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New Clinical Advances in Pancreatobiliary Diseases
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New Clinical Advances in Pancreatobiliary 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: 10 July 2026 | Viewed by 4797

Special Issue Editor

Prof. Dr. Kyong Joo Lee

E-Mail Website
Guest Editor
Division of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong-si 18450, Republic of Korea
Interests: pancreatitis; cholangitis; pancreatobiliary cancer; EUS; ERCP; chemotherapy

Special Issue Information

Dear Colleagues,

Recent years have seen a paradigm shift in the diagnosis and management of pancreatobiliary diseases, driven by remarkable advances in both endoscopic techniques and pharmacologic therapies. Diseases such as early-stage pancreatic and biliary cancers, chronic pancreatitis, and cholangitis—once difficult to diagnose and treat—are now approached with greater precision and confidence.

The development of advanced endoscopic tools, including ERCP, EUS, cholangioscopy, and pancreatoscopy, has significantly improved diagnostic accuracy. Furthermore, interventional EUS and novel endoscopic procedures are expanding the therapeutic landscape, offering less invasive yet highly effective treatment options. In parallel, new pharmacological agents, including targeted therapies and immunotherapies, are emerging as promising alternatives or adjuncts to conventional treatment.

This Special Issue aims to explore new clinical perspectives and innovative therapeutic strategies for pancreatobiliary diseases. We welcome original research, reviews, and case-based discussions that highlight cutting-edge diagnostic and therapeutic developments—particularly those involving endoscopy and novel drug therapies.

Prof. Dr. Kyong Joo Lee
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 250 words) can be sent to the Editorial Office for assessment.

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

  • pancreatobiliary diseases
  • EUS
  • ERCP
  • interventional endoscopy
  • targeted therapy
  • pancreatobiliary cancer

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Published Papers (3 papers)

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Review

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20 pages, 867 KB  
Review
Medical Management of Well-Differentiated Pancreatic Neuroendocrine Tumors: From Conventional Therapies to Emerging Strategies
by Min Je Sung and Namyoung Park
J. Clin. Med. 2026, 15(5), 1713; https://doi.org/10.3390/jcm15051713 - 24 Feb 2026
Viewed by 2095
Abstract
Grade 1–2 pancreatic neuroendocrine tumors exhibit considerable biological and clinical diversity, which translates into a broad range of available therapeutic approaches. Given the absence of a universally accepted treatment sequence, treatment selection requires a practical framework based on tumor biology and clinical presentation. [...] Read more.
Grade 1–2 pancreatic neuroendocrine tumors exhibit considerable biological and clinical diversity, which translates into a broad range of available therapeutic approaches. Given the absence of a universally accepted treatment sequence, treatment selection requires a practical framework based on tumor biology and clinical presentation. Clinical management should be individualized by integrating the histologic grade, disease extent, symptom burden, and somatostatin receptor (SSTR) expression. For patients with low-volume, SSTR-positive, and clinically indolent disease (Ki-67 < 10%), long-acting somatostatin analogues, including octreotide and lanreotide, are commonly used as initial therapies to control hormonal symptoms and delay tumor progression. In patients with radiologic progression requiring systemic disease control, targeted agents such as everolimus and sunitinib represent established subsequent options, particularly when disease stabilization is the primary therapeutic goal. Peptide receptor radionuclide therapy with 177Lu-DOTATATE has demonstrated meaningful antitumor activity and is generally considered in patients with SSTR-positive tumors with progressive disease (Ki-67 ≥ 10%) or increasing tumor burdens, especially when tumor reduction is desirable. Combination cytotoxic chemotherapy, most notably the capecitabine–temozolomide (CAPTEM) regimen, remains an important consideration for patients with higher tumor burdens or more aggressive tumor biology. This review summarizes current evidence and provides a practical overview of treatment selection and sequencing for the systemic management of Grade 1–2 pancreatic neuroendocrine tumors, while also highlighting emerging therapeutic strategies, including targeted alpha therapy and SSTR2 antagonist-based approaches. Full article
(This article belongs to the Special Issue New Clinical Advances in Pancreatobiliary Diseases)
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15 pages, 808 KB  
Review
Point-of-Care Testing and Biomarkers in Biliary Diseases: Current Evidence and Future Directions
by Jang Han Jung, Kyong Joo Lee, Se Woo Park, Dong Hee Koh and Jin Lee
J. Clin. Med. 2025, 14(19), 6724; https://doi.org/10.3390/jcm14196724 - 24 Sep 2025
Cited by 3 | Viewed by 1692
Abstract
Biliary tract diseases, including both benign and malignant conditions such as cholangitis, cholelithiasis, primary sclerosing cholangitis, cholangiocarcinoma, and gallbladder cancer, present significant challenges for timely diagnosis and effective clinical management. Conventional diagnostic approaches, which primarily rely on imaging and standard laboratory tests, often [...] Read more.
Biliary tract diseases, including both benign and malignant conditions such as cholangitis, cholelithiasis, primary sclerosing cholangitis, cholangiocarcinoma, and gallbladder cancer, present significant challenges for timely diagnosis and effective clinical management. Conventional diagnostic approaches, which primarily rely on imaging and standard laboratory tests, often lack the sensitivity and specificity needed for early detection, accurate risk stratification, and personalized treatment planning. In recent years, advancements in point-of-care (POC) diagnostic technologies, along with the identification and validation of novel biomarkers, have begun to reshape the diagnostic landscape. This review provides a comprehensive overview of the clinical utility and limitations of current POC tests and biomarkers, ranging from well-established markers such as carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) to emerging molecular indicators such as circulating microRNAs and circulating tumor DNA. We examine their applications across acute management, chronic disease monitoring, and cancer detection; identify existing gaps in diagnostic practice; and discuss strategies for incorporating these tools into standard clinical workflows to enhance patient outcomes. Full article
(This article belongs to the Special Issue New Clinical Advances in Pancreatobiliary Diseases)
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Other

