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Cheng Y, Feng J, Chen X, Lin J, Wang H. Endoscopic retrograde cholangiopancreatography consultation after digestive tract reconstruction and risk factors for complications. Eur J Med Res 2025; 30:135. [PMID: 40001247 PMCID: PMC11853183 DOI: 10.1186/s40001-025-02391-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2024] [Accepted: 02/17/2025] [Indexed: 02/27/2025] Open
Abstract
BACKGROUND Endoscopic retrograde cholangiopancreatography (ERCP) has been widely used in the diagnosis and treatment of biliary and pancreatic diseases, and its success rate and therapeutic effect are considerable, and its use in patients with gastrointestinal tract reconstruction is also increasing. The anatomical structure of the digestive tract has been changed in these patients, which makes the use of endoscopic retrograde cholangiopancreatography technically more challenging. The aim of this study was to investigate the efficacy of transendoscopic retrograde cholangiopancreatography in patients after gastrointestinal reconstruction and its risk factors for postoperative complications. METHODS A retrospective analysis was conducted on clinical data of 522 patients who underwent ERCP for diagnostic and therapeutic purposes after gastrointestinal reconstruction surgery at Zhongnan Hospital, Wuhan University, from January 2017 to December 2023. Univariate analysis, multicollinearity testing, and binary logistic regression were performed to explore the factors associated with ERCP efficacy and complications. RESULTS A total of 522 patients were included in the study. The success rate of intubation was 96.93% (506/522), the success rate of cannulation was 91.09% (466/506), and the therapeutic success rate was 95.28% (444/466). Multivariate logistic regression analysis of failed intubation showed that independent risk factors included total gastrectomy (P = 0.000, OR = 7.114, 95% CI 2.454-20.622), gastrojejunostomy (P = 0.000, OR = 46.881, 95% CI 10.250-214.423), and the use of a forward-viewing endoscope (P = 0.010, OR = 2.322, 95% CI 1.228-4.389). Post-ERCP complications included hyperamylasemia in 67 cases (12.84%), acute pancreatitis in 13 cases (2.49%), acute cholangitis in 3 cases (0.57%), bleeding in 3 cases (0.57%), and perforation in 2 cases (0.38%). Univariate analysis of the complications showed that a history of cholecystectomy (P = 0.042, OR = 1.800, 95% CI 1.015-3.193) was an independent risk factor for hyperamylasemia; difficult cannulation (P = 0.000, OR = 47.619, 95% CI 13.317-170.275) was an independent risk factor for acute pancreatitis; and a history of pancreatitis (P = 0.040, OR = 42.75, 95% CI 3.399-537.620) was an independent risk factor for bleeding. CONCLUSIONS ERCP performed in patients after gastrointestinal reconstruction at our hospital achieved a high success rate. Total gastrectomy, gastrojejunostomy, and the use of a forward-viewing endoscope were independent risk factors for failed intubation. A history of cholecystectomy, recurrent cannulation, and a history of pancreatitis were identified as independent risk factors for hyperamylasemia, acute pancreatitis, and bleeding, respectively.
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Affiliation(s)
- Yan Cheng
- Department of Gastroenterology, Zhongnan Hospital, Wuhan University, Wuhan, 430000, China
| | | | | | - Jun Lin
- Department of Gastroenterology, Zhongnan Hospital, Wuhan University, Wuhan, 430000, China.
| | - Hongling Wang
- Department of Gastroenterology, Zhongnan Hospital, Wuhan University, Wuhan, 430000, China.
