Gastroenterologia y hepatologia最新文献

{"title":"Computer-assisted adenoma detection colonoscopy with an ENDO-AID artificial intelligence system and Endocuff- versus Endocuff-assisted colonoscopy: A randomized controlled trial.","authors":"Antonio Z Gimeno-García, Anjara Hernández, Domingo Hernández Negrin, Eduardo Rodríguez, Gloria Lorenzo, Jorge Mon, Rafael Romero, Alejandro Jiménez, Vanessa Felipe, Zaida Adrián, Raquel de la Barreda, Juan Ortega, Yaiza Cedrés, Manuel Hernández-Guerra, David Nicolás-Pérez","doi":"10.1016/j.gastrohep.2026.502757","DOIUrl":"10.1016/j.gastrohep.2026.502757","url":null,"abstract":"<p><strong>Background: </strong>Compared with conventional colonoscopy, computer-assisted adenoma detection (CADe) colonoscopy and Endocuff-Vision (EV) have been shown to increase the adenoma detection rate (ADR). However, the evidence for whether their combination further increases the ADR compared with that of EV alone is limited. The aim was to compare the combination of CADe and EV, with EV alone.</p><p><strong>Methods: </strong>In all, 696 patients were randomized 1:1 to receive either CADe (ENDO-AID [OIP-1]) plus EV or EV alone at a tertiary care hospital. The primary outcome was the ADR. The secondary outcomes included the advanced ADR and the number of adenomas per colonoscopy (APC). Both intention-to-treat (ITT) and per-protocol (PP) analyses were conducted for the primary outcome.</p><p><strong>Results: </strong>In the ITT analysis, the ADR was 54.6% and 51.1% in the combination and EV groups, respectively (OR 1.15, 95% CI (0.85-1.55)). In the PP analysis, the ADRs were 58.7% and 56.6%, respectively (OR 1.09, 95% CI (0.79-1.52)), for the combination and EV groups. The ADR in the proximal colon was significantly greater in the combination group than in the EV group (39.6% vs. 30%; P=0.015). The APC value was significantly greater in the combination group than in the EV group (mean: 1.7, SD: 2.34 vs. mean: 1.31, SD: 1.92; P=0.029), which was primarily due to increased detection of flat diminutive adenomas.</p><p><strong>Conclusions: </strong>Compared with EV alone, colonoscopy assisted by both ENDO-AID (OIP-1) and EV does not significantly increase the ADR. However, this combination may be beneficial for the detection of proximal and diminutive flat adenomas (NCT05141773).</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502757"},"PeriodicalIF":1.9,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147618319","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}

{"title":"Diagnostic yield of capsule endoscopy in iron-deficiency anemia in a low-complexity hospital.","authors":"Itziar Rubio de la Plaza, Francisco Javier Parra, Alba Sanz Prieto, Marina Gil Santana, Luis Alonso Castillo Herrera, Irene Chivato Martín-Falquina, Esteban Fuentes-Valenzuela, Alicia Bejerano Domínguez","doi":"10.1016/j.gastrohep.2026.502759","DOIUrl":"10.1016/j.gastrohep.2026.502759","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502759"},"PeriodicalIF":1.9,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147618310","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}

{"title":"Diagnostic performance of ASGE criteria for choledocholithiasis in acute biliary pancreatitis: A retrospective cohort study","authors":"Romario Ruiz ,&nbsp;Milagros Dávalos ,&nbsp;Edson Guzmán ,&nbsp;Ramiro Díaz ,&nbsp;Edgar Alva ,&nbsp;Javier Contreras ,&nbsp;Felipe De La Torre ,&nbsp;Luis Cervera","doi":"10.1016/j.gastrohep.2025.502610","DOIUrl":"10.1016/j.gastrohep.2025.502610","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the diagnostic performance of the 2019 American Society for Gastrointestinal Endoscopy (ASGE) criteria for choledocholithiasis in patients with acute biliary pancreatitis (ABP).</div></div><div><h3>Patients and methods</h3><div>We retrospectively analyzed patients diagnosed with ABP and suspected choledocholithiasis at a tertiary hospital between January and December 2024. Common bile duct (CBD) stones were confirmed by magnetic resonance cholangiopancreatography (MRCP) or computed tomography (CT) followed by endoscopic retrograde cholangiopancreatography (ERCP). Patients were stratified according to ASGE 2019 criteria. Diagnostic accuracy was assessed, and cut-off values for alkaline phosphatase (ALP), total bilirubin (TB), and CBD diameter were determined using receiver operating characteristic (ROC) analysis and logistic regression. Biochemical follow-up was analyzed in intermediate-risk patients without confirmed stones.</div></div><div><h3>Results</h3><div>A total of 197 patients were included; 52 (26.4%) had confirmed choledocholithiasis. Prevalence was 46.9% in the high-risk group and 22.4% in the intermediate group. High-risk classification showed low sensitivity (28.8%) but high specificity (88.3%). Alkaline phosphatase (ALP) was the only independent predictor (cut-off 518<!--> <!-->IU/L). In intermediate-risk patients without stones, 95% achieved biochemical normalization within 2 weeks.</div></div><div><h3>Conclusions</h3><div>ASGE 2019 criteria overestimate the risk of choledocholithiasis in ABP, particularly in intermediate-risk patients. Early biochemical follow-up may avoid unnecessary imaging and procedures in this group, while ALP remains the most consistent independent predictor. These results support more conservative and cost-effective management strategies in ABP.</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"49 4","pages":"Article 502610"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145476903","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}

