Gastroenterology Research最新文献

{"title":"Treatment of Crohn's Disease With Infliximab and Subsequent Development of Takayasu's Arteritis.","authors":"Kei Nomura, Tomoyoshi Shibuya, Momoko Furusho, Hirotaka Ishino, Masayuki Orikasa, Masashi Omori, Rina Odakura, Masao Koma, Kentaro Ito, Takafumi Maruyama, Dai Ishikawa, Mariko Hojo, Akihito Nagahara","doi":"10.14740/gr1792","DOIUrl":"10.14740/gr1792","url":null,"abstract":"<p><p>A 23-year-old man was diagnosed with Crohn's disease (CD) of the large intestine after colonoscopy revealed longitudinal ulcers, and pathology revealed non-caseating epithelioid cell granulomas and anal fistulas. The CD relapsed, and therefore prednisolone (PSL) and infliximab (IFX) treatment was initiated. The PSL was gradually tapered. Steroid-free remission was maintained with IFX. The patient subsequently developed a high fever and headache, while CD-related symptoms did not worsen. Laboratory data showed white blood cells at 14,200/µL and C-reactive protein at 17.2 mg/dL. Contrast-enhanced computed tomography revealed thoracoabdominal aortitis, and the patient was consequently diagnosed with Takayasu's arteritis (TA). We therefore again initiated PSL treatment that immediately reduced the fever and headache. The PSL dose was again tapered and the administration of IFX was resumed to maintain CD remission. No further episodes of aortitis relapse were noted after restarting IFX, and the CD currently remains in remission. This is a rare case of TA onset during IFX treatment for CD, and, as such, contributes to the limited literature on such cases. More specifically, this case highlights that when patients with CD present with symptoms such as fever or headache, it is necessary to investigate the possibility of vasculitis.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"17 5-6","pages":"217-223"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Impact of Phosphatidylethanol Testing on Hospital Outcomes.","authors":"Rakahn Haddadin, Steven Molina, George Trad, John Ryan, Robert Gish","doi":"10.14740/gr1790","DOIUrl":"10.14740/gr1790","url":null,"abstract":"<p><strong>Background: </strong>Alcohol dependence remains a significant global health issue, exacerbated by the coronavirus disease 2019 (COVID-19) pandemic. Phosphatidylethanol (PEth), a direct biomarker of recent alcohol consumption, offers improved specificity, sensitivity, and a longer detection window of 2 - 4 weeks compared to traditional biomarkers. This study evaluates the association between PEth testing and hospital outcomes in hospitalized patients by comparing outcomes among patients with positive PEth and negative PEth test results.</p><p><strong>Methods: </strong>This retrospective cohort study used data from the TriNetX database, comprising de- identified medical records from 66 US healthcare organizations from 2015 to 2024. The study population included patients with documented PEth test results. Patients were divided into two groups: positive PEth test results (≥ 20 ng/mL) and negative PEth test results (≤ 19 ng/mL). Propensity score matching was performed to minimize bias, balancing for age, sex, race, ethnicity, and comorbidities such as cirrhosis, diabetes mellitus, hypertension, coronary artery disease, and chronic obstructive pulmonary disease (COPD). Key hospital outcomes assessed included mortality, delirium tremens, endoscopy/colonoscopy, liver transplant status, liver transplant rejection, liver transplant complications, hepatorenal syndrome, intensive care unit (ICU) admission, hepatic encephalopathy, and sarcopenia. These outcomes were chosen based on their prevalence in patients with alcohol use.</p><p><strong>Results: </strong>Patients with positive PEth results demonstrated significantly worse outcomes compared to patients in the negative PEth group. Positive PEth results were associated with higher mortality (odds ratio, 10.037; P < 0.001), ICU admissions, and rates of complications such as hepatorenal syndrome, hepatic encephalopathy, and sarcopenia. Postoperative liver transplant complications and rejection were also more frequent in the positive cohort.</p><p><strong>Conclusions: </strong>This study highlights the association between recent alcohol use, as identified by PEth testing, and severe hospital outcomes. While PEth testing provides an objective measure of recent alcohol consumption, further research is needed to explore its role in improving clinical outcomes and guiding interventions for patients with alcohol use.