Expert Review of Gastroenterology & Hepatology最新文献

Rethinking selection criteria for liver transplantation in hepatocellular carcinoma: from morphology to artificial intelligence. 重新思考肝癌肝移植选择标准：从形态学到人工智能。

IF 3.3 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2026-10-18 DOI: 10.1080/17474124.2026.2750985

Quirino Lai, Silvia Quaresima, Chiara Matrascia, Fabio Melandro

{"title":"Rethinking selection criteria for liver transplantation in hepatocellular carcinoma: from morphology to artificial intelligence.","authors":"Quirino Lai, Silvia Quaresima, Chiara Matrascia, Fabio Melandro","doi":"10.1080/17474124.2026.2750985","DOIUrl":"https://doi.org/10.1080/17474124.2026.2750985","url":null,"abstract":"Introduction: Liver transplantation (LT) is a uniquely curative treatment for hepatocellular carcinoma (HCC), as it removes both the tumor and the underlying cirrhotic liver. However, organ scarcity makes candidate selection a central clinical and ethical issue. Over the past three decades, selection has evolved from simple morphologic thresholds toward increasingly multidimensional models of oncologic risk.Areas covered: This review examines the evolution of selection criteria for LT in HCC, from the Milan criteria and subsequent morphology-based expansions to models incorporating tumor biology, serum biomarkers, treatment response, waiting-list dynamics, and artificial intelligence. The literature discussed includes landmark morphologic criteria, AFP-based models, PIVKA-II and AFP-L3 integration, downstaging strategies, dynamic scores such as TRAIN and NYCA, and machine-learning models including MoRAL-AI, TRIUMPH, and TRAIN-AI.Expert opinion: The field is moving from categorical eligibility rules toward individualized, continuous risk estimation. Future selection should not aim merely to expand transplant access, but to identify patients most likely to achieve durable oncologic benefit. Artificial intelligence, radiomics, liquid biopsy, and multi-omic profiling may refine risk prediction, but their clinical adoption will require prospective validation, transparency, calibration, transportability, and integration into allocation systems.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-9"},"PeriodicalIF":3.3,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215334","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

Revisiting chronic pancreatitis as a risk factor for pancreatic ductal adenocarcinoma: toward precision risk stratification. 重新审视慢性胰腺炎作为胰腺导管腺癌的危险因素：走向精确的危险分层。

IF 3.3 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2026-10-17 DOI: 10.1080/17474124.2026.2750981

Takehiro Okabayashi, Motoyasu Tabuchi, Teppei Tokumaru, Sunao Uemura, Shuta Tamura

{"title":"Revisiting chronic pancreatitis as a risk factor for pancreatic ductal adenocarcinoma: toward precision risk stratification.","authors":"Takehiro Okabayashi, Motoyasu Tabuchi, Teppei Tokumaru, Sunao Uemura, Shuta Tamura","doi":"10.1080/17474124.2026.2750981","DOIUrl":"10.1080/17474124.2026.2750981","url":null,"abstract":"Introduction: Chronic pancreatitis (CP) is an established risk factor for pancreatic ductal adenocarcinoma (PDAC). However, individual risk varies substantially, and the association between CP and PDAC is more complex than a uniform inflammation-driven pathway. Reverse causation, shared etiological factors, and biological heterogeneity may contribute to the observed association.Areas covered: We critically review epidemiological, mechanistic, and causal evidence linking CP with PDAC, focusing on heterogeneity across CP subtypes and disease trajectories. We examine five domains potentially relevant to individual PDAC risk: genetic susceptibility, cumulative pancreatic injury, metabolic trajectories including new-onset diabetes, longitudinal imaging phenotypes, and emerging molecular alterations. We propose a multidomain framework for individualized and dynamic risk stratification and risk-adapted surveillance.Expert opinion: CP should not be regarded as a uniformly high-risk condition for PDAC. Individual risk is shaped by the interaction of genetic, inflammatory, metabolic, structural, and molecular factors. The key question should therefore shift from whether CP increases PDAC risk to which patients are most likely to develop clinically consequential PDAC. Although multidomain and longitudinal assessment may enable targeted surveillance, most biomarkers and prediction strategies remain insufficiently validated. Prospective studies are required to determine whether this approach improves early detection and patient outcomes.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-13"},"PeriodicalIF":3.3,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192031","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

Developing mentors and leaders in gulf gastroenterology: the Gastroleaders framework. 发展海湾胃肠病学的导师和领导者：胃肠领导者框架。

