AIM:To assess the patency of pancreaticoenterostomy and pancreatic exocrine function after three surgical methods. METHODS: A pig model of pancreatic ductal dilation was made by ligating the main pancreatic duct. Afte...AIM:To assess the patency of pancreaticoenterostomy and pancreatic exocrine function after three surgical methods. METHODS: A pig model of pancreatic ductal dilation was made by ligating the main pancreatic duct. After 4 wk ligation, a total of 36 piglets were divided randomly into four groups. The piglets in the control group underwent laparotomy only; the others were treated by three anastomoses: (1) end-to-end pancreaticojejunostomy invagination (EEPJ); (2) end-to-side duct-to- mucosa sutured anastomosis (ESPJ); or (3) binding pancreaticojejunostomy (BPJ). Anastomotic patency was assessed after 8 wk by body weight gain, intrapancreatic ductal pressure, pancreatic exocrine function secretin test, pancreatography, and macroscopic and histologic features of the anastomotic site. RESULTS: The EEPJ group had significantly slower weight gain than the ESPJ and BPJ groups on postoperative weeks 6 and 8 (P < 0.05). The animals in both the ESPJ and BPJ groups had a similar body weight gain.Intrapancreatic ductal pressure was similar in ESPJ and BPJ. However, pressure in EEPJ was significantly higher than that in ESPJ and BPJ (P < 0.05). All three functional parameters, the secretory volume, the flow rate of pancreatic juice, and bicarbonate concentration, were significantly higher in ESPJ and BPJ as compared to EEPJ (P < 0.05). However, the three parameters were similar in ESPJ and BPJ. Pancreatography performed after EEPJ revealed dilation and meandering of the main pancreatic duct, and the anastomotic site exhibited a variable degree of occlusion, and even blockage. Pancreatography of ESPJ and BPJ, however, showed normal ductal patency. Histopathology showed that the intestinal mucosa had fused with that of the pancreatic duct, with a gradual and continuous change from one to the other. For EEPJ, the portion of the pancreatic stump protruding into the jejunal lumen was largely replaced by cicatricial fibrous tissue. CONCLUSION: A mucosa-to-mucosa pancreatico- jejunostomy is the best choice for anastomotic patency when compared with EEPJ. BPJ can effectively maintain anastomotic patency and preserve pancreatic exocrine function as well as ESPJ.展开更多
The pancreaticoduodenectomy(PD) procedure may lead to pancreatic exocrine and endocrine insufficiency.There are several types of reconstruction for this kind of operation.Pancreaticogastrostomy(PG) was introduced to r...The pancreaticoduodenectomy(PD) procedure may lead to pancreatic exocrine and endocrine insufficiency.There are several types of reconstruction for this kind of operation.Pancreaticogastrostomy(PG) was introduced to reduce the rate of postoperative pancreatic fistula.Although some randomized control trials have shown no differences regarding pancreatic leakage between PG and pancreaticojejunostomy(PJ),recently some reports reveal benefits from the PG over the PJ.Some surgeons concern about the performing of the PG and inactivation of pancreatic enzymes being in contact with the gastric juice,and the detrimental results over the exocrine pancreatic function.The pancreatic exocrine function can be measured with direct and indirect tests.Direct tests have the highest sensitivity and specificity for detection of exocrine insufficiency but require tube placement.Among the tubeless indirect tests,the van de Kamer stool fat analysis remains the standard to diagnose fat malabsorption.The patient compliance and time consuming makes it not so suitable for its clinical use.Fecal immunoreactive elastase test is employed for screening of exocrine insufficiency,is not cumbersome,and has been used to study pancreatic function after resection.We analyze the FE1 levels in our patients after the PD with two types of reconstruction,PG and PJ,and we discuss some considerations about the pancreaticointestinal drainage method after pancreaticoduodenectomy.展开更多