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Mirante VG, Lonardo A, Grillo S, Franzoni F, Sassatelli R. Intravenous lactated Ringer’s solution alone and in combination with NSAIDs in prevention of post-ERCP acute pancreatitis: an updated systematic review. EXPLORATION OF MEDICINE 2024. [DOI: 10.37349/emed.2024.00247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 08/02/2024] [Indexed: 01/11/2025] Open
Affiliation(s)
- Vincenzo Giorgio Mirante
- Gastroenterology A, Ospedale Borgo Trento-Azienda Ospedaliera Universitaria Integrata di Verona, 37126 Verona, Italy
| | - Amedeo Lonardo
- Department of Internal Medicine, Ospedale Civile di Baggiovara, Azienda Ospedaliero-Universitaria di Modena, 41126 Modena, Italy
| | - Simone Grillo
- Gastroenterology and Digestive Endoscopy, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Francesca Franzoni
- Clinical Trials Center, Infrastruttura Ricerca e Statistica, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Romano Sassatelli
- Gastroenterology and Digestive Endoscopy, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
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Li Q, Li S, Hou S, Zhang L, Chen S, Wang J, Lv J, Wu Y, Huang Q, Li Y. ERCP-Related adverse events in pediatric patients: a 10-years single-site review. Pediatr Surg Int 2024; 40:199. [PMID: 39019990 DOI: 10.1007/s00383-024-05784-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/10/2024] [Indexed: 07/19/2024]
Abstract
PURPOSE This retrospective analysis aimed to assess the feasibility and safety of endoscopic retrograde cholangiopancreatography (ERCP) in pediatric patients by examining ERCP-related adverse events (AEs) occurring over a decade at a single center. METHODS Pediatric patients under 18 years old who underwent ERCP at the Second Hospital of Hebei Medical University from 1/2013 to 11/2023 were included. ERCP-related AEs were defined according to ERCP-related adverse events: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Clinical data of patients experiencing ERCP-related AEs were obtained from electronic medical records for analysis. RESULTS Over the past decade, a total of 76 pediatric patients underwent 113 ERCP procedures, including 26 patients who underwent repeat ERCP, totaling 63 procedures. There were 32 males and 44 females, with a median age of 13 years (range 3 years and 5 months-17 years and 9 months). Among all ERCP procedures, 14 (12.4%) were diagnostic and 99 (87.6%) were therapeutic, with a 100% success rate. 16 cases (14.2%) of ERCP-related AEs, all post-ERCP pancreatitis (PEP), were observed, while no other AEs defined by ESGE such as bleeding, perforation, cholangitis, cholecystitis, or sedation-related events were noted. Additionally, 23 cases (20.4%) of ERCP-related AEs not included in the ESGE definition were observed, including post-ERCP abdominal pain in 20 cases (17.7%), post-ERCP nausea and vomiting in 2 cases (1.8%), and unplanned reoperation in 1 case (0.9%). In the 26 cases of pediatric patients who underwent repeat ERCP, we observed that AEs occurred in 15 cases (57.7%) during their initial ERCP, which was much higher than the overall average level. CONCLUSIONS Post-ERCP abdominal pain and PEP are the most common ERCP-related AEs in pediatric patients, while severe AEs such as bleeding and perforation are rare. The incidence of AEs after initial ERCP in pediatric patients who received repeat ERCP is higher than the overall average level. Based on our center's experience, we believe that ERCP can be safely performed in children over 3 years old with biliary and pancreatic diseases and obtain reliable clinical benefits. However, active monitoring and management of ERCP-related AEs are essential to improve the clinical outcomes of pediatric ERCP.
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Affiliation(s)
- Qinqin Li
- Hebei Medical University, Shijiazhuang, Hebei, China
| | - Suolin Li
- Departments of Pediatric Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Senlin Hou
- Departments of Biliary and Pancreatic Endoscopic Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Lichao Zhang
- Departments of Biliary and Pancreatic Endoscopic Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Shengxiong Chen
- Departments of Hepatobiliary Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Jianlong Wang
- Departments of Minimally Invasive Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Jiaxun Lv
- Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yuqing Wu
- Hebei Medical University, Shijiazhuang, Hebei, China
| | - Qizheng Huang
- Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yingchao Li
- Departments of Pediatric Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
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Caragut RL, Ilie M, Cabel T, Günșahin D, Panaitescu A, Pavel C, Plotogea OM, Rînja EM, Constantinescu G, Sandru V. Updates in Diagnosis and Endoscopic Management of Cholangiocarcinoma. Diagnostics (Basel) 2024; 14:490. [PMID: 38472961 DOI: 10.3390/diagnostics14050490] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/10/2024] [Accepted: 02/17/2024] [Indexed: 03/14/2024] Open
Abstract
Cholangiocarcinoma (CCA) is an adenocarcinoma originating from the epithelial cells of the bile ducts/hepatocytes or peribiliary glands. There are three types of cholangiocarcinoma: intrahepatic, perihilar and distal. CCA represents approximately 3% of the gastrointestinal malignancies. The incidence of CCA is higher in regions of the Eastern world compared to the Western countries. There are multiple risk factors associated with cholangiocarcinoma such as liver fluke, primary sclerosing cholangitis, chronic hepatitis B, liver cirrhosis and non-alcoholic fatty liver disease. Endoscopy plays an important role in the diagnosis and management of cholangiocarcinoma. The main endoscopic methods used for diagnosis, biliary drainage and delivering intrabiliary local therapies are endoscopic retrograde cholangiopancreatography and endoscopic ultrasound. The purpose of this review is to analyze the current data found in literature about cholangiocarcinoma, with a focus on the actual diagnostic tools and endoscopic management options.
