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  • 1. Aims and Scope

    Gut and Liver is an international journal of gastroenterology, focusing on the gastrointestinal tract, liver, biliary tree, pancreas, motility, and neurogastroenterology. Gut atnd Liver delivers up-to-date, authoritative papers on both clinical and research-based topics in gastroenterology. The Journal publishes original articles, case reports, brief communications, letters to the editor and invited review articles in the field of gastroenterology. The Journal is operated by internationally renowned editorial boards and designed to provide a global opportunity to promote academic developments in the field of gastroenterology and hepatology. +MORE

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    Editor-in-Chief
    Yong Chan Lee Professor of Medicine
    Director, Gastrointestinal Research Laboratory
    Veterans Affairs Medical Center, Univ. California San Francisco
    San Francisco, USA

    Deputy Editor

    Deputy Editor
    Jong Pil Im Seoul National University College of Medicine, Seoul, Korea
    Robert S. Bresalier University of Texas M. D. Anderson Cancer Center, Houston, USA
    Steven H. Itzkowitz Mount Sinai Medical Center, NY, USA
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    All papers submitted to Gut and Liver are reviewed by the editorial team before being sent out for an external peer review to rule out papers that have low priority, insufficient originality, scientific flaws, or the absence of a message of importance to the readers of the Journal. A decision about these papers will usually be made within two or three weeks.
    The remaining articles are usually sent to two reviewers. It would be very helpful if you could suggest a selection of reviewers and include their contact details. We may not always use the reviewers you recommend, but suggesting reviewers will make our reviewer database much richer; in the end, everyone will benefit. We reserve the right to return manuscripts in which no reviewers are suggested.

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Prognosis and Clinical Characteristics of Patients with Pancreatic Ductal Adenocarcinoma Diagnosed by Endoscopic Ultrasonography but Indeterminate on Computed Tomography

Sung Woo Ko1 , Tae Hyeon Kim2 , Tae Jun Song1 , Seong-Hun Kim3 , Dong-Wan Seo1 , Jai Hoon Yoon4 , Chang Min Cho5 , Jae Hee Cho6 , Jun-Ho Choi7 , Dong Wook Lee8 , Sang Hyub Lee9 , Seung Bae Yoon10 , Tae Hoon Lee11 , Gwang Ha Kim12 , and Hoon Jai Chun13

1Department of Gastroenterology, Asan Medical Center, Seoul, 2Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, 3Department of Internal Medicine, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, 4Division of Gastroenterology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, 5Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, 6Department of Internal Medicine, Gachon University College of Medicine, Incheon, 7Department of Internal Medicine, Dankook University College of Medicine, Cheonan, 8Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, 9Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, 10Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, 11Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University School of Medicine, Cheonan, 12Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, and 13Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Korea

Correspondence to:Tae Hyeon Kim
ORCID https://orcid.org/0000-0002-9723-2136
E-mail kth@wku.ac.kr
Tae Jun Song
ORCID https://orcid.org/0000-0002-6156-8746
E-mail medi01@naver.com

Received: March 18, 2021; Revised: July 1, 2021; Accepted: July 13, 2021

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Gut and Liver

Published online October 7, 2021

Copyright © Gut and Liver.

Abstract

Background/Aims: Endoscopic ultrasonography (EUS) provides high-resolution images and is superior to computed tomography (CT) scan in diagnosing small pancreatic ductal adenocarcinoma (PDAC). As a result, the use of EUS for early detection of PDAC has attracted attention. This study aimed to identify the clinical and radiological characteristics of patients with PDAC diagnosed by EUS but not found on CT scan.
Methods: The medical records of patients diagnosed with PDAC at 12 tertiary referral centers in Korea from January 2003 to April 2019 were reviewed. This study included patients with pancreatic masses not clearly observed on CT scan but identified on EUS. The clinical characteristics and radiological features of the patients were analyzed, and survival analysis was performed.
Results: A total of 83 patients were enrolled. The most common abnormal CT findings other than a definite mass was pancreatic duct dilatation, which was identified in 61 patients (73.5%). All but four patients underwent surgery. The final pathologic stages were as follows: IA (n=31, 39.2%), IB (n=8, 10.1%), IIA (n=20, 25.3%), IIB (n=17, 21.5%), III (n=2, 2.5%), and IV (n=1, 1.4%). The 5-year survival rate of these patients was 50.6% (95% confidence interval, 38.8% to 66.7%). Elevated liver function testing and R1 resection emerged as significant predictors of mortality in the multivariable Cox regression analysis.
Conclusions: This multicenter study demonstrated favorable long-term prognosis in patients with PDAC diagnosed by EUS but indeterminate on CT scan. EUS should be considered for patients with suspected PDAC but indeterminate on CT scan.