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18 pages, 3588 KB  
Systematic Review
Chemotherapy for Older Adults with Locally Advanced or Metastatic Pancreatic Ductal Adenocarcinoma: A Systematic Review and Meta-Analysis
by Dong Woo Shin, Ji Su Ahn, Hyunjoo Song, Sung-Hoon Moon and Jong-chan Lee
J. Clin. Med. 2026, 15(6), 2254; https://doi.org/10.3390/jcm15062254 - 16 Mar 2026
Viewed by 640
Abstract
Background: Treatment decisions for older adults with locally advanced or metastatic pancreatic ductal adenocarcinoma (PDAC) often rely on heterogeneous observational evidence and clinical judgment regarding survival benefits, regimen intensity, and tolerability. Methods: We systematically searched Embase, PubMed, and Scopus from inception to 30 [...] Read more.
Background: Treatment decisions for older adults with locally advanced or metastatic pancreatic ductal adenocarcinoma (PDAC) often rely on heterogeneous observational evidence and clinical judgment regarding survival benefits, regimen intensity, and tolerability. Methods: We systematically searched Embase, PubMed, and Scopus from inception to 30 March 2025, for studies reporting overall survival (OS) and/or progression-free survival (PFS) in older adults with advanced PDAC receiving systemic chemotherapy, as well as age-stratified outcomes among chemotherapy-treated patients. Hazard ratios (HRs) with 95% confidence intervals (CIs) were primarily extracted from multivariable-adjusted analyses. In cases without reported HRs, estimates were derived from summary statistics or Kaplan–Meier curves. The review protocol was registered in PROSPERO (CRD420261292913). Results: A total of 40 predominantly retrospective studies were included. Chemotherapy was associated with improved OS compared to best supportive care in older adults (9 studies; HR 0.46, 95% CI 0.39–0.54; I2 = 18%). Among chemotherapy-treated patients, OS (34 studies; HR 1.00, 95% CI 0.99–1.02; I2 = 23%) and PFS (11 studies; HR 0.96, 95% CI 0.86–1.07; I2 = 10%) did not differ by age. Combination chemotherapy demonstrated superior OS (13 studies; HR 0.66, 95% CI 0.54–0.80; I2 = 86%) with substantial heterogeneity and PFS (7 studies; HR 0.63, 95% CI 0.53–0.74; I2 = 30%) compared to monotherapy. FOLFIRINOX and gemcitabine plus nab-paclitaxel demonstrated comparable OS (8 studies; HR 0.98, 95% CI 0.90–1.05; I2 = 60%) and PFS (2 studies; HR 0.97, 95% CI 0.92–1.02; I2 = 0%). Conclusions: Among carefully selected older adults with advanced PDAC, chemotherapy was associated with improved survival compared to supportive care. Chronological age did not predict outcomes, highlighting the need for geriatric-informed prospective trials. Full article
(This article belongs to the Special Issue New Clinical Advances in Pancreatobiliary Diseases)
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