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Clinical Endoscopic Management of Pancreaticobiliary Diseases
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Clinical Endoscopic Management of Pancreaticobiliary Diseases

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: closed (31 December 2024) | Viewed by 1222

Special Issue Editor

Prof. Dr. Pier Alberto Testoni

E-Mail Website
Guest Editor
Division of Gastroenterology and Gastrointestinal Endoscopy, Vita-Salute San Raffaele University, San Raffaele Scientific Institute, 20132 Milan, Italy
Interests: endoscopic retrograde; cholangiopancreatography; esophageal diseases; biliary tract diseases; IBS pancreatic diseases; cholangiocarcinoma; cirrhosis; gastrointestinal diseases; endoscopy; gastrointestinal endo

Special Issue Information

Dear Colleagues,

The Special Issue delves deeply into the advanced clinical management of pancreatic diseases, shedding light on the utilization of advanced endoscopic techniques to diagnose, treat, and monitor disorders affecting the pancreas.

Four main topics will be included in this issue.

Clinical and endoscopic management of acute recurrent pancreatitis. This topic will focus on diagnosing and treating pancreatic and biliary conditions associated with recurrent pancreatitis.

Clinical and endoscopic management of chronic obstructive pancreatitis. This topic will include the endoscopic management of pain and obstructive conditions in chronic pancreatitis, including complications and outcomes.

Clinical and endoscopic management of fluid collections and walled-off necrosis. This topic will focus mainly on the ultrasound-guided and endoscopic therapy of pancreatitis-related complications, such as fluid collection and long-term consequences (walled-off necrosis).

Clinical and endoscopic management of pancreatic solid lesions. This topic will focus on the ultrasound-guided diagnosis and therapy of pancreatic masses, including thermal or cryothermal ablation and immunological response induced by local ablative therapy.

The collection of articles within this Special Issue encapsulates the evolution and refinement of advanced endoscopic techniques. It highlights their pivotal role in the contemporary landscape of gastroenterology and pancreatology and provides a detailed roadmap of best practices and emerging trends in pancreatic endoscopy.

Ultimately, this Special Issue contributes significantly to the advancement of precision medicine in digestive health and serves as a valuable compendium for gastroenterologists, endoscopists, surgeons, and other healthcare professionals involved in the multidisciplinary approach to pancreatic diseases.

Prof. Dr. Pier Alberto Testoni
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • pancreatic diseases
  • endoscopic management
  • diagnosis
  • treatment
  • surveillance

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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Review

13 pages, 1102 KiB  
Review
The Multidisciplinary Approach to Acute Necrotizing Pancreatitis
by Dana Ben-Ami Shor, Einat Ritter, Tom Borkovsky and Erwin Santo
J. Clin. Med. 2025, 14(9), 2904; https://doi.org/10.3390/jcm14092904 - 23 Apr 2025
Viewed by 391
Abstract
Acute pancreatitis is a common gastrointestinal condition, primarily caused by gallstones and alcohol abuse, with other causes including hypertriglyceridemia, trauma, infections, etc. While most cases are mild and self-limiting, up to 20% of patients develop severe pancreatitis with pancreatic necrosis, increasing the risk [...] Read more.
Acute pancreatitis is a common gastrointestinal condition, primarily caused by gallstones and alcohol abuse, with other causes including hypertriglyceridemia, trauma, infections, etc. While most cases are mild and self-limiting, up to 20% of patients develop severe pancreatitis with pancreatic necrosis, increasing the risk of multi-organ failure and mortality. Conservative management involves fluid resuscitation, nutritional support, and antibiotics for infected peripancreatic fluid collections (PFCs). When PFCs are infected or symptoms persist, invasive interventions such as endoscopic ultrasound (EUS)-guided drainage or percutaneous drainage are recommended. Dual modalities (endoscopic and percutaneous drainage) offer better outcomes with fewer complications. Direct endoscopic necrosectomy is considered for patients who do not improve with drainage. A multidisciplinary team, including endoscopists, interventional radiologists, surgeons, and specialists, is essential for optimal management of severe necrotizing pancreatitis. Full article
(This article belongs to the Special Issue Clinical Endoscopic Management of Pancreaticobiliary Diseases)
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15 pages, 664 KiB  
Review
Endoscopic Management of Recurrent Acute Pancreatitis
by Pier Alberto Testoni and Sabrina Testoni
J. Clin. Med. 2025, 14(7), 2150; https://doi.org/10.3390/jcm14072150 - 21 Mar 2025
Viewed by 559
Abstract
This review aims to summarize the role of endoscopic therapy in the management and outcomes of recurrent acute pancreatitis (RAP). RAP is a clinical entity characterized by repeated episodes of acute pancreatitis in the setting of a normal gland or chronic pancreatitis (CP). [...] Read more.
This review aims to summarize the role of endoscopic therapy in the management and outcomes of recurrent acute pancreatitis (RAP). RAP is a clinical entity characterized by repeated episodes of acute pancreatitis in the setting of a normal gland or chronic pancreatitis (CP). The aetiology of RAP can be identified in about 70% of cases; for the remaining cases, the term “idiopathic” (IRAP) is used. However, advanced diagnostic techniques may reduce the percentage of IRAP to 10%. Recognized causes of RAP are gallstone disease, including microlithiasis and biliary sludge, sphincter of Oddi dysfunction (SOD), pancreatic ductal abnormalities (either congenital or acquired) interfering with pancreatic juice or bile outflow, genetic mutations, and alcohol consumption. SOD, as a clinical entity, was recently revised in the Rome IV consensus, which only recognized type 1 dysfunction as a true pathological condition, while type 2 SOD was defined as a suspected functional biliary sphincter disorder requiring the documentation of elevated basal sphincter pressure to be considered a true clinical entity and type 3 was abandoned as a diagnosis and considered functional pain. Endoscopic therapy by retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) has been proven effective when a mechanical obstruction is found and can be removed. If an obstruction is not documented, few treatment options are available to prevent the recurrence of pancreatitis and progression toward chronic disease. In gallstone disease, endoscopic biliary sphincterotomy (EBS) is effective when a dilated common bile duct or biliary sludge/microlithiasis is documented. In type 1 SOD, biliary or dual sphincterotomy is generally successful, while in type 2 SOD, endotherapy should be reserved for patients with documented sphincter dysfunction. However, in recent years, doubts have been expressed about the real efficacy of sphincterotomy in this setting. When sphincter dysfunction is not confirmed, endotherapy should be discouraged. In pancreas divisum (PD), minor papilla sphincterotomy is effective when there is a dilated dorsal duct, and the success rate is the highest in RAP patients. In the presence of obstructive conditions of the main pancreatic duct, pancreatic endotherapy is generally successful if RAP depends on intraductal hypertension. However, despite the efficacy of endotherapy, progression toward CP has been shown in some of these patients, mainly in the presence of PD, very likely depending on underlying genetic mutations. In patients with IRAP, the real utility of endotherapy still remains unclear; this is because several unknown factors may play a role in the disease, and data on outcomes are few, frequently contradictory or uncontrolled, and, in general, limited to a short period of time. Full article
(This article belongs to the Special Issue Clinical Endoscopic Management of Pancreaticobiliary Diseases)
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