Digestive and Liver Disease最新文献

Recent trends in foreign body ingestion (FBI) epidemiology: A national cohort study. 异物摄入（FBI）流行病学的最新趋势：全国队列研究。

IF 4 3区医学

Digestive and Liver Disease Pub Date : 2024-10-29 DOI: 10.1016/j.dld.2024.10.002

Cecilia Mantegazza, Francesca Destro, Simona Ferraro, Davide Biganzoli, Giuseppe Marano, Paolo Quitadamo, Giovanni Di Nardo, Monica Malamisura, Giulia Chiarazzo, Sara Renzo, Luca Scarallo, Giorgio Fava, Martina Ichino, Roberto Panceri, Debora Sala, Maristella Pellegrino, Francesco Macchini, Paolo Gandullia, Giacomo Tantari, Matteo Bramuzzo, Marco Deganello Saccomani, Maria Teresa Illiceto, Paolo Orizio, Simona Gatti, Antonio Pizzol, Enrico Felici, Claudio Romano, Silvia Iuliano, Alessandra Marinari, Antonio Marseglia, Salvatore Oliva

{"title":"Recent trends in foreign body ingestion (FBI) epidemiology: A national cohort study.","authors":"Cecilia Mantegazza, Francesca Destro, Simona Ferraro, Davide Biganzoli, Giuseppe Marano, Paolo Quitadamo, Giovanni Di Nardo, Monica Malamisura, Giulia Chiarazzo, Sara Renzo, Luca Scarallo, Giorgio Fava, Martina Ichino, Roberto Panceri, Debora Sala, Maristella Pellegrino, Francesco Macchini, Paolo Gandullia, Giacomo Tantari, Matteo Bramuzzo, Marco Deganello Saccomani, Maria Teresa Illiceto, Paolo Orizio, Simona Gatti, Antonio Pizzol, Enrico Felici, Claudio Romano, Silvia Iuliano, Alessandra Marinari, Antonio Marseglia, Salvatore Oliva","doi":"10.1016/j.dld.2024.10.002","DOIUrl":"https://doi.org/10.1016/j.dld.2024.10.002","url":null,"abstract":"Background and aims: Foreign body ingestion (FBI) in children is a critical health concern. This study aimed to describe the epidemiology of FBI in children in Italy.Methods: We retrospectively enrolled children <18 years admitted for FBI from January 2015 to December 2020. Data were collected across 21 hospitals with dedicated pediatric endoscopy services and normalized by the population of the corresponding municipalities.Results: A total of 5,771 FBI cases were analyzed. FBI incidents showed consistent time trends across age groups, with most events occurring at home and being witnessed (94.7 %). Children <6 years accounted for 74.3 % of cases. Comorbidities were present in 5.3 % of cases, primarily neurologic/psychiatric disorders in older children (6-17 years). Blunt objects accounted for 65.5 % of ingestions. Young males commonly ingested button batteries, while females showed higher rates of ingesting hair products and jewelry. Most children were discharged (60 %) or observed briefly (75 % of total admissions), with endoscopic removal performed in 24 % of cases.Conclusions: Rates of FBI have remained stable over the years, including during the COVID-19 pandemic. FBI predominantly occurs in domestic settings among healthy young children, particularly those ≤5 years old. These findings emphasize the need for preventive measures to reduce the impact of FBI among children.","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Liver transplant for hepatocellular carcinoma in metabolic dysfunction-associated steatotic liver disease versus other etiologies: A meta-analysis. 代谢功能障碍相关脂肪性肝病与其他病因导致的肝细胞癌的肝移植对比：荟萃分析

IF 4 3区医学

Digestive and Liver Disease Pub Date : 2024-10-28 DOI: 10.1016/j.dld.2024.09.025

Alessandro Parente, Flavio Milana, Shahin Hajibandeh, Shahab Hajibandeh, Krishna V Menon, Ki-Hun Kim, A M James Shapiro, Andrea Schlegel

