Gut and Liver最新文献

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Gallstone Dissolution Effects of Combination Therapy with n-3 Polyunsaturated Fatty Acids and Ursodeoxycholic Acid: A Randomized, Prospective, Preliminary Clinical Trial. n-3 多不饱和脂肪酸和熊去氧胆酸联合疗法对胆石溶解的影响:一项随机、前瞻性、初步临床试验。
IF 3.4 3区 医学
Gut and Liver Pub Date : 2024-11-15 Epub Date: 2024-05-07 DOI: 10.5009/gnl230494
See Young Lee, Sung Ill Jang, Jae Hee Cho, Min Young Do, Su Yeon Lee, Arong Choi, Hye Sun Lee, Juyeon Yang, Dong Ki Lee
{"title":"Gallstone Dissolution Effects of Combination Therapy with n-3 Polyunsaturated Fatty Acids and Ursodeoxycholic Acid: A Randomized, Prospective, Preliminary Clinical Trial.","authors":"See Young Lee, Sung Ill Jang, Jae Hee Cho, Min Young Do, Su Yeon Lee, Arong Choi, Hye Sun Lee, Juyeon Yang, Dong Ki Lee","doi":"10.5009/gnl230494","DOIUrl":"10.5009/gnl230494","url":null,"abstract":"<p><strong>Background/aims: </strong>: Ursodeoxycholic acid (UDCA) is the only well-established and widely used agent for dissolving gallstones. Epidemiological and animal studies have suggested potential therapeutic benefits of n-3 polyunsaturated fatty acids (PUFA) for dissolving cholesterol gallstones. We evaluated whether adding PUFA to UDCA improves gallstone dissolution in patients with cholesterol gallstones.</p><p><strong>Methods: </strong>: This randomized, prospective, preliminary clinical trial compared the efficacy and safety of UDCA plus PUFA combination therapy (combination group) with those of UDCA monotherapy (monotherapy group). The inclusion criteria were a gallstone diameter ≤15 mm on ultrasonography, radiolucent stones on plain X-ray, and no to mild symptoms. Gallstone dissolution rates, response rates, and adverse events were evaluated.</p><p><strong>Results: </strong>: Of the 59 screened patients, 45 patients completed treatment (24 and 21 in the monotherapy and combination groups, respectively). The gallstone dissolution rate tended to be higher in the combination group than in the monotherapy group (45.7% vs 9.9%, p=0.070). The radiological response rate was also significantly higher in the combination group (90.5% vs 41.7%, p=0.007). In both groups, dissolution and response rates were higher in patients with gallbladder sludge than in those with distinct stones. Four adverse events (two in each group) were observed, none of which were study drug-related or led to drug discontinuation. The incidence of these adverse events was similar in both groups (combination vs monotherapy: 9.5% vs 8.3%, p=0.890).</p><p><strong>Conclusions: </strong>: UDCA plus PUFA therapy dissolves cholesterol gallstones more effectively than UDCA monotherapy, without significant complications. Further prospective, large-scale studies of this combination therapy are warranted.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"1069-1079"},"PeriodicalIF":3.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Autoimmune Gastritis in Korean Patients with Gastric Tumors: Clinicopathologic Correlations and Diagnostic Histological Features. 韩国胃肿瘤患者的自身免疫性胃炎:临床病理相关性和诊断性组织学特征
IF 3.4 3区 医学
Gut and Liver Pub Date : 2024-11-07 DOI: 10.5009/gnl240223
Soomin Ahn, Tae-Se Kim, Ryoji Kushima, Jun Haeng Lee, Kyoung-Mee Kim
{"title":"Autoimmune Gastritis in Korean Patients with Gastric Tumors: Clinicopathologic Correlations and Diagnostic Histological Features.","authors":"Soomin Ahn, Tae-Se Kim, Ryoji Kushima, Jun Haeng Lee, Kyoung-Mee Kim","doi":"10.5009/gnl240223","DOIUrl":"10.5009/gnl240223","url":null,"abstract":"<p><strong>Background/aims: </strong>Autoimmune gastritis (AIG) is a corpus-dominant atrophic gastritis in which patients are positive for antiparietal cell antibody (APCA) and/or anti-intrinsic factor antibody. The risk of developing gastric cancer in patients with AIG remains unclear, and reliable frequency data of AIG in patients with gastric cancer are lacking.