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Introduction

We aimed to assess the role of islet autoimmunity and family history of diabetes in the presence of CFRD in children with CF.

Aims & Methods

Data from 78 children were analysed from the CF-related Pancreatic Disorders Registry. Pancreatic islet autoantibodies (AABs) (glutamic acid decarboxylase (GAD), insulin (IAA), islet antigen-2 (IA-2) and zinc transporter 8 (ZnT8) were measured and family history of diabetes was collected in a cross-sectional manner. Family history of T1DM and T2DM was assessed using the criterion by Blackman et al., 2009 and Ferrat et al., 2020. Fischer, Kruskal-Wallis and Mann-Witney U test were used.

Results

Males comprised 55% of the study population, with a median age of 8.7 years (IQR: 5.4–14.0 years). 51 children were on CFTR modulator therapy. Children with CFRD were significantly older with a median age of 15.9 years (IQR: 7.5–18.7) for any AAB-positive CFRD compared to 8.0 years (IQR: 6.2–12.4) for non-CFRD, and 12.1 years (IQR: 9.9–13.5) for AAB-negative CFRD compared to 7.9 years (IQR: 4.0–13.6) for non-CFRD. Any AAB and single AAB positivity was significantly associated with CFRD (Table 1). Only two children reported T1DM in any relative. Family history of diabetes showed no association with CFRD. Any AAB positivity frequency was comparable among children with positive and negative family history (Blackman criteria p=0.136; Ferrat criteria p=0.133).

Variables	CFRD (n=14)	non-CFRD (n=64)	p-value
any AAB positivity	5/14 (36%)	8/64 (13%)	0.0499
single AAB positivity	5/14 (36%)	6/64 (9%)	0.0225
multiple AAB positivity	0/14 (0%)	2/64 (3%)	1.0000
GAD positivity	0/14 (0%)	4/64 (6%)	0.2925
IA-2 positivity	2/14 (14%)	2/64 (3%)	0.1456
IAA positivity	3/14 (21%)	4/64 (6%)	0.1049
ZnT8 positivity	0/14 (0%)	1/64 (2%)	1.0000

Conclusion

Islet AAB positivity is associated with CFRD in children with CF. CFRD, regardless of autoantibody status, is more common in older individuals, which aligns with known disease progression in cystic fibrosis. The usefulness of family history of diabetes as a prognostic factor in the development of CFRD is limited.

CYSTIC FIBROSIS-RELATED DIABETES IS ASSOCIATED WITH ISLET AUTOANTIBODY POSITIVITY, BUT NOT WITH FAMILY HISTORY OF DIABETES IN CHILDREN

Boróka Borbála Varga 1, Regina Molnár 2, Marcell Imrei 3, Andrea Párniczky 3, Klementina Ocskay 4

1 Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary

2 Heim Pál National Pediatric Institute, Budapest, Hungary|||Centre for Translational Medicine, Semmelweis University, Budapest, Hungary|||Uzsoki Street Hospital Budapest, Budapest, Hungary

3 Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary|||Heim Pál National Pediatric Institute, Budapest, Hungary

4 Heim Pál National Pediatric Institute, Budapest, Hungary|||Pharmaceutical Sciences and Health Technologies Division, Doctoral School, Semmelweis University, Budapest, Hungary

Conference

UEG Week Berlin 2025

Topics

Pancreas

Submission format

Abstract

Session

Chronic pancreatic disease: Pancreatitis and cystic fibrosis (Posters)

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Introduction

Pancreatic fluid collections (PFCs) are significant local complications that can arise from acute pancreatitis, and its management often involves drainage, although the benefits of metal stents over plastic stents remain uncertain. This meta-analysis compared the efficacy and safety of metal stents versus plastic stents for endoscopic ultrasound (EUS)-guided drainage of PFCs.

Aims & Methods

We searched PubMed, Embase, and Cochrane Library for randomized controlled trials (RCTs) comparing metal with plastic stents for drainage of PFCs. The odds ratio (OR) was used for binary outcomes and the mean difference (MD) for continuous outcomes with their respective 95% confidence interval (CI).