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"17 5-6","pages":"205-211"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Pemafibrate on the Lipid Profile, Liver Function, and Liver Fibrosis Among Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease.","authors":"Mona Hassan, Hasan Al-Obaidi, Megan Karrick, Nooraldin Merza, Yusuf Nawras, Omar Saab, Ahmed Dheyaa Al-Obaidi, Fatima Merza, Hashim Talib Hashim, Khalid Al Zubaidi, Daniah Al-Sabbagh, Rand Matbachi, Zainab Noori, Hajra Amatul-Raheem, Sarmad Mansur, Omer Al Najafi, Marwah Algodi, Tamarah Al Hamdany, Abdallah Kobeissy","doi":"10.14740/gr1750","DOIUrl":"10.14740/gr1750","url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH) are prevalent conditions linked to obesity and metabolic disturbances, with potential complications such as cirrhosis and cardiovascular risks. This systematic review and meta-analysis aimed to evaluate the efficacy of pemafibrate, a drug targeting fat and sugar metabolism genes, in treating patients with MASLD/MASH.</p><p><strong>Methods: </strong>Databases such as MEDLINE, Web of Science, Cochrane Library, and Scopus were searched until September 2023 to identify relevant studies. Selected studies underwent a thorough quality assessment using tools like Risk of Bias 2 tool (ROB-2) and the National Institutes of Health (NIH) Quality Assessment Tools. Comprehensive meta-analysis software was used for statistical evaluations, with a focus on lipid profiles, liver function tests, and fibrosis measurements.</p><p><strong>Results: </strong>A total of 13 studies were included; 10 of them were included in the quantitative analysis. Our findings showed that pemafibrate significantly decreased low-density lipoprotein cholesterol (LDL-C) (effect size (ES) = -9.61 mg/dL, 95% confidence interval (CI): -14.15 to -5.08), increased high-density lipoprotein cholesterol (HDL-C) (ES = 3.15 mg/dL, 95% CI: 1.53 to 4.78), and reduced triglycerides (TG) (ES = -85.98 mg/dL, 95% CI: -96.61 to -75.36). Additionally, pemafibrate showed a marked reduction in liver enzyme levels, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamyl transpeptidase (GGT), and alkaline phosphatase (ALP), with significant effect sizes and P values. For liver stiffness outcomes, pemafibrate decreased AST to platelet ratio index (APRI) (ES = -0.180, 95% CI: -0.221 to -0.138).</p><p><strong>Conclusions: </strong>Pemafibrate, with its enhanced efficacy and safety profile, presents as a pivotal agent in MASLD/MASH treatment. Its lipid-regulating properties, coupled with its beneficial effects on liver inflammation markers, position it as a potentially invaluable therapeutic option.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"17 4","pages":"159-174"},"PeriodicalIF":1.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Efficacy of Transcatheter Arterial Chemoembolization Combined With Percutaneous Microwave Coagulation Therapy for Advanced Hepatocellular Carcinoma.","authors":"Hu Hu Ren, Zhi Qun Wu, Jian Chen, Chen Li","doi":"10.14740/gr1713","DOIUrl":"10.14740/gr1713","url":null,"abstract":"<p><strong>Background: </strong>The aim of the study was to explore the clinical efficacy of transcatheter arterial chemoembolization (TACE) combined with percutaneous microwave coagulation therapy (PMCT) for advanced hepatocellular carcinoma (HCC).</p><p><strong>Methods: </strong>Eighty-three advanced HCC patients were divided into the experimental group (TACE + PMCT, 57 cases) and the control group (TACE alone, 26 cases). They received TACE treatment first, and computed tomography (CT) or hepatic artery angiography was performed 3 - 4 weeks after each treatment. Based on the comprehensive evaluation of iodine oil deficiency, fistula recanalization, residual lesions, and lesion progression, TACE or PMCT treatment was selectively performed, and three consecutive treatments were considered as one treatment cycle.</p><p><strong>Results: </strong>The experimental group had a response rate (RR) of 49.1%, and the control group had a RR of 38.4%. The reduction rate of alpha-fetoprotein (AFP) in the experimental group was significantly higher than the control group (P < 0.05). The cumulative survival rates in the experimental at 1-, 1.5-, and 2-year post-treatment were higher than the control group. The cumulative recurrence and metastasis rates in the experimental at 1.5-, and 2-year post-treatment were significantly lower than those in the control group (P < 0.05). In addition, there were no significant differences in treatment-related complications in the two groups.</p><p><strong>Conclusions: </strong>The combined treatment of TACE and PMCT for advanced HCC is a safe, feasible, and effective treatment method, prolonging the survival time, and reducing the recurrence and metastasis rate, without increased toxic and side effects.