Keywords: Pancreatic neoplasms, Endosonography, Kaplan-Meier estimate


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Gut and Liver

Published online October 7, 2021

Copyright © Gut and Liver.

Prognosis and Clinical Characteristics of Patients with Pancreatic Ductal Adenocarcinoma Diagnosed by Endoscopic Ultrasonography but Indeterminate on Computed Tomography

Sung Woo Ko1 , Tae Hyeon Kim2 , Tae Jun Song1 , Seong-Hun Kim3 , Dong-Wan Seo1 , Jai Hoon Yoon4 , Chang Min Cho5 , Jae Hee Cho6 , Jun-Ho Choi7 , Dong Wook Lee8 , Sang Hyub Lee9 , Seung Bae Yoon10 , Tae Hoon Lee11 , Gwang Ha Kim12 , and Hoon Jai Chun13

1Department of Gastroenterology, Asan Medical Center, Seoul, 2Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, 3Department of Internal Medicine, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, 4Division of Gastroenterology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, 5Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, 6Department of Internal Medicine, Gachon University College of Medicine, Incheon, 7Department of Internal Medicine, Dankook University College of Medicine, Cheonan, 8Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, 9Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, 10Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, 11Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University School of Medicine, Cheonan, 12Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, and 13Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Korea

Correspondence to:Tae Hyeon Kim
ORCID https://orcid.org/0000-0002-9723-2136
E-mail kth@wku.ac.kr
Tae Jun Song
ORCID https://orcid.org/0000-0002-6156-8746
E-mail medi01@naver.com

Received: March 18, 2021; Revised: July 1, 2021; Accepted: July 13, 2021

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background/Aims: Endoscopic ultrasonography (EUS) provides high-resolution images and is superior to computed tomography (CT) scan in diagnosing small pancreatic ductal adenocarcinoma (PDAC). As a result, the use of EUS for early detection of PDAC has attracted attention. This study aimed to identify the clinical and radiological characteristics of patients with PDAC diagnosed by EUS but not found on CT scan.
Methods: The medical records of patients diagnosed with PDAC at 12 tertiary referral centers in Korea from January 2003 to April 2019 were reviewed. This study included patients with pancreatic masses not clearly observed on CT scan but identified on EUS. The clinical characteristics and radiological features of the patients were analyzed, and survival analysis was performed.
Results: A total of 83 patients were enrolled. The most common abnormal CT findings other than a definite mass was pancreatic duct dilatation, which was identified in 61 patients (73.5%). All but four patients underwent surgery. The final pathologic stages were as follows: IA (n=31, 39.2%), IB (n=8, 10.1%), IIA (n=20, 25.3%), IIB (n=17, 21.5%), III (n=2, 2.5%), and IV (n=1, 1.4%). The 5-year survival rate of these patients was 50.6% (95% confidence interval, 38.8% to 66.7%). Elevated liver function testing and R1 resection emerged as significant predictors of mortality in the multivariable Cox regression analysis.
Conclusions: This multicenter study demonstrated favorable long-term prognosis in patients with PDAC diagnosed by EUS but indeterminate on CT scan. EUS should be considered for patients with suspected PDAC but indeterminate on CT scan.

Keywords: Pancreatic neoplasms, Endosonography, Kaplan-Meier estimate

Gut and Liver

Vol.15 No.5
September, 2021

pISSN 1976-2283
eISSN 2005-1212

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