{"title":"Diagnostic value and clinical implications of 75SeHCAT scan in bile acid diarrhea","authors":"Daniel Riado Mínguez ,&nbsp;Flor María Fernández-Gordón ,&nbsp;Miguel Casado Portolés ,&nbsp;Celia Gómez Labrador ,&nbsp;Cristina Cuadrado Tiemblo ,&nbsp;Carolina Georgina Suárez Cabredo ,&nbsp;Luis Wesley Wong Becerra ,&nbsp;Carlos Castaño Milla","doi":"10.1016/j.gastrohep.2025.502584","DOIUrl":"10.1016/j.gastrohep.2025.502584","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"49 4","pages":"Article 502584"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174721","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}

{"title":"Spanish clinical practice guidelines for the diagnosis and management of cholestatic liver diseases in adult and pediatric population: Joint report from AEEH and SEGHNP","authors":"Álvaro Díaz-González ,&nbsp;Cristina Molera ,&nbsp;Elena Gómez-Domínguez ,&nbsp;Gema Muñoz-Bartolo ,&nbsp;Javier Ampuero ,&nbsp;Conrado Fernández-Rodríguez ,&nbsp;Jesus Quintero ,&nbsp;Esther Molina ,&nbsp;Magdalena Salcedo ,&nbsp;Antonio Olveira ,&nbsp;Rosa Morillas ,&nbsp;María Alós Díez ,&nbsp;Marta Casado ,&nbsp;Luisa García-Buey ,&nbsp;Sergio Rodríguez-Tajes ,&nbsp;Francisco Jorquera ,&nbsp;Marina Berenguer ,&nbsp;Jose Luis Montero ,&nbsp;Maria Carlota Londoño","doi":"10.1016/j.gastrohep.2025.502629","DOIUrl":"10.1016/j.gastrohep.2025.502629","url":null,"abstract":"<div><div>Cholestatic liver diseases comprise a heterogeneous group of disorders affecting both adult and pediatric population, characterized by alterations in bile formation, secretion, or flow, leading to the accumulation of bile acids and other toxic substances in the liver. In recent years, advances in new pharmacological therapies, the availability of next-generation genetic sequencing techniques, and the development of specific treatments for genetic cholestasis have transformed the diagnostic and therapeutic approach to these conditions. This document, jointly prepared by the “Asociación Española para el Estudio del Hígado” (AEEH) and the “Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediátrica” (SEGHNP), presents a national evidence-based guideline for the diagnosis and management of hepatic cholestasis in Spain. It addresses recommendations for differential diagnosis, diagnostic algorithms, indications for genetic studies, treatment and follow-up criteria in diseases such as primary biliary cholangitis, primary sclerosing cholangitis, genetic cholestasis, intrahepatic cholestasis of pregnancy, and vanishing bile duct syndrome. In addition, recommendations are included for the management of extrahepatic complications, indications for liver transplantation, and special considerations in pregnancy and childhood. The guideline emphasizes the importance of a multidisciplinary approach, the use of non-invasive tools for risk stratification, and the incorporation of new targeted therapies, with the aim of improving the prognosis and quality of life of patients affected by cholestatic liver diseases.</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"49 4","pages":"Article 502629"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145512736","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}

{"title":"Impacto de los agonistas del receptor GLP-1 en cápsula endoscópica: Propuesta de adaptación de protocolos de preparación","authors":"Ana García-Rodríguez,&nbsp;Beatriz García Zafra,&nbsp;Natacha Llopart,&nbsp;Carla Santos","doi":"10.1016/j.gastrohep.2025.502627","DOIUrl":"10.1016/j.gastrohep.2025.502627","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"49 4","pages":"Article 502627"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145488179","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}

{"title":"Ganglio de la hermana María José en cáncer de colon","authors":"José Richard Tenazoa-Villalobos ,&nbsp;Edgar Fermín Yan-Quiroz ,&nbsp;Olga Mercedes Viviana Burgos-García ,&nbsp;Gladys Llerena-Cobián","doi":"10.1016/j.gastrohep.2025.502590","DOIUrl":"10.1016/j.gastrohep.2025.502590","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"49 4","pages":"Article 502590"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145354440","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}

{"title":"Deciphering the role of ammonia in MASLD: From a neurotoxin to a metabolic by-product","authors":"Carola Zurita-Palomo ,&nbsp;Franz Martín-Bermudo ,&nbsp;Douglas Maya-Miles ,&nbsp;Javier Ampuero ,&nbsp;Manuel Romero-Gómez ,&nbsp;Rocío Gallego-Durán","doi":"10.1016/j.gastrohep.2026.502664","DOIUrl":"10.1016/j.gastrohep.2026.502664","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"49 4","pages":"Article 502664"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044001","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}

{"title":"Melanoma gástrico primario","authors":"José Richard Tenazoa-Villalobos ,&nbsp;Edgar Fermín Yan-Quiroz ,&nbsp;Mónica Alexandra Olivera-Aldana","doi":"10.1016/j.gastrohep.2025.502588","DOIUrl":"10.1016/j.gastrohep.2025.502588","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"49 4","pages":"Article 502588"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307772","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}

{"title":"Hemorragia digestiva por metástasis gástricas de carcinoma renal: una causa poco frecuente","authors":"Guillén Bernal-Bandrés ,&nbsp;María Escuín-Sanmartín ,&nbsp;Sergio García-Mateo ,&nbsp;Reynaldo Alfonso Vilorio-Guzmán ,&nbsp;Enrique Ceamanos-Ibarra ,&nbsp;Marta Latre-Santos ,&nbsp;Gonzalo Hijos-Mallada","doi":"10.1016/j.gastrohep.2025.502626","DOIUrl":"10.1016/j.gastrohep.2025.502626","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"49 4","pages":"Article 502626"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145470869","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}