Pancreatic, Liver, Biliary Tract and Intestinal Diseases: Pathogenesis, Diagnostics and Therapy—2nd Edition

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: 31 October 2025 | Viewed by 1256

Special Issue Editors


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Guest Editor
Department of Digestive Tract Surgery, Medical University of Silesia, Katowice, Poland
Interests: pancreaticoduodenectomy; vascular resection; distal and total pancreatectomy; middle segment pancreatectomy; pancreaticojejunostomy; POPF; drainage operations in chronic pancreatitis
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Special Issue Information

Dear Colleagues, 

Gastrointestinal diseases involve various benign and malignant pathologies affecting the digestive tract, liver, biliary tract and pancreas. Their diagnosis and treatment are usually very challenging and require the involvement of a multidisciplinary team comprising gastroenterologists, radiologists, oncologists and surgeons. The diagnosis of gastrointestinal diseases involves laboratory, imaging, endoscopic, non-invasive and invasive investigations. Furthermore, their management encompasses a wide spectrum: from observation and conservative treatment to invasive radiological, endoscopic and surgical procedures. Recently, advancements in both the diagnosis and treatment of gastrointestinal diseases have significantly improved, including molecular laboratory tests, gastrointestinal endoscopy with artificial intelligence, targeted and immunological oncological therapy, as well as robotic surgery.

This Special Issue entitled “Pancreatic, Liver, Biliary Tract and Intestinal Diseases: Pathogenesis, Diagnostics and Therapy 2.0” will focus on new aspects regarding laboratory diagnostics as well as the pharmacological, immunological, and targeted treatment of these diseases. We invite original research and review papers related to all novel aspects of the diagnosis and treatment of gastrointestinal diseases.

Dr. Beata Jabłońska
Dr. Sławomir Mrowiec
Guest Editors

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Keywords

  • inflammatory bowel disease
  • gastrointestinal tumor
  • gastrointestinal cancer
  • acute pancreatitis
  • chronic pancreatitis
  • pancreatic cyst
  • biliary cyst
  • liver disease
  • biliary tract disease

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Published Papers (2 papers)

