Expert Review of Gastroenterology & Hepatology最新文献

A practical guide to dilating inflammatory bowel disease strictures.

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-03-03 DOI: 10.1080/17474124.2025.2471873

Natasha K Klemm, Joseph D Feuerstein

{"title":"A practical guide to dilating inflammatory bowel disease strictures.","authors":"Natasha K Klemm, Joseph D Feuerstein","doi":"10.1080/17474124.2025.2471873","DOIUrl":"10.1080/17474124.2025.2471873","url":null,"abstract":"Introduction: Stricturing Crohn's disease is a common phenotype and treatment aims to improve symptoms, prevent complications, assess for proximal bowel disease activity, and screen for upstream neoplasm. Management is challenging due to diagnostic limitations, stricture composition, and recurrence rate.Areas covered: Categorizing a stricture as inflammatory or fibrotic is necessary to determine appropriate management. Inflammatory strictures are treated with medical therapy, and fibrostenotic strictures require endoscopic or surgical management. While EBD is increasingly utilized, stricture recurrence rates remain high, necessitating repeat endoscopic procedures or surgery. We performed a PubMed (MEDLINE database) search for the latest research on IBD-related stricture management, including detection, diagnosis, and medical and procedural therapies. We highlight the current literature on endoscopic techniques for the treatment of intestinal strictures and future areas of research.Expert opinion: The field of intestinal stricture management is expected to evolve in the coming years and will include enhanced imaging modalities, medication optimization, and increasing use of advanced endoscopic techniques.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-11"},"PeriodicalIF":3.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482574","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

Cholestatic liver diseases: modern therapeutics.

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-03-02 DOI: 10.1080/17474124.2025.2473490

Bridgette B McNally, Elizabeth J Carey

{"title":"Cholestatic liver diseases: modern therapeutics.","authors":"Bridgette B McNally, Elizabeth J Carey","doi":"10.1080/17474124.2025.2473490","DOIUrl":"10.1080/17474124.2025.2473490","url":null,"abstract":"Introduction: Cholestatic liver disease encompasses a broad group of disorders related to impaired normal bile formation, secretion, or excretion. These diseases present with symptoms of fatigue, jaundice, pruritus, and biochemical changes.Areas covered: We focus on updates in the management of autoimmune cholestatic liver disease. The mainstay therapy in PBC is UDCA (ursodeoxycholic acid), but OCA (obeticholic acid) can be considered if suboptimal response or intolerance. Fibrates have shown some promising effects in PBC patients who have not responded to or are intolerant of UDCA and/or OCA; however, they are not FDA approved. Peroxisome Proliferator-Activated Receptor Agonists (PPARs) have emerged as a promising new class of oral agents in PBC. Also, Ileal Bile Acid Transporter (IBAT) inhibitors are being investigated for the treatment of pruritus related to PBC. There are no available treatments for PSC; however, there have been previous investigations into many agents. There are ongoing clinical trials investigating the role of various antibiotics, PPARs, and immunomodulators for the treatment of PSC.Expert opinion: Ongoing investigations into the treatment of both PBC and PSC are essential. We anticipate that alternative management strategies for PBC and PSC will continue to arise in the next 5-10 years.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-6"},"PeriodicalIF":3.8,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515047","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

Arterial stiffness as a complication of metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis.

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-02-28 DOI: 10.1080/17474124.2025.2471871

Alexios Giannakodimos, Evangelos Oikonomou, Panteleimon Pantelidis, Panagiotis Theofilis, Niki Katsiki, Athina Goliopoulou, Georgios E Zakynthinos, Emmanouil Korakas, Vasiliki Kalogera, Maciej Banach, Vaia Lampadiari, Eva Kassi, Ignatios Ikonomidis, Gerasimos Siasos

