-PFCs, but approximately one quarter of peri-PFCs will recur.
Article
Gastroenterology & Hepatology
Ji Young Bang, C. Mel Wilcox, Juan Pablo Arnoletti, Shyam Varadarajulu
Summary: In patients with disconnected pancreatic duct syndrome (DPDS), replacing lumen-apposing metal stents (LAMS) with indwelling plastic stents after resolving pancreatic fluid collection (PFC) can significantly reduce the risk of PFC recurrence and morbidity.
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
(2021)
Article
Radiology, Nuclear Medicine & Medical Imaging
Matthew L. Hung, Shawn Ma, Richard D. Shlansky-Goldberg
Summary: Transgastric drainage (TGD) is an effective and safe treatment for pancreatic duct leaks (PDLs), with high technical success and low complication rates.
JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY
(2023)
Review
Gastroenterology & Hepatology
Harsimran Bhatia, Neha Yadav, Pankaj Gupta
Summary: Disconnected pancreatic duct syndrome (DPDS) is a significant complication of acute necrotizing pancreatitis (ANP) associated with long-term morbidity and mortality. While endoscopic retrograde cholangiopancreatography (ERCP) is considered the gold standard for diagnosing and treating DPDS patients, a noninvasive diagnosis based on radiological tests is desirable. Radiological literature on DPDS diagnosis is limited, with substantial ambiguity in the definitions.
EXPERT REVIEW OF GASTROENTEROLOGY & HEPATOLOGY
(2022)
Review
Gastroenterology & Hepatology
Tsuyoshi Hamada, Takuji Iwashita, Tomotaka Saito, Hideyuki Shiomi, Mamoru Takenaka, Hiroyuki Isayama, Ichiro Yasuda, Yousuke Nakai
Summary: Patients with DPDS are more likely to experience PFC recurrence after endoscopic treatment and require prolonged stent placement. There were no significant differences between the groups in terms of technical success, adverse events, or mortality.
DIGESTIVE ENDOSCOPY
(2022)
Article
Surgery
Yan Qin, Yong-Hua Chen, Zhen-Jiang Zheng, Chun-Lu Tan
Summary: This article introduces a new surgical method, the double-cannula pancreatic gastrostomy, for the treatment of disconnected pancreatic duct syndrome. The method successfully treated a patient with recurrent acute pancreatitis and avoided the risks associated with traditional surgical methods.
INTERNATIONAL JOURNAL OF SURGERY CASE REPORTS
(2023)
Article
Gastroenterology & Hepatology
Neda Amini, Neda Rezaee, Joseph R. Habib, Alex Blair, Ross M. Beckman, Lindsey Manos, John L. Cameron, Ralph H. Hruban, Matthew J. Weiss, Elliot K. Fishman, Atif Zaheer, Kelly J. Lafaro, Richard A. Burkhart, Anne M. O'Broin Lennon, William R. Burns, Jin He, Christopher L. Wolfgang
Summary: This study aimed to determine the incidence of high-grade dysplasia (HGD) or invasive carcinoma in patients with small branch duct intraductal papillary mucinous neoplasms (BDIPMNs). The risk of harboring high-risk disease remains low in small BD-IPMNs, but Sendai-negative patients who are older than 65 years old and those with minimal dilation of MPD are at higher risk of high-risk lesions.
Review
Gastroenterology & Hepatology
Hester C. Timmerhuis, Sven M. van Dijk, Robert C. Verdonk, Thomas L. Bollen, Marco J. Bruno, Paul Fockens, Jeanin E. van Hooft, Rogier P. Voermans, Marc G. Besselink, Hjalmar C. van Santvoort
Summary: Various diagnostic modalities are accurate in diagnosing a disrupted pancreatic duct in patients with acute pancreatitis, with endoscopic ultrasound and endoscopic retrograde cholangiopancreatography showing a sensitivity of 100%. Amylase measurement in drain fluid should be standardized. Secretin-magnetic resonance cholangiopancreatography or magnetic resonance cholangiopancreatography are recommended as the first diagnostic modality due to their less invasive nature, but further prospective studies are needed.
DIGESTIVE DISEASES AND SCIENCES
(2021)
Review
Medicine, General & Internal
Hua Hai, Zhuyin Li, Ziwei Zhang, Yao Cheng, Zuojin Liu, Jianping Gong, Yilei Deng
Summary: This study compared different types of pancreaticojejunostomy for patients undergoing pancreaticoduodenectomy in terms of postoperative outcomes, but the evidence was very uncertain, highlighting the need for more research to determine the effects.