</p><p><strong>Methods: </strong>We included 624 Korean patients with gastric tumors (612 gastric cancers and 12 neuroendocrine tumors) who had APCA results and were available for AIG evaluation. In patients with positive APCA results, endoscopy and histology findings were reviewed to diagnose AIG.</p><p><strong>Results: </strong>Of the 624 patients, 37 (5.9%) tested positive for APCA, and ultimately, 11 (1.8%) met the diagnostic criteria for AIG (5 both endoscopy and histology findings, 4 endoscopy-only findings, 2 histology-only findings). The frequency of AIG in patients with gastric cancer was 1.3% (8/612), and that in patients with neuroendocrine tumors was 25.0% (3/12). Of the 11 patients with AIG, serum <i>Helicobacter pylori</i> antibody was positive in six patients (54.5%), all of whom had gastric cancer. Histologically, three patients showed pure AIG, four patients exhibited concurrent AIG and <i>H. pylori</i> gastritis, and the findings for four were indefinite for AIG. The pepsinogen (PG) I levels and PG I/II ratio were significantly lower in patients with gastric cancer with AIG than in patients with gastric cancer without AIG (p=0.042 and p=0.016, respectively).</p><p><strong>Conclusions: </strong>The frequency of AIG in gastric cancer patients was very low compared to that in patients with neuroendocrine tumors. Rather, concurrent AIG and <i>H. pylori</i> gastritis was common in patients with AIG with gastric cancer.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590334","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
Anxiety and Depression Are Associated with Poor Long-term Quality of Life in Moderate-to-Severe Ulcerative Colitis: Results of a 3-Year Longitudinal Study of the MOSAIK Cohort. 焦虑和抑郁与中重度溃疡性结肠炎患者长期生活质量低下有关:MOSAIK队列3年纵向研究结果。
IF 3.4 3区 医学
Gut and Liver Pub Date : 2024-11-07 DOI: 10.5009/gnl240146
Shin Ju Oh, Chang Hwan Choi, Sung-Ae Jung, Geun Am Song, Yoon Jae Kim, Ja Seol Koo, Sung Jae Shin, Geom Seog Seo, Kang-Moon Lee, Byung Ik Jang, Eun Suk Jung, Youngdoe Kim, Chang Kyun Lee
{"title":"Anxiety and Depression Are Associated with Poor Long-term Quality of Life in Moderate-to-Severe Ulcerative Colitis: Results of a 3-Year Longitudinal Study of the MOSAIK Cohort.","authors":"Shin Ju Oh, Chang Hwan Choi, Sung-Ae Jung, Geun Am Song, Yoon Jae Kim, Ja Seol Koo, Sung Jae Shin, Geom Seog Seo, Kang-Moon Lee, Byung Ik Jang, Eun Suk Jung, Youngdoe Kim, Chang Kyun Lee","doi":"10.5009/gnl240146","DOIUrl":"10.5009/gnl240146","url":null,"abstract":"<p><strong>Background/aims: </strong>We previously reported that patients with moderate-to-severe ulcerative colitis (UC) often experience common mental disorders (CMDs) such as anxiety and depression, necessitating immediate psychological interventions within the first 4 weeks of diagnosis. In this 3-year follow-up study of the MOSAIK cohort in Korea, we examined the effects of CMDs at initial diagnosis on clinical outcomes and health-related quality of life (HRQoL).</p><p><strong>Methods: </strong>We examined differences in clinical outcomes (evaluated based on clinical response, relapse, hospitalization, and medication use) and HRQoL (assessed using the Inflammatory Bowel Disease Questionnaire [IBDQ] and Short Form 12 [SF-12]) according to Hospital Anxiety and Depression Scale (HADS) scores at diagnosis.</p><p><strong>Results: </strong>In a study involving 199 UC patients, 47.7% exhibited significant psychological distress (anxiety and/or depression) at diagnosis. Clinical follow-up showed no major differences in outcomes, including remission rates, response rates, or hospitalization rates, between patients with anxiety or depression at diagnosis and patients without anxiety or depression at diagnosis. The HRQoL at the end of follow-up was notably lower in those with baseline CMDs, particularly anxiety, across all domains of the IBDQ and SF-12. Linear mixed-effect models revealed that higher HADS scores, as well as higher Mayo scores, were independently associated with lower IBDQ scores and both summary domains of the SF-12. Additionally, regular attendance at follow-up visits during the study period was also related to improvements in HRQoL (all p<0.05).