BACKGROUND Previous studies have shown that individuals with type 1 diabetes(T1D)frequently present with reduced fecal elastase levels,suggesting exocrine pancreatic insufficiency.However,the underlying determinants a...BACKGROUND Previous studies have shown that individuals with type 1 diabetes(T1D)frequently present with reduced fecal elastase levels,suggesting exocrine pancreatic insufficiency.However,the underlying determinants and the longitudinal trajectory of these changes remain poorly understood.AIM To evaluate longitudinal changes in fecal elastase among individuals with T1D,identify associated factors,and determine clinical implications.METHODS Pancreatic exocrine function was evaluated in a cohort of patients with T1D by measuring fecal elastase concentrations(FECs).After a mean follow-up of 8.5±0.5 years,participants were recontacted,and a second stool sample was obtained.At both time points,detailed medical histories were collected,including information on diabetes progression,metabolic control,complications,gastrointestinal symptoms,and nutritional status.The study was approved by the institutional ethics committee,and written informed consent was obtained from all participants.RESULTS A total of 106 individuals with T1D(mean age=46.2 years;50%male)were enrolled.At baseline,the median FEC was 239.5μg/g,with 44 participants(41.5%)demonstrating abnormally low levels(<200μg/g).Reduced fecal elastase was significantly associated with male sex,diabetes-related complications,particularly retinopathy,and higher glycated hemoglobin levels.No significant differences in gastrointestinal symptoms,body mass index,nor most serum nutritional markers were observed between individuals with normal vs reduced fecal elastase levels.Sixty-six participants completed follow-up.Their median fecal elastase was 171.5μg/g,with 59.1%presenting levels below 200μg/g.Paired analysis showed a non-significant decline in FEC s over time.No clinical nor metabolic variables predicted longitudinal changes in FEC independently.CONCLUSION Fecal elastase levels are frequently reduced in individuals with T1D and may show a gradual decline over time.The clinical impact of these changes appears to be limited.展开更多
Autoimmune pancreatitis, a recently recognized type of chronic pancreatitis, is not rare in Japan, but reports of it elsewhere are relatively uncommon. We report the first preoperatively diagnosed case of autoimmune p...Autoimmune pancreatitis, a recently recognized type of chronic pancreatitis, is not rare in Japan, but reports of it elsewhere are relatively uncommon. We report the first preoperatively diagnosed case of autoimmune pancreatitis in Hungary, which responded well to steroid treatment and provided radiographic and functional evidence of this improvement. A 62-year-old female presented with a 4-month history of recurrent epigastric pain and a 5-kg weight loss. The oral glucose tolerance test （OGTT） indicated diabetes mellitus and the result of the fecal elastase test was abnormal. Ultrasonography （US） and the CT scan demonstrated a diffusely enlarged pancreas, and endoscopic retrograde cholangiopancreatography （ERCP） an irregular main pancreatic duct with long strictures in the head and tail. Autoimmune pancreatitis was diagnosed. The patient was started on 32 mg prednisolone daily, After 4 wk, the OGTT and faecal elastase test results had normalized. The repeated US and CT scan revealed a marked improvement of the diffuse pancreatic swelling, while on repeated ERCP, the main pancreatic duct narrowing was seen to be ameliorated. It is important to be aware of this disease and its diagnosis, because AIP can clinically resemble pancreatobiliary malignancies, or chronic or acute pancreatitis, However, in contrast with chronic pancreatitis, its symptoms and morphologic and laboratory alterations are completely reversed by oral steroid therapy.展开更多
Benign,premalignant or low-grade malignant pancreatic tumors are increasingly diagnosed owing to the widespread uptake of cross-sectional imaging.Surgical excision is a potential treatment option for these tumors.Panc...Benign,premalignant or low-grade malignant pancreatic tumors are increasingly diagnosed owing to the widespread uptake of cross-sectional imaging.Surgical excision is a potential treatment option for these tumors.Pancreatoduodenectomy and distal pancreatectomy are the standard resections for tumors located in the pancreatic head-neck or body-tail,respectively,and not uncommonly sacrifice a significant amount of healthy pancreatic parenchyma.Central pancreatectomy(CP)is a parenchyma-sparing procedure,initially performed by Dagradi and Serio in 1982,in a patient with pancreatic neck insulinoma.Since then,an increasing number of cases are being performed worldwide,either via open or minimally invasive surgical access.Additionally,pancreatic enucleation is reserved for tumors<3 cm,without involvement of the main pancreatic duct.CP remains an alternative approach in selected cases,albeit in the presence of some controversies,such as its use in early pancreatic ductal adenocarcinoma or metastatic deposits to the central aspect of the pancreas from other malignancies.In recent years,clarity is lacking as regards indications for CP,and despite accumulating evidence in favor of limited resections for suitable pancreatic tumors,no evidence-based consensus guidelines are yet available.Nevertheless,it appears that appropriate patient selection is of paramount importance to maximize the advantages of preservation of endocrine and exocrine pancreatic functions as well as to mitigate the risks of higher complication rates.In this comprehensive review,we explore the role of CP in the treatment of lesions located in the neck and proximal body of the pancreas.展开更多
