Gastroenterologia y hepatologia最新文献_第3页

Long-term outcomes of endoscopic ultrasound-guided pancreatic duct interventions: A single tertiary center experience. 内镜超声引导下胰管介入治疗的长期疗效：一家三级中心的经验。

IF 2.2 4区医学

Gastroenterologia y hepatologia Pub Date : 2024-06-19 DOI: 10.1016/j.gastrohep.2024.502221

Joan B Gornals, Albert Sumalla-Garcia, Daniel Luna-Rodriguez, Maria Puigcerver-Mas, Julio G Velasquez-Rodriguez, Silvia Salord, Sandra Maisterra, Juli Busquets

{"title":"Long-term outcomes of endoscopic ultrasound-guided pancreatic duct interventions: A single tertiary center experience.","authors":"Joan B Gornals, Albert Sumalla-Garcia, Daniel Luna-Rodriguez, Maria Puigcerver-Mas, Julio G Velasquez-Rodriguez, Silvia Salord, Sandra Maisterra, Juli Busquets","doi":"10.1016/j.gastrohep.2024.502221","DOIUrl":"10.1016/j.gastrohep.2024.502221","url":null,"abstract":"Background and aims: Endoscopic ultrasound-guided pancreatic duct intervention (EUS-PDI) is one of the most technically challenging procedures. There remains a knowledge gap due to its rarity. The aim is to report the accumulated EUS-PDI experience in a tertiary center.Methods: Single tertiary center, retrospective cohort study of prospectively collected data during the study period, from January 2013 to June 2021.Results: In total, 14 patients (85% male; mean age, 61 years, range 37-81) and 25 EUS-PDI procedures for unsuccessful endoscopic retrograde pancreatography (ERP) were included. Principal etiology was chronic pancreatitis with pancreatic duct obstruction (78%). EUS-guided assisted (colorant and/or guidewire, rendezvous) ERP was performed in 14/25 (56%); and transmural drainage in 11 procedures, including pancreaticogastrosmy in 9/25 (36%) and pancreaticoduodenostomy in 2/25 (8%). Overall technical and clinical success was 78.5% (11/14). Three (21%) patients required a second procedure with success in all cases. Two failed cases required surgery. Three (21%) adverse events (AEs) were noted (fever, n=1; perforation, n=1; pancreatitis, n=1). Patients underwent a median of 58 months (range 24-108) follow-up procedures for re-stenting. Spontaneous stent migration was detected in 50% of cases.Conclusions: EUS-PDI is an effective salvage therapy for unsuccessful ERP, although 21% of patients may still experience AEs. In case of EUS-guided rendezvous failure, it can cross over to a transmural drainage.","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141436767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Secondary uncovered versus fully-covered metal stents for the management of occluded stent in unresectable distal malignant biliary obstruction. 在治疗无法切除的远端恶性胆道梗阻的闭塞支架时，二次覆盖与全覆盖金属支架的比较。

IF 2.2 4区医学

Gastroenterologia y hepatologia Pub Date : 2024-06-08 DOI: 10.1016/j.gastrohep.2024.502218

Javier Tejedor-Tejada, Aranzazu Alvarez-Alvarez, Jose Manuel Olmos, Ana Cristina González-Bernal, Andrea Jimenez-Jurado, Samuel Robles-Gaitero, Jose M Perez-Pariente

{"title":"Secondary uncovered versus fully-covered metal stents for the management of occluded stent in unresectable distal malignant biliary obstruction.","authors":"Javier Tejedor-Tejada, Aranzazu Alvarez-Alvarez, Jose Manuel Olmos, Ana Cristina González-Bernal, Andrea Jimenez-Jurado, Samuel Robles-Gaitero, Jose M Perez-Pariente","doi":"10.1016/j.gastrohep.2024.502218","DOIUrl":"10.1016/j.gastrohep.2024.502218","url":null,"abstract":"Introduction: Self-expandable metallic stents (SEMS) have been widely placed for unresectable distal malignant biliary obstruction (UDMBO). However, the dysfunction rate is 19-40% and its treatment is controversial. We aimed asses the efficacy and safety of a secondary biliary stents (uncovered (UC) versus fully-covered (FC) stent) for the management of occluded SEMS.Patients and methods: Between 2015 and June 2023, 41 patients with UDMBO underwent secondary biliary stent placement as \"stent-in-stent\" (20 FCSEMS and 21 UCSEMS). The primary outcomes were technical and clinical success of SEMS placement. Secondary outcomes included adverse events (AEs), patency and survival. Patients were prospectively followed until death or loss of follow-up.Results: Technical (100% vs 85.5%) and clinical (100% vs 95.2%) success rates were similar in FCSEMS and UCSEMS groups. The median follow-up period was 510 days (range 290-630). The median duration of stent patency of FCSEMS (220 days, IQR 137.5-442.5) was longer than UCSEMS (150 days, IQR 110-362.5) (P=0.395), although stent dysfunction within 6 months was not different between groups. Multivariate analysis indicated that sex (HR=0.909, 0.852-0.970), antitumor treatment (HR=0.248, 0.032-0.441), stent patency (HR=0.992, 0.986-0.998) and clinical success (HR=0.133, 0.026-0.690) were significant factors for overall survival. There were no remarkable differences in AEs.Conclusions: The placement of additional biliary stent using the stent-in-stent method is an effective and safe rescue treatment for patients with UDMBO and occluded stent. In addition, the use of FCSEMS compared UCSEMS has unclear benefits regarding stent patency and overall survival.","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Characterization of obstructive defecation from a structural and a functional perspective. 从结构和功能角度分析梗阻性排便的特征。