{"title":"Arterial stiffness as a complication of metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis.","authors":"Alexios Giannakodimos, Evangelos Oikonomou, Panteleimon Pantelidis, Panagiotis Theofilis, Niki Katsiki, Athina Goliopoulou, Georgios E Zakynthinos, Emmanouil Korakas, Vasiliki Kalogera, Maciej Banach, Vaia Lampadiari, Eva Kassi, Ignatios Ikonomidis, Gerasimos Siasos","doi":"10.1080/17474124.2025.2471871","DOIUrl":"10.1080/17474124.2025.2471871","url":null,"abstract":"Introduction: The purpose of this systematic review and meta-analysis is to investigate the association of metabolic dysfunction-associated steatotic liver disease (MASLD) with arterial stiffness and enlighten on potential cardiometabolic co-factors.Methods: A literature search in PubMed/Medline, Embase, Scopus, and Web of Science databases was conducted. All the observational studies comparing arterial stiffness indices between adults with Non-alcoholic Fatty Liver Disease (NAFLD), Metabolic Dysfunction Associated-Fatty Liver Disease (MAFLD), or MASLD and apparently healthy individuals with normal liver function were included. Pulse wave velocity (PWV) and augmentation index (AIx) were mainly used as arterial stiffness indices.Results: Fourty one unique studies were included in the systematic review, with 27 deemed eligible for meta-analysis. Patients with MASLD had increased carotid-femoral PWV (14 studies, Mean difference (MD): 0.96 m/s, 95% confidence interval (CI) 0.65-1.27, p < 0.001) compared with healthy individuals. This finding was independent from body mass index, triglycerides, high-density lipoprotein, systolic blood pressure, and fasting plasma glucose. Moreover, patients with MASLD had higher brachial-ankle PWV (13 studies, MD: 78.14 cm/s, 95% CI 60.37-95.90, p < 0.001) and AIx (7 studies, MD: 3.85%, 95% CI 0.87-6.82, p = 0.0195) compared with controls.Conclusions: MASLD is correlated with increased arterial stiffness. This relation is unaffected by common cardiometabolic risk factors.Registration: PROSPERO (ID: CRD42023468258).","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-14"},"PeriodicalIF":3.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482575","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

The reliability of freely accessible, baseline, general-purpose large language model generated patient information for frequently asked questions on liver disease: a preliminary cross-sectional study.

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-02-27 DOI: 10.1080/17474124.2025.2471874

Madunil A Niriella, Pathum Premaratna, Mananjala Senanayake, Senerath Kodisinghe, Uditha Dassanayake, Anuradha Dassanayake, Dileepa S Ediriweera, H Janaka de Silva

{"title":"The reliability of freely accessible, baseline, general-purpose large language model generated patient information for frequently asked questions on liver disease: a preliminary cross-sectional study.","authors":"Madunil A Niriella, Pathum Premaratna, Mananjala Senanayake, Senerath Kodisinghe, Uditha Dassanayake, Anuradha Dassanayake, Dileepa S Ediriweera, H Janaka de Silva","doi":"10.1080/17474124.2025.2471874","DOIUrl":"10.1080/17474124.2025.2471874","url":null,"abstract":"Background: We assessed the use of large language models (LLMs) like ChatGPT-3.5 and Gemini against human experts as sources of patient information.Research design and methods: We compared the accuracy, completeness and quality of freely accessible, baseline, general-purpose LLM-generated responses to 20 frequently asked questions (FAQs) on liver disease, with those from two gastroenterologists, using the Kruskal-Wallis test. Three independent gastroenterologists blindly rated each response.Results: The expert and AI-generated responses displayed high mean scores across all domains, with no statistical difference between the groups for accuracy [H(2) = 0.421, p = 0.811], completeness [H(2) = 3.146, p = 0.207], or quality [H(2) = 3.350, p = 0.187]. We found no statistical difference between rank totals in accuracy [H(2) = 5.559, p = 0.062], completeness [H(2) = 0.104, p = 0.949], or quality [H(2) = 0.420, p = 0.810] between the three raters (R1, R2, R3).Conclusion: Our findings outline the potential of freely accessible, baseline, general-purpose LLMs in providing reliable answers to FAQs on liver disease.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-6"},"PeriodicalIF":3.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476091","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

An expert's guide to classical manometric patterns seen in high-resolution colonic manometry.

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-02-27 DOI: 10.1080/17474124.2025.2468301

Phil G Dinning

{"title":"An expert's guide to classical manometric patterns seen in high-resolution colonic manometry.","authors":"Phil G Dinning","doi":"10.1080/17474124.2025.2468301","DOIUrl":"10.1080/17474124.2025.2468301","url":null,"abstract":"Introduction: High-resolution colonic manometry is a research and diagnostic tool used to evaluate colonic motility. Used in health it helps us understand normal colonic motility and the colonic response to physiological stimuli such as meal, as well as chemical (laxatives) and mechanical (distension) stimuli. In pediatric and adult patients with suspected colonic disorders, it can help to understand the abnormal colonic motility associated with the condition.Area covered: High-resolution manometric catheters contain multiple closely spaced sensors that detect intraluminal pressure changes and contractile force, which can be interpreted as contractile activity. This activity forms several distinctive motor patterns that help in understanding normal colonic physiology and provide insights into the potential pathophysiology underlying colonic disorders such as constipation. After a PubMed search of colonic high-resolution manometry studies, this review provides an overview of the characterized motor patterns, when they occur, how they are initiated, their clinical relevance, and their role, if any, in guiding therapeutic interventions.Expert opinion: High-resolution colonic manometry has identified motor patterns that were missed or mislabeled by low-resolution recordings. How best to use this information to guide treatment remains to be determined.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-14"},"PeriodicalIF":3.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425437","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

The role of immunogenicity in optimizing biological therapies for inflammatory bowel disease.