BACKGROUND For tumors in the neck and body of the pancreas,distal pancreatectomy(DP)has been the standard surgical procedure for the last few decades and central pancreatectomy(CP)is an alternative surgical option.Whe...BACKGROUND For tumors in the neck and body of the pancreas,distal pancreatectomy(DP)has been the standard surgical procedure for the last few decades and central pancreatectomy(CP)is an alternative surgical option.Whether CP better preserves remnant pancreatic endocrine and exocrine functions after surgery remains a subject of debate.AIM To evaluate the safety and efficacy of CP compared with DP for benign or lowgrade malignant pancreatic tumors in the neck and body of the pancreas.METHODS This retrospective study enrolled 296 patients who underwent CP or DP for benign and low-malignant neoplasms at the same hospital between January 2016 and March 2020.Perioperative outcomes and long-term morbidity of endocrine/exocrine function were prospectively evaluated.RESULTS No significant difference was observed in overall morbidity or clinically relevant postoperative pancreatic fistula between the two groups(P=0.055).Delayed gastric emptying occurred more frequently in the CP group than in the DP group(29.4%vs 15.3%;P<0.005).None of the patients in the CP group had new-onset or aggravated distal metastasis,whereas 40 patients in the DP group had endocrine function deficiency after surgery(P<0.05).There was no significant difference in the incidence of diarrhea immediately after surgery,but at postoperative 12 mo,a significantly higher number of patients had diarrhea in the DP group than in the CP group(0%vs 9.5%;P<0.05).CONCLUSION CP is a generally safe procedure and is better than DP in preserving long-term pancreatic endocrine and exocrine functions.Therefore,CP might be a better option for treating benign or low-grade malignant neoplasms in suitable patients.展开更多
The unique structure of the stomach,including the rumen,reticulum,omasum,and abomasum,indicates the differences between the ruminant and monogastric animals in the digestion of nutrients.This difference is reflected i...The unique structure of the stomach,including the rumen,reticulum,omasum,and abomasum,indicates the differences between the ruminant and monogastric animals in the digestion of nutrients.This difference is reflected in the majority of dietary nutrients that may be fermented in the rumen.Significant proteins and a certain amount of starch can flow to the small intestine apart from rumen.The initial phase of small intestinal digestion requires pancreatic digestive enzymes.In theory,the enzymatic digestion and utilization efficiency of starch in the small intestine are considerably higher than that in the rumen,but the starch digestibility in the small intestine is quite low in ruminants.Therefore,improving the digestion of nutrients,especially starch in the small intestine is more urgent for high-yield ruminants.Although the pancreas plays a central role in nutrient digestion,the progress of research investigating pancreatic exocrine regulation in the ruminant is slow due to some factors,such as the complex structure of the pancreas,the selection of experimental model and duration,and internal(hormones or ages) and external(diet) influences.The present review is based on the research findings of pancreatic exocrine regulation of dairy animals and expounded from the physiological structure of the ruminant pancreas,the factors affecting the digestion and exocrine processing of carbohydrates,and the regulatory mechanism governing this process.The review aims to better understand the characteristics of enzymatic digestion,thereby advancing pancreatic exocrine research and improving the digestion and utilization of nutrients in ruminants.Additionally,this review provides the theoretical basis for improving nutrient utilization efficiency,reducing wastage of feed resources,and promoting the efficient development of the dairy industry.展开更多
