Yun Chae Lee

Autoimmune pancreatitis (AIP) is a distinct subtype of chronic pancreatitis characterized by immune-mediated inflammation and a favorable response to steroid therapy. Currently, the lack of standardized clinical practice guidelines in South Korea has led to significant variations in clinical practice, with diagnosis, steroid use, maintenance therapy, and relapse management often relying on individual clinician’s experience and judgment. To address this issue, the Pancreas Research Group of the Korean Pancreatobiliary Association (KPBA) has developed a clinical practice guideline for the diagnosis, treatment, and follow-up of AIP, reflecting the latest global evidence and the specific healthcare environment in Korea. These recommendations were established through an extensive literature review and expert consensus using the Delphi method, with the level of evidence and strength of recommendation presented according to a standardized classification system. This clinical practice guideline aims to support consistent and rational clinical decision-making for patients with AIP and to provide a standard for evidence-based treatment suitable for the Korean medical context.

Choledocholithiasis occurs in approximately 10-20% of patients with gallstones and can lead to severe complications, including obstructive jaundice, acute cholangitis, and acute pancreatitis. This review evaluates the diagnostic and therapeutic approaches for choledocholithiasis in patients scheduled for cholecystectomy. Diagnosis is based on clinical history, laboratory tests, ultrasonography, endoscopic ultrasound, and magnetic resonance cholangiopancreatography. Management strategies include the one-step approach, combining laparoscopic cholecystectomy and bile duct exploration, and the two-step approach, performing endoscopic retrograde cholangiopancreatography (ERCP) before cholecystectomy. The one-step approach offers advantages such as shorter hospitalization but requires experienced surgeons. The two-step approach is more suitable for patients with acute cholangitis, pancreatitis, narrow bile ducts, impacted stones, or multiple stones. In South Korea, the two-step approach is predominantly favored due to the widespread availability of advanced endoscopic techniques and the expertise of gastroenterologists. ERCP is highly standardized and effective for biliary drainage, particularly in emergency settings. Effective management of choledocholithiasis requires a tailored approach that considers patient condition, stone characteristics, and available resources. Collaboration between gastroenterologists and surgeons is critical to achieving optimal outcomes. Further research, particularly large-scale multicenter studies, is necessary to refine treatment guidelines and improve patient care.

Background/Aims: Early pancreatic cancer diagnosis is crucial for timely intervention and better outcomes. The coronavirus disease 2019 (COVID-19) pandemic has disrupted routine health care globally. The COVID-19 pandemic has disrupted routine health care globally. This study aimed to evaluate the impact of COVID-19 on the diagnosis and treatment of pancreatic cancer. Materials and Methods: This retrospective study compared pancreatic cancer patients from 2 tertiary hospitals in pre and COVID-19 periods. Pre-COVID-19 period spanned from January 1, 2018, to January 19, 2020, while the COVID-19 period extended from January 20, 2020, to December 31, 2021. Results: A total of 542 patients were included. In the pre-COVID-19 period, 280 new cases of pancreatic cancer were enrolled, compared to 262 during COVID-19. The annual incidence rates were 136.63 and 134.50 patients, respectively. The median age was significantly lower during COVID-19 (71.5 years) compared to pre-COVID-19 (77 years) (P < .001). In subgroup analyses for stage 3 and 4, the proportion of stage 4 pancreatic cancer increased during COVID-19 (χ2 = 5.53, P = .019), and the COVID-19 group had younger diagnoses, better performance status, more surgery, higher use of FOLFIRINOX chemotherapy, fewer hospital referrals, and better median overall survival compared to the pre-COVID-19 group. Conclusion: This study revealed changes in the characteristics and treatment of patients diagnosed with pancreatic cancer during the COVID-19 pandemic. Although further large-scale research is necessary, the findings of this study can function as foundational data for formulating policies for the management of patients with pancreatic cancer during future pandemics of other infectious diseases. Cite this article as: Chon HK, Lee EJ, Lee YC, Kim S. Impact of coronavirus disease 2019 on the diagnosis and treatment of pancreatic cancer: An observational cohort study. Turk J Gastroenterol. 2024;35(5):408-417