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-02-25 DOI: 10.1080/17474124.2025.2468302

Konika Sharma, Bruno César da Silva, Stephen B Hanauer

{"title":"The role of immunogenicity in optimizing biological therapies for inflammatory bowel disease.","authors":"Konika Sharma, Bruno César da Silva, Stephen B Hanauer","doi":"10.1080/17474124.2025.2468302","DOIUrl":"10.1080/17474124.2025.2468302","url":null,"abstract":"Introduction: Immunogenicity of biologic agents for inflammatory bowel disease (IBD) is a critical issue, especially for tumor necrosis factor (TNF) inhibitors, where anti-drug antibodies (ADAs) significantly impact drug clearance, efficacy, and safety. Studies have demonstrated that non-TNF biologics tend to have lower susceptibility to immunogenicity, potentially offering advantages, especially in long-term management. Understanding these differences is important for optimizing IBD treatment outcomes.Areas covered: This review examines immunogenicity associated with different classes and individual biologic agents used in IBD; including TNF inhibitors and biologics targeting integrins and interleukins. We discuss key factors influencing ADAs formation, including drug structure, route of administration, and patient-specific factors. The literature reviewed includes recent clinical studies and long-term trials focusing on strategies to reduce immunogenicity such as therapeutic drug monitoring (TDM) and advanced combination.Expert opinion: While newer biologics demonstrate lower immunogenicity compared to anti-TNF agents, challenges remain in management to overcome existing ADAs responses while advances in genetic profiling, point-of-care TDM, and combination therapies offer promising pathways to reduce immunogenicity and enhance treatment durability. Continued research and innovation in biologic delivery methods, such as oral and subcutaneous formulations, will be critical in the next decade to further mitigate immunogenic risks and improve patient outcomes.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-16"},"PeriodicalIF":3.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440414","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

Endoscopic ultrasound guided liver biopsy and portal pressure gradient: when, why and how? Can it become the standard of care in endo-hepatology?

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-02-25 DOI: 10.1080/17474124.2025.2469838

Jahnvi Dhar, Amit Yadav, Suvradeep Mitra, Zaheer Nabi, Manik Aggarwal, Pankaj Gupta, Antonio Facciorusso, Stefano Francesco Crinò, Guru Trikudanathan, Jayanta Samanta

{"title":"Endoscopic ultrasound guided liver biopsy and portal pressure gradient: when, why and how? Can it become the standard of care in endo-hepatology?","authors":"Jahnvi Dhar, Amit Yadav, Suvradeep Mitra, Zaheer Nabi, Manik Aggarwal, Pankaj Gupta, Antonio Facciorusso, Stefano Francesco Crinò, Guru Trikudanathan, Jayanta Samanta","doi":"10.1080/17474124.2025.2469838","DOIUrl":"10.1080/17474124.2025.2469838","url":null,"abstract":"Introduction: The armamentarium of 'Endo-hepatology' is proliferating with the advancements in techniques and availability of new devices in the field of endoscopic ultrasound (EUS). This has resulted in the merger of multitude of diagnostic and therapeutic interventions, such as EUS-liver biopsy (LB), EUS-angioembolization of gastric varices, EUS-portal pressure gradient (PPG) measurement, and others into a 'one-stop-shop' for efficient patient management. Lack of standardization of these techniques forms a major hinderance in their widespread adoption.Areas covered: A comprehensive literature search was undertaken across various databases on EUS-LB and EUS-PPG till November 2024 for reviews, observational studies, and randomized trials on EUS-LB and EUS-PPG, describing its indications, technique, and data of safety and efficacy, detailing its role in day-to-day clinical practice.Expert opinion: EUS-LB and EUS-PPG have shown promise in the ever-growing field of endo-hepatology. EUS-LB has exhibited excellent safety profile and comparable tissue yield compared to its percutaneous counterpart. On the other hand, EUS-PPG seems to be a viable alternative although it needs to be standardized further. From a patient and hospital perspective, they might prove to be convenient and cost-effective. Nevertheless, more evidence is warranted before they can be labeled as the new standard of care.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-18"},"PeriodicalIF":3.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467547","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

Progressing advanced therapies for inflammatory bowel disease: Current status including dual biologic therapy and discontinuation of biologics.