</p><p><strong>Conclusions: </strong>While CMDs present at the time of UC diagnosis did not influence long-term clinical outcomes, they persistently impaired HRQoL. Our findings support the routine incorporation of psychological interventions into the long-term management of moderate-to-severe UC.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590329","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
Trends and Factors Related to Quality of Life in Patients with Inflammatory Bowel Disease. 与炎症性肠病患者生活质量相关的趋势和因素。
IF 3.4 3区 医学
Gut and Liver Pub Date : 2024-11-07 DOI: 10.5009/gnl240172
Sihyun Kim, Yu Kyung Jun, Yonghoon Choi, Cheol Min Shin, Young Soo Park, Nayoung Kim, Dong Ho Lee, Hyuk Yoon
{"title":"Trends and Factors Related to Quality of Life in Patients with Inflammatory Bowel Disease.","authors":"Sihyun Kim, Yu Kyung Jun, Yonghoon Choi, Cheol Min Shin, Young Soo Park, Nayoung Kim, Dong Ho Lee, Hyuk Yoon","doi":"10.5009/gnl240172","DOIUrl":"10.5009/gnl240172","url":null,"abstract":"<p><strong>Background/aims: </strong>Inflammatory bowel disease (IBD) affects health-related quality of life (HRQoL). The Short Inflammatory Bowel Disease Questionnaire (SIBDQ) score is strongly correlated with HRQoL in IBD patients. This study aimed to assess the factors influencing HRQoL in IBD patients.</p><p><strong>Methods: </strong>In this prospective study, all patients with ulcerative colitis (UC) and Crohn's disease (CD) completed the SIBDQ at enrollment; some patients also completed a second SIBDQ at follow-up. Multiple linear regression analysis was used to determine associations between SIBDQ scores and clinical factors.</p><p><strong>Results: </strong>A total of 1,020 patients participated (UC, 67%; CD, 33%). The median SIBDQ score was 52 (interquartile range, 44 to 59). In UC patients, the stool frequency (β=-2.333, p<0.001), Physician Global Assessment score (β=-3.950, p<0.001), fecal calprotectin level (β=-4.014, p<0.001), and corticosteroid use (β=-4.809, p=0.006) were negatively correlated with the SIBDQ score. In CD patients, the number of diarrhea episodes per day (β=-1.467, p=0.024) and Crohn's Disease Activity Index score (β=-0.045, p<0.001) were negatively correlated with the SIBDQ score. A total of 202 patients completed the second SIBDQ within a mean of 3.4 years. The distributions of SIBDQ score changes were as follows: decrease >10%, 28%; -10%<change<10%, 29%; and increase >10%, 43%. In both the initial SIBDQ and follow-up SIBDQ, scores for items pertaining to systemic symptoms (tension and fatigue) were relatively low.</p><p><strong>Conclusions: </strong>Bowel movement-related problems significantly affect the HRQoL of both UC and CD patients. IBD patients scored lower on SIBDQ items related to general well-being. After 3 years of follow-up at the IBD clinic, 43% of patients showed a significant improvement in HRQoL.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590355","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
Short-term and Long-term Clinical Outcomes of Combined Caudate Lobectomy for Intrahepatic Cholangiocarcinoma Involving the Hepatic Hilus: A Propensity Score Analysis. 联合尾状叶切除术治疗累及肝门的肝内胆管癌的短期和长期临床疗效:倾向评分分析
IF 3.4 3区 医学
Gut and Liver Pub Date : 2024-09-27 DOI: 10.5009/gnl240158
Di Zeng, Yaoqun Wang, Ningyuan Wen, Bei Li, Nansheng Cheng, Jiong Lu
