Gastroenterologia y hepatologia最新文献

{"title":"Oesophageal mucosal bridge: An unexpected endoscopic finding.","authors":"Guillermo Castillo-López, Carmen García Huerta, César Prieto de Frías, José María Riesco López","doi":"10.1016/j.gastrohep.2025.502499","DOIUrl":"10.1016/j.gastrohep.2025.502499","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502499"},"PeriodicalIF":2.2,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225268","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":"Analysis of risk factors for complications after protective ileostomy reconstruction in patients operated on for rectal cancer.","authors":"Manuel González Bermúdez, María Lourdes García Jiménez, Sergio Rodríguez Rojo, Jose Antonio Romero González, Pablo Concheiro Coello, Javier Aguirrezabalaga González, José Francisco Noguera Aguilar","doi":"10.1016/j.gastrohep.2025.502495","DOIUrl":"10.1016/j.gastrohep.2025.502495","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the incidence of complications following ileostomy reversal and to identify associated risk factors.</p><p><strong>Patients and methods: </strong>A retrospective cohort study was conducted, including patients who underwent rectal cancer surgery with a protective ileostomy. The minimum follow-up period was one year. A univariate analysis was performed to identify potential risk factors for complications, and variables with P<0.1 were included in a multivariate analysis.</p><p><strong>Results: </strong>Between January 1, 2015, and December 31, 2023, a total of 220 patients underwent surgery. Thirteen percent did not undergo ileostomy reversal. Thus, 193 patients were included in the final analysis. The median time to ileostomy reversal was 292 days. Postoperative complications occurred in approximately 27.5% of cases. Among the potential risk factors, albumin levels <4g/dl, open surgical approach for rectal pathology, absence of efferent loop stimulation, and side-to-side anastomosis were associated with P<.1 in univariate analysis. In the multivariate analysis, only low albumin levels and the open surgical approach for rectal pathology remained significantly associated with an increased risk of complications.</p><p><strong>Conclusion: </strong>Modifiable factors such as the use of a laparoscopic approach for rectal surgery, stimulation of the efferent loop, and optimization of preoperative nutritional status may help reduce the incidence of postoperative complications.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502495"},"PeriodicalIF":2.2,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208330","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":"Double pylorus: An uncommon complication of peptic ulcer.","authors":"Raúl Fernández García, Marta Lecuona Muñoz, Eduardo Redondo Cerezo, Maria Del Carmen Fernández Cano","doi":"10.1016/j.gastrohep.2025.502498","DOIUrl":"10.1016/j.gastrohep.2025.502498","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502498"},"PeriodicalIF":2.2,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208331","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":"Windsock duodenal diverticulum: An unusual cause of upper gastrointestinal bleeding.","authors":"Sara Sánchez Moreno, Ana Plaza Fernández, Francisca Anguita Montes","doi":"10.1016/j.gastrohep.2025.502497","DOIUrl":"10.1016/j.gastrohep.2025.502497","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502497"},"PeriodicalIF":2.2,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208332","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":"Use of PET in preoperative malignancy determination of gastric schwannomas. Systematic review and contribution of a case.","authors":"Ignacio Antonio Gemio Del Rey, Roberto de la Plaza Llamas, Daniel Alejandro Díaz Candelas, Ludovica Gorini, Rodrigo Arellano González","doi":"10.1016/j.gastrohep.2025.502496","DOIUrl":"10.1016/j.gastrohep.2025.502496","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502496"},"PeriodicalIF":2.2,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198943","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":"Evaluation of the «textbook outcomes» surgery quality indicator as a good prognostic factor for pancreatic adenocarcinoma.","authors":"Aingeru Sarriugarte Lasarte, Hector Marín Ortega, Miren San Martin Murillo, Silvia Perez Fernandez, Gerardo Moro Portela, Beatriz Villota Tamayo, Javier Uriarte Gonzalez, Jasone Larrea Oleaga, Raul Saa Álvarez","doi":"10.1016/j.gastrohep.2025.502493","DOIUrl":"10.1016/j.gastrohep.2025.502493","url":null,"abstract":"<p><strong>Objectives: </strong>Pancreatic surgery is burdened with high morbidity and mortality. There are quality indicators of the surgical process known as textbook outcomes (TO) that have been validated in areas such as esophagogastric surgery or liver surgery, and are beginning to be used in pancreatic surgery. This indicator assesses the absence of: 1) Mortality, 2) Pancreatic fistula, 3) Hemorrhage, 4) Biliary fistula, 5) Clavien-Dindo>II and 6) Readmission; TO is considered if all criteria are got. The aim of this study is to assess the impact of the achievement of TO on the prognosis of pancreatic adenocarcinoma.