{"title":"Liver transplant for hepatocellular carcinoma in metabolic dysfunction-associated steatotic liver disease versus other etiologies: A meta-analysis.","authors":"Alessandro Parente, Flavio Milana, Shahin Hajibandeh, Shahab Hajibandeh, Krishna V Menon, Ki-Hun Kim, A M James Shapiro, Andrea Schlegel","doi":"10.1016/j.dld.2024.09.025","DOIUrl":"https://doi.org/10.1016/j.dld.2024.09.025","url":null,"abstract":"Background & aims: Liver transplantation for hepatocellular carcinoma (HCC) in metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly being diagnosed and predicted to rise further. We compared outcomes of transplantation for MASLD-related HCC versus other etiologies (OE).Methods: Databases were searched to identify studies comparing outcomes after transplantation MASLD-related HCC with OE-related HCC. Study data were pooled using random-effects modelling. Survival outcomes were analyzed using hazard ratio (HR) for overall survival (OS) and odds ratio (OR) for 1-,3-, and 5-years OS and disease-free survival (DFS).Results: Ten retrospective comparative studies were identified including a total number of 51'761 patients (MASLD-related HCC=6'793, OE-related HCC=44'968). There were no significant differences in time-to-even survival (HR:0.93, CI95 % 0.81-1.07,p = 0.29), 1-year (87.6% vs 88 %;OR:1.15; CI95 %0.73-1.79,p = 0.55), 3-year (77.2% vs 76 %;OR:1.36;CI95 %0.96-1.94,p = 0.08), or 5-year (67.7% vs 66.3 %;OR:1.08; CI95 %0.77-1.53,p = 0.65) OS rates between the groups. DFS was comparable at 1-year (87.9% vs. 87 %; OR:1.07,p = 0.62), 3-years (77.6% vs. 73.6 %;OR:1.66,p = 0.13) and 5-year (68% vs. 65.6 %;OR:1.37,p = 0.39).Conclusion: This meta-analysis of the best available evidence (Level 2a) demonstrated that liver transplantation for MASLD-related and OE-related HCC has comparable survival outcomes. Given the global rise in MASLD-related HCC as indication for transplantation, larger studies from other continents, including Europe and Asia, are needed to confirm our findings.","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Duodenal gastric heterotopia diagnosed by spectral CT. 通过光谱 CT 诊断的十二指肠胃异位症。

IF 4 3区医学

Digestive and Liver Disease Pub Date : 2024-10-28 DOI: 10.1016/j.dld.2024.10.019

Bo Duan, Ying Zhao, Hongliang Li, Qingyu Ji

引用次数: 0

Sarcopenia in patients receiving TIPS is independently associated with increased risk of complications and mortality. 接受 TIPS 治疗的患者中的肌少症与并发症和死亡风险的增加密切相关。

IF 4 3区医学

Digestive and Liver Disease Pub Date : 2024-10-28 DOI: 10.1016/j.dld.2024.10.013

Emma Vanderschueren, Philippe Meersseman, Alexander Wilmer, Vincent Vandecaveye, Evelyne Dubois, Anne Van Eldere, Jan Clerick, Jo P Peluso, Eveline Claus, Lawrence Bonne, Chris Verslype, Geert Maleux, Wim Laleman

{"title":"Sarcopenia in patients receiving TIPS is independently associated with increased risk of complications and mortality.","authors":"Emma Vanderschueren, Philippe Meersseman, Alexander Wilmer, Vincent Vandecaveye, Evelyne Dubois, Anne Van Eldere, Jan Clerick, Jo P Peluso, Eveline Claus, Lawrence Bonne, Chris Verslype, Geert Maleux, Wim Laleman","doi":"10.1016/j.dld.2024.10.013","DOIUrl":"https://doi.org/10.1016/j.dld.2024.10.013","url":null,"abstract":"Background: Sarcopenia is an acknowledged risk factor for individuals with chronic liver disease, however, the influence on outcomes in patients receiving transjugular intrahepatic portosystemic shunt (TIPS) remains underexplored.Aims: This study aimed to investigate the association between sarcopenia and incidence of complications and mortality post-TIPS.Methods: A retrospective analysis was performed on 175 patients who underwent TIPS between 2011-2021 at a Belgian tertiary care center. Transverse psoas muscle thickness (TPMT) was measured at baseline, with a subset of 85 patients having a second TPMT after 1-2 years for assessment of evolution.Results: Over a median follow-up of 453 days (IQR 76-1179), sarcopenic patients exhibited a higher prevalence of complications (74.1% vs. 57.9%, p = 0.04) and one-year mortality (53.4% vs. 22.3%, p < 0.001) post-TIPS. Notably, 58.8% of patients showed an increase >10% from baseline TPMT/length post-TIPS, with the greatest improvement observed in severely sarcopenic patients (4.00 ± 4.55 mm/m vs. -0.82 ± 2.68 mm/m, p < 0.001) and in those patients free from TIPS-related complications (3.18 ± 4.09 mm/m vs. 1.31 ± 3.21 mm/m, p = 0.022).Conclusion: Sarcopenia increases the risk of complications and mortality post-TIPS. Importantly, sarcopenia improves in patients receiving TIPS, particularly in those with severe sarcopenia at baseline and free of TIPS-related complications.","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Feasibility, safety and efficacy of endoscopic submucosal dissection for recurrent superficial rectal neoplastic lesions after transanal microsurgery. 内镜黏膜下剥离术治疗经肛门显微手术后复发的直肠浅表肿瘤病变的可行性、安全性和有效性。