{"title":"Short-term and Long-term Clinical Outcomes of Combined Caudate Lobectomy for Intrahepatic Cholangiocarcinoma Involving the Hepatic Hilus: A Propensity Score Analysis.","authors":"Di Zeng, Yaoqun Wang, Ningyuan Wen, Bei Li, Nansheng Cheng, Jiong Lu","doi":"10.5009/gnl240158","DOIUrl":"https://doi.org/10.5009/gnl240158","url":null,"abstract":"<p><strong>Background/aims: </strong>Extended hepatectomy combined with caudate lobe resection has been approved for the radical resection of hilar cholangiocarcinoma. There was a lack of credible research on the clinical value of caudate lobectomy (CL) for intrahepatic cholangiocarcinoma involving the hepatic hilus when combined with hepatectomy. We aimed to compare the short-term and long-term outcomes of the combined procedure with those of only CL for curative resection of intrahepatic cholangiocarcinoma involving the hepatic hilus.</p><p><strong>Methods: </strong>This single-center retrospective cohort study of patients with hilar cholangiocarcinoma was conducted from January 2007 to December 2021. Patients who underwent radical resection were enrolled in this study. The short-term and long-term clinical outcomes of the groups were compared before and after propensity score matching (PSM).</p><p><strong>Results: </strong>A total of 282 patients were included. There were no statistically significant differences in perioperative clinical outcomes between the CL group and the non-CL group before and after PSM. Compared to patients in the non-CL group, patients in the CL group had significantly longer overall survival before and after PSM (p=0.007 before PSM, p=0.033 after PSM). Moreover, compared to the non-CL group, the CL group had longer disease-free survival before and after PSM (p<0.001 before PSM, p=0.019 after PSM).</p><p><strong>Conclusions: </strong>The postoperative complications of the CL group were comparable to those of the non-CL group. CL improved the long-term survival of patients with intrahepatic cholangiocarcinoma involving the hepatic hilus when combined with hepatectomy. Therefore, hepatectomy combined with caudate lobe resection should be performed for patients with hilar cholangiocarcinoma.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345203","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
Effect of Probiotics on Improving Intestinal Mucosal Permeability and Inflammation after Surgery. 益生菌对改善手术后肠道黏膜通透性和炎症的影响
IF 3.4 3区 医学
Gut and Liver Pub Date : 2024-09-27 DOI: 10.5009/gnl240170
Min-Jae Kim, Young Ju Lee, Zahid Hussain, Hyojin Park
{"title":"Effect of Probiotics on Improving Intestinal Mucosal Permeability and Inflammation after Surgery.","authors":"Min-Jae Kim, Young Ju Lee, Zahid Hussain, Hyojin Park","doi":"10.5009/gnl240170","DOIUrl":"https://doi.org/10.5009/gnl240170","url":null,"abstract":"<p><strong>Background/aims: </strong>We explored the mechanisms underlying the improvement of postoperative ileus (POI) following probiotic pretreatment. We assessed intestinal permeability, inflammation, tight junction (TJ) protein expression in the gut epithelium, and plasma interleukin (IL)-17 levels in a guinea pig model of POI.</p><p><strong>Methods: </strong>Guinea pigs were divided into control, POI, and probiotic groups. The POI and probiotic groups underwent surgery, but the probiotic group received probiotics before the procedure. The ileum and proximal colon were harvested. Intestinal permeability was measured via horseradish peroxidase permeability. Inflammation was evaluated via leukocyte count in the intestinal wall muscle layer, and calprotectin expression in each intestinal wall layer was analyzed immunohistochemically. TJ proteins were analyzed using immunohistochemical staining, and plasma IL-17 levels were measured using an enzyme-linked immunosorbent assay.</p><p><strong>Results: </strong>The POI group exhibited increased intestinal permeability and inflammation, whereas probiotic pretreatment reduced the extent of these POI-induced changes. Probiotics restored the expression of TJ proteins occludin and zonula occludens-1 in the proximal colon, which were increased in the POI group. Calprotectin expression significantly increased in the muscle layer of the POI group and was downregulated in the probiotic group; however, no distinct differences were observed between the mucosal and submucosal layers. Plasma IL-17 levels did not significantly differ among the groups.