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"17 4","pages":"175-182"},"PeriodicalIF":1.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142157167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-Cut Papillotomy Versus Endoscopic Ultrasound-Rendezvous for Difficult Biliary Cannulation: A Systematic Review and Meta-Analysis.","authors":"Amna Iqbal, Zohaib Ahmad, Muhammad Aziz, Abdulmajeed Alharbi, Hassam Ali, Ahmed Al-Chalabi, Manesh Kumar Gangwani, Dushyant Singh Dahiya, Wade Lee Smith, Shailendra Singh, Yaseen Alastal, Abdallah Kobeissy","doi":"10.14740/gr1738","DOIUrl":"10.14740/gr1738","url":null,"abstract":"<p><strong>Background: </strong>Various endoscopic techniques are employed to achieve biliary cannulation when confronted with difficult biliary access. Every procedure carries its own risk in terms of bleeding, infection, pancreatitis, and cholangitis. Our meta-analysis aimed to compare pre-cut papillotomy and endoscopic ultrasound (EUS)-rendezvous in terms of technical success rates, and post-procedure pancreatitis and bleeding.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of studies that compared pre-cut papillotomy and EUS-rendezvous. The primary outcome was technical success by achieving biliary cannulation. Secondary outcomes were postoperative pancreatitis and bleeding. A random-effects model was used to calculate the risk ratios (RRs) and confidence intervals (CIs). A P value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Our meta-analysis included four studies comparing pre-cut papillotomy and EUS-rendezvous. The studies included 13,659 total endoscopic retrograde cholangiopancreatography (ERCP) procedures, of whom 1,004 patients underwent alternate biliary cannulation procedures due to difficult biliary cannulation. The mean age of the study population was noted to be 49.5 years and males represented 53.3% of the total participants. Both procedures were similar in terms of technical success (RR: 0.95, 95% CI (0.88, 1.02)). No difference was found between rates of post procedure pancreatitis (RR: 1.82, 95% CI (0.80, 4.15)) and post procedure bleeding (RR: 2.80, 95% CI (0.67, 11.66)).</p><p><strong>Conclusions: </strong>There was no difference in technical success of procedure or post-procedure complications such as pancreatitis and bleeding between pre-cut papillotomy and EUS-rendezvous technique. More randomized controlled trials (RCTs) are needed to compare both procedural techniques and complications rates. However, currently, both procedures are equally effective and safe during difficult biliary cannulation in the hands of experienced endoscopists.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"17 4","pages":"151-158"},"PeriodicalIF":1.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extraction Basket Entangled in Surgical Sutures in Common Bile Duct Forty-Five Years After Hepatobiliary Surgery: A Bizarre Adverse Event of Endoscopic Retrograde Cholangiopancreatography.","authors":"Ante Bogut, Ivan Saric, Vedran Dragisic, Andela Azinovic, Ivan Romic, Branko Bakula, Marko Puljiz, Zeljko Puljiz","doi":"10.14740/gr1752","DOIUrl":"10.14740/gr1752","url":null,"abstract":"<p><p>Endoscopic retrograde cholangiopancreatography (ERCP) is an important technique for treating biliary obstruction. A case report of a 75-year-old male with diagnosed choledocholithiasis and cholangitis was presented. He had a history of hepatic surgery 45 years ago, and during the ERCP, an unusual clinical scenario was encountered. Retained extraction basket during ERCP is a rare but known complication and there are no standard recommendations to manage it. To our knowledge, this is the first case report described in the literature with retention of an extraction basket in surgical sutures at ERCP and the longest period from surgery to stone formation in the biliary system. This case report aims to emphasize that in patients with a history of hepatobiliary surgery, postoperative material can cause complications during ERCP.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"17 4","pages":"183-188"},"PeriodicalIF":1.