Endocrine and exocrine functions of the pancreas control nutritional absorption,utilisation and systemic metabolic homeostasis.Under basal conditions,the lysosome is pivotal in regulating intracellular organelles and ...Endocrine and exocrine functions of the pancreas control nutritional absorption,utilisation and systemic metabolic homeostasis.Under basal conditions,the lysosome is pivotal in regulating intracellular organelles and metabolite turnover.In response to acute or chronic stress,the lysosome senses metabolic flux and inflammatory challenges,thereby initiating the adaptive programme to re-establish cellular homeostasis.A growing body of evidence has demonstrated the pathophysiological relevance of the lysosomal stress response in metabolic diseases in diverse sets of tissues/organs,such as the liver and the heart.In this review,we discuss the pathological relevance of pancreatic lysosome stress in diabetes mellitus.We begin by summarising lysosomal biology,followed by exploring the immune and metabolic functions of lysosomes and finally discussing the interplay between lysosomal stress and the pathogenesis of pancreatic diseases.Ultimately,our review aims to enhance our understanding of lysosomal stress in disease pathogenesis,which could potentially lead to the discovery of innovative treatment methods for these conditions.展开更多
文摘AIM:To assess the patency of pancreaticoenterostomy and pancreatic exocrine function after three surgical methods. METHODS: A pig model of pancreatic ductal dilation was made by ligating the main pancreatic duct. After 4 wk ligation, a total of 36 piglets were divided randomly into four groups. The piglets in the control group underwent laparotomy only; the others were treated by three anastomoses: (1) end-to-end pancreaticojejunostomy invagination (EEPJ); (2) end-to-side duct-to- mucosa sutured anastomosis (ESPJ); or (3) binding pancreaticojejunostomy (BPJ). Anastomotic patency was assessed after 8 wk by body weight gain, intrapancreatic ductal pressure, pancreatic exocrine function secretin test, pancreatography, and macroscopic and histologic features of the anastomotic site. RESULTS: The EEPJ group had significantly slower weight gain than the ESPJ and BPJ groups on postoperative weeks 6 and 8 (P < 0.05). The animals in both the ESPJ and BPJ groups had a similar body weight gain.Intrapancreatic ductal pressure was similar in ESPJ and BPJ. However, pressure in EEPJ was significantly higher than that in ESPJ and BPJ (P < 0.05). All three functional parameters, the secretory volume, the flow rate of pancreatic juice, and bicarbonate concentration, were significantly higher in ESPJ and BPJ as compared to EEPJ (P < 0.05). However, the three parameters were similar in ESPJ and BPJ. Pancreatography performed after EEPJ revealed dilation and meandering of the main pancreatic duct, and the anastomotic site exhibited a variable degree of occlusion, and even blockage. Pancreatography of ESPJ and BPJ, however, showed normal ductal patency. Histopathology showed that the intestinal mucosa had fused with that of the pancreatic duct, with a gradual and continuous change from one to the other. For EEPJ, the portion of the pancreatic stump protruding into the jejunal lumen was largely replaced by cicatricial fibrous tissue. CONCLUSION: A mucosa-to-mucosa pancreatico- jejunostomy is the best choice for anastomotic patency when compared with EEPJ. BPJ can effectively maintain anastomotic patency and preserve pancreatic exocrine function as well as ESPJ.
文摘The pancreaticoduodenectomy(PD) procedure may lead to pancreatic exocrine and endocrine insufficiency.There are several types of reconstruction for this kind of operation.Pancreaticogastrostomy(PG) was introduced to reduce the rate of postoperative pancreatic fistula.Although some randomized control trials have shown no differences regarding pancreatic leakage between PG and pancreaticojejunostomy(PJ),recently some reports reveal benefits from the PG over the PJ.Some surgeons concern about the performing of the PG and inactivation of pancreatic enzymes being in contact with the gastric juice,and the detrimental results over the exocrine pancreatic function.The pancreatic exocrine function can be measured with direct and indirect tests.Direct tests have the highest sensitivity and specificity for detection of exocrine insufficiency but require tube placement.Among the tubeless indirect tests,the van de Kamer stool fat analysis remains the standard to diagnose fat malabsorption.The patient compliance and time consuming makes it not so suitable for its clinical use.Fecal immunoreactive elastase test is employed for screening of exocrine insufficiency,is not cumbersome,and has been used to study pancreatic function after resection.We analyze the FE1 levels in our patients after the PD with two types of reconstruction,PG and PJ,and we discuss some considerations about the pancreaticointestinal drainage method after pancreaticoduodenectomy.
