In the treatment of malignant obstructive jaundice, endoscopic ultrasonography guided biliary drainage is safer and more effective than percutaneous transhepatic biliary drainage when performed by experienced practitioners after failed ERCP. Its more widespread use is recommended.

Recent studies have demonstrated that the expression of the long non-coding RNA (lncRNA) AFAP1-AS1 in pancreatic cancer is negatively correlated with survival and prognosis. However, the effects of oridonin and lncRNA AFAP1-AS1 on the epithelial-to-mesenchymal transition (EMT) and migration of pancreatic cancer cells have not been fully elucidated. Surgery is the only potentially curative method for pancreatic cancer, but postoperative recurrence and metastasis are common. The aim of the present study was to assess the effect of oridonin and lncRNA AFAP1-AS1 silencing on pancreatic cancer cells. The pancreatic cancer cell lines BxPC-3 and PANC-1 cells were transfected with siAFAP1-AS1 and its negative control (siNC). After that, oridonin was used to treat the siAFAP1-AS1-transfected cells. The expression of lncRNA AFAP1-AS1 was downregulated in the pancreatic cancer cell lines BxPC-3 and PANC-1. The apoptosis and cell cycle progression of pancreatic cancer cells were evaluated by flow cytometry and Hoechst 33258 staining. Metastasis and invasion of BxPC-3 and PANC-1 cells were detected by transwell migration assay, real-time cell analysis, and western blot analysis. Cells were transfected with the lentiviral siAFAP1-AS1 and siNC, and tumorigenesis was evaluated in BALB/C nude mice. Immunohistochemical examination was used to verify the effects of oridonin and siAFAP1-AS1 on pancreatic cancer. The results demonstrated that the combination of oridonin and siAFAP1-AS1 inhibited pancreatic cancer cell proliferation, induced apoptosis, arrested cell cycle progression, prevented the migration, regulated EMT-related protein expression in BxPC-3 and PANC-1 cells, and inhibited pancreatic cancer cell tumorigenicity and EMT in nude mice.

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This study aimed to analyze the clinical safety and effectiveness of endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) in alleviating intractable abdominal pain caused by advanced pancreatic cancer. A total of 58 patients with inoperable pancreatic cancer who underwent EUS-CPN from May 2015 to December 2017 were enrolled. Pain levels before and after EUS-CPN were assessed and compared using the Visual Analogue Scale. The preoperative Visual Analogue Scale score was 8.2 ± 2.3, which decreased significantly to 3.6 ± 1.5 at 2 days after EUS-CPN and to 2.2 ± 0.8 after 1 month. The response rate was 79.3%. No patient experienced serious complications; 14 patients experienced mild, transient side effects (self-limiting diarrhea, reflex hypotension, and worsening of abdominal pain) that resolved within 48 hours. For pancreatic cancer patients, EUS-CPN can effectively control pain with minimal adverse effects.

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Background Laparoscopic pancreatic tumor enucleation (LPE) is a viable option for the removal of non-malignant pancreatic masses leading to maximally preservation of organ function. However, postoperative pancreatic fistula (POPF) is a concern, particularly when the mass is close to the main pancreatic duct (MPD). Pancreatic duct stents are used to treat refractory pancreatic leakage, Preoperative stenting of the MPD might prevent its injury when performing LPE. Aimas To explore the application value of pancreatic duct stents in laparoscopic pancreatic tumor enucleation. Methods We reviewed the clinical data of patients who underwent either Laparoscopic pancreatic enucleation with pancreatic stenting (LPE + PS) or LPE from January 2016 to December 2019. The patients were divided into two groups as LPE + PS and LPE. Results Twenty (9 LPE and 11 LPE + PS) were included in the final analysis. The 2 groups were equivalent in baseline characteristics and pathologic variables. LPE + PS group showed shorter hospital stay (p = 0.045), lower Grade B/C postoperative pancreatic fistula rates than the LPE group (p = 0.047). Intraoperative and postoperative outcomes, including operating time (p = 0.124), estimated blood loss (p = 0.258), were similar in the two groups. No local recurrence and no patients presented exocrine or endocrine insufficiency was detected in either group. Conclusion This procedure is associated with acceptable morbidity and it is safe. The preoperative stenting of the MPD may facilitates to identify the main pancreatic duct intraoperatively, might avoid the occurrence of Grade B/C POPF.