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Affiliation(s)
- Roxana-Luiza Caragut
- Clinical Department of Gastroenterology, Bucharest Emergency Clinical Hospital, 014461 Bucharest, Romania
| | - Madalina Ilie
- Clinical Department of Gastroenterology, Bucharest Emergency Clinical Hospital, 014461 Bucharest, Romania
- Department of Gastroenterology, University of Medicine and Pharmacy "Carol Davila" Bucharest, 050474 Bucharest, Romania
| | - Teodor Cabel
- Clinical Department of Gastroenterology, Bucharest Emergency Clinical Hospital, 014461 Bucharest, Romania
| | - Deniz Günșahin
- Clinical Department of Gastroenterology, Bucharest Emergency Clinical Hospital, 014461 Bucharest, Romania
| | - Afrodita Panaitescu
- Clinical Department of Gastroenterology, Bucharest Emergency Clinical Hospital, 014461 Bucharest, Romania
| | - Christopher Pavel
- Clinical Department of Gastroenterology, Bucharest Emergency Clinical Hospital, 014461 Bucharest, Romania
- Department of Gastroenterology, University of Medicine and Pharmacy "Carol Davila" Bucharest, 050474 Bucharest, Romania
| | - Oana Mihaela Plotogea
- Clinical Department of Gastroenterology, Bucharest Emergency Clinical Hospital, 014461 Bucharest, Romania
- Department of Gastroenterology, University of Medicine and Pharmacy "Carol Davila" Bucharest, 050474 Bucharest, Romania
| | - Ecaterina Mihaela Rînja
- Clinical Department of Gastroenterology, Bucharest Emergency Clinical Hospital, 014461 Bucharest, Romania
| | - Gabriel Constantinescu
- Clinical Department of Gastroenterology, Bucharest Emergency Clinical Hospital, 014461 Bucharest, Romania
- Department of Gastroenterology, University of Medicine and Pharmacy "Carol Davila" Bucharest, 050474 Bucharest, Romania
| | - Vasile Sandru
- Clinical Department of Gastroenterology, Bucharest Emergency Clinical Hospital, 014461 Bucharest, Romania
- Department of Gastroenterology, University of Medicine and Pharmacy "Carol Davila" Bucharest, 050474 Bucharest, Romania
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Chen J, Qian K, Liu CH, Li XL, Chen Y, Wang JQ. Effects of intravenous administration of magnesium sulfate in propofol-based sedation for ERCP in elderly patients: a randomized, double-blind, placebo-controlled study. BMC Geriatr 2023; 23:413. [PMID: 37420201 PMCID: PMC10326926 DOI: 10.1186/s12877-023-04107-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 06/14/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Propofol-based sedations are widely used in elderly patients for endoscopic retrograde cholangiopancreatography (ERCP) procedure, but respiratory depression and cardiovascular adverse events commonly occur. Magnesium administered intravenously can alleviate pain and decrease propofol requirements during surgery. We hypothesized that intravenous magnesium was used as adjuvant to propofol might be beneficial in elderly patients undergoing ERCP procedures. METHODS Eighty patients aged from 65 to 79 years who were scheduled for ERCP were enrolled. All patients were intravenously administered 0.1 µg/kg sufentanil as premedication. The patients were randomized to receive either intravenous magnesium sulfate 40 mg/kg (group M, n = 40) or the same volume of normal saline (group N, n = 40) over 15 min before the start of sedation. Intraoperative sedation was provided by propofol. Total propofol requirement during ERCP was the primary outcome. RESULTS The total propofol consumption were reduced by 21.4% in the group M compared with the group N (151.2 ± 53.3 mg vs. 192.3 ± 72.1 mg, P = 0.001). The incidences of respiratory depression episodes and involuntary movement were less in the group M than those in the group N (0/40 vs. 6/40, P = 0.011; 4/40 vs. 11/40, P = 0.045; respectively). In the group M, the patients experienced less pain than those in the group N at 30 min after the procedure (1 [0-1] vs. 2 [1-2], P < 0.001). Correspondingly, the patients' satisfaction was clearly higher in the group M (P = 0.005). There was a tendency towards lower intraoperative heart rate and mean arterial pressure in group M. CONCLUSIONS A single bolus of 40 mg/kg of intravenous magnesium can significantly reduce propofol consumption during ERCP, with higher sedation success and lower adverse events. TRIAL REGISTRATION ID UMIN000044737. Registered 02/07/2021.