</p><p><strong>Conclusions: </strong>Probiotic pretreatment may relieve POI by reducing intestinal permeability and inflammation and TJ protein expression in the gut epithelium. These findings suggest a potential therapeutic approach for POI management.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345202","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
Impact of Korean Military Service on the Prevalence of Steatotic Liver Disease: A Longitudinal Study of Pre-enlistment and In-Service Health Check-Ups. 韩国兵役对脂肪肝患病率的影响:入伍前和服役期健康检查纵向研究》。
IF 3.4 3区 医学
Gut and Liver Pub Date : 2024-09-15 Epub Date: 2024-07-02 DOI: 10.5009/gnl240077
Jaejun Lee, Jae Hyeop Jung, Sung Jun Choi, Beomman Ha, Hyun Yang, Pil Soo Sung, Si Hyun Bae, Jeong-A Yu
{"title":"Impact of Korean Military Service on the Prevalence of Steatotic Liver Disease: A Longitudinal Study of Pre-enlistment and In-Service Health Check-Ups.","authors":"Jaejun Lee, Jae Hyeop Jung, Sung Jun Choi, Beomman Ha, Hyun Yang, Pil Soo Sung, Si Hyun Bae, Jeong-A Yu","doi":"10.5009/gnl240077","DOIUrl":"10.5009/gnl240077","url":null,"abstract":"<p><strong>Background/aims: </strong>Young Korean men are obligated to serve in the military for 18 to 21 months. We investigated the effects of military service on steatotic liver disease (SLD) and other metabolic parameters.</p><p><strong>Methods: </strong>Pre-enlistment health check-up performed from 2019 to 2022 and in-service health check-up performed from 2020 to 2022 were merged as paired data. SLD was defined as a hepatic steatosis index of 36 or higher. Hypertension (HTN) and hypertriglyceridemia were also included in the analysis.</p><p><strong>Results: </strong>A total of 503,136 paired cases were included in the analysis. Comparing pre-enlistment and in-service health check-ups, the prevalence of SLD (22.2% vs 17.6%, p<0.001), HTN (7.6% vs 4.3%, p<0.001), and hypertriglyceridemia (8.1% vs 2.9%, p<0.001) decreased during military service. In terms of body mass index, the proportion of underweight (8.2% vs 1.4%, p<0.001) and severely obese (6.1% vs 4.9%, p<0.001) individuals decreased over time. Regarding factors associated with SLD development and resolution, age was positively associated with SLD development (odds ratio, 1.146; p<0.001) and a health check-up interval of <450 days was a protective factor for SLD development (odds ratio, 0.746; p<0.001). Those serving in the marines were less likely to develop SLD, whereas those serving in the navy were more likely to develop SLD. Serving in the army or the navy was negatively associated with SLD resolution, whereas serving in the air force was positively associated with SLD resolution.</p><p><strong>Conclusions: </strong>The prevalence of SLD, HTN, and hypertriglyceridemia decreased substantially during Korean military service.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"888-896"},"PeriodicalIF":3.4,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11391135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141476478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effect of Biliary Drainage on the Prognosis of Patients with Hepatocellular Carcinoma and Bile Duct Invasion. 胆道引流对胆管受侵肝细胞癌患者预后的影响
IF 3.4 3区 医学
Gut and Liver Pub Date : 2024-09-15 Epub Date: 2024-07-18 DOI: 10.5009/gnl240032
Keungmo Yang, Hyun Yang, Chang Wook Kim, Hee Chul Nam, Ji Hoon Kim, Ahlim Lee, U Im Chang, Jin Mo Yang, Hae Lim Lee, Jung Hyun Kwon, Soon Woo Nam, Soon Kyu Lee, Pil Soo Sung, Ji Won Han, Jeong Won Jang, Si Hyun Bae, Jong Young Choi, Seung Kew Yoon, Hee Yeon Kim
