Publications by authors named "Pandanaboyana Sanjay"
Background: The use of minimally invasive (laparoscopic and robotic) pancreatoduodenectomy (PD) is being increasingly adopted despite the lack of hard evidence to support its utilisation. With recent randomised controlled trials (RCTs) comparing open pancreatoduodenectomy (OPD) with robotic or laparoscopic pancreatoduodenectomy (RPD or LPD), we undertook a network meta-analysis (NMA) comparing all 3 approaches to evaluate comparative outcomes.
Methods: A systematic search of MEDLINE, EMBASE, and Cochrane CENTRAL was conducted up to May 2024 and relevant RCTs were identified.
Methods: The review was conducted adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist.
Results: 15 studies including 147 patients (adult n = 71/paediatric n = 76) reported on CGM use post-TP (n = 42) and TPIAT (n = 105). 4 were randomized controlled trials and 10 observational studies.
Analgesia in paediatric acute pancreatitis: A scoping systematic review.
J Pediatr Gastroenterol Nutr
January 2025
Article Synopsis
- Acute pancreatitis (AP) is common in children, yet there is limited information on effective pain management strategies, which this scoping review aims to address.
- The review involved a systematic search of various medical databases, analyzing three studies focused on analgesic practices in pediatric AP with a total of 658 patients in North America.
- Findings indicate that opioids are predominantly used for pain relief, but there are knowledge gaps regarding factors affecting analgesic choices, their influence on recovery outcomes, and long-term pain management after discharge.
Background: Since there is no current international consensus on the optimal approach for pain management in acute pancreatitis (AP), analgesic practices may vary across different healthcare settings.
Objective: This study explored global disparities in analgesic use, in particular opioids, during admission and at discharge in hospitalised AP patients.
Methods: This was a post hoc analysis of the prospective PAINAP database, which included all admissions for AP between April and June 2022 with a 1-month follow-up.
Article Synopsis
- Intraductal oncocytic papillary neoplasms (IOPNs) are now identified as distinct from intraductal papillary mucinous neoplasms (IPMNs), with limited information on their recurrence and survival outcomes.
- A study analyzed outcomes of 415 patients with invasive IOPNs and adenocarcinoma from IPMN over a median of 6 years, finding similar recurrence rates between invasive IOPNs and ductal A-IPMN, but poorer survival compared to colloid A-IPMN.
- The research concluded that invasive IOPNs behave like aggressive cancers, with adjuvant chemotherapy showing no significant impact on recurrence rates in any of the studied cancer types.
Article Synopsis
- The study examines the outcomes of different precursor epithelial subtypes of adenocarcinoma from intraductal papillary mucinous neoplasms (A-IPMN), focusing on clinical features and recurrence patterns among patients who underwent pancreatic surgery.
- A total of 297 patients were analyzed, revealing that gastric, pancreatobiliary, and mixed subtypes have similar outcomes that are worse than the intestinal subtype in terms of recurrence and overall survival.
- The research found that adjuvant chemotherapy specifically improved survival rates in the pancreatobiliary subtype, but not in gastric, intestinal, or mixed subtypes, indicating a potential area for further exploration in treatment strategies.
Article Synopsis
- - The study investigates factors affecting long-term survival and recurrence in patients with adenocarcinoma from intraductal papillary mucinous neoplasms, focusing on those who had pancreatic resection between 2010 and 2017 in Europe and Asia.
- - It analyzed data from 288 patients, revealing that 48% experienced recurrence within about 98 months, with 35% remaining disease-free at the 5-year mark.
- - Key negative predictors for long-term disease-free survival included multivisceral resection, tumor location in the pancreatic tail, poor differentiation, lymphovascular invasion, and perineural invasion, leading to the development of a predictive model with a good success rate.
Introduction: Opioids used to manage severe pain in acute pancreatitis (AP) might exacerbate the disease through effects on gastrointestinal and immune functions. Methylnaltrexone, a peripherally acting µ-opioid receptor antagonist, may counteract these effects without changing analgesia.
Methods: This double-blind, randomized, placebo-controlled trial included adult patients with AP and systemic inflammatory response syndrome at 4 Danish centers.
Simultaneous pancreas-kidney (SPK) transplantation improves quality of life and limits progression of diabetic complications. There is reluctance to accept pancreata from donors with abnormal blood tests, due to concern of inferior outcomes. We investigated whether donor amylase and liver blood tests (markers of visceral ischaemic injury) predict pancreas graft outcome using the UK Transplant Registry (2016-2021).
View Article and Find Full Text PDFLiver fibrosis is the excessive accumulation of extracellular matrix proteins that occurs in most types of chronic liver disease. At the cellular level, liver fibrosis is associated with the activation of hepatic stellate cells (HSCs) which transdifferentiate into a myofibroblast-like phenotype that is contractile, proliferative and profibrogenic. HSC transdifferentiation induces genome-wide changes in gene expression that enable the cell to adopt its profibrogenic functions.
View Article and Find Full Text PDFArticle Synopsis
- A study was conducted to determine the effects of adjuvant chemotherapy on patients with adenocarcinoma from intraductal papillary mucinous neoplasia after surgical resection, analyzing data from 459 patients across 18 centers between 2010 and 2020.
- The results showed that 59.9% of patients received various chemotherapy regimens, but there was no significant difference in recurrence rates or survival outcomes between those who received chemotherapy and those who did not.
- Overall, the study concluded that adjuvant chemotherapy does not appear to improve recurrence patterns or survival rates in this patient population.
Article Synopsis
- The study aimed to compare long-term cancer outcomes between patients with adenocarcinoma from intraductal papillary mucinous neoplasms (A-IPMN) and pancreatic ductal adenocarcinoma (PDAC) after surgical resection.
- Data revealed that A-IPMN patients generally had better survival rates and lower recurrence rates compared to PDAC patients, including longer median survival (39.0 months for A-IPMN vs. 19.5 months for PDAC).
- While A-IPMN showed higher rates of peritoneal and lung recurrence, PDAC had more locoregional recurrences, but overall, systemic recurrence rates were similar between the two groups.
Background: The effect of analgesic modalities on short-term outcomes in acute pancreatitis remains unknown. However, preclinical models have raised safety concerns regarding opioid use in patients with acute pancreatitis.
Objective: This study aimed to assess the association between analgesics, particularly opioids, and severity and mortality in hospitalised patients with acute pancreatitis.
Article Synopsis
- Pancreatic Ductal Adenocarcinoma (PDAC) shows diverse responses to treatment, with RNA gene sequencing revealing different tumor subtypes that influence patient survival.* -
- A review analyzed 15 studies with over 2700 patients, identifying two main tumor subtypes: classical (better outcomes) and basal-like (poorer outcomes), along with other specific subtypes affecting survival rates.* -
- While molecular subtyping can pinpoint high-risk patients, its clinical application is hampered by the high costs of RNA sequencing and the large amounts of data generated.*
Background: The temporal evolution of HRQoL and the importance of other PROs to patients, following resection for pancreatic and peripancreatic malignancy remains unexplored.
Methods: Patients undergoing pancreatic resection between 2021 and 2022 were enrolled from 2 UK HPB centres. Patients completed the EORTC QLQ-C30, QLQ-PAN26 tools and rated 56 PROs preoperatively (T1), at discharge (T2), 6-weeks (T3), 3-months (T4) and 6-months (T5) postoperatively.