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Advances in Diagnosis and Management of Pancreatobiliary Disorders—2nd Edition
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Advances in Diagnosis and Management of Pancreatobiliary Disorders—2nd Edition

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: 9 January 2026 | Viewed by 2533

Special Issue Editor

Dr. Francesca Lodato

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Guest Editor
Department of Gastroenterology and Interventional Endoscopy, AUSL Bologna Bellaria, Maggiore Hospital Bologna, 40133 Bologna, Italy
Interests: endoscopy; EUS; biliary diseases; pancreatology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue is the second edition of “Advances in Diagnosis and Management of Pancreatobiliary Disorders” (https://www.mdpi.com/journal/jcm/special_issues/8H3J192QOL).

In recent years, the management of many diseases of the biliary tract and pancreas has undergone great changes due to the rapid progression of diagnostic and therapeutic technologies.

For biliary diseases, the constant technological evolution of endoscopic methods such as EUS, ERCP, and cholangioscopy has changed the diagnostic and therapeutic approach and management of many common pathologies, such as biliary lithiasis and its complications. Pancreatology is also constantly evolving, both from a clinical and diagnostic-instrumental point of view, such as in the approach to solid and cystic lesions of the pancreas, due to the increasingly routine use of EUS, both diagnostic and therapeutic, and the new knowledge regarding rarer neoplasms such as neuroendocrine tumors. Beyond that, new technologies based on artificial intelligence are beginning to make their way into gastroenterology. The evaluation of patients with biliopancreatic pathology is becoming increasingly complex and challenging, imposing a multidisciplinary medical, surgical, radiological, and anatomopathological approach.

These innovations often make it difficult to properly manage the gastroenterological patient in internist settings, which are settings that patients with pancreatic and biliary tract diseases often attend.
This Special Issue focuses on the latest innovations in the management of pancreatic and biliary tract diseases with the goal of providing the internal medicine physician with a state-of-the-art update and insights into the most current innovations.

Dr. Francesca Lodato
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

  • pancreas diseases
  • pancreatic tumors
  • biliary tract diseases and neoplams
  • ERCP
  • EUS
  • cholangioscopy

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Related Special Issue

Published Papers (3 papers)

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Research

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13 pages, 404 KB  
Article
Endoscopic Ultrasound for Nodal Staging in Patients with Resectable Cholangiocarcinoma
by David M. de Jong, Lydi M. J. W. van Driel, Sundeep Lakhtakia, Mohan Ramchandani, Sana Fathima Memon, Abhishek Tyagi, Parathasarathy Kumaraswamy, Shreeyash Modak, Anuradha Sekaran, Marco J. Bruno, Duvvur Nageshwar Reddy and Hardik Rughwani
J. Clin. Med. 2025, 14(21), 7545; https://doi.org/10.3390/jcm14217545 - 24 Oct 2025
Viewed by 227
Abstract
Background: Lymph node (LN) involvement is a negative prognostic factor for patients with cholangiocarcinoma (CCA). Preoperative assessment of the LN could potentially aid therapy decision making. Endoscopic ultrasound (EUS) can be used to sample suspicious LN. The aim of this study was [...] Read more.
Background: Lymph node (LN) involvement is a negative prognostic factor for patients with cholangiocarcinoma (CCA). Preoperative assessment of the LN could potentially aid therapy decision making. Endoscopic ultrasound (EUS) can be used to sample suspicious LN. The aim of this study was to evaluate the clinical impact of EUS for suspicious LN in patients with presumed resectable CCA. Methods: In this single-center cohort study, patients with potentially resectable CCA who underwent preoperative linear EUS between 2019 and 2024 were retrospectively included. The primary aims were the percentage of malignant LN detected and the clinical impact of EUS, which was defined as the percentage of patients who were precluded from surgical exploration due to pathologically confirmed LN metastases found with EUS tissue acquisition (EUS-TA). The secondary aim was the complication rate of EUS-TA. Results: A total of 135 patients were included, of whom 12 (8.9%) had intrahepatic CCA (iCCA), 65 (48.1%) had perihilar CCA (pCCA), 13 had (9.6%) middle bile duct CCA (mCCA), and 45 (33.3%) had distal CCA (dCCA). Across 148 EUS procedures, 139 LNs were identified, and EUS-TA was performed on 63 LNs among 55 patients. LN metastases were detected by EUS-TA for iCCA, pCCA, mCCA, and dCCA, in 25%, 6.2%, 15.4%, and 4.4%, respectively. EUS and EUS-TA influenced surgical work-up for iCCA, pCCA, mCCA, and dCCA in 25%, 1.5%, 15.4%, and 0.0%, respectively. No complications associated with EUS were noted. Conclusions: Preoperative EUS for nodal staging had an important clinical impact in patients with presumed resectable iCCA and mCCA, but less for pCCA and dCCA. Further prospective studies should investigate whether systematic nodal staging with EUS could improve preoperative decision making even further. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Management of Pancreatobiliary Disorders—2nd Edition)
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10 pages, 1629 KB  
Article
Evaluating Novel Braided Metal Stent for Bilateral Simultaneous Side-by-Side Stenting in Malignant Hilar Biliary Obstruction: A Multicenter, Single-Arm Prospective Study
by Jungnam Lee, Seok Jeong, Eui Joo Kim, Huapyong Kang, Dong Uk Kim and Chang-Il Kwon
J. Clin. Med. 2025, 14(18), 6557; https://doi.org/10.3390/jcm14186557 - 18 Sep 2025
Viewed by 394
Abstract
Background: While the side-by-side stenting technique-characterized by the parallel placement of stents offers procedural simplicity, the augmented radial force exerted by the initial stent may complicate subsequent deployment. This multicenter study evaluated the practicality and safety of bilateral side-by-side stenting using novel [...] Read more.
Background: While the side-by-side stenting technique-characterized by the parallel placement of stents offers procedural simplicity, the augmented radial force exerted by the initial stent may complicate subsequent deployment. This multicenter study evaluated the practicality and safety of bilateral side-by-side stenting using novel braided self-expandable metal stents (BenefitTM; M.I.Tech Co., Ltd., Pyeongtaek, Republic of Korea). Statistical analysis included survival analysis (Kaplan–Meier) and Cox proportional hazards regression to identify predictive factors. Patients and Methods: In this multicenter study, patients with inoperable malignant hilar biliary obstruction (Bismuth type II–IV) underwent simultaneous side-by-side endoscopic placement of two braided self-expandable metal stents. The primary outcome was stent patency. The secondary outcomes included technical and clinical success, and adverse events monitored for up to one year. Results: A total of 27 patients were included in the final analysis. The technical success rate was 92.6% (25/27), and the clinical success rate was 88.0% (22/25). The median stent patency was 93 days, with cumulative patency rates of 87.4% at 3 months and 49.7% at 12 months. Tumor ingrowth was the most common cause of stent occlusion (66.7%). Early adverse events occurred in 2 patients (one cholangitis and one stent migration), supporting the favorable safety profile of this approach. Conclusions: The simultaneous side-by-side placement of novel braided self-expandable metal stents yielded high technical success and favorable clinical outcomes in patients with inoperable malignant hilar biliary obstruction. This approach provided substantial stent patency with a low complication rate, supporting its utility as a safe and effective palliative strategy for the management of malignant hilar biliary obstruction. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Management of Pancreatobiliary Disorders—2nd Edition)
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Review