COCHRANE DATABASE OF SYSTEMATIC REVIEWS
(2022)
Article
Surgery
Maxwell T. Trudeau, Fabio Casciani, Brett L. Ecker, Laura Maggino, Thomas F. Seykora, Priya Puri, Matthew T. McMillan, Benjamin Miller, Wande B. Pratt, Horacio J. Asbun, Chad G. Ball, Claudio Bassi, Stephen W. Behrman, Adam C. Berger, Mark P. Bloomston, Mark P. Callery, Carlos Fernandez-del Castillo, John D. Christein, Mary E. Dillhoff, Euan J. Dickson, Elijah Dixon, William E. Fisher, Michael G. House, Steven J. Hughes, Tara S. Kent, Giuseppe Malleo, Ronald R. Salem, Christopher L. Wolfgang, Amer H. Zureikat, Charles M. Vollmer
Summary: This study aims to present different patient presentations of pancreatic fistula risk and define the effectiveness of mitigation strategies in the most prevalent and vulnerable scenarios for surgeons. Through analysis of data from multiple international institutions, specific scenarios and optimal mitigation approaches associated with CR-POPF occurrence were identified.
Article
Anesthesiology
Terrie Vasilopoulos, Richa Wardhan, Parisa Rashidi, Roger B. Fillingim, Margaret R. Wallace, Paul L. Crispen, Hari K. Parvataneni, Hernan A. Prieto, Tiago N. Machuca, Steven J. Hughes, Gregory J. A. Murad, Patrick J. Tighe
Summary: The study identified five distinct postoperative pain trajectories, with many patients experiencing moderate-to-high pain. Factors influencing the high pain trajectory included younger age, female gender, higher anxiety, and more pain behaviors.
Article
Anesthesiology
Raheleh Baharloo, Jose C. Principe, Roger B. Fillingim, Margaret R. Wallace, Baiming Zou, Paul L. Crispen, Hari K. Parvataneni, Hernan A. Prieto, Tiago N. Machuca, Xinlei Mi, Steven J. Hughes, Gregory J. A. Murad, Parisa Rashidi, Patrick J. Tighe
Summary: The study shows that wavelet analysis can extract temporal patterns of acute pain intensity from clinically documented records, and these patterns can predict pain outcomes on postoperative day 30.
ANESTHESIA AND ANALGESIA
(2021)
Article
Surgery
Samer AlMasri, Mazen S. Zenati, Georgios Papachristou, Adam Slivka, Michael Sanders, Jennifer Chennat, Mordechai Rabinowitz, Asif Khalid, Andres Gelrud, John Nasr, Savreet Sarkaria, Rohit Das, Kenneth K. Lee, Wolfgang Schraut, Steve J. Hughes, A. James Moser, Alessandro Paniccia, Melissa E. Hogg, Herbert J. Zeh, Amer H. Zureikat
Summary: LA-ERCP is effective in treating pancreaticobiliary pathology after RYGB, with high success rates and low adverse events. The study identified a learning curve for surgical and gastroenterology teams at case 27 and case 9 respectively, and highlighted the need for 3-5 cases per surgeon to optimize operative metrics.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2022)
Letter
Pathology
Ashwin S. Akki, Xiuli Liu, William L. Clapp, Petr Starostik, Kimberly J. Newsom, Steven J. Hughes, Ashwini K. Esnakula
PATHOLOGY INTERNATIONAL
(2021)
Article
Surgery
Fabio Casciani, Maxwell T. Trudeau, Horacio J. Asbun, Chad G. Ball, Claudio Bassi, Stephen W. Behrman, Adam C. Berger, Mark P. Bloomston, Mark P. Callery, John D. Christein, Massimo Falconi, Carlos Fernandez-del Castillo, Mary E. Dillhoff, Euan J. Dickson, Elijah Dixon, William E. Fisher, Michael G. House, Steven J. Hughes, Tara S. Kent, John W. Kunstman, Giuseppe Malleo, Stefano Partelli, Christopher L. Wolfgang, Amer H. Zureikat, Charles M. Vollmer
Summary: This study revealed a connection between high estimated blood loss and increased clinically relevant pancreatic fistula rates after pancreatoduodenectomy, and identified high estimated blood loss as an independent predictor for clinically relevant pancreatic fistula occurrence. Minimizing blood loss is crucial for reducing postoperative complications and optimizing surgical outcomes.
Correction
Surgery
Samer AlMasri, Mazen S. Zenati, Georgios I. Papachristou, Adam Slivka, Michael Sanders, Jennifer Chennat, Mordechai Rabinowitz, Asif Khalid, Andres Gelrud, John Nasr, Savreet Sarkaria, Rohit Das, Kenneth K. Lee, Wolfgang Schraut, Steve J. Hughes, A. James Moser, Alessandro Paniccia, Melissa E. Hogg, Herbert J. Zeh, Amer H. Zureikat
Summary: The article was updated to correct a typo in the first sentence of the Results section of the abstract, changing the number of patients from 31 to 131.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2022)
Article
Surgery
Andrea N. Riner, Kelly M. Herremans, Daniel W. Neal, Crystal Johnson-Mann, Steven J. Hughes, Kandace P. McGuire, Gilbert R. Upchurch, Jose G. Trevino
Summary: The study found that a disproportionately small number of faculty from minority groups obtain leadership positions in academic surgery, with female members of racial/ethnic minority groups potentially facing greater challenges in achieving leadership roles compared to their male colleagues. These findings highlight the urgency to diversify surgical leadership.
