Korean Red ginseng supplements improve quality of life in patients with mild chronic pancreatitis symptoms: A prospective clinical trial.

Background: Managing symptoms of chronic pancreatitis (CP) remains a significant challenge. Korean Red ginseng (KRG), a well-known herbal supplement, has shown potential benefits in various health conditions, prompting its investigation in CP patients.

Methods: We conducted a single-arm, prospective clinical trial to evaluate the effect of KRG on quality of life in CP patients exhibiting mild symptoms, as defined by a Clinical Global Impression (CGI) score of 0 or 1.

Comparison of 5-Fluorouracil/Leucovorin and Capecitabine as Adjuvant Therapies in Biliary Tract Cancer.

Background: The prognosis of biliary tract cancer (BTC) is poor, and recurrence rates remain high even after curative resection. This study aimed to compare the efficacy and safety of capecitabine and 5-fluorouracil/leucovorin (FL) as adjuvant treatments following curative resection in patients with BTC.

Methods: We retrospectively reviewed the medical records of patients with BTC (including gallbladder and extrahepatic and intrahepatic bile duct cancers) who underwent curative surgical resection and adjuvant chemotherapy between 2011 and 2023.

Prevention of stent migration of covered self-expandable metal stents in distal malignant biliary obstruction: a review of literature.

Distal malignant biliary obstruction (dMBO) is a common complication of advanced malignancies, particularly pancreatic cancer and biliary tract cancer, requiring biliary drainage to relieve symptoms. Endoscopic drainage using self-expandable metal stents (SEMS) is widely preferred due to improved long-term patency compared with plastic stents. However, the choice between fully covered SEMS (FCSEMS) and uncovered SEMS (UCSEMS) remains controversial, primarily due to migration risks associated with FCSEMS.

Endoscopic papillectomy for laterally spreading lesions of the papilla - a propensity score matched analysis.

Background And Aims: Endoscopic papillectomy (EP) is a standard treatment for ampullary lesions (AL), typically small and confined to the papillary mound. Laterally spreading lesions (LSL) of the papilla Vateri are a rare AL subtype involving extensive duodenal mucosa. Data on EP outcomes for LSL are limited.

Endoscopic hemostasis with a self-expandable metal stent as bridge therapy for hemobilia.

Background And Study Aims: Management of hemobilia is often challenging. Recently, endoscopic hemostasis with a self-expandable metal stent (SEMS) has shown promising efficacy for controlling bleeding at the endoscopic sphincterotomy site. This study aimed to assess efficacy and feasibility of endoscopic hemostasis as bridge therapy for hemobilia.

A randomized non-inferiority trial investigating antibiotic adjustments based on blood culture in acute cholangitis.

Objectives: This study evaluated the adequacy of using blood cultures alone for antibiotic therapy in mild-to-moderate acute cholangitis after adequate biliary drainage.

Methods: A prospective, multi-centre, non-inferiority, randomized trial was conducted from August 2015 to September 2023 across 12 tertiary hospitals in South Korea. Patients were randomly assigned 1:1 to groups.

ATR inhibition promotes synergistic antitumor effect in platinum-resistant pancreatic cancer.

Background: Oxaliplatin is a commonly used platinum-based chemotherapy drug for patients with pancreatic cancer (PC). Drug resistance is a major challenge in PC treatment, underscoring the urgent need for new approaches. Targeting DNA damage repair, one of the factors responsible for platinum resistance, is an attractive strategy to overcome drug resistance.

Endoscopic papillectomy versus surgical ampullectomy for adenomas and early cancers of the papilla: a retrospective Pancreas2000/European Pancreatic Club analysis.

Objective: Ampullary neoplastic lesions can be resected by endoscopic papillectomy (EP) or transduodenal surgical ampullectomy (TSA) while pancreaticoduodenectomy is reserved for more advanced lesions. We present the largest retrospective comparative study analysing EP and TSA.

Design: Of all patients in the database, lesions with prior interventions, benign histology advanced malignancy (T2 and more), patients with hereditary syndromes and those undergoing pancreatoduodenectomy were excluded.