文摘BACKGROUND Previous studies have shown that individuals with type 1 diabetes(T1D)frequently present with reduced fecal elastase levels,suggesting exocrine pancreatic insufficiency.However,the underlying determinants and the longitudinal trajectory of these changes remain poorly understood.AIM To evaluate longitudinal changes in fecal elastase among individuals with T1D,identify associated factors,and determine clinical implications.METHODS Pancreatic exocrine function was evaluated in a cohort of patients with T1D by measuring fecal elastase concentrations(FECs).After a mean follow-up of 8.5±0.5 years,participants were recontacted,and a second stool sample was obtained.At both time points,detailed medical histories were collected,including information on diabetes progression,metabolic control,complications,gastrointestinal symptoms,and nutritional status.The study was approved by the institutional ethics committee,and written informed consent was obtained from all participants.RESULTS A total of 106 individuals with T1D(mean age=46.2 years;50%male)were enrolled.At baseline,the median FEC was 239.5μg/g,with 44 participants(41.5%)demonstrating abnormally low levels(<200μg/g).Reduced fecal elastase was significantly associated with male sex,diabetes-related complications,particularly retinopathy,and higher glycated hemoglobin levels.No significant differences in gastrointestinal symptoms,body mass index,nor most serum nutritional markers were observed between individuals with normal vs reduced fecal elastase levels.Sixty-six participants completed follow-up.Their median fecal elastase was 171.5μg/g,with 59.1%presenting levels below 200μg/g.Paired analysis showed a non-significant decline in FEC s over time.No clinical nor metabolic variables predicted longitudinal changes in FEC independently.CONCLUSION Fecal elastase levels are frequently reduced in individuals with T1D and may show a gradual decline over time.The clinical impact of these changes appears to be limited.
基金Supported by ETT (5 K.503), OTKA (5 K507) and the Hungarian Academy of Sciences (BO 5/2003)
文摘Autoimmune pancreatitis, a recently recognized type of chronic pancreatitis, is not rare in Japan, but reports of it elsewhere are relatively uncommon. We report the first preoperatively diagnosed case of autoimmune pancreatitis in Hungary, which responded well to steroid treatment and provided radiographic and functional evidence of this improvement. A 62-year-old female presented with a 4-month history of recurrent epigastric pain and a 5-kg weight loss. The oral glucose tolerance test （OGTT） indicated diabetes mellitus and the result of the fecal elastase test was abnormal. Ultrasonography （US） and the CT scan demonstrated a diffusely enlarged pancreas, and endoscopic retrograde cholangiopancreatography （ERCP） an irregular main pancreatic duct with long strictures in the head and tail. Autoimmune pancreatitis was diagnosed. The patient was started on 32 mg prednisolone daily, After 4 wk, the OGTT and faecal elastase test results had normalized. The repeated US and CT scan revealed a marked improvement of the diffuse pancreatic swelling, while on repeated ERCP, the main pancreatic duct narrowing was seen to be ameliorated. It is important to be aware of this disease and its diagnosis, because AIP can clinically resemble pancreatobiliary malignancies, or chronic or acute pancreatitis, However, in contrast with chronic pancreatitis, its symptoms and morphologic and laboratory alterations are completely reversed by oral steroid therapy.
文摘Benign,premalignant or low-grade malignant pancreatic tumors are increasingly diagnosed owing to the widespread uptake of cross-sectional imaging.Surgical excision is a potential treatment option for these tumors.Pancreatoduodenectomy and distal pancreatectomy are the standard resections for tumors located in the pancreatic head-neck or body-tail,respectively,and not uncommonly sacrifice a significant amount of healthy pancreatic parenchyma.Central pancreatectomy(CP)is a parenchyma-sparing procedure,initially performed by Dagradi and Serio in 1982,in a patient with pancreatic neck insulinoma.Since then,an increasing number of cases are being performed worldwide,either via open or minimally invasive surgical access.Additionally,pancreatic enucleation is reserved for tumors<3 cm,without involvement of the main pancreatic duct.CP remains an alternative approach in selected cases,albeit in the presence of some controversies,such as its use in early pancreatic ductal adenocarcinoma or metastatic deposits to the central aspect of the pancreas from other malignancies.In recent years,clarity is lacking as regards indications for CP,and despite accumulating evidence in favor of limited resections for suitable pancreatic tumors,no evidence-based consensus guidelines are yet available.Nevertheless,it appears that appropriate patient selection is of paramount importance to maximize the advantages of preservation of endocrine and exocrine pancreatic functions as well as to mitigate the risks of higher complication rates.In this comprehensive review,we explore the role of CP in the treatment of lesions located in the neck and proximal body of the pancreas.
