Qianxin Huang , Qingqiao Zhang , Hao Xu , Maoheng Zu , Yuming Gu , He Ma , Wei Kang , Caifang Ni
{"title":"Clinical characteristics and risk factors of hepatocellular carcinoma development in Budd-Chiari syndrome patients after endovascular treatment","authors":"Qianxin Huang , Qingqiao Zhang , Hao Xu , Maoheng Zu , Yuming Gu , He Ma , Wei Kang , Caifang Ni","doi":"10.1016/j.dld.2025.02.008","DOIUrl":"10.1016/j.dld.2025.02.008","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Endovascular treatment has improved Budd-Chiari syndrome (BCS) patient outcomes, but patients remain at risk for developing hepatocellular carcinoma (HCC). We aimed to analyse the characteristics and risk factors for HCC development in BCS patients after endovascular treatment.</div></div><div><h3>Methods</h3><div>Clinical data of BCS patients who had received endovascular treatment were retrospectively reviewed. Characteristics of BCS patients who developed HCC post-treatment were compared with those without HCC development. Univariable and multivariable Cox regression analyses were used to determine the risk factors.</div></div><div><h3>Results</h3><div>We enrolled 302 BCS patients. HCC was confirmed in 31 patients after treatment. Early-stage tumours were the most common (11/31, 35.5 %) according to the Barcelona Clinic Liver Cancer staging system. A serum alpha fetoprotein (AFP) cut-off level of > 15.7 ng/mL showed a sensitivity of 69.3 % and specificity of 97.4 % for detecting HCC in these patients. The presence of preoperative liver cirrhosis (hazard ratio (HR)=4.677; <em>P</em> = 0.043) and postoperative restenosis (HR=6.867; <em>P</em> < 0.001) were independent risk factors associated with HCC development in BCS patients after endovascular treatment.</div></div><div><h3>Conclusion</h3><div>HCCs that develop after endovascular treatment in BCS patients are often detected at an early stage. Preoperative liver cirrhosis and postoperative restenosis were independent risk factors for HCC development in these individuals.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"57 6","pages":"Pages 1301-1307"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691079","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}
Simone Di Cola , Jakub Gazda , Stefano Fonte , Lucia Lapenna , Silvia Nardelli , Giulia Cusi , Adriano De Santis , Manuela Merli
{"title":"The impact of bacterial infection on the risk of portal vein thrombosis development in patients with cirrhosis: A post-hoc analysis","authors":"Simone Di Cola , Jakub Gazda , Stefano Fonte , Lucia Lapenna , Silvia Nardelli , Giulia Cusi , Adriano De Santis , Manuela Merli","doi":"10.1016/j.dld.2025.03.024","DOIUrl":"10.1016/j.dld.2025.03.024","url":null,"abstract":"<div><h3>Background</h3><div>Portal vein thrombosis (PVT) is a common complication in liver cirrhosis. Bacterial infections (BIs) may increase PVT risk through bacterial translocation, systemic inflammation, and coagulation dysfunction, but evidence is limited.</div></div><div><h3>Aims</h3><div>This study investigates the 6-month risk of onset of PVT in patients hospitalized with BIs.</div></div><div><h3>Methods</h3><div>This post-hoc analysis included 563 cirrhotic patients hospitalized between 2011 and 2021, with or without BIs diagnosis, and followed for 6 months post-discharge. Patients with HCC outside of Milan criteria were excluded. The main endpoint was the onset of PVT, diagnosed via abdominal ultrasound or CT/MRI.</div></div><div><h3>Results</h3><div>BI was diagnosed in 146 patients (26 %). Forty-seven patients (8.5 %) experienced PVT events within 6 months, including 15 (10 %) with BIs and 32 (7.8 %) without (<em>p</em> = 0.4). Logistic regression showed no significant effect of BI on PVT occurrence (OR 1.35, 95 % CI 0.69–2.54), even after adjusting for confounding factors. However, urinary tract infections were independently associated with higher PVT risk (OR 3.17, 95 % CI 1.05–10.8, <em>p</em> = 0.048). Other infection sites (pneumonia, spontaneous bacterial peritonitis-SBP, spontaneous bacteremia) and isolated microbial strains (<em>n</em> = 77) were not associated with increased PVT risk. When analyzing the population excluding patients with HCC, the risk of developing PVT was significantly higher in patients with previous BI, regardless of the severity of liver disease (OR 2.92, 95 % CI 1.06–8.16).</div></div><div><h3>Conclusions</h3><div>In this large cohort, BIs did not significantly increase PVT risk within 6 months post-hospitalization in cirrhotic patients. However, when the cohort was reduced to patients without HCC, the risk of PVT appears to be significant.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"57 6","pages":"Pages 1260-1265"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976384","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}