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Research

12 pages, 960 KB  
Article
First Spanish Experience with Stereotactic MR-Guided Adaptive Radiotherapy (SMART) in Borderline Resectable and Locally Advanced Pancreatic Cancer: A Prospective Study
by Daniela Gonsalves, Abrahams Ocanto, Eduardo Meilan, Alberto Gomez, Jesus Dominguez, Lisselott Torres, Castalia Fernández, Macarena Teja, Isabel Garrido, Maria Gonzalez, Miren Gaztañaga, Daniel Herrero, Israel J. Thuissard, Cristina Andreu, Tomas Gonzalez, Jose Antonio González, Jon Andreescu Yagüe, Esther Holgado, Diego Alcaraz, Escarlata López, Maia Dzhugashbli, Luis Glaria, Fernando Lopez-Campos, Esther Dominguez, Jesús Rodriguez Pascual, Eva Maria Lozano Martin, David Sanz-Rosa, Michael D. Chuong, Olivier Riou and Felipe Couñagoadd Show full author list remove Hide full author list
Biomedicines 2025, 13(10), 2390; https://doi.org/10.3390/biomedicines13102390 - 29 Sep 2025
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Abstract
Background/Objectives: In Spain, pancreatic ductal adenocarcinoma (PDAC) is the seventh leading cause of cancer-related death, with only 20% of patients eligible for surgery at diagnosis. For the remaining majority, prognosis is poor and effective non-surgical strategies are needed. Stereotactic MR-guided adaptive radiotherapy (SMART) [...] Read more.
Background/Objectives: In Spain, pancreatic ductal adenocarcinoma (PDAC) is the seventh leading cause of cancer-related death, with only 20% of patients eligible for surgery at diagnosis. For the remaining majority, prognosis is poor and effective non-surgical strategies are needed. Stereotactic MR-guided adaptive radiotherapy (SMART) may facilitate the delivery of ablative doses of radiation safely with low toxicity. This study reports the first national experience in Spain with SMART for patients with borderline resectable (BRPC) or locally advanced pancreatic cancer and evaluates its feasibility, safety, and early clinical outcomes. Methods: A prospective observational study was conducted including 28 patients with histologically confirmed BRPC or LAPC treated between August 2023 and December 2024. All patients received induction chemotherapy—mainly FOLFIRINOX (57.1%)—followed by SMART delivered in five fractions (40–50 Gy) using a 0.35T MR-guided linear accelerator. Daily online adaptive recontouring and replanning were performed for all 140 treatment fractions. Toxicities were assessed using CTCAE v5.0, and survival outcomes were estimated using Kaplan–Meier analysis. Results: The median patient age was 67 years, and 71.4% of tumors were located in the pancreatic head. At a median follow-up of 7.4 months after SMART (12.25 months from diagnosis), 6-month local progression-free survival (LPFS) was 89.3% from the start of SMART and 82.1% from diagnosis. Distant progression-free survival (DPFS) at 6 and 12 months was 92.9% and 68.2%, respectively. Median progression-free survival (PFS) was 11.5 months, and the median treatment-free interval was 5.7 months. Median overall survival (OS) was not reached; 6- and 12-month OS rates were 89.3% and 74.1%, respectively. Treatment-related toxicity was limited to grade 2 abdominal pain in 14.3% of patients, with no grade ≥3 adverse events attributed to SMART. Conclusions: SMART is a feasible and safe treatment modality for BRPC and LAPC in real-world clinical practice. These encouraging early outcomes support further clinical investigation and broader implementation. Full article
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13 pages, 256 KB  
Article
Pancreatic Solid Pseudopapillary Neoplasms—Clinicopathological Characteristics and Surgical Outcomes: A 10-Year Single-Centre Observational Study
by Agnieszka Partyka, Wiktoria Bajek, Paulina Wietrzycka, Beata Jabłońska and Sławomir Mrowiec
Biomedicines 2025, 13(9), 2050; https://doi.org/10.3390/biomedicines13092050 - 22 Aug 2025
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Abstract
Background: Pancreatic solid pseudopapillary neoplasms (SPNs) are rare exocrine tumours with predominance in young women. These tumours are of low malignant potential, become considerably large before causing symptoms and are associated with good prognosis. This study aimed to present and analyse clinicopathological [...] Read more.
Background: Pancreatic solid pseudopapillary neoplasms (SPNs) are rare exocrine tumours with predominance in young women. These tumours are of low malignant potential, become considerably large before causing symptoms and are associated with good prognosis. This study aimed to present and analyse clinicopathological features and surgical outcome of SPNs. Methods: A retrospective analysis of 22 patients who underwent pancreatic surgery for SPNs in a single high-volume surgical centre in 2014–2023 was performed. Results: SPN was the most frequent in females (n = 21, 95.45%) in a mean age of 34 ± 11.09 (18–55) years. Fourteen (63.64%) patients were asymptomatic, and eight (36.36%) presented with symptoms. The most common clinical symptom was abdominal pain (n = 7, 31.82%). The majority of tumours were located in the pancreatic body (n = 8, 36.36%), and most patients underwent distal pancreatectomy (n = 11, 50%). The median tumour size was 3.6 cm (IQR = 4.9; range: 1.3–14). The median duration of hospitalisation was 12.5 days, and the postoperative complication rate was 40.91%. R0 resection was achieved in 18 (81.82%) patients. Postpancreatectomy acute pancreatitis (PPAP) was the most common postoperative complication. No adjuvant therapy in any patient was needed. One-year overall survival (OS) equalled 100% and five-year OS reached 85%. None of the patients developed diabetes or signs of impaired pancreatic secretion in the follow-up period. Histopathology showed features like perineural invasion in 72.73% of cases, pseudocapsule (59.09%), haemorrhage (45.45%), vascular invasion (40.91%), mucosal metaplasia (40.91%), necrosis (31.82%), and calcification in the capsule (31.82%). Ki67 did not exceed 7%. In one case (4.55%), metastasis to a lymph node was found. Clinical suspicion agreed with histopathological results in only 10 (45.45%) cases. Conclusions: SPN most often occurs in young females. The majority of cases are asymptomatic accidental findings. The final diagnosis of SPN can be based just on analysis of histopathological examination results. Full article
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