Digital single-operator cholangioscopy for difficult anastomotic biliary strictures in living donor liver transplant recipients after failure of standard ERCP: SPYPASS-2 study (with videos).

Background And Aims: Liver transplantation (LT) is a curative treatment for end-stage liver disease. Anastomotic biliary strictures (ABSs) are more common in living donor LT (LDLT). However, the success rate of ERCP for ABSs remains unsatisfactory.

Safety and efficacy of HK-660S in patients with primary sclerosing cholangitis: A randomized double-blind phase 2a trial.

Background/aims: A clinical unmet need persists for medications capable of modulating the progression of primary sclerosing cholangitis (PSC). This study aimed to assess the clinical feasibility of HK-660S (beta-lapachone) in PSC.

Methods: In this multicenter, randomized, double-blind, placebo-controlled, parallel-group phase 2 trial, participants were assigned in a 2:1 ratio to receive either 100 mg of HK-660S or a placebo twice daily for 12 weeks.

Optimal timing of surgery after neoadjuvant treatment in borderline resectable pancreatic cancer.

Background: Neoadjuvant treatment (NAT) is standard for borderline resectable pancreatic cancer (BRPC). However, consensus is lacking on the optimal surgical timing for patients with BRPC undergoing NAT. The aim of this study was to investigate the long-term outcomes of patients undergoing NAT for BRPC and suggest optimal resection timing.

Survival benefit of adjuvant treatment for ampullary cancer with lymph nodal involvement: A systematic review and meta-analysis.

Background: The efficacy of adjuvant treatment (AT) in ampullary cancer (AmC) remains controversial. This systematic review and meta-analysis aimed to evaluate the role of AT for AmC.

Data Sources: A comprehensive systematic search was performed in PubMed, EMBASE, Cochrane Library, and Web of Science databases.

Aggressive hydration with lactated Ringer's solution versus plasma solution for the prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (ALPS study): protocol for a multicentre, double-blind, randomised controlled trial.

Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) plays an indispensable role in treating pancreato-biliary diseases but carries a risk of post-ERCP pancreatitis (PEP). Despite advances in the prevention strategies, prevention of PEP remains imperfect, necessitating more refined hydration methods. This study investigates the effectiveness of lactated Ringer's solution versus plasma solution in preventing PEP.

Pancreatic Cancer Treatment Targeting the HGF/c-MET Pathway: The MEK Inhibitor Trametinib.

Pancreatic cancer is characterized by fibrosis/desmoplasia in the tumor microenvironment, which is primarily mediated by pancreatic stellate cells and cancer-associated fibroblasts. HGF/c-MET signaling, which is instrumental in embryonic development and wound healing, is also implicated for its mitogenic and motogenic properties. In pancreatic cancer, this pathway, along with its downstream signaling pathways, is associated with disease progression, prognosis, metastasis, chemoresistance, and other tumor-related factors.

Diagnostic performance of EUS-guided elastography for differential diagnosis of gallbladder polyp.

Background And Aims: It is difficult to differentiate between neoplastic and non-neoplastic gallbladder (GB) polyps before surgery. EUS-guided elastography (EUS-EG) is a noninvasive complementary diagnostic method. The utility of EUS-EG in the differential diagnosis of GB polyps has not been investigated.

Enhanced Anti-tumor Effect of Flavopiridol in Combination With Gemcitabine in Pancreatic Cancer.

Background/aim: The efficacy of current chemotherapies for pancreatic ductal adenocarcinoma (PDAC) is still unsatisfactory. Flavopiridol inhibits multiple cyclin-dependent kinases, causing cell cycle arrest and inducing cancer cell apoptosis. This study aimed to evaluate the anti-tumor effect of flavopiridol and gemcitabine in PDAC in vitro and in vivo.

Prognostic value of initial and longitudinal changes in body composition in metastatic pancreatic cancer.

Background: Sarcopenia or visceral adipose tissue has been reported to be related to pancreatic cancer prognosis. However, clinical relevance of the comprehensive analysis of body compositions and their longitudinal changes is lacking. This study analysed the association between body composition changes after chemotherapy and survival in patients with metastatic pancreatic cancer.