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Affiliation(s)
- Jie Chen
- Department of Anaesthesiology, People's Hospital of Chongqing Banan District, Chongqing, China
| | - Ke Qian
- Department of Anaesthesiology, People's Hospital of Chongqing Banan District, Chongqing, China
| | - Chun-Hong Liu
- Department of Anaesthesiology, People's Hospital of Chongqing Banan District, Chongqing, China
| | - Xiao-Li Li
- Department of Anaesthesiology, People's Hospital of Chongqing Banan District, Chongqing, China
| | - Yan Chen
- Department of Anaesthesiology, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Jin-Quan Wang
- Department of Anaesthesiology, The Ninth People's Hospital of Chongqing, No. 69, Hejia Road, Jialing village, Beibei District, Chongqing, 400700, P. R. China.
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Eisenberg I, Gaidhane M, Kahaleh M, Tyberg A. Drainage Approach for Malignant Biliary Obstruction: A Changing Paradigm. J Clin Gastroenterol 2023; 57:546-552. [PMID: 37079870 DOI: 10.1097/mcg.0000000000001854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
Endoscopic retrograde cholangiopancreatography (ERCP) is the standard of care in the management of unresectable malignant biliary obstruction. However, endoscopic ultrasound (EUS)-guided biliary drainage has become widely accepted over the past several years for complicated biliary drainage in cases when ERCP is unsuccessful or not feasible. Recent emerging evidence suggests EUS-guided hepaticogastrostomy and EUS-guided choledochoduodenostomy are noninferior, and possibly even superior to conventional ERCP for primary palliation of malignant biliary obstruction. This article reviews the procedural techniques and considerations of the different techniques as well as comparative literature on safety and efficacy between techniques.
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Affiliation(s)
- Ian Eisenberg
- Division of Gastroenterology and Hepatology, University of Maryland School of Medicine, Baltimore, MD
| | - Monica Gaidhane
- Department of Gastroenterology and Hepatology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Michel Kahaleh
- Department of Gastroenterology and Hepatology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Amy Tyberg
- Department of Gastroenterology and Hepatology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
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Xu X, Guan L, Wu Y, Ke H, Zhao Y, Liu P. One hundred most cited articles related to Endoscopic retrograde cholangiopancreatography: A bibliometric analysis. Front Surg 2022; 9:1005771. [PMID: 36439532 PMCID: PMC9681810 DOI: 10.3389/fsurg.2022.1005771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/20/2022] [Indexed: 11/11/2022] Open
Abstract
Background Endoscopic retrograde cholangiopancreatography (ERCP) has developed over the past few decades into a reliable technology for diagnostic and therapeutic purposes. Through a bibliometric analysis, this research attempted to evaluate the characteristics of the top 100 articles on ERCP that had the most citations. Methods We extracted pertinent publications from the Web of Science Core Collection (WoSCC) on July 9, 2022. The top 100 ERCP articles with the most citations were identified and analyzed. The following data were extracted: publication year, country/region, organization, total citation times, annual citation times, research type and research field, etc. To implement the network’s visual analysis, a bibliographic coupling network based on keywords was built using the VOSviewer 1.6.17 program. Results The journal with the most publications were GASTROINTESTINAL ENDOSCOPY, with 45 articles. Most of the top 100 articles came from the United States (n = 47) and Italy (n = 14). Indiana University and the University of Amsterdam were among the most important institutions in ERCP research. ML Freeman of the University of Minnesota contributed the highest number (n = 9) and the most highly cited paper. The age of the paper and article type is closely related to citation frequency. Of the 100 most-cited articles, clinical application in the field of ERCP has focused on three aspects: diagnosis, treatment, and complications. Clinical use of ERCP has shifted from diagnosis to treatment. Post-ERCP pancreatitis is the focus of attention, and the clinical application of technically complex therapeutic ERCP is the future development trend. Conclusion This study lists the most influential articles in ERCP by exposing the current state of the field, and showing the evolution of research trends to provide perspective for the future development of ERCP.