{"title":"Effect of Biliary Drainage on the Prognosis of Patients with Hepatocellular Carcinoma and Bile Duct Invasion.","authors":"Keungmo Yang, Hyun Yang, Chang Wook Kim, Hee Chul Nam, Ji Hoon Kim, Ahlim Lee, U Im Chang, Jin Mo Yang, Hae Lim Lee, Jung Hyun Kwon, Soon Woo Nam, Soon Kyu Lee, Pil Soo Sung, Ji Won Han, Jeong Won Jang, Si Hyun Bae, Jong Young Choi, Seung Kew Yoon, Hee Yeon Kim","doi":"10.5009/gnl240032","DOIUrl":"10.5009/gnl240032","url":null,"abstract":"<p><strong>Background/aims: </strong>Bile duct invasion (BDI) is rarely observed in patients with advanced hepatocellular carcinoma (HCC), leading to hyperbilirubinemia. However, the efficacy of pretreatment biliary drainage for HCC patients with BDI and obstructive jaundice is currently unclear. Thus, the aim of this study was to assess the effect of biliary drainage on the prognosis of these patients.</p><p><strong>Methods: </strong>We retrospectively enrolled a total of 200 HCC patients with BDI from multicenter cohorts. Patients without obstructive jaundice (n=99) and those who did not undergo HCC treatment (n=37) were excluded from further analysis. Finally, 64 patients with obstructive jaundice (43 subjected to drainage and 21 not subjected to drainage) were included. Propensity score matching was then conducted.</p><p><strong>Results: </strong>The biliary drainage group showed longer overall survival (median 10.13 months vs 4.43 months, p=0.004) and progression-free survival durations (median 7.00 months vs 1.97 months, p<0.001) than the non-drainage group. Multivariate analysis showed that biliary drainage was a significantly favorable prognostic factor for overall survival (hazard ratio, 0.42; p=0.006) and progression-free survival (hazard ratio, 0.30; p<0.001). Furthermore, in the evaluation of first response after HCC treatment, biliary drainage was beneficial (p=0.005). Remarkably, the durations of overall survival (p=0.032) and progression-free survival (p=0.004) were similar after propensity score matching.</p><p><strong>Conclusions: </strong>Biliary drainage is an independent favorable prognostic factor for HCC patients with BDI and obstructive jaundice. Therefore, biliary drainage should be contemplated in the treatment of advanced HCC with BDI to improve survival outcomes.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"877-887"},"PeriodicalIF":3.4,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11391144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Real-World Bleeding Risk of Anticoagulant and Nonsteroidal Anti-inflammatory Drugs Combotherapy versus Anticoagulant Monotherapy. 抗凝血剂和非甾体抗炎药联合疗法与抗凝血剂单一疗法的实际出血风险。
IF 3.4 3区 医学
Gut and Liver Pub Date : 2024-09-15 Epub Date: 2024-05-10 DOI: 10.5009/gnl230541
Moonhyung Lee, Jae Myung Cha
{"title":"Real-World Bleeding Risk of Anticoagulant and Nonsteroidal Anti-inflammatory Drugs Combotherapy versus Anticoagulant Monotherapy.","authors":"Moonhyung Lee, Jae Myung Cha","doi":"10.5009/gnl230541","DOIUrl":"10.5009/gnl230541","url":null,"abstract":"<p><strong>Background/aims: </strong>The incidence of acute gastrointestinal bleeding (GIB) increases with the utilization of anticoagulant and nonsteroidal anti-inflammatory drugs (NSAIDs). This study aimed to compare the risk of GIB between anticoagulant and NSAIDs combotherapy and anticoagulant monotherapy in real-world practice.</p><p><strong>Methods: </strong>We investigated the relative risk of GIB in individuals newly prescribed anticoagulant and NSAIDs combination therapy and that in individuals newly prescribed anticoagulant monotherapy at three hospitals using \"common data model.\" Cox proportional hazard models and Kaplan-Meier estimation were employed for risk comparison after propensity score matching.