IF 3.3 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2026-10-15 DOI: 10.1080/17474124.2026.2745666

Eyad Gadour, Mohamed Fathy Guda, Diamond Joy, Emad S Aljahdl, Mohammed Albeshir, Ibrahim Alhafid, Abdulrahman Alfadda, Fuad Muafa, Abdullah Alotaibi, Turki Alamri, Syed Anjum Gardezi, Abed Al-Lehibi

{"title":"Developing mentors and leaders in gulf gastroenterology: the Gastroleaders framework.","authors":"Eyad Gadour, Mohamed Fathy Guda, Diamond Joy, Emad S Aljahdl, Mohammed Albeshir, Ibrahim Alhafid, Abdulrahman Alfadda, Fuad Muafa, Abdullah Alotaibi, Turki Alamri, Syed Anjum Gardezi, Abed Al-Lehibi","doi":"10.1080/17474124.2026.2745666","DOIUrl":"10.1080/17474124.2026.2745666","url":null,"abstract":"Introduction: Gulf Cooperation Council (GCC) gastroenterology services are expanding, but published evidence on structured specialty-specific mentorship and leadership development remains uneven and is concentrated in a small number of countries.Areas covered: This critical perspective distinguishes the proposed GastroLeaders leadership-and-mentorship intervention from clinical education and independent procedural accreditation. PubMed/MEDLINE was searched from inception through 31 August 2026 using terms for mentorship, leadership, gastroenterology training, hepatology, inflammatory bowel disease (IBD), motility and endoscopy; official society and regulator websites were checked through early September 2026. The paper provides a six-country situational analysis, uses the UK JRCPTB/JAG system as an adaptable, not flawless, exemplar, expands priorities in hepatology, inflammatory bowel disease, neurogastroenterology and motility, advanced endoscopy, nutrition and communication, and specifies a prospective multicentre pilot with SMART targets, validated measures, cost and equity indicators, and 24-month follow-up.Expert opinion: GastroLeaders should first be tested as a bounded, cross-specialty-compatible professional-development program. Scale-up should depend on predefined feasibility, equity and effectiveness thresholds; clinical credentials must remain with recognized national and procedural authorities.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-10"},"PeriodicalIF":3.3,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164777","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

Recent developments in the role of oxidative stress in pathogenesis and treatment of inflammatory bowel diseases. 氧化应激在炎症性肠病发病机制和治疗中的作用的最新进展。

IF 3.3 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2026-10-12 DOI: 10.1080/17474124.2026.2744666

Karolina Merecz, Julia Jarząbek, Jakub Fichna

{"title":"Recent developments in the role of oxidative stress in pathogenesis and treatment of inflammatory bowel diseases.","authors":"Karolina Merecz, Julia Jarząbek, Jakub Fichna","doi":"10.1080/17474124.2026.2744666","DOIUrl":"10.1080/17474124.2026.2744666","url":null,"abstract":"Introduction: Inflammatory bowel disease (IBD) is a chronic and relapsing disorder of the gastrointestinal tract. Its prevalence has risen rapidly, and nowadays it is a global health concern. Currently available medications reduce inflammation and alleviate the symptoms, but do not cure the disease. Recent findings suggest that dysregulated redox homeostasis may contribute to IBD progression, positioning oxidative stress as one of the primary mechanisms driving inflammation.Areas covered: Data for this review were identified through a comprehensive search of PubMed and Google Scholar for the period from February 2013 to September 2026. This review aims to describe recent approaches focused on oxidative stress and IBD, including the use of oxidative stress biomarkers, treatment options employing neutrophils and nanoparticles, the emerging role of the Nrf2 signaling pathway, ferroptosis suppression, and oxidative stress-related changes in the microbiome. Furthermore, inflammaging and dietary interventions are discussed in the context of oxidative stress, as they modulate redox homeostasis and influence inflammatory pathways.Expert opinion: A better understanding of the interplay between ROS, inflammation, microbiome, and dietary interventions may provide valuable insights into mechanisms underlying IBD pathology, while targeting these pathways may facilitate the development of novel, adjunctive therapeutic approaches in IBD management.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-12"},"PeriodicalIF":3.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149106269","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

Helicobacter pylori eradication and gastric cancer prevention: current evidence and future perspectives. 根除幽门螺杆菌和预防胃癌：目前的证据和未来的展望。