IF 4 3区医学

Digestive and Liver Disease Pub Date : 2024-10-28 DOI: 10.1016/j.dld.2024.10.011

Ali Jaafar, Jeremie Jacques, Sarah Leblanc, Romain Legros, Vincent Lepilliez, Arthur Berger, Edouard Chabrun, Yann Le Baleur, Mathieu Pioche, Maximilien Barret, Timothee Wallenhorst, Thibault Degand, Felix Corre, Marion Schaefer, Xavier Dray

{"title":"Feasibility, safety and efficacy of endoscopic submucosal dissection for recurrent superficial rectal neoplastic lesions after transanal microsurgery.","authors":"Ali Jaafar, Jeremie Jacques, Sarah Leblanc, Romain Legros, Vincent Lepilliez, Arthur Berger, Edouard Chabrun, Yann Le Baleur, Mathieu Pioche, Maximilien Barret, Timothee Wallenhorst, Thibault Degand, Felix Corre, Marion Schaefer, Xavier Dray","doi":"10.1016/j.dld.2024.10.011","DOIUrl":"https://doi.org/10.1016/j.dld.2024.10.011","url":null,"abstract":"Background and aims: We aimed to evaluate the feasibility, safety and efficacy of endoscopic submucosal dissection for recurrent rectal neoplastic lesions after transanal microsurgery of superficial rectal neoplasms.Methods: Multicenter retrospective study.Main outcomes: recurrence at first endoscopic follow-up, En bloc, R0 and curative resections.Results: 39 patients were included. 71 % percent of lesions were located in the lower rectum, 57 % reached the pectineal line. 67 % were laterally spreading tumor granular type, 33 % were protruding lesions. Median size was 41 mm (IQR 30 - 60). Median operation time was 70 min (IQR 35 - 97). 92 % were successfully resected en bloc. R0 and curative resection rates were 77 % and 71 %, respectively. Perirectal fat was visualized in 10 patients, none of them required surgery. One significant hematochezia (3 %), two stenosis (6 %) and one untreatable anal incontinence (3 %) occurred. Median hospital stay after endoscopic submucosal dissection was 2 days (IQR 1-2). Median period for the first endoscopy follow-up was 6 months (IQR 4-8). A single post endoscopic submucosal dissection recurrence adenoma was found during follow-up (3 %), occurring after a non-en bloc resection.Conclusion: Endoscopic submucosal dissection is a good option for safely achieving high rates of complete en bloc resection in cases of recurrent superficial rectal tumor after transanal microsurgery.","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Submucosal tumor-like acute purulent gastritis. 粘膜下肿瘤样急性化脓性胃炎。

IF 4 3区医学

Digestive and Liver Disease Pub Date : 2024-10-28 DOI: 10.1016/j.dld.2024.10.008

Mengpei Zhang, Bo Hong, Minfang Zhou, Lijiang Huang

引用次数: 0

Why and when could nucleos(t)ide analogues treatment be withdrawn? 为什么以及何时可以停止核苷类似物治疗？

IF 4 3区医学

Digestive and Liver Disease Pub Date : 2024-10-28 DOI: 10.1016/j.dld.2024.10.012

Jimmy Che-To Lai, Piero Colombatto, Grace Lai-Hung Wong, Maurizia Rossana Brunetto