</p><p><strong>Results: </strong>A comprehensive analysis of 2,951 matched pairs showed that patients who received anticoagulant and NSAIDs combousers exhibited a significantly higher risk of GIB than those who received anticoagulant monousers (hazard ratio [HR], 1.66; 95% confidence interval [CI], 1.30 to 2.12; p<0.001). The risk of GIB associated with anticoagulant and NSAIDs combination therapy was also significantly higher than that associated with anticoagulant monotherapy in patients aged >65 years (HR, 1.53; 95% CI, 1.15 to 2.03; p=0.003) and >75 years (HR, 1.89; 95% CI, 1.23 to 2.90; p=0.003). We also found that the risk of GIB was significantly higher in the patients who received anticoagulant and NSAIDs combousers than that in patients who received anticoagulant monousers in both male (p=0.016) and female cohorts (p=0.010).</p><p><strong>Conclusions: </strong>The risk of GIB is significantly higher in patients who receive anticoagulant and NSAIDs combotherapy than that in patients who receive anticoagulant monotherapy. In addition, the risk of GIB associated with anticoagulant and NSAIDs combotherapy was much higher in individuals aged >75 years. Therefore, physicians should be more aware of pay more attention to the risk of GIB when they prescribe anticoagulant and NSAIDs.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"824-833"},"PeriodicalIF":3.4,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11391146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140897886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Risk of Hematologic Malignancies in Patients with Inflammatory Bowel Disease: A Meta-Analysis of Cohort Studies. 炎症性肠病患者罹患血液恶性肿瘤的风险:队列研究的 Meta 分析。
IF 3.4 3区 医学
Gut and Liver Pub Date : 2024-09-15 Epub Date: 2024-07-02 DOI: 10.5009/gnl240119
Xiaoshuai Zhou, Qiufeng Zhang, Dongying Wang, Zhiyi Xiang, Jiale Ruan, Linlin Tang
{"title":"Risk of Hematologic Malignancies in Patients with Inflammatory Bowel Disease: A Meta-Analysis of Cohort Studies.","authors":"Xiaoshuai Zhou, Qiufeng Zhang, Dongying Wang, Zhiyi Xiang, Jiale Ruan, Linlin Tang","doi":"10.5009/gnl240119","DOIUrl":"10.5009/gnl240119","url":null,"abstract":"<p><strong>Background/aims: </strong>Inflammatory bowel disease (IBD) may contribute to the development of hematologic malignancies. In this study, the potential relationship between IBD and hematologic malignancies was investigated.</p><p><strong>Methods: </strong>We searched the PubMed, Web of Science, Embase, and Cochrane Library databases for all cohort studies comparing the incidence of hematologic malignancies in non-IBD populations with that in IBD patients, and we extracted relevant data from January 2000 to June 2023 for meta-analysis.</p><p><strong>Results: </strong>Twenty cohort studies involving 756,377 participants were included in this study. The results showed that compared with the non-IBD cohort, the incidence of hematologic malignancies in the IBD cohort was higher (standardized incidence ratio [SIR]=3.05, p<0.001). According to the specific types of IBD, compared with the non-IBD patients, the incidences of hematologic malignancies in ulcerative colitis patients (SIR=2.29, p=0.05) and Crohn's disease patients (SIR=3.56, p=0.005) were all higher. In the subgroup analysis of hematologic malignancy types, compared with the control group, the incidences of non-Hodgkin's lymphoma (SIR=1.70, p=0.01), Hodgkin's lymphoma (SIR=3.47, p=0.002), and leukemia (SIR=3.69, p<0.001) were all higher in the IBD cohort.</p><p><strong>Conclusions: </strong>The incidence of hematologic malignancies, including non-Hodgkin's lymphoma, Hodgkin's lymphoma, and leukemia is higher in patients with IBD (ulcerative colitis or Crohn's disease) than in non-IBD patients.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"845-856"},"PeriodicalIF":3.4,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11391147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141476479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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