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Affiliation(s)
- Xuan Xu
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China
- First Clinical Medical College, Nanchang University, Nanchang, China
| | - Lulu Guan
- First Clinical Medical College, Nanchang University, Nanchang, China
| | - Yao Wu
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Huajing Ke
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yuanbin Zhao
- Second Clinical Medical College, Nanchang University, Nanchang, China
| | - Pi Liu
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China
- Department of Gastroenterology, The People’s Hospital of Longhua, Shenzhen, China
- Correspondence: Pi Liu
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de Medeiros KS, Aragão Fernandes AC, Fulco Gonçalves G, Villarim CVO, Costa e Silva LC, de Sousa VMC, Meneses Rêgo AC, Araújo-Filho I. Cholecystectomy before, simultaneously, or after ERCP in patients with acute cholecystitis: A protocol for systematic review and/or meta analysis. Medicine (Baltimore) 2022; 101:e30772. [PMID: 36181122 PMCID: PMC9524974 DOI: 10.1097/md.0000000000030772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Cholecystectomy is the intervention of choice for treating acute cholecystitis; when conservative management does not work, it operates on the patient outside the critical condition. It can be performed together with or after endoscopic papillotomy through endoscopic retrograde cholangiopancreatography (ERCP) when it is concurrent with a situation of cholechodocolithiasis or when there is compression and consequent increase in pressure in the bile duct caused by a calculus jammed in the vesicular infundibulum (Mirizzi's syndrome), with or without jaundice, fever, and pain in the right hypochondrium (Charcot's Triad), which can progress to sepsis of biliary origin. This review aims to assess whether the timing of cholecystectomy (before or after ERCP) interferes with the postoperative period and clinical outcome in patients with acute cholecystitis. METHODS AND ANALYSIS By searching the MEDLINE/PubMed, Embase, Web of Science, ScienceDirect, ClinicalTrials.gov, CINAHAL, Latin American and Caribbean Literature in Health Sciences, Scopus and Cochrane Central databases, Controlled Trials Registry Randomized clinical trials will be searched to analyze whether ERCP performed before or after open or laparoscopic cholecystectomy (LC) in patients with acute cholecystitis is beneficial or not, through the analysis of postoperative complications. No language or publication period restrictions will be imposed. The primary outcome will be postoperative complications (postoperative morbidity and mortality). Four independent reviewers will select the studies and extract data from the original publications, with a fifth reviewer in case of disagreement regarding the inclusion or not of particular research in the present review. The risk of bias will be assessed using The Risk of Bias 2 (RoB 2.0) tool, and the certainty of evidence will be evaluated using the grading of recommendations assessment, development, and evaluation. Data synthesis will be performed using the Review Manager software (RevMan V.5.2.3). To assess heterogeneity, we will calculate the I2 statistics. Additionally, a quantitative synthesis will be performed if the included studies are sufficiently homogeneous. ETHICS AND DISCLOSURE Since the present study will review secondary data, previously published and scientifically validated, it will not be necessary to obtain ethical approval. The results of this systematic review will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER International Prospective Registry of Systematic Reviews (PROSPERO) CRD42021290726.
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Affiliation(s)
- Kleyton Santos de Medeiros
- Postgraduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, RN, Brazil
- Instituto de Ensino, Pesquisa e Inovação. Liga Contra o Câncer, Natal, RN, Brazil
- *Correspondence: Kleyton Santos de Medeiros, Eliza Branco Pereira dos Santos St., n 750, 26, Parque das Nações, Parnamirim, RN 59.158-160, Brazil (e-mail: )
| | | | | | | | | | | | | | - Irami Araújo-Filho
- Postgraduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, RN, Brazil
- Instituto de Ensino, Pesquisa e Inovação. Liga Contra o Câncer, Natal, RN, Brazil
- Department of Surgical, Federal University of Rio Grande do Norte, Natal, RN, Brazil
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Tonini V, Zanni M. Pancreatic cancer in 2021: What you need to know to win. World J Gastroenterol 2021; 27:5851-5889. [PMID: 34629806 PMCID: PMC8475010 DOI: 10.3748/wjg.v27.i35.5851] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 07/14/2021] [Accepted: 08/23/2021] [Indexed: 02/06/2023] Open
Abstract
Pancreatic cancer is one of the solid tumors with the worst prognosis. Five-year survival rate is less than 10%. Surgical resection is the only potentially curative treatment, but the tumor is often diagnosed at an advanced stage of the disease and surgery could be performed in a very limited number of patients. Moreover, surgery is still associated with high post-operative morbidity, while other therapies still offer very disappointing results. This article reviews every aspect of pancreatic cancer, focusing on the elements that can improve prognosis. It was written with the aim of describing everything you need to know in 2021 in order to face this difficult challenge.
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Affiliation(s)
- Valeria Tonini
- Department of Medical Sciences and Surgery, University of Bologna- Emergency Surgery Unit, IRCCS Sant’Orsola Hospital, Bologna 40121, Italy
| | - Manuel Zanni
- University of Bologna, Emergency Surgery Unit, IRCCS Sant'Orsola Hospital, Bologna 40121, Italy
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