IF 2.2 4区医学

Gastroenterologia y hepatologia Pub Date : 2024-06-08 DOI: 10.1016/j.gastrohep.2024.502219

Lluís Mundet, Alba Raventós, Sílvia Carrión, Cristina Bascompte, Pere Clavé

{"title":"Characterization of obstructive defecation from a structural and a functional perspective.","authors":"Lluís Mundet, Alba Raventós, Sílvia Carrión, Cristina Bascompte, Pere Clavé","doi":"10.1016/j.gastrohep.2024.502219","DOIUrl":"10.1016/j.gastrohep.2024.502219","url":null,"abstract":"Background/aims: Defecation disorders can occur as a consequence of functional or structural anorectal dysfunctions during voiding. The aims of this study is to assess the prevalence of structural (SDD) vs functional (FDD) defecation disorders among patients with clinical complaints of obstructive defecation (OD) and their relationship with patients' expulsive capacity.Patients and methods: Retrospective study of 588 patients with OD studied between 2012 and 2020 with evacuation defecography (ED), and anorectal manometry (ARM) in a subgroup of 294.Results: 90.3% patients were women, age was 58.5±12.4 years. Most (83.7%) had SDD (43.7% rectocele, 45.3% prolapse, 19.3% enterocele, and 8.5% megarectum), all SDD being more prevalent in women except for megarectum. Functional assessments showed: (a) absence of rectification of anorectal angle in 51% of patients and poor pelvic descent in 31.6% at ED and (b) dyssynergic defecation in 89.9%, hypertonic IAS in 44%, and 33.3% rectal hyposensitivity, at ARM. Overall, 46.4% of patients were categorized as pure SDD, 37.3% a combination of SDD+FDD, and 16.3% as having pure FDD. Rectal emptying was impaired in 66.2% of SDD, 71.3% of FDD and in 78% of patients with both (p=0.017).Conclusions: There was a high prevalence of SDD in middle-aged women with complaints of OD. Incomplete rectal emptying was more prevalent in FDD than in SDD although FDD and SDD frequently coexist. We recommend a stepwise therapeutic approach always starting with therapy directed to improve FDD and relaxation of striated pelvic floor muscles.","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Common questions and rationale answers about the intestinal bacterial overgrowth syndrome (SIBO). 关于细菌性肠道过度生长综合征（BIBOS）的常见问题和合理解答。

IF 2.2 4区医学

Gastroenterologia y hepatologia Pub Date : 2024-06-07 DOI: 10.1016/j.gastrohep.2024.502216

Javier Alcedo González, Fermín Estremera-Arévalo, Julyssa Cobián Malaver, Javier Santos Vicente, Luis Gerardo Alcalá-González, Juan Naves, Elizabeth Barba Orozco, Claudia Barber Caselles, Blanca Serrano-Falcón, Anna Accarino Garaventa, Carmen Alonso-Cotoner, Jordi Serra Pueyo

引用次数: 0

Perivascular epithelioid cell neoplasm (PEComa) harboring TFE3 gene rearrangements in a patient with Lynch syndrome. 一名林奇综合征患者的血管周围上皮样细胞肿瘤（PEComa）携带 TFE3 基因重排。

IF 2.2 4区医学

Gastroenterologia y hepatologia Pub Date : 2024-06-07 DOI: 10.1016/j.gastrohep.2024.502217

Ana B Larqué, Gerard Frigola, Natalia Castrejón, Sherley Díaz-Mercedes, Eva Musulén Palet, Carolina Martínez Ciarpaglini, Stefania Landolfi, Antonio M Lacy, Francesc Balaguer, Miriam Cuatrecasas

引用次数: 0

Why your doctor is not an algorithm: Exploring logical principles of different clinical inference methods using liver transplantation as a model. 为什么你的医生不是算法：以肝移植为模型，探索不同临床推断方法的逻辑原理。

IF 2.2 4区医学

Gastroenterologia y hepatologia Pub Date : 2024-06-07 DOI: 10.1016/j.gastrohep.2024.502215

