Current Gastroenterology Reports最新文献_第7页

The Role of Endoscopy in the Management of Adolescent Bariatric Patients: A Primer For Pediatric Gastroenterologists. 内窥镜在青少年减肥患者治疗中的作用：儿科胃肠病学家的入门知识。

Current Gastroenterology Reports Pub Date : 2023-11-01 Epub Date: 2023-10-03 DOI: 10.1007/s11894-023-00894-5

Robert E Kramer

{"title":"The Role of Endoscopy in the Management of Adolescent Bariatric Patients: A Primer For Pediatric Gastroenterologists.","authors":"Robert E Kramer","doi":"10.1007/s11894-023-00894-5","DOIUrl":"10.1007/s11894-023-00894-5","url":null,"abstract":"Purpose of review: The prevalence of childhood and adolescent obesity in the United States has reached alarming levels, necessitating effective interventions such as bariatric surgery. This article reviews the current state of bariatric surgery in the adolescent population, highlighting the common complications encountered in post-bariatric patients. Furthermore, it outlines the pivotal role of endoscopy in both the prevention and management of these bariatric complications.Recent findings: Though only a minority of eligible adolescent patients undergo bariatric surgery the number of cases continues to increase. Sleeve gastrectomy has emerged as the preferred type of surgery, with the best balance of safety and efficacy. However, only a small number of pediatric surgeons have additional bariatric training and a number of technical aspects of the surgery itself impact the risk for post-surgical complications. Gastric sleeve stenosis, anastomotic leaks and gastroesophageal reflux are the most common of these complications. Ability to perform dilation of sleeve stenosis, closure of anastomotic leaks and evaluation of reflux are critical tools in the endoscopic toolbox necessary for the management of these complicated patients. Bariatric surgery remains the most effective treatment available for management of morbid obesity in adolescents but has significant associated complications. Pediatric gastroenterologists must be familiar in the endoscopic management of these complications and are crucial in creating a high functioning adolescent bariatric program.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":" ","pages":"299-307"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41143299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Treatment of Pediatric Eosinophilic Esophagitis: Traditional and Novel Therapies. 儿童嗜酸性粒细胞性食管炎的治疗:传统与新疗法。

Current Gastroenterology Reports Pub Date : 2023-11-01 Epub Date: 2023-09-02 DOI: 10.1007/s11894-023-00893-6

Colby S Sharlin, Vincent A Mukkada, Philip E Putnam, Scott M Bolton

引用次数: 0

Update on Cystic Fibrosis in Pediatric Patients. 儿科患者囊性纤维化的最新进展。

Current Gastroenterology Reports Pub Date : 2023-11-01 Epub Date: 2023-09-01 DOI: 10.1007/s11894-023-00896-3

Sarah Shrager Lusman

引用次数: 1

Promoting Research that Supports High-Quality Gastrointestinal Endoscopy in Children. 促进支持儿童高质量胃肠内窥镜检查的研究。

Current Gastroenterology Reports Pub Date : 2023-11-01 Epub Date: 2023-10-02 DOI: 10.1007/s11894-023-00897-2

Lisa B Mahoney, Catharine M Walsh, Jenifer R Lightdale

引用次数: 0

Endoscopic Management of Gallbladder Disease. 胆囊疾病的内镜治疗。

Current Gastroenterology Reports Pub Date : 2023-10-01 Epub Date: 2023-11-02 DOI: 10.1007/s11894-023-00886-5

Joshua L Hudson, Todd H Baron

{"title":"Endoscopic Management of Gallbladder Disease.","authors":"Joshua L Hudson, Todd H Baron","doi":"10.1007/s11894-023-00886-5","DOIUrl":"10.1007/s11894-023-00886-5","url":null,"abstract":"Purpose of review: Diseases of the gallbladder can be increasingly managed through endoscopic interventions, either serving as an alternative to or obviating the need for cholecystectomy. In this review, we aim to review the most recent data on endoscopic management of the most common gallbladder diseases.Recent findings: The development of lumen-opposing metal stents (LAMS) marked a major shift in gallbladder management, with transmural techniques now well studied for management of cholecystitis. Endoscopic ultrasound (EUS) is also a well-developed technique for gallbladder imaging, comparable or superior to transabdominal ultrasound. Novel techniques with LAMS for gallbladder lesion/polyp resection and treatment of non-cholecystitis gallbladder diseases mark important milestones in gallbladder preservation and increasingly less invasive management of diseases of the gallbladder. There are multiple interventional endoscopic techniques that can be used to manage common gallbladder diseases including cholecystitis, cholelithiasis, gallbladder lesions/polyps, and gallbladder cancer. Ongoing development of novel therapeutic techniques holds promise for additional minimally invasive techniques in the future.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":" ","pages":"250-254"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71421498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