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14 pages, 597 KB  
Review
Endoscopic Ultrasound-Guided Pancreatic Cystic Fluid Biochemical and Genetic Analysis for the Differentiation Between Mucinous and Non-Mucinous Pancreatic Cystic Lesions
by Angelo Bruni, Luigi Tuccillo, Giuseppe Dell’Anna, Francesco Vito Mandarino, Andrea Lisotti, Marcello Maida, Claudio Ricci, Lorenzo Fuccio, Leonardo Henry Eusebi, Giovanni Marasco and Giovanni Barbara
J. Clin. Med. 2025, 14(11), 3825; https://doi.org/10.3390/jcm14113825 - 29 May 2025
Viewed by 1695
Abstract
Pancreatic cystic lesions (PCLs) are increasingly identified via computerized tomography (CT) and magnetic resonance (MR), with a prevalence of 2–45%. Distinguishing mucinous PCLs (M-PCLs), which include intraductal papillary mucinous neoplasms (IPMNs) and mucinous cystic neoplasms (MCNs) that can progress to pancreatic ductal adenocarcinoma, [...] Read more.
Pancreatic cystic lesions (PCLs) are increasingly identified via computerized tomography (CT) and magnetic resonance (MR), with a prevalence of 2–45%. Distinguishing mucinous PCLs (M-PCLs), which include intraductal papillary mucinous neoplasms (IPMNs) and mucinous cystic neoplasms (MCNs) that can progress to pancreatic ductal adenocarcinoma, from non-mucinous PCLs (NM-PCLs) is essential. Carcinoembryonic antigen (CEA) remains widely used but often demonstrates limited sensitivity and specificity. In contrast, endoscopic ultrasound-guided measurement of intracystic glucose more accurately differentiates PCL subtypes, as tumor-related metabolic changes lower cyst fluid glucose in mucinous lesions. Numerous prospective and retrospective studies suggest a glucose cut-off between 30 and 50 mg/dL, yielding a sensitivity of 88–95% and specificity of 76–91%, frequently outperforming CEA. Additional benefits include immediate point-of-care assessment via standard glucometers and minimal interference from blood contamination. DNA-based biomarkers, including KRAS and GNAS mutations, enhance specificity (up to 99%) but exhibit moderate sensitivity (61–71%) and necessitate specialized, expensive platforms. Molecular analyses can be crucial in high-risk lesions, yet their uptake is constrained by technical challenges. In practice, combining glucose assessment with targeted molecular assays refines risk stratification and informs the choice between surgical resection or active surveillance. Future investigations should establish standardized glucose thresholds, improve the cost-effectiveness of genetic testing, and integrate advanced biomarkers into routine protocols. Ultimately, these strategies aim to optimize patient management, limit unnecessary interventions for benign lesions, and ensure timely therapy for lesions at risk of malignant transformation. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Management of Pancreatobiliary Disorders—2nd Edition)
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