</p><p><strong>Patients and methods: </strong>Retrospective comparative study between two periods; before and after the creation of a pancreatic surgery unit. The results have been evaluated using Textbook Outcomes and the impact on survival of the achievement of these criteria was analyzed.</p><p><strong>Results: </strong>A total of 185 patients with pancreatic adenocarcinoma were analyzed, divided into two 5-year periods before and after the creation of the pancreatic surgery unit. There were no significant differences in clinical-pathological variables. Since the creation of the unit, TO achievement increased from 47 to 80.7% (P<.05). The OS of patients at 1, 2, and 3 years in the groups with and without TO criteria fulfillment was 86.9, 55.7, 41 and 62.7, 40.3 and 31.3% respectively, with a statistically significant difference as shown in Image 1 (P=.013). Multivariate analysis of OS showed that compliance with all TOs significantly affects mortality (HR: 0.5 [0.31-0.81]; P=.004).</p><p><strong>Conclusion: </strong>The results support the hypothesis that the achievement of the TO surgical quality criteria has a positive impact on the oncological prognosis of curative surgery for pancreatic cancer. Centralization of pancreatic cancer surgery could help to meet the surgical quality criteria largely and thus improve the prognosis of patients.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502493"},"PeriodicalIF":2.2,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198940","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":"Fecal elastase-1 and ¹³C-mixed triglyceride breath test vs. coefficient of fat absorption to diagnose exocrine pancreatic insufficiency after pancreatic surgery.","authors":"Paula Sirera-Sirera, Núria Lluís, Fèlix Lluís, Pedro Zapater, Pablo López-Guillén, José M Ramia-Ángel, Rahma Amrani, Trinidad Castillo-García, José Andreu-Viseras, Karina Cárdenas-Jaén, Lucía Guilabert, Sara Pérez-Brotons, Emma Martínez-Moneo, Nerea Gendive-Martin, Iván González Hermoso, Enrique de-Madaria, María José Ferri","doi":"10.1016/j.gastrohep.2025.502492","DOIUrl":"10.1016/j.gastrohep.2025.502492","url":null,"abstract":"<p><strong>Objective: </strong>Exocrine pancreatic insufficiency (EPI) is common after pancreatic surgery. In patients with chronic pancreatitis, our previous results supported the use of fecal elastase-1 (FE-1) over the ¹³C-mixed triglyceride breath test (¹³C-MTBT) for the diagnosis of EPI. However, it is poorly established how the performance of these two tests compares to the diagnosis of EPI after pancreatic surgery.</p><p><strong>Patients and methods: </strong>FE-1 and ¹³C-MTBT were compared with the gold standard coefficient of fat absorption (CFA). Area under ROC curve (AUC) and best cutoffs were used to assess presence of EPI. Patient characteristics were evaluated by extent of pancreatic resection.</p><p><strong>Results: </strong>The AUC (95% confidence interval) was 0.724 (0.578-0.871) for FE-1 and 0.640 (0.482-0.799) for ¹³C-MTBT in the diagnosis of EPI. A pairwise comparison of the FE-1 and ¹³C-MTBT AUCs showed no statistically significant difference (P=.20). The best cut-off point was 65.5μg/g for FE-1 and 22.5% for ¹³C-MTBT. According to contingency analysis, both the FE-1 threshold of 65.5μg/g (P=.005) and the ¹³C-MTBT threshold of 22.5% (P=.015) showed statistical significance for diagnosing EPI.</p><p><strong>Conclusion: </strong>FE-1 was more accurate for diagnosing EPI after pancreatic surgery, but the differences were not statistically different.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502492"},"PeriodicalIF":2.2,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198941","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":"Sex-based differences in the relationship between health-related quality of life, physical activity, and inflammatory markers in people with Crohn's disease.","authors":"Susana Herrero-Rodríguez, Leticia Martín-Cordero, Raquel Mayordomo, Isabel Gálvez, Eduardo Ortega","doi":"10.1016/j.gastrohep.2025.502494","DOIUrl":"10.1016/j.gastrohep.2025.502494","url":null,"abstract":"<p><strong>Objective: </strong>Managing Crohn's disease (CD) requires addressing factors beyond medical treatment alone, including health-related quality of life (HRQoL) and physical activity. This study aimed to understand the relationships between different intensities of physical activity, HRQoL, and inflammatory biomarkers in CD, considering sex as a factor that could influence these associations.