Results

This study included eight RCTs and over 500 patients. Procedure duration was shorter in the metal stent arm compared with the plastic stent arm (MD -10.63; 95%CI -16.12 to -5.15, p<0.001). However, there was no statistically significant difference between metal and plastic stents in clinical success (p=0.78), technical success (p=0.65), overall mortality (p=0.48), recurrence (p=0.23), number of interventions (p=0.85), need of necrosectomy (p=0.35), need of surgery (p=0.35), length of hospitalization (p=0.86), exocrine insufficiency (p=0.54), endocrine insufficiency (p=0.77), and AEs (p=0.36).

Conclusion

Metal stents for EUS-guided drainage of PFCs are associated with a shorter procedure duration. Besides that, it did not improve other clinically relevant outcomes in comparison with plastic stents.

SAFETY AND EFFICACY OF METAL STENTS VERSUS PLASTIC STENTS FOR ENDOSCOPIC ULTRASOUND (EUS)-GUIDED DRAINAGE OF PANCREATIC FLUID COLLECTIONS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED STUDIES WITH TRIAL SEQUENTIAL ANALYSIS

Erica Holanda 1, Andrew Fondelli 2, Rafael Kleimmann 3, Paula Pauperio 4, Julia Tschaen 5, Matheus Fernandes 6

1 General Hospital Dr Waldemar De Alcantara, Fortaleza, Brazil

2 University of Taubate (UNITAU), Sao Paulo, Brazil

3 Federal University of Paraná (UFPR), Curitiba, Brazil

4 Bahiana School of Medicine and Public Health, Salvador, Brazil

5 Superior School of Sciences of Santa Casa of Victoria, Vitoria, Brazil

6 UFCSPA, Balneário Camboriú, Brazil

Conference

UEG Week Berlin 2025

Topics

Pancreas

Submission format

Abstract

Session

PANCREAS (Posters)

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Introduction

Pancreatic fluid collection (PFC) often necessitates drainage or necrosectomy. Recently, minimally invasive endoscopic treatments have emerged as the first-line approach. However, limited data are available on the outcomes of such treatments in elderly patients.

Aims & Methods

This study aimed to evaluate the clinical outcomes of endoscopic treatment for PFC in elderly patients using a large-scale, multicenter cohort from Japan. This retrospective analysis included 349 patients who underwent endoscopic ultrasound-guided pancreatic fluid drainage (EUS-PFD) for PFC. The study cohort, derived from 11 institutions within the WONDERFUL study group between 2010 and 2021, was stratified into an elderly group (n = 54, aged ≥75 years) and a non-elderly group (n = 295). Treatment outcomes were compared between the two groups.

Results

The Charlson Comorbidity Index (CCI) of ≥2 was significantly more prevalent in the elderly group (28.4% vs. 10.1%, p < 0.001). No significant differences were observed between the groups in terms of gender, BMI, etiology of pancreatitis, or indications for treatment. PFC characteristics, including lesion proportion, size, morphology, and the prevalence of walled-off necrosis (WON), were comparable between the groups. However, pre-treatment white blood cell counts were significantly higher in the elderly group (10,250/μL vs. 8,060/μL, p= 0.003), and pre-treatment albumin levels were significantly lower (2.35 g/dL vs. 2.85 g/dL, p < 0.001). Clinical success rates of endoscopic treatment were similar between the elderly and non-elderly groups (82% vs. 87%, p = 0.29), as were rates of endoscopic necrosectomy (24.1% vs. 31.9%, p = 0.54), adverse events (16.7% vs. 17.6%, p = 0.99), surgical conversion (1.9% vs. 7.1%, p = 0.22), PFC recurrence (1.9% vs. 9.4%, p = 0.10), time to clinical success (41 days vs. 46 days, p = 0.49), number of endoscopic treatments (2 vs. 3, p = 0.19), and total treatment duration (86 minutes vs. 114 minutes, p = 0.54). However, the mortality rate was significantly higher in the elderly group (16.7% vs. 5.1%, p = 0.005). Multivariate analysis identified a statistically significant association between CCI ≥2 and mortality (odds ratio [OR]: 5.37, 95% confidence interval [CI]: 1.59–11.4, p = 0.007), while the elderly group showed a trend toward significance (OR: 3.31, 95% CI: 0.93–11.7, p = 0.06).