基金Supported by the National Natural Science Foundation of China,No.82172859,81801566,and 82071867the National Key Research and Development Program of China,No.2019YFC1316000.
文摘BACKGROUND For tumors in the neck and body of the pancreas,distal pancreatectomy(DP)has been the standard surgical procedure for the last few decades and central pancreatectomy(CP)is an alternative surgical option.Whether CP better preserves remnant pancreatic endocrine and exocrine functions after surgery remains a subject of debate.AIM To evaluate the safety and efficacy of CP compared with DP for benign or lowgrade malignant pancreatic tumors in the neck and body of the pancreas.METHODS This retrospective study enrolled 296 patients who underwent CP or DP for benign and low-malignant neoplasms at the same hospital between January 2016 and March 2020.Perioperative outcomes and long-term morbidity of endocrine/exocrine function were prospectively evaluated.RESULTS No significant difference was observed in overall morbidity or clinically relevant postoperative pancreatic fistula between the two groups(P=0.055).Delayed gastric emptying occurred more frequently in the CP group than in the DP group(29.4%vs 15.3%;P<0.005).None of the patients in the CP group had new-onset or aggravated distal metastasis,whereas 40 patients in the DP group had endocrine function deficiency after surgery(P<0.05).There was no significant difference in the incidence of diarrhea immediately after surgery,but at postoperative 12 mo,a significantly higher number of patients had diarrhea in the DP group than in the CP group(0%vs 9.5%;P<0.05).CONCLUSION CP is a generally safe procedure and is better than DP in preserving long-term pancreatic endocrine and exocrine functions.Therefore,CP might be a better option for treating benign or low-grade malignant neoplasms in suitable patients.
基金supported by the National Key Research and Development Program of China(Award Numbers:2018YFD0501600 and 2017YFD0500500)the National Natural Science Foundation of China(Award Numbers:31672451 and 31472122)。
文摘The unique structure of the stomach,including the rumen,reticulum,omasum,and abomasum,indicates the differences between the ruminant and monogastric animals in the digestion of nutrients.This difference is reflected in the majority of dietary nutrients that may be fermented in the rumen.Significant proteins and a certain amount of starch can flow to the small intestine apart from rumen.The initial phase of small intestinal digestion requires pancreatic digestive enzymes.In theory,the enzymatic digestion and utilization efficiency of starch in the small intestine are considerably higher than that in the rumen,but the starch digestibility in the small intestine is quite low in ruminants.Therefore,improving the digestion of nutrients,especially starch in the small intestine is more urgent for high-yield ruminants.Although the pancreas plays a central role in nutrient digestion,the progress of research investigating pancreatic exocrine regulation in the ruminant is slow due to some factors,such as the complex structure of the pancreas,the selection of experimental model and duration,and internal(hormones or ages) and external(diet) influences.The present review is based on the research findings of pancreatic exocrine regulation of dairy animals and expounded from the physiological structure of the ruminant pancreas,the factors affecting the digestion and exocrine processing of carbohydrates,and the regulatory mechanism governing this process.The review aims to better understand the characteristics of enzymatic digestion,thereby advancing pancreatic exocrine research and improving the digestion and utilization of nutrients in ruminants.Additionally,this review provides the theoretical basis for improving nutrient utilization efficiency,reducing wastage of feed resources,and promoting the efficient development of the dairy industry.
基金funded by National Institute of Health Sciences(R01 DK126817).
文摘Endocrine and exocrine functions of the pancreas control nutritional absorption,utilisation and systemic metabolic homeostasis.Under basal conditions,the lysosome is pivotal in regulating intracellular organelles and metabolite turnover.In response to acute or chronic stress,the lysosome senses metabolic flux and inflammatory challenges,thereby initiating the adaptive programme to re-establish cellular homeostasis.A growing body of evidence has demonstrated the pathophysiological relevance of the lysosomal stress response in metabolic diseases in diverse sets of tissues/organs,such as the liver and the heart.In this review,we discuss the pathological relevance of pancreatic lysosome stress in diabetes mellitus.We begin by summarising lysosomal biology,followed by exploring the immune and metabolic functions of lysosomes and finally discussing the interplay between lysosomal stress and the pathogenesis of pancreatic diseases.Ultimately,our review aims to enhance our understanding of lysosomal stress in disease pathogenesis,which could potentially lead to the discovery of innovative treatment methods for these conditions.