Carlo Felix Maria Jung , Cecilia Binda , Elisa Liverani , Elton Dajti , Carmela Abbatiello , Ludovica Cristofaro , Luigina Vanessa Alemanni , Alessandro Sartini , Barbara Perini , Paolo Giuffrida , Chiara Coluccio , Giulia Gibiino , Stefano Fabbri , Carla Serra , Carlo Fabbri
{"title":"Diagnosis and staging of chronic pancreatitis-Diagnostic accuracy and agreement between endoscopic ultrasound and transabdominal ultrasound shear wave elastography","authors":"Carlo Felix Maria Jung , Cecilia Binda , Elisa Liverani , Elton Dajti , Carmela Abbatiello , Ludovica Cristofaro , Luigina Vanessa Alemanni , Alessandro Sartini , Barbara Perini , Paolo Giuffrida , Chiara Coluccio , Giulia Gibiino , Stefano Fabbri , Carla Serra , Carlo Fabbri","doi":"10.1016/j.dld.2025.03.013","DOIUrl":"10.1016/j.dld.2025.03.013","url":null,"abstract":"<div><h3>Background</h3><div>Diagnosis of chronic pancreatitis (CP) is invasive and depending on endoscopic ultrasound (EUS) evaluation using Rosemont Criteria (RC). Non invasive ultrasound (US) based tests are necessary to detect CP.</div></div><div><h3>Aim</h3><div>We compared transabdominal 2D Shear Wave Elastography (SWE) of the pancreas and the Gemelli Ultrasound Chronic Pancreatitis Score to EUS/RC for the diagnosis of chronic pancreatitis.</div></div><div><h3>Methods</h3><div>We conducted a single center prospective case-control study. EUS with RC defined cohorts with (<em>n</em> = 51) and without CP (<em>n</em> = 51). Patients underwent US evaluation of the pancreas using 2D SWE and USCP.</div></div><div><h3>Results</h3><div>Median SWE values were different between groups (no CP 1.45m/s; IQR 1.34–1.60 and with CP 1.72m/s; IQR 1.63–1.96; <em>p</em> < 0.0001) and different between RC subgroups (RC indeterminate for CP 1.67m/s, IQR 1.52–1.72 vs. RC suggestive 1.72m/s, IQR 1.62–1.97 vs. RC consistent with CP 1.90 m/s, IQR 1.72–2.12 m/s; <em>p</em> < 0.0001). Median USCP was different between groups. 2D SWE correlated with USCP (<em>p</em> < 0.0001) and RC (<em>p</em> < 0.0001). We defined a cut off SWE value of <1.42m/s to rule out CP (Sensitivity 96 %; NPV 92 %) and a SWE cut off >1.87m/s to diagnose CP (Specifity 96 %;PPV 90 %).</div></div><div><h3>Conclusion</h3><div>Pancreatic US evaluation with 2D SWE is a widely applicable and unexpensive tool for the diagnosis of CP. Larger studies are needed to confirm these results.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"57 6","pages":"Pages 1280-1287"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988028","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}
{"title":"Author's reply: “Aetiology-specific inflammation patterns in patients and rat models of compensated cirrhosis: New perspectives and recommendations”","authors":"Benedikt Silvester Hofer , Thomas Reiberger","doi":"10.1016/j.dld.2025.04.022","DOIUrl":"10.1016/j.dld.2025.04.022","url":null,"abstract":"","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"57 6","pages":"Pages 1350-1351"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995731","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}
Jiayu Feng , Rongdang Fu , Lei Zhang , Dong Yang , Hanbing Wang
{"title":"The significance of the modified surgical apgar score in predicting postoperative acute kidney injury among patients undergoing hepatectomy","authors":"Jiayu Feng , Rongdang Fu , Lei Zhang , Dong Yang , Hanbing Wang","doi":"10.1016/j.dld.2025.01.207","DOIUrl":"10.1016/j.dld.2025.01.207","url":null,"abstract":"<div><h3>Aim</h3><div>The incidence of acute kidney injury (AKI) following hepatectomy ranges from 0.9 % to 21.6 %. Postoperative AKI is associated with increased mortality, prolonged hospital stays, and more healthcare costs. Previous predictive models either neglected intraoperative factors or were excessively complicated for application. Based on estimated blood loss, minimum heart rate, and minimum mean arterial pressure, the Surgical Apgar Score (SAS) has been validated as an indicator of major complications and outcomes following surgeries. Furthermore, previous studies have linked hematocrit levels to the incidence of AKI. Our aim was to determine whether the modified SAS, calculated using both SAS and hematocrit, could accurately predict AKI following hepatectomy.