Conclusion

Elderly patients undergoing endoscopic treatment for PFC exhibited higher comorbidity burdens compared to their younger counterparts, as reflected by higher CCI scores. Despite comparable safety and clinical efficacy outcomes, mortality was significantly higher in the elderly cohort. These findings underscore the importance of comprehensive risk assessment, particularly considering systemic comorbidities, prior to initiating endoscopic treatment for PFC in elderly patients.

CLINICAL OUTCOMES OF ENDOSCOPIC TREATMENT FOR PANCREATIC FLUID COLLECTION IN ELDERLY PATIENTS (WONDERFUL STUDY GROUP)

Arata Sakai 1, Atsuhiro Masuda 1, Tomotaka Saito 2, Tsuyoshi Hamada 2, Masahiro Tsujimae 1, Tomohiro Yamazaki 3, Shunsuke Omoto 3, Mamoru Takenaka 3, Ryota Nakano 4, Hideyuki Shiomi 4, Sho Takahashi 5, Toshio Fujisawa 5, Suda Kentaro 6, Keito Nakagawa 6, Saburo Matsubara 6, Shinya Uemura 7, Takuji Iwashita 7, Akinori Maruta 8, Kensaku Yoshida 9, Yuhei Iwasa 10, Keisuke Iwata 10, Nobuhiko Hayashi 11, Tsuyoshi Mukai 12, Hiroyuki Isayama 5, Ichiro Yasuda 11, Yousuke Nakai 13

1 Kobe University Graduate School of Medicine, Kobe, Japan

2 Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

3 Kindai University, Faculty of Medicine, Osakasayama, Japan

4 Hyogo Medical University, Nishinomiya, Japan

5 Juntendo University, Graduate School of Medicine, Tokyo, Japan

6 Saitama Medical Center, Saitama Medical University, Kawagoe, Japan

7 Gifu University Hospital, Gifu, Japan

8 Gifu Prefectural General Medical Center, Gifu, Japan|||Gifu University Hospital, Gifu, Japan

9 Gifu Prefectural General Medical Center, Gifu, Japan

10 Gifu Municipal Hospital, Gifu, Japan

11 University Of Toyama, Toyama City, Japan

12 Kanazawa Medical University, Uchinada, Japan

13 Graduate School of Medicine, The University of Tokyo, Tokyo, Japan|||Tokyo Women's Medical University, Tokyo, Japan

Conference

UEG Week Berlin 2025

Topics

Pancreas

Submission format

Abstract

Session

A scope, a needle and a stent: All you need in treating pancreatitis (Posters)

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Introduction

Pancreatic ductal adenocarcinoma (PDAC) ranks among the most aggressive malignancies, with a five-year survival rate below 10%. Its poor prognosis stems from late diagnosis, rapid disease progression, and marked resistance to conventional therapies, largely driven by frequent KRAS and TP53 mutations. These genetic alterations disrupt multiple cellular processes, including intracellular calcium (Ca²⁺) signaling, which plays a critical role in tumor progression. Plasma membrane calcium ATPase isoform 4 (PMCA4) is a major regulator of cytosolic Ca²⁺ levels, essential for maintaining cellular homeostasis. Elevated expression of PMCA4 in PDAC has been associated with enhanced cell migration, apoptosis resistance, and poor clinical outcomes. PMCA4 localizes at focal adhesions, supporting motility and metastatic potential. Paradoxically, PMCA4 dysfunction can lead to Ca²⁺ overload, activating oncogenic pathways that drive cell proliferation and survival. The cystic fibrosis transmembrane conductance regulator (CFTR), an epithelial chloride channel, also modulates calcium homeostasis. CFTR deficiency or dysfunction impairs PMCA4 activity, while paradoxically inducing its overexpression, likely as a compensatory mechanism in response to altered Ca²⁺ signaling. This functional interaction between CFTR and PMCA4 is particularly relevant in pancreatic ductal epithelial cells, where both proteins co-localize at the apical membrane. Their coordinated function is crucial for regulating calcium and chloride transport, and its disruption may contribute to PDAC progression.