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adult-Onset Autoimmune Enteropathy Mimicking Disaccharidase Deficiency.","authors":"Georgeta Giblen, Jerry Huang, Brandon Yu, Jinping Lai","doi":"10.14740/gr1737","DOIUrl":"10.14740/gr1737","url":null,"abstract":"<p><p>Adult-onset autoimmune enteropathy is a rare disorder characterized by severe diarrhea, weight loss, malnutrition, and enteric mucosal atrophy resulting from immune-mediated injury. Disaccharidase deficiencies are a group of disorders characterized by inadequate activity of disaccharidase in the small intestine, leading to impaired digestion of disaccharides and malabsorption. Here, we present a case of adult-onset autoimmune enteropathy initially diagnosed as disaccharidase deficiency based on the clinical symptoms of chronic diarrhea, weight loss, and severely reduced levels of lactase, maltase, palatinase, and sucrase in duodenal aspirates. However, follow-up duodenal biopsy revealed markedly villous blunting, goblet and Paneth cell depletion, increased crypt apoptotic bodies and lamina propria lymphoplasmacytic inflammation, leading to a revised diagnosis of autoimmune enteropathy. This case highlights the diagnostic challenges of adult-onset autoimmune enteropathy and the importance of considering it in adults with unexplained gastrointestinal symptoms. It also emphasizes the need for tissue biopsies in cases with inconclusive initial diagnostic tests. Increased awareness of these disorders and their mimickers can improve diagnosis and management, ultimately benefiting patients with these conditions.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"17 4","pages":"189-193"},"PeriodicalIF":1.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Needle-Knife Fistulotomy Versus Needle-Knife Papillotomy in Difficult Biliary Cannulation: A Systematic Review and Meta-Analysis.","authors":"Saqr Alsakarneh, Tim Brotherton, Fouad Jaber, Mahmoud Y Madi, Laith Numan, Mohamed Ahmed, Yazan Sallam, Mohammad Adam, Dushyant Singh Dahiya, Pearl Aggarwal, Fazel Dinary","doi":"10.14740/gr1726","DOIUrl":"10.14740/gr1726","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic retrograde cholangiopancreatography (ERCP) is an essential endoscopic therapeutic modality for biliary and pancreatic diseases. Needle-knife fistulotomy (NKF) and papillotomy (NKP) are the two most commonly used rescue techniques for patients with difficult biliary cannulation. However, there remains a need for comparative studies on these approaches to inform clinical decision-making. This meta-analysis aimed to evaluate the efficacy and safety of NKF compared to NKP as a rescue technique in difficult biliary cannulation after failed conventional ERCP.</p><p><strong>Methods: </strong>We searched PubMed, Scopus, Embase, and Web of Science databases through November 2023 to include all studies that directly compared the outcomes of NKF with NKP in difficult biliary cannulation. Single-arm studies were excluded. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) for dichotomous data related to clinical events were calculated using the Mantel-Haenszel method within a random-effect model. The primary outcome was the biliary cannulation success rate.</p><p><strong>Results: </strong>Four studies with 823 patients (n = 376 NKF vs. n = 447 NKP) were included in our analysis. There was no significant difference between the two groups in biliary cannulation success rate (91.7% vs. 86.9%, respectively; OR = 1.54, 95% CI: 0.21 - 2.49, P = 0.14; I² = 0%). However, the overall rate of adverse events was significantly lower in the NKF group than in the NKP group (OR = 0.46, 95% CI: 0.25 - 0.84, P = 0.01). Pancreatitis (OR = 0.23, 95% CI: 0.05 - 1.11, P = 0.07) and bleeding (OR = 1.43, 95% CI: 0.59 - 3.46, P = 0.42) were similar between the two groups. No significant differences in cholangitis, cholecystitis, perforation, or mortality were observed.</p><p><strong>Conclusions: </strong>Our meta-analysis indicates comparable success rates in comparing NKF and NKP techniques for difficult biliary cannulation after failed conventional ERCP cannulation. Notably, the NKF technique significantly reduces overall adverse events compared to NKP, suggesting that NKF may be preferable due to its favorable safety profile. Additional randomized controlled trials (RCTs) are warranted to evaluate the interval benefit of an NKF technique.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"17 3","pages":"101-108"},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11236341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141590124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Risk of Infection-Caused Mortality in Gastric Adenocarcinoma: A Population-Based Study.","authors":"Adnan Malik, Farman Ali, Muhammad Imran Malik, Shahbaz Qureshi","doi":"10.14740/gr1715","DOIUrl":"10.14740/gr1715","url":null,"abstract":"<p><strong>Background: </strong>Gastric adenocarcinoma (GAC) is a deadly tumor. Postoperative complications, including infections, worsen its prognosis and may affect overall survival. Little is known about perioperative complications as well as modifiable and non-modifiable risk factors. Early detection and treatment of these risk factors may affect overall survival and mortality.