{"title":"Why and when could nucleos(t)ide analogues treatment be withdrawn?","authors":"Jimmy Che-To Lai, Piero Colombatto, Grace Lai-Hung Wong, Maurizia Rossana Brunetto","doi":"10.1016/j.dld.2024.10.012","DOIUrl":"https://doi.org/10.1016/j.dld.2024.10.012","url":null,"abstract":"Oral antiviral therapy to hepatitis B virus (HBV) with nucleos(t)ide analogues (NUCs) is effective in suppressing the viral load leading to improved clinical outcomes. However, functional cure of HBV, indicated by hepatitis B surface antigen (HBsAg) clearance from the serum, is rare. Although safety and adherence may represent minor issues in long-term treatment with the available NUCs, more efficacious treatments with finite treatment duration for patients with chronic hepatitis B (CHB) are currently undergoing active clinical investigation. Available data suggest that HBsAg loss can be achieved in 10% to 20% of patients after NUC discontinuation, at the cost of about 50% to 80% virological relapse and 40% to 55% retreatment with NUC. With this, NUC treatment in patients with cirrhosis should not be stopped to avoid detrimental risk of hepatic decompensation and death. Viral and immune biomarkers, which may be potentially useful in stratifying the patients at risk of relapse after stopping NUC therapy, are under investigation. In the era of personalized medicine aided by artificial intelligence tools, tight monitoring of viral kinetics and algorithmic modeling appear a promising strategy to assist in individualized decision and conclude the optimal timing of the NUC treatment discontinuation.","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Utilizing both IgA tissue transglutaminase and IgG-deamidated gliadin peptide antibodies offers accurate celiac disease diagnosis without duodenal biopsy. 利用 IgA 组织转谷氨酰胺酶和 IgG 去酰胺麦胶蛋白肽抗体，无需十二指肠活检即可准确诊断乳糜泻。

IF 4 3区医学

Digestive and Liver Disease Pub Date : 2024-10-28 DOI: 10.1016/j.dld.2024.10.010

Fabiana Zingone, Gary L Norman, Edgardo Smecuol, Daria Maniero, Antonio Carroccio, Federico Biagi, Juan P Stefanolo, Sonia Niveloni, Geoffrey Holmes, Vincenzo Villanacci, Antonella Santonicola, Julio C Bai, Carolina Ciacci

{"title":"Utilizing both IgA tissue transglutaminase and IgG-deamidated gliadin peptide antibodies offers accurate celiac disease diagnosis without duodenal biopsy.","authors":"Fabiana Zingone, Gary L Norman, Edgardo Smecuol, Daria Maniero, Antonio Carroccio, Federico Biagi, Juan P Stefanolo, Sonia Niveloni, Geoffrey Holmes, Vincenzo Villanacci, Antonella Santonicola, Julio C Bai, Carolina Ciacci","doi":"10.1016/j.dld.2024.10.010","DOIUrl":"https://doi.org/10.1016/j.dld.2024.10.010","url":null,"abstract":"Background: Gastroenterologists still raise concerns about adopting a non-biopsy strategy for diagnosing celiac disease (CeD) in adults.Aim: To assess the performance of the concurrent detection of two autoantibodies targeting two independent antigens, tissue transglutaminase (tTG) and deamidated gliadin peptides (DGP).Methods: This prospective, multicenter, binational study collected consecutive patients with a high pre-test probability for CeD. Between 2018 and 2020, adults were enrolled at four Italian and one Argentinian center. Serology was also blindly analyzed by a central laboratory (Werfen, San Diego, USA) for tTG IgA and DGP IgG by Aptiva Particle-based multi-analyte technology (PMAT) assays. CeD diagnosis required histological confirmation of Marsh 3 damage.Results: 181 adult patients with suspected CeD were enrolled (134 with histological diagnosis of CeD and 47 not histologically confirmed as CeD). Patients positive for both tTG IgA and DGP IgG (double positive) were predictive of CeD in 92.5 % of patients at >1x upper limit of normal (ULN). Double positivity for tTG IgA and DGP IgG, both at >10x ULN, had a 100 % positive predictive value for the presence of Marsh 3 histology.Conclusions: Incorporating DGP IgG alongside tTG IgA in a single-step approach can be considered a valid confirmatory strategy for definitive non-biopsy diagnosis of CeD.","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical and imaging predictors for the development of diabetes mellitus following a single episode of acute pancreatitis in youth. 青少年单次急性胰腺炎后发展为糖尿病的临床和影像学预测因素。

IF 4 3区医学

Digestive and Liver Disease Pub Date : 2024-10-26 DOI: 10.1016/j.dld.2024.10.009

Gila Ginzburg, Pradipta Debnath, Yin Zhang, Nadeen Abu Ata, Peter R Farrell, Vineet Garlapally, Nicole Kotha, Tyler Thompson, David S Vitale, Andrew T Trout, Maisam Abu-El-Haija