Aims & Methods

This study aim to investigate whether CFTR deficiency contributes to PMCA4 overexpression in PDAC cells and whether pharmacological restoration of CFTR function using Trikafta can normalize calcium signaling and modulate tumor cell behavior. Therefore we utilized both human pancreatic ductal organoids (hPOs) and the Capan-1 PDAC cell line to assess calcium and chloride transport. Intracellular calcium levels were measured using FURA-2-AM, and chloride efflux was monitored with MQAE dye. Immunofluorescence staining was employed to analyze the expression and localization of CFTR, PMCA4, SOX9, Vimentin, and α-SMA.

Results

We successfully cultured human pancreatic organoids from adult pancreas-derived stem cells using standard 3D culture conditions. Following the establishment of primary organoids, we performed the first passage to expand the culture. The organoids were then dissociated into single cells and plated onto 24 mm cover glasses for further analysis. Our experiments confirmed the expression of ductal markers in 2D human pancreatic organoids (hPOs) with the lack of mesenchymal markers Vimentin, and α-SMA. Immunofluorescent staining was visualized using a Zeiss LSM880 confocal microscope. Functional assays revealed that Capan-1 cells exhibited significantly reduced Ca²⁺ and Cl⁻ efflux compared to hPOs, indicating impaired CFTR and PMCA acitivty. Notably, treatment with Trikafta, a clinically approved CFTR modulator, successfully restored CFTR and PMCA4 activity in Capan-1 cells.

Conclusion

Our findings indicate that CFTR dysfunction contributes to the increased PMCA expression in PDAC cells, which can be ameliorated by Trikafta treatment. This study highlights the critical interplay between CFTR dysfunction and calcium homeostasis in pancreatic ductal adenocarcinoma (PDAC). These results underscore the relevance of epithelial ion transport pathways in PDAC pathophysiology and support further investigation of adjunctive approach in PDAC treatment.

DISRUPTED CALCIUM EFFLUX IN PANCREATIC DUCTAL ADENOCARCINOMA: THE ROLE OF CFTR AND PMCA4 DYSFUNCTION

Zsófia Horváth 1, Aletta Kata Kiss 2, Arpad Varga 2, Petra Pallagi 2, Tamara Madacsy 2, József Maléth 2

1 University of Szeged, Szeged, Hungary|||University of Szeged, Szeged, Hungary

2 University of Szeged, Szeged, Hungary|||University of Szeged, Szeged, Hungary|||University of Szeged, Szeged, Hungary

Conference

UEG Week Berlin 2025

Topics

Pancreas

Submission format

Abstract

Session

PANCREAS (Posters)

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Introduction

Acute pancreatitis (AP) is a common gastrointestinal disorder with significant morbidity and mortality in severe cases. Pre-existing comorbidities and newly developed complications, like heart failure may influence outcomes in AP patients.

Aims & Methods

This study aimed to evaluate the impact of pre-existing and newly developed cardiac conditions on in-hospital and post-discharge mortality in patients with acute pancreatitis. A single-center registry analysis of the Hungarian Pancreatic Study Group Acute Pancreatitis Registry was conducted at Semmelweis University, Budapest, Hungary, involving 1,316 patients diagnosed with acute pancreatitis between 2021-2024. Data on pre-existing chronic heart failure (CHF), atrial fibrillation (AF), stroke history, and newly developed acute heart failure (AHF) were collected. Electrocardiogram (ECG) findings, including QTc prolongation, were also analyzed. In-hospital mortality and post-discharge mortality within one year were assessed. Odds ratios (OR) with 95% confidence intervals (CI) were calculated to quantify the strength of associations.