TIPS: indications, Contraindications, and Evaluation. TIPS:适应症、禁忌症和评估。

Current Gastroenterology Reports Pub Date : 2023-10-01 Epub Date: 2023-08-21 DOI: 10.1007/s11894-023-00884-7

Allison Carroll, Justin R Boike

引用次数: 0

Nutrition in Liver Disease - A Review. 肝病中的营养——综述。

Current Gastroenterology Reports Pub Date : 2023-10-01 Epub Date: 2023-10-17 DOI: 10.1007/s11894-023-00887-4

Corrin Hepburn, Natasha von Roenn

{"title":"Nutrition in Liver Disease - A Review.","authors":"Corrin Hepburn, Natasha von Roenn","doi":"10.1007/s11894-023-00887-4","DOIUrl":"10.1007/s11894-023-00887-4","url":null,"abstract":"PURPOSE OF REVIEW : Nutrition is commonly overlooked in chronic liver disease. Both obesity and malnutrition are independent risk factors of poor prognosis in cirrhosis. This review aims to summarize the current literature regarding how nutrition contributes to liver disease, how to screen patients, and what nutritional and activity recommendations can help prevent adverse outcomes. RECENT FINDINGS: Screening for malnutrition, obesity, and sarcopenia through ambulatory bedside methods is recommended every 8-12 weeks in high risk patients. A Mediterranean diet with emphasis on high protein intake of 1.2-1.5 g/kg/day, and increasing physical activity can help to improve nutritional status. It remains critical to screen and identify patients with liver disease for malnutrition, obesity, and sarcopenia. Identifying an individualized action plan through a multidisciplinary approach can be helpful. Dietary recommendations to improve outcomes should be based on well-studied approaches. These can include the use of the Mediterranean diet in those with metabolic dysfunction-associated steatotic liver disease (MASLD) and a high protein diet in those with cirrhosis and sarcopenia. Routine assessment of improvement or decline should continue throughout a patient's clinical course.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":" ","pages":"242-249"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41233013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Current Status of Living Donor Liver Transplantation: Impact, Advantages, and Challenges. 活体肝移植的现状:影响、优势和挑战。

Current Gastroenterology Reports Pub Date : 2023-10-01 Epub Date: 2023-08-21 DOI: 10.1007/s11894-023-00882-9

Hao Liu, Eishan Ashwat, Abhinav Humar

{"title":"Current Status of Living Donor Liver Transplantation: Impact, Advantages, and Challenges.","authors":"Hao Liu, Eishan Ashwat, Abhinav Humar","doi":"10.1007/s11894-023-00882-9","DOIUrl":"10.1007/s11894-023-00882-9","url":null,"abstract":"Purpose of this review: This review provides an overview of the current status of Living Donor Liver Transplant (LDLT). It discusses the impact of LDLT on waitlist and post-transplantation outcomes, highlighting the technical challenges and unique advantages of LDLT.Recent findings: Recent findings show that LDLT offers several theoretical advantages over deceased donor liver transplant, including shorter wait times, better graft quality, and improved post-transplant outcomes. Non-alcoholic fatty liver disease (NAFLD) and hepatocellular carcinoma (HCC) are emerging as the leading indications for adult LDLT in the US. LDLT demonstrates comparable or better overall survival rates and organ-specific outcomes compared to deceased donor transplants. However, challenges exist, including donor and recipient risks such as biliary complications and small-for-size syndrome. Ongoing research focuses on refining surgical techniques, exploring minimally invasive approaches, utilizing predetermined donors to modulate the recipient's immune system, and ensuring ethical practices. LDLT is a valuable solution for patients with end-stage liver failure or disorders requiring transplantation. It offers advantages such as shorter wait times as well as improved waitlist and post-transplant outcomes. Continued research and advancements in LDLT will benefit patients in need of liver transplantation.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":" ","pages":"225-231"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10029571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Advances in the Management of Pain in Chronic Pancreatitis. 慢性胰腺炎疼痛治疗进展。