Article
Anesthesiology
Xinlei Mi, Baiming Zou, Parisa Rashidi, Raheleh Baharloo, Roger B. Fillingim, Margaret R. Wallace, Paul L. Crispen, Hari K. Parvataneni, Hernan A. Prieto, Chancellor F. Gray, Tiago N. Machuca, Steven J. Hughes, Gregory J. A. Murad, Elizabeth Thomas, Atif Iqbal, Patrick J. Tighe
Summary: The study suggests that acute postoperative pain may mediate the relationship with persistent postsurgical pain, being influenced by specific patient and surgical factors.
CLINICAL JOURNAL OF PAIN
(2021)
Article
Oncology
Patrick W. Underwood, Andrea N. Riner, Dan Neal, Miles E. Cameron, Anastasiya Yakovenko, Sushanth Reddy, John Bart Rose, Steven J. Hughes, Jose G. Trevino
Summary: This study suggests that unlike other malignancies, race/ethnicity does not affect survival differences in patients with PNETs. Instead, patients with lower socioeconomic status have worse survival outcomes.
JOURNAL OF SURGICAL ONCOLOGY
(2021)
Article
Oncology
Thomas J. George, Azka Ali, Yu Wang, Ji-Hyun Lee, Alison M. Ivey, David DeRemer, Karen C. Daily, Carmen J. Allegra, Steven J. Hughes, Z. Hugh Fan, Miles E. Cameron, Andrew R. Judge, Jose G. Trevino
Summary: Combining dasatinib with FOLFOX regimen in previously untreated patients with metastatic pancreatic cancer showed limited clinical activity, with no significant incremental benefit observed. Further research is ongoing to better understand the role of this treatment approach.
Article
Surgery
Lisa S. Brubaker, Fabio Casciani, William E. Fisher, Amy L. Wood, Martha Navarro Cagigas, Maxwell T. Trudeau, Viraj J. Parikh, Katherine A. Baugh, Horacio J. Asbun, Chad G. Ball, Stephen W. Behrman, Adam C. Berger, Mark P. Bloomston, Mark P. Callery, John D. Christein, Carlos Fernandez-del Castillo, Mary E. Dillhoff, Elijah Dixon, Michael G. House, Steven J. Hughes, Tara S. Kent, John W. Kunstman, Christopher L. Wolfgang, Amer H. Zureikat, Charles M. Vollmer, George Van Buren
Summary: This study aimed to investigate the impact of multiple intraperitoneal drains compared to a single drain in high-risk cases of clinically relevant postoperative pancreatic fistula (CR-POPF). The results showed that in intermediate/high-risk cases, placement of a single or multiple drains can mitigate the complication burden, while no drains are associated with inferior outcomes.
Article
Gastroenterology & Hepatology
Ibrahim Nassour, Samer AlMasri, Jacob C. Hodges, Steven J. Hughes, Amer Zureikat, Alessandro Paniccia
Summary: This study emphasizes the importance of Delta DFA in predicting CR-POPF following distal pancreatectomy and provides a calculator to facilitate prediction and postoperative drain management.
JOURNAL OF GASTROINTESTINAL SURGERY
(2022)
Article
Gastroenterology & Hepatology
Florence E. M. de Rijk, Charlotte L. van Veldhuisen, Marc G. Besselink, Jeanin E. van Hooft, Hjalmar C. van Santvoort, Erwin J. M. van Geenen, Peter Hegyi, J-Matthias Lohr, Juan E. Dominguez-Munoz, Pieter Jan F. de Jonge, Marco J. Bruno, Robert C. Verdonk
Summary: A lack of consensus and substantial practice variation among international pancreatologists regarding the management of exocrine pancreatic insufficiency was identified in this study, emphasizing the need for further adaptation of guidelines based on current expert opinion and scientific evidence.
Article
Oncology
Kelly M. Herremans, Dominique D. Szymkiewicz, Andrea N. Riner, Riley P. Bohan, Gerik W. Tushoski, Aaron M. Davidson, XiangYang Lou, Man Chong Leong, Bayli DiVita Dean, Michael Gerber, Patrick W. Underwood, Song Han, Steven J. Hughes
Summary: Interleukin-1 (IL-1) plays a crucial role in pancreatic ductal adenocarcinoma (PDAC) and is associated with immune checkpoints, immune cell types, and patient survival.