Results

Of the 1316 patients, 45% were female, the average age was 55.8 (range: 18-95) years, 8% had severe, 25% had moderate, and 65% had mild AP. Regarding cardiovascular background, pre-existing CHF and stroke history did not show a significant association with increased in-hospital mortality in AP (OR: 1.85, 95% CI: 0.63-5.44 and OR: 1.21, 95% CI: 0.36-4.02, respectively). Although AP patients with pre-existing AF had four-fold higher odds of in-hospital mortality (OR: 4.01, 95% CI: 1.92-8.34). Assessing in-hospital cardiovascular alterations, newly discovered AF was not significantly associated with increased in-hospital mortality (OR: 4.40, 95% CI: 0.97-20.02). Moreover, QTc prolongation on ECG was not significantly associated with in-hospital mortality (OR: 2.10, 95% CI: 0.61-7.25) or post-discharge mortality within one year after AP (OR: 1.65, 95% CI: 0.20-13.74). However, AP patients with newly developed AHF had a 25-times higher odds of in-hospital mortality (OR: 25.81, 95% CI: 12.13-54.98) and a 4-times higher odds for post-discharge mortality within one year (OR: 4.93, 95% CI: 1.01-24.26).

Conclusion

Pre-existing AF and newly developed AHF are significantly associated with increased in-hospital mortality in patients AP, moreover, newly developed AHF is also associated with increased post-discharge mortality within one year. These findings highlight the importance of cardiac monitoring and management in AP patients to improve outcomes.

IMPACT OF PRE-EXISTING AND NEWLY DEVELOPED CARDIOVASCULAR CONDITIONS ON IN-HOSPITAL AND POST-DISCHARGE MORTALITY IN ACUTE PANCREATITIS: A SINGLE-CENTER REGISTRY ANALYSIS

Veronika Lillik 1, Kamilla Marosi 2, Mahmoud Obeidat 2, Andrea Szentesi 3, Peter Hegyi 4, Rita Nagy 5

1 Szent György University Teaching Hospital of Fejér County, Székesfehérvár, Hungary|||Semmelweis University, Budapest, Hungary

2 Semmelweis University, Budapest, Hungary

3 University of Pécs, Pécs, Hungary|||Semmelweis University, Budapest, Hungary

4 Semmelweis University, Budapest, Hungary|||University of Pecs, Pecs, Hungary|||Semmelweis University, Budapest, Hungary

5 Heim Pál National Pediatric Institute, Budapest, Hungary|||Semmelweis University, Budapest, Hungary

Conference

UEG Week Berlin 2025

Topics

Pancreas

Submission format

Abstract

Session

PANCREAS (Posters)

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Introduction

Neurofilaments are cytoskeletal proteins specific to neuronal tissue. As their blood levels rise following neuronal damage, they are increasingly being studied as the biomarkers for neuroaxonal injury in various conditions, such as Alzheimer’s disease, multiple sclerosis, amyotrophic lateral sclerosis, or type 2 diabetes mellitus (T2DM) related neuropathy. Pancreatic ductal adenocarcinoma (PDAC) is a malignant disease known for its poor prognosis, rapid spread, silent progression, and lack of effective diagnostic tools in its early stages. Perineural and/or endoneural invasion and neuronal damage are hallmarks of PDAC.

Aims & Methods

The aim of our study was to measure the levels of neurofilament light chain (NfL) in patients with PDAC, T2DM, chronic pancreatitis (ChP), and healthy controls. We used a Single Molecule Array (Simoa; Quanterix) to measure NfL levels in patients with PDAC (n=50, mean age 63.16 ± 8.8 years), T2DM (n=42, mean age 61.6 ± 8.4 years), ChP (n=30, mean age 56 ± 13.6 years), and healthy controls (n=46, mean age 54 ± 9.06 years).