IF 3.3 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2026-09-28 DOI: 10.1080/17474124.2026.2737750

Iqbal Taufiqqurrachman, Ari Fahrial Syam, Murdani Abdullah, Hasan Maulahela, Takashi Matsumoto, Yuichi Matsuo, Yoshio Yamaoka

{"title":"Helicobacter pylori eradication and gastric cancer prevention: current evidence and future perspectives.","authors":"Iqbal Taufiqqurrachman, Ari Fahrial Syam, Murdani Abdullah, Hasan Maulahela, Takashi Matsumoto, Yuichi Matsuo, Yoshio Yamaoka","doi":"10.1080/17474124.2026.2737750","DOIUrl":"https://doi.org/10.1080/17474124.2026.2737750","url":null,"abstract":"Introduction: Helicobacter pylori infection is the principal etiological factor in gastric carcinogenesis that can be prevented through eradication; however, the global burden of gastric cancer (GC) remains substantial.Areas covered: This review summarizes recent and future gastric cancer and H. pylori-induced GC. Relevant literature was identified from PubMed and Scopus, searched between March and April 2026 using specific keywords (Helicobacter pylori eradication OR Gastric cancer prevention), although this was not conducted as a formal systematic review.Expert opinion: Helicobacter pylori remains the main etiological factor for GC, and high atrophic severity in the gastric mucosa is associated with a higher risk of developing GC. As H. pylori eradication can prevent future GC incidence, even in the presence of dysplasia or early GC, a 'screen-and-treat' program with earlier detection and a family-based approach is considered the current best practice for GC prevention. Health policy-making to facilitate access to healthcare, diagnostic tests, and eradication regimens is needed to optimize the population-based 'screen-and-treat' program. Future progress will likely depend on integrating eradication programs with improved risk stratification based on mucosal status, bacterial virulence, and host factors to enable strategies for at-risk populations.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-19"},"PeriodicalIF":3.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069351","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

Preoperative biliary drainage in resectable perihilar cholangiocarcinoma: real-world burden. 可切除的肝门周围胆管癌术前胆道引流：现实世界的负担。

IF 3.3 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2026-09-28 DOI: 10.1080/17474124.2026.2738820

Noa Toussaint, Arthur Marichez, Mehdi Boubaddi, Bruno Lapuyade, Christophe Laurent, Laurence Chiche

{"title":"Preoperative biliary drainage in resectable perihilar cholangiocarcinoma: real-world burden.","authors":"Noa Toussaint, Arthur Marichez, Mehdi Boubaddi, Bruno Lapuyade, Christophe Laurent, Laurence Chiche","doi":"10.1080/17474124.2026.2738820","DOIUrl":"10.1080/17474124.2026.2738820","url":null,"abstract":"Background: Preoperative biliary drainage (PBD) in perihilar cholangiocarcinoma (pCCA) remains challenging, and its burden among patients who ultimately do not undergo curative-intent surgery is uncertain. We characterized the PBD pathway and identify factors associated with failure of curative-intent management.Research design and methods: This retrospective, single-center cohort study included 109 patients with initially resectable pCCA requiring PBD at a tertiary hepatobiliary center between 2010 and 2025. Drainage sequences, complications, surgical and oncological outcomes, and factors associated with surgical exclusion or 90-day mortality were assessed.Results: Resection was achieved in 84 patients (77.1%). Repeated drainage increased septic morbidity (83.1% vs 62.0%, p = 0.013). Pancreatitis with a CT Severity Index ≥4 or severe acute pancreatitis was associated with surgical exclusion (50.0% vs 20.2%, p = 0.048). Drainage-related septic complications independently predicted impaired disease-free survival (HR 3.69, 95%CI 1.58-8.59, p = 0.002). A 7-point score including age >70 years, arterial hypertension, post-drainage pancreatitis, and post-drainage septic complications predicted surgical exclusion or 90-day mortality (AUC 0.766).Conclusions: PBD carries substantial morbidity and may compromise the curative pathway for resectable pCCA. Early expert referral and planned first-attempt drainage are essential. Optimal management of the PBD period before surgery may help to reduce the burden of the surgical resection.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-15"},"PeriodicalIF":3.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024268","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

From the editors: shaping the next chapter of Expert Review of Gastroenterology & Hepatology. 来自编辑：塑造胃肠病学和肝病学专家评论的下一章。

IF 3.3 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2026-09-15 DOI: 10.1080/17474124.2026.2725481