Current Gastroenterology Reports Pub Date : 2023-10-01 Epub Date: 2023-09-15 DOI: 10.1007/s11894-023-00898-1

Amit Maydeo, Nagesh Kamat, Ankit Dalal, Gaurav Patil

{"title":"Advances in the Management of Pain in Chronic Pancreatitis.","authors":"Amit Maydeo, Nagesh Kamat, Ankit Dalal, Gaurav Patil","doi":"10.1007/s11894-023-00898-1","DOIUrl":"10.1007/s11894-023-00898-1","url":null,"abstract":"Purpose of review: The data on recent advances in managing chronic pancreatitis (CP) pain is limited. This review highlights the role of endotherapy and the advances in the overall management of pain in CP.Recent findings: Of late, pancreatic biodegradable stents have been used in endotherapy with appreciable success. These include slow, medium, and fast degrading stents, which optimize the overall management of CP and could prevent the need for multiple procedures. Endoscopic ultrasound-guided celiac plexus block is reserved in selected patients to treat debilitating pain. Total pancreatectomy with islet autotransplantation in small duct disease has shown promising results. The indications for treating pain in CP with endoscopy and surgery need to be better defined. The complexity of pain control due to the incomplete understanding of pathomorphology makes the management of CP challenging. The current treatment methods are still evolving. Therapy aims to reduce pain, optimize recovery, maintain quality of life, and meet postoperative needs. Initial management includes lifestyle modification, nutrition optimization, risk factor reduction with abstinence from alcohol, cessation of tobacco and smoking. Supportive medical management involves the judicial use of analgesics, neuromodulators, antioxidants, pancreatic enzyme replacement for insufficiency, and diabetes management. Patients with intractable pain are ideal for therapeutic intervention. Being less invasive with an acceptable complication rate makes endotherapy the preferred first-line treatment. If found to be cost-effective, biodegradable stents can reduce the overall cost. Unfortunately, if patients remain symptomatic, surgery is preferred in case of failure or recurrence. For optimal results, appropriate patient selection is vital to maximizing outcomes.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":" ","pages":"260-266"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10592224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Screening, Diagnosis, and Staging of Non-Alcoholic Fatty Liver Disease (NAFLD): Application of Society Guidelines to Clinical Practice. 非酒精性脂肪肝（NAFLD）的筛查、诊断和分期：社会指南在临床实践中的应用。

Current Gastroenterology Reports Pub Date : 2023-10-01 Epub Date: 2023-09-28 DOI: 10.1007/s11894-023-00883-8

Ysabel C Ilagan-Ying, Bubu A Banini, Albert Do, Robert Lam, Joseph K Lim

{"title":"Screening, Diagnosis, and Staging of Non-Alcoholic Fatty Liver Disease (NAFLD): Application of Society Guidelines to Clinical Practice.","authors":"Ysabel C Ilagan-Ying, Bubu A Banini, Albert Do, Robert Lam, Joseph K Lim","doi":"10.1007/s11894-023-00883-8","DOIUrl":"10.1007/s11894-023-00883-8","url":null,"abstract":"Purpose of review: Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly nonalcoholic fatty liver disease (NAFLD), is the most common chronic liver disease affecting 30% of the global population. In this article, we summarize current expert guidelines, review clinical practice implications, and provide insight into the utility of non-invasive tests (NITs).Recent findings: The burden of MASLD is growing with the obesity epidemic, yet disease awareness and diagnosis is low. Patients can progress to metabolic dysfunction-associated steatohepatitis (MASH, formerly NASH), which can advance to liver fibrosis, cirrhosis, hepatic decompensation, and liver cancer. NITs help identify high-risk patients who may benefit from specialty referral and MASH-directed therapy. Global societies offer various recommendations for the screening and diagnosis of MASLD utilizing evidence-based, widely accessible methods such as serum indices, NITs, and liver biopsy. Several targeted steatotic liver disease (SLD) screening tools and novel therapies are under development.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":" ","pages":"213-224"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41118181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0