Results

The following concentrations of NfL were obtained from the samples: PDAC: 30.31 ± 39.79 pg/ml, T2DM: 12.59 ± 10.19 pg/ml, ChP: 16.64 ± 13.78 pg/ml, Healthy controls:
7.93 ± 4.18 pg/ml. NfL levels were significantly different between PDAC and healthy controls (p < 0.001) and between T2DM and healthy controls (p < 0.001). Differences between other
groups were not significant. Further analysis confirmed age as a significant predictor of NfL levels (p < 0.001), indicating that NfL levels increase with age by 0.48 per year. We did not find a
significant impact of glycemic control (represented by glycated haemoglobin levels) or body mass index on NfL concentrations. Because of the correlation between age and NfL levels, we examined the relationship between age, diagnosis, and NfL levels using a statistical model comparison approach. After controlling for age, we found that PDAC and ChP showed significantly higher NfL levels compared to T2DM and healthy controls (p < 0.01). No significant differences were found between T2DM and healthy controls

Conclusion

This is the first study to date that evaluates serum levels of NfL in PDAC and chronic pancreatitis. The results support the possible role of NfL as a biomarker in certain non-neurological conditions. Elevated serum levels of NfL in PDAC and ChP suggest that this biomarker reflects neuronal damage, which is present in ChP and is a key feature of PDAC, even in the early stages of the disease.

LEVELS OF NEUROFILAMENT LIGHT CHAIN IN PANCREATIC CANCER, TYPE 2 DIABETES MELLITUS AND CHRONIC PANCREATITIS

Pavel Hrabák 1, Tomas Krechler 1, Michaela Sluková 2, Jan Šoupal 1, Michal Vočka 1, Tomáš Hanuš 1, Luboš Petruželka 1, Štěpán Svačina 1, Aleš Žák 1, Tomáš Zima 2, Marta Kalousová 2

1 First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia

2 First Faculty of Medicine, Charles University and General University Hospital in Prague/ Institute of Medical Biochemistry and Laboratory Diagnostics, Prague, Czechia

Conference

UEG Week Berlin 2025

Topics

Pancreas

Submission format

Abstract

Session

PANCREAS (Posters)

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Introduction

The aetiology of acute pancreatitis remains elusive in 10-30% of patients after clinical, biological and morphological investigations. Endoscopic ultrasound has shown promise and is particularly effective in exploring the bilio-pancreatic region.

Aims & Methods

The aim of our study was to evaluate the contribution of endoscopic ultrasound to the aetiological diagnosis of unexplained acute pancreatitis.
This is a retrospective descriptive study of 89 patients who underwent endoscopic ultra sound for unexplained acute pancreatitis between January 2010 and January 2025.

Results

The mean age of our patients was 55 +/- 16.3 years, with extremes ranging from 17 to 89 years. The sex ratio (M/F) was 0.81, with a slight female predominance of 55.1%. A history of previous acute pancreatitis was found in 31.9% of cases, and 16.3% of patients had undergone cholecystectomy. The diagnostic yield in our study was 68%. Biliary origin was retained in 40.4% (n=36) of patients, 19 of whom underwent complementary ERCP at the same anaesthetic time. Neoplastic pathology was found in 32.5% of cases (n=30). Chronic pancreatitis was reported in 22.4% of patients (n=20). Two cases of pancreas divisum, one case of sphincter of Oddi dysfunction and one case of choledocele were found. In the remaining 32% of cases, the endoscopic ultrasound was normal and no cause could be found.

Conclusion

Endoscopic ultrasound is currently an indispensable tool in the etiological investigation of unexplained acute pancreatitis. In our study, the diagnostic efficiency was around 68%.

CONTRIBUTION OF ENDOSCOPIC ULTRASOUND TO THE AETIOLOGICAL DIAGNOSIS OF UNEXPLAINED ACUTE PANCREATITIS

Sara HDIYE 1, Samir Mrabti 1, Ahlame Benhamdane 1, Firdaouss Ait iken 1, Meriem Amine 1, Amine Achemlal 1, Sakina Oualaalou 1, Salma Azammam 1, Imane KARAM 1, souhaila akir 1, Tarik Addajou 1, Reda Berraida 1, elkoti ilham 1, Rouibaa Fedoua 1, Hassan Seddik 1

1 Mohammed V Military Hospital, Faculty of Medicine and Pharmacy of Rabat, Department of Gastroenterology II, RABAT, Morocco, Rabat, Morocco

Conference

UEG Week Berlin 2025

Topics

Pancreas

Submission format

Abstract

Session

PANCREAS (Posters)

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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