引用次数: 0

Screening strategies for colorectal cancer: adjusting for individual risk factors. 结直肠癌筛查策略：调整个体危险因素。

IF 3.3 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2026-09-01 Epub Date: 2026-09-27 DOI: 10.1080/17474124.2026.2737747

Kelsey L Anderson, Sophie Montgomery, Ashlee Winslow, Joseph D Feuerstein

{"title":"Screening strategies for colorectal cancer: adjusting for individual risk factors.","authors":"Kelsey L Anderson, Sophie Montgomery, Ashlee Winslow, Joseph D Feuerstein","doi":"10.1080/17474124.2026.2737747","DOIUrl":"10.1080/17474124.2026.2737747","url":null,"abstract":"Introduction: Colorectal cancer (CRC) is a common cause of cancer-related mortality. While overall incidence has declined, certain populations - particularly younger patients - have experienced a rise. This suggests a more complex risk profile than the dichotomous average vs high risk delineated in guidelines. Risk is currently largely characterized by polyp and family history; however, many additional variables contribute to risk.Areas covered: We synthesize the available data (Pubmed database, focus on article updates in the past 10 years) on non-modifiable and modifiable risk factors for CRC. We explore how these factors could affect screening and surveillance decisions in otherwise average-risk individuals. We then suggest strategies for personalized approaches to CRC screening, explore the role of shared decision making with patients, and highlight future directions for CRC screening.Expert opinion: Our understanding of CRC risk must become increasingly more nuanced to adequately serve, screen, and surveil our patients. Precision medicine offers a pathway to accomplish this, but will require significant research to accurately measure risk, and the ability to adapt risk models as our data evolves. This undertaking grows evermore relevant as medicine becomes increasingly personalized and shared decision making becomes the mainstay of counseling between physicians and patients.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"751-763"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012034","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 calf circumference in the measurement of sarcopenia in cirrhosis: a narrative review. 小腿围围在肝硬化肌肉减少症测量中的作用：一篇叙述性综述。

IF 3.3 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2026-09-01 Epub Date: 2026-09-07 DOI: 10.1080/17474124.2026.2729331

Arjuna P De Silva, Shashini Hathurusinghe, Krishanni Prabagar, Madunil A Niriella, H Janaka de Silva

{"title":"The role of calf circumference in the measurement of sarcopenia in cirrhosis: a narrative review.","authors":"Arjuna P De Silva, Shashini Hathurusinghe, Krishanni Prabagar, Madunil A Niriella, H Janaka de Silva","doi":"10.1080/17474124.2026.2729331","DOIUrl":"10.1080/17474124.2026.2729331","url":null,"abstract":"Introduction: Cirrhosis is a global health challenge associated with significant morbidity and mortality. Sarcopenia is a clinically relevant prognostic marker in cirrhosis but is frequently overlooked in traditional prognostic scores. Gold standard diagnosis relies on imaging modalities that are expensive, not widely available, and involve radiation exposure, creating a need for a simple, reliable surrogate marker that can be incorporated into prognostic systems. Calf circumference (CC) meets these requirements as a practical screening tool with potential future utility within prognostic assessment, pending further validation.Areas covered: A literature search of PubMed, Scopus, Embase, CINAHL, the Cochrane Library, Informed, and the JBI Database of Systematic Reviews (January 2000-November 2025) identified publications on sarcopenia in cirrhosis and the use of CC as a screening tool. International guidelines, systematic reviews, meta-analyses, large observational cohort studies, and narrative reviews were included. This review summarizes the pathophysiology and prognostic relevance of sarcopenia in cirrhosis and evaluates the utility of CC as a cost-effective screening measure with prognostic potential.Expert opinion: CC is a feasible, low-cost surrogate marker of sarcopenia in cirrhosis with potential for integration into prognostic scores. Future studies should focus on validating standardized cutoffs and incorporating CC into prognostic models.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"807-819"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886841","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

Neonatal Fc receptor (FcRn) inhibition and the implications for inflammatory bowel disease and co-existing immune-mediated diseases. 新生儿fc受体（fcrn）抑制及其对炎症性肠病和共存的免疫介导疾病的影响

IF 3.3 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2026-09-01 Epub Date: 2026-08-17 DOI: 10.1080/17474124.2026.2720169

Michael Colwill, Nidhi Sofat, Ashley Spencer, Jennifer Spillane, Sailish Honap

引用次数: 0