Mario Romero-Cristóbal, Magdalena Salcedo Plaza, Rafael Bañares

{"title":"Why your doctor is not an algorithm: Exploring logical principles of different clinical inference methods using liver transplantation as a model.","authors":"Mario Romero-Cristóbal, Magdalena Salcedo Plaza, Rafael Bañares","doi":"10.1016/j.gastrohep.2024.502215","DOIUrl":"10.1016/j.gastrohep.2024.502215","url":null,"abstract":"The development of machine learning (ML) tools in many different medical settings is largely increasing. However, the use of the resulting algorithms in daily medical practice is still an unsolved challenge. We propose an epistemological approach (i.e., based on logical principles) to the application of computational tools in clinical practice. We rely on the classification of scientific inference into deductive, inductive, and abductive comparing the characteristics of ML tools with those derived from evidence-based medicine [EBM] and experience-based medicine, as paradigms of well-known methods for generation of knowledge. While we illustrate our arguments using liver transplantation as an example, this approach can be applied to other aspects of the specialty. Regarding EBM, it generates general knowledge that clinicians apply deductively, but the certainty of its conclusions is not guaranteed. In contrast, automatic algorithms primarily rely on inductive reasoning. Their design enables the integration of vast datasets and mitigates the emotional biases inherent in human induction. However, its poor capacity for abductive inference (a logical mechanism inherent to human clinical experience) constrains its performance in clinical settings characterized by uncertainty, where data are heterogeneous, results are highly influenced by context, or where prognostic factors can change rapidly.","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141295931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 endoscopic model for gastric carcinogenesis and Helicobacter pylori infection: A potential visual mind-map during gastroscopy examination. 胃癌和幽门螺旋杆菌感染的内窥镜模型：胃镜检查中的潜在视觉思维导图。

IF 2.2 4区医学

Gastroenterologia y hepatologia Pub Date : 2024-06-04 DOI: 10.1016/j.gastrohep.2024.502214

Pedro Delgado-Guillena, Mireya Jimeno, Antonio López-Nuñez, Henry Córdova, Gloria Fernández-Esparrach

{"title":"The endoscopic model for gastric carcinogenesis and Helicobacter pylori infection: A potential visual mind-map during gastroscopy examination.","authors":"Pedro Delgado-Guillena, Mireya Jimeno, Antonio López-Nuñez, Henry Córdova, Gloria Fernández-Esparrach","doi":"10.1016/j.gastrohep.2024.502214","DOIUrl":"10.1016/j.gastrohep.2024.502214","url":null,"abstract":"Helicobacter pylori (Hp) is the main trigger of chronic gastric atrophy and the main leading cause of gastric cancer. Hp infects the normal gastric mucosa and can lead to chronic inflammation, glandular atrophy, intestinal metaplasia, dysplasia and finally adenocarcinoma. Chronic inflammation and gastric atrophy associated with Hp infection appear initially in the distal part of the stomach (the antrum) before progressing to the proximal part (the corpus-fundus). In recent years, endoscopic developments have allowed for the characterization of various gastric conditions including the normal mucosa (pyloric/fundic gland pattern and regular arrangement of collecting venules), Hp-related gastritis (Kyoto classification), glandular atrophy (Kimura-Takemoto classification), intestinal metaplasia (Endoscopic Grading of Gastric Intestinal Metaplasia), and dysplasia/adenocarcinoma (Vessel plus Surface classification). Despite being independent classifications, all these scales can be integrated into a single model: the endoscopic model for gastric carcinogenesis. This model would assist endoscopists in comprehending the process of gastric carcinogenesis and conducting a systematic examination during gastroscopy. Having this model in mind would enable endoscopists to promptly recognize the implications of Hp infection and the potential patient's risk of developing gastric cancer.","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141283523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Combined biologic treatment in patient with chronic spontaneous urticaria and Crohn's disease. 慢性自发性荨麻疹和克罗恩病患者的联合生物治疗。

IF 1.9 4区医学

Gastroenterologia y hepatologia Pub Date : 2024-05-28 DOI: 10.1016/j.gastrohep.2024.502213

Alejandro García Martínez, María Del Pilar Lobato de la Sierra, Teresa Castro Aguilar-Tablada

引用次数: 0

Azathioprine: a rare cause of sialadenitis. Two cases report. "硫唑嘌呤：引起唾液腺炎的罕见病因。两例报告"。

IF 1.9 4区医学

Gastroenterologia y hepatologia Pub Date : 2024-05-20 DOI: 10.1016/j.gastrohep.2024.502212

Ana Hurtado-Soriano, Ana Tirado, Francisco Javier Puchol-Rodrigo, José Cameo, Lucía Madero, Ana Gutiérrez

引用次数: 0

WITHDRAWN: ¿Qué estrategias empleamos en la prevención y el seguimiento del virus del papiloma humano en pacientes con enfermedad inflamatoria intestinal? 我们在预防和监测炎症性肠病患者的人类乳头瘤病毒方面采取了哪些策略？

IF 1.9 4区医学

Gastroenterologia y hepatologia Pub Date : 2024-05-17 DOI: 10.1016/j.gastrohep.2024.502211

Paula Fraga-Blanco, Nuria Boullon-Batalla, Jose Manuel Benitez, Cristina Suarez-Ferrer, Iria Baston-Rey, Margalida Calafat

引用次数: 0