</p><p><strong>Patients and methods: </strong>A cross-sectional, observational study was conducted in 63 CD patients. Sociodemographic and clinical data, including C-reactive protein and fecal calprotectin determinations, were collected. The Inflammatory Bowel Disease Questionnaire (IBDQ-9) and the Global Physical Activity Questionnaire (GPAQ) were used to measure HRQoL and physical activity, respectively.</p><p><strong>Results: </strong>Although females had similar inflammation levels to males, they engaged in less physical activity and reported lower HRQoL (especially in psychosocial wellbeing). Sedentary behavior and intense physical activity negatively impacted HRQoL in the overall sample and only in females. Higher fecal calprotectin concentrations were associated with poorer HRQoL in the total group and only in males. No correlation was found between inflammation and physical activity.</p><p><strong>Conclusions: </strong>Sex differences influence the relationship between inflammation, physical activity, and HRQoL in CD. Given the greater impact of CD on emotional and social wellbeing in females, irrespective of physiological measures of inflammation, our findings support considering sex differences, which may inform more individualized approaches to improve HRQoL.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502494"},"PeriodicalIF":2.2,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198942","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":"The Spanish National Strategic Plan for Hepatitis C: A legacy of success.","authors":"Javier Crespo, Agustín Albillos, María Buti","doi":"10.1016/j.gastrohep.2025.502457","DOIUrl":"https://doi.org/10.1016/j.gastrohep.2025.502457","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502457"},"PeriodicalIF":2.2,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600239","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":"Exploring infliximab serum level variability in inflammatory bowel disease: Comprehensive analysis of patient subgroups and treatment outcomes.","authors":"Carles Iniesta-Navalón, Lorena Rentero-Redondo, Rosa Gómez-Espín, Manuel Ríos Saorín, Isabel Nicolás de Prado, Juan José Gascón-Cánovas","doi":"10.1016/j.gastrohep.2025.502472","DOIUrl":"10.1016/j.gastrohep.2025.502472","url":null,"abstract":"<p><strong>Background and aims: </strong>Inflammatory bowel disease (IBD) features diverse clinical presentations and progressions, impacting IFX exposure. Understanding IFX serum concentration changes is crucial for tailored monitoring in specific patient groups. The main objective of this study was to analyze ITL trajectories in patients with IBD to identify distinct groups and subgroups, revealing heterogeneity in treatment responses.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted involving IBD patients treated with infliximab in a regional reference hospital in Spain. Latent class linear mixed models were applied to identify subgroups based on serum infliximab measurements over time. To analyze the factors associated with IFX discontinuation, we employed both logistic regression and Cox regression models.</p><p><strong>Results: </strong>The study included 165 IBD patients, and a total of 799 ITL samples were analyzed. The selected model included three clusters, with a random intercept and a random effect on both time and natural cubic spline time in the linear mixed model. Cluster 1 (20.6%) had lower IFX exposure, with 93.9% experiencing treatment discontinuation, compared to 45.1% in Cluster 2 (43.0%) and 43.3% in Cluster 3 (36.4%) (p<0.001). Treatment discontinuation was observed in 91 individuals (55.2%) out of the total patients. In the multivariate analysis, the presence of cluster 1 was a significant predictor (OR: 7.25, 95% CI: 1.45-36.12). Bayesian dose adjustment was found to significantly reduce the risk of IFX discontinuation (OR: 0.19, 95% CI: 0.46-1.96).</p><p><strong>Conclusions: </strong>The lack of TDM during induction and a lower proportion of adjustments made through Bayesian methods were associated with a subgroup demonstrating suboptimal pharmacokinetic profiles and reduced drug persistence. These findings highlight the clinical relevance of model-informed TDM in optimizing IFX exposure and minimizing treatment discontinuation in IBD.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502472"},"PeriodicalIF":2.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142271","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}