{"title":"Clinical and imaging predictors for the development of diabetes mellitus following a single episode of acute pancreatitis in youth.","authors":"Gila Ginzburg, Pradipta Debnath, Yin Zhang, Nadeen Abu Ata, Peter R Farrell, Vineet Garlapally, Nicole Kotha, Tyler Thompson, David S Vitale, Andrew T Trout, Maisam Abu-El-Haija","doi":"10.1016/j.dld.2024.10.009","DOIUrl":"https://doi.org/10.1016/j.dld.2024.10.009","url":null,"abstract":"Background: Acute pancreatitis (AP) increases the risk of diabetes mellitus (DM). Our aim was to identify clinical, laboratory and imaging predictors of preDM/DM in youth post index AP.Methods: This was a prospective cohort study of patients ≤21 years-old with an index admission for AP and follow up at 3 and/or 12 months. Clinical laboratory values, imaging findings, admission course, and plasma chemokine and cytokine measures collected at index admission were tested for association with preDM/DM development. A multivariable regression model was used to predict preDM/DM.Results: Among 187 enrolled participants, 137 (73 %) and 144 (77 %) underwent DM screening at 3 and 12 months respectively, and 137 (73 %) had imaging available. PreDM/DM occurred in 22/137 (16 %; preDM n = 21, DM n = 1) at 3 months and 23/144 (16 %; preDM n = 18, DM n = 5) participants at 12 months. Univariate associations with preDM/DM at 12 months included: severe AP (SAP) (52 % preDM/DM vs. 17 % no DM; p = 0.0008), median [IQR] IL-6 (910 pg/ml [618-3438] vs. 196 pg/ml [71-480], p < 0.05) and CRP (4.16 mg/L [1.67-10.7] vs. 1.55 mg/L [0.4-3.68], p = 0.1) at time of AP attack. The optimal multivariable model to predict preDM/DM included with clinical variables was severe acute pancreatitis (SAP), c reactive protein (CRP), interleukin-6 (IL-6), and age [AUC = 0.80; (0.70, 0.88)]. Including imaging markers, the ideal model included SAP, CRP, IL-6, subcutaneous fat area, age and presence of autoimmune disease with an AUC [0.82 (0.71, 0.90)].Conclusions: Development of preDM/DM following an index AP episode can be predicted by baseline AP severity, baseline CRP, IL-6 levels, and subcutaneous fat area.","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Safety of endoscopist-directed nurse-administered sedation in an Italian referral hospital: An audit of 2 years and 19,407 procedures. 意大利一家转诊医院由内镜医师指导护士使用镇静剂的安全性：对 2 年和 19,407 例手术的审计。

IF 4 3区医学

Digestive and Liver Disease Pub Date : 2024-10-26 DOI: 10.1016/j.dld.2024.10.007

R Conigliaro, F Pigò, M Gottin, G Grande, S Russo, S Cocca, M Marocchi, M Lupo, M Marsico, S Sculli, H Bertani

{"title":"Safety of endoscopist-directed nurse-administered sedation in an Italian referral hospital: An audit of 2 years and 19,407 procedures.","authors":"R Conigliaro, F Pigò, M Gottin, G Grande, S Russo, S Cocca, M Marocchi, M Lupo, M Marsico, S Sculli, H Bertani","doi":"10.1016/j.dld.2024.10.007","DOIUrl":"https://doi.org/10.1016/j.dld.2024.10.007","url":null,"abstract":"Background and study aims: Balanced propofol sedation (BPS) administered by adequately trained non-anaesthesiologist personnel has gained popularity in GI endoscopy because of its shorter procedure and recovery time, high patient satisfaction, and low rate of adverse events (AEs), despite being considered controversial. We report data from an audit of endoscopist-directed (ED) nurse-administered sedation in an Italian referral hospital.Patients and methods: Consecutive endoscopic procedures performed between 2020 and 2022 were considered. Under the guidance of the endoscopist, the nurse administered midazolam/fentanyl, followed by a progressive top-up dosage of a 10-20 mg bolus of propofol to achieve moderate to deep sedation. The endoscopists and nurses were all certified in our hospital with a continuous and scheduled training from 2006.Results: During the study period, a total of 19,407 examinations (7,803 EGDS, 10,439 colonoscopies, 77 PEG, 697 EUS, and 365 ERCP) and 14,415 patients were included. Of these, 29.4 % of patients were classified as ASA I, 66.5 % as ASA II, and 5.1 % as ASA III. Hypotension was recorded in 1,293 (6 %) examinations and bradycardia in 176 (0.9 %) patients. Eleven patients (0.06 %) had minor respiratory adverse events. Two patients (0.01 %) had major AEs requiring orotracheal intubation.Conclusions: ED-BPS is safe in low-risk patients. Major AEs occurred in 0.01 % of procedures.","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0