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-02-24 DOI: 10.1080/17474124.2025.2469832

Kazuo Yashima, Hiroki Kurumi, Naoyuki Yamaguchi, Hajime Isomoto

{"title":"Progressing advanced therapies for inflammatory bowel disease: Current status including dual biologic therapy and discontinuation of biologics.","authors":"Kazuo Yashima, Hiroki Kurumi, Naoyuki Yamaguchi, Hajime Isomoto","doi":"10.1080/17474124.2025.2469832","DOIUrl":"10.1080/17474124.2025.2469832","url":null,"abstract":"Introduction: Advanced therapies (ADT) that encompass biological agents and small molecules have been approved for the treatment of inflammatory bowel disease (IBD), broadening the spectrum of available treatment options. Nevertheless, a substantial proportion of patients fail to achieve satisfactory responses, necessitating surgical intervention. Treatment objectives have evolved beyond clinical remission, reduction of inflammation, and mucosal healing, shifting focus toward enhancing the quality of life, acknowledging the profound impact of IBD on physical and mental well-being.Area covered: This comprehensive review describes the current landscape of ADT for IBD, including dual biologic therapy (DBT), which involves the combination of two biologics or a single biologic with a small-molecule compound, as well as considerations surrounding the discontinuation of biologics.Expert opinion: ADT is the standard treatment for moderate to severe IBD, while DBT appears promising for specific subsets of patients, including those with refractory disease or extraintestinal manifestations. However, these approaches may increase the risk of adverse effects, including malignancy. To optimize individualized treatment strategies in patients with refractory IBD, further trials are needed to refine ADT's predictive value, establish DBT's safety and indications, define biologic discontinuation criteria, and evaluate emerging biomarkers, artificial intelligence, and bowel ultrasound in patient management.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-20"},"PeriodicalIF":3.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448609","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

Psychosocial risks in metabolic dysfunction-associated steatotic liver disease.

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-02-22 DOI: 10.1080/17474124.2025.2468297

Hanne Åström, Christine Takami Lageborn, Hannes Hagström

{"title":"Psychosocial risks in metabolic dysfunction-associated steatotic liver disease.","authors":"Hanne Åström, Christine Takami Lageborn, Hannes Hagström","doi":"10.1080/17474124.2025.2468297","DOIUrl":"10.1080/17474124.2025.2468297","url":null,"abstract":"Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly becoming more prevalent in the general population. MASLD is more common in persons with low socioeconomic status (SES), yet little is known about the psychosocial challenges associated with this disease, and clinical recommendations on how to approach psychosocial challenges are lacking.Areas covered: A PubMed search using the search terms MASLD, psychosocial risks, stigmatization, psychiatric comorbidities (i.e. depression, bipolar disorder, psychosis, attention deficit hyperactivity disorder, and substance abuse), SES, quality of life (QoL), over the past 20 years (2004-2024) was performed.Expert opinion: Persons with MASLD often experience psychosocial adversities that may be expressed as lower SES, high prevalence of depression, and reduced QoL. Knowledge gaps remain regarding the association between severe mental disorders (e.g. psychosis and bipolar disorders). Timely detection and treatment of MASLD in persons with psychosocial risks may require attention and cross-field collaboration. Studies on QoL in persons with MASLD differ in methodology which makes formal comparisons difficult. Psychosocial adversity may be a barrier to lifestyle modifications, which remain the cornerstone of MASLD management. Guidelines on how to address psychosocial adversities in a clinical setting are warranted to improve outcomes and decrease further multimorbidity.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-18"},"PeriodicalIF":3.8,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425438","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

Comprehensive management of gastrointestinal fistulas in necrotizing pancreatitis: a review of diagnostic and therapeutic approaches.

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-02-19 DOI: 10.1080/17474124.2025.2469835

Dujiang Yang, Lingrui Yue, Bowen Tan, Weiming Hu, Mao Li, Huimin Lu

{"title":"Comprehensive management of gastrointestinal fistulas in necrotizing pancreatitis: a review of diagnostic and therapeutic approaches.","authors":"Dujiang Yang, Lingrui Yue, Bowen Tan, Weiming Hu, Mao Li, Huimin Lu","doi":"10.1080/17474124.2025.2469835","DOIUrl":"https://doi.org/10.1080/17474124.2025.2469835","url":null,"abstract":"Introduction: Gastrointestinal fistula (GIF) is a rare but severe complication in patients with necrotizing pancreatitis (NP), significantly prolonging disease course and increasing morbidity and mortality. Its subtle and nonspecific early symptoms often delay diagnosis and intervention. Despite its clinical significance, the low incidence of GIF in NP has resulted in limited research and a lack of consensus on optimal diagnostic and therapeutic strategies.Areas covered: This review focuses on the epidemiology, pathophysiology, diagnostic approaches, and therapeutic management of GIF in NP patients. Imaging techniques, such as contrast-enhanced computed tomography and endoscopy, have been integral to early diagnosis. Advances in interventional and surgical techniques provide new avenues for treatment, but variability in clinical practice highlights the need for standardized protocols.Expert opinion: Recent advances in diagnostic imaging have improved the detection of GIF, while innovations in interventional and surgical treatments show promise. Current research is still insufficient and varied. Future research should focus on developing diagnostic methods and treatment measures for such complications. By improving early diagnosis and offering insights into effective management strategies, it is hoped that patient outcomes can be improved.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448606","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