</div></div><div><h3>Methods</h3><div>This retrospective study ultimately enrolled 960 patients who underwent hepatectomy. The study included a total of 28 preoperative and intraoperative variables. Univariate and multivariate logistic regression analyses were performed to determine the predictive ability of the modified SAS.</div></div><div><h3>Results</h3><div>We demonstrated significant associations between the modified SAS and the incidence of AKI (OR 0.65, 95 % CI 0.54–0.78, <em>p</em> < 0.001). A lower total score increases the likelihood of postoperative AKI, with a cutoff value set at 9.</div></div><div><h3>Conclusions</h3><div>The modified SAS appears to be a valid predictive factor for AKI following hepatectomy.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"57 6","pages":"Pages 1288-1293"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472306","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}
{"title":"AI-based measurement of adipose body composition in patients with acute pancreatitis: The holy grail to define the prognosis?","authors":"Antonio Facciorusso , Enrique De-Madaria","doi":"10.1016/j.dld.2025.02.012","DOIUrl":"10.1016/j.dld.2025.02.012","url":null,"abstract":"","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"57 6","pages":"Pages 1216-1217"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604327","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}
María José Casanova, María Chaparro, Javier P. Gisbert
{"title":"Author's Reply: “Ustekinumab and vedolizumab: A step forward in managing complex perianal fistulas in Crohn's disease”","authors":"María José Casanova, María Chaparro, Javier P. Gisbert","doi":"10.1016/j.dld.2025.04.005","DOIUrl":"10.1016/j.dld.2025.04.005","url":null,"abstract":"","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"57 6","pages":"Pages 1340-1341"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062799","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}
Hanfeng Guo , Decai Zhang , Zhaoqi Li , Shaojun Liu , Rui Wang
{"title":"Global burden of gallbladder cancer in 2022 and predictions to 2042","authors":"Hanfeng Guo , Decai Zhang , Zhaoqi Li , Shaojun Liu , Rui Wang","doi":"10.1016/j.dld.2025.02.007","DOIUrl":"10.1016/j.dld.2025.02.007","url":null,"abstract":"<div><h3>Background & Aims</h3><div>This study aims to provide updated estimate on the global burden of Gallbladder cancer (GBC) in 2022 and to predict the trends through the year 2042.</div></div><div><h3>Methods</h3><div>Data were extracted from GLOBOCAN 2022 database. Incidence and mortality rates were calculated by sex, country, world region and Human Development Index (HDI). Trends up to the year 2042 were predicted based on global demographic projections by HDI.</div></div><div><h3>Results</h3><div>Worldwide, there were 122,469 new GBC cases and 89,045 deaths identified in 2022. While the highest absolute number was observed in South Central Asia and Eastern Asia, particularly India and China, countries in South America, particularly Bolivia, showed the highest age-standardised rate. Medium HDI countries showed more than double the incidence and mortality rates compared to low HDI countries. Over half of GBC cases and deaths occurred in individuals aged 50–74 years. Predictions indicate a 65.3 % increase in new cases and a 67.6 % increase in deaths by 2042, with High HDI countries and Low HDI countries experiencing the largest absolute and percentage increases, respectively.</div></div><div><h3>Conclusions</h3><div>The global burden of GBC is substantial, especially concentrated in South Central Asia, Eastern Asia and South America. With significant increase of burden over the next 20 years, there is an urgent need for effective cancer control strategies in regions exhibiting great GBC burden.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"57 6","pages":"Pages 1294-1300"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624038","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}
{"title":"Comment on “Intrahepatic cholangiocarcinoma with FGFR alterations: A series of Chinese cases with an emphasis on their clinicopathologic and genetic features”","authors":"Preeti Advani, Santosh Kumar","doi":"10.1016/j.dld.2025.02.023","DOIUrl":"10.1016/j.dld.2025.02.023","url":null,"abstract":"<div><div><Dummy abstract></div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"57 6","pages":"Page 1354"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639560","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}