</p><p><strong>Methods: </strong>We extracted GAC patient's data from the Surveillance, Epidemiology, and End Results (SEER) database and analyzed using Pearson's Chi-square, Cox regression, Kaplan-Meier, and binary regression methods in SPSS.</p><p><strong>Results: </strong>At the time of analysis, 59,580 GAC patients were identified, of which 854 died of infection. Overall, mean survival in months was better for younger patients, age < 50 years vs. ≥ 50 years (60.45 vs. 56.75), and in females vs. males (65.23 vs. 53.24). The multivariate analysis showed that the risk of infectious mortality was higher in patients with age ≥ 50 years (hazard ratio (HR): 3.137; 95% confidence interval (CI): 2.178 - 4.517), not treated with chemotherapy (HR: 1.669; 95% CI: 1.356 - 2.056), or surgery (HR: 1.412; 95% CI:1.132 - 1.761) and unstaged patients (HR: 1.699; 95% CI: 1.278 - 2.258). In contrast, the mortality risk was lower in females (HR: 0.658; 95% CI: 0.561 - 0.773) and married patients (HR: 0.627; 95% CI: 0.506 - 0.778). The probability of infection was higher in older patients (odds ratio (OR) of 2.094 in ≥ 50 years), other races in comparison to Whites and Blacks (OR: 1.226), lesser curvature, not other specified (NOS) as a primary site (OR: 1.325), and patients not receiving chemotherapy (OR: 1.258).</p><p><strong>Conclusion: </strong>Older, unmarried males with GAC who are not treated with chemotherapy or surgery are at a higher risk for infection-caused mortality and should be given special attention while receiving treatment.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"17 3","pages":"133-145"},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11236340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141590126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Efficacy and Safety of Laparoscopy Plus Choledochoscopy Combined With Holmium Laser Lithotripsy for Choledocholithiasis and Hepatolithiasis.","authors":"Hui Li, Qun Feng Zhong, Qiong Rong Liu, Qiang Wu, Wen Zhang, Guo Pei Luo","doi":"10.14740/gr1710","DOIUrl":"10.14740/gr1710","url":null,"abstract":"<p><strong>Background: </strong>With the advancement of laparoscopic technology, the combination of laparoscopy, choledochoscopy, and holmium laser lithotripsy has emerged as an effective treatment modality for both choledocholithiasis and hepatolithiasis. This study aimed to assess the efficacy and safety of this approach.</p><p><strong>Methods: </strong>Retrospective analysis was conducted on the medical records of 76 patients diagnosed with choledocholithiasis and hepatolithiasis between April 2021 and March 2023. Patients were divided into two groups based on the treatment plan: the control group, which underwent traditional laparotomy and choledochoscopy lithotripsy (n = 38), and the experimental group, which underwent laparoscopy combined with choledochoscopy and holmium laser lithotripsy (n = 38). Comparative analysis was performed on various operation-related parameters, stone-free rate, complication rates, and changes in biochemical, liver function, inflammatory, stress response indicators, and pain scores between the two groups.</p><p><strong>Results: </strong>The experimental group demonstrated significantly shorter stone removal time, reduced intraoperative bleeding, and shorter hospital stay compared to the control group (P < 0.05). Moreover, the experimental group exhibited lower incidence of postoperative complications and lower pain scores at 2 weeks to 3 months post-operation (P < 0.05). Biochemical indicators including total bile acid (TBA), total bilirubin (TBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and glutamyl transpeptidase (GGT) were significantly lower in the observation group compared to the control group (P < 0.05). Additionally, stress and inflammation indicators were also lower in the experimental group (P < 0.05).</p><p><strong>Conclusions: </strong>The combination of laparoscopy, choledochoscopy, and holmium laser lithotripsy presents favorable therapeutic outcomes in the management of choledocholithiasis and hepatolithiasis, indicating its potential for widespread clinical application.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"17 3","pages":"126-132"},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11236342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141590105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}