Journal of Digestive Diseases最新文献

{"title":"Single Jaundice in Cirrhosis: A Neglected Acute Decompensation of Acute-on-Chronic Liver Failure and Mortality.","authors":"Xin Zhang, Xian Bo Wang, Xin Zheng, Wen Ting Tan, Xiu Hua Jiang, Yan Huang, Zhong Ji Meng, Yan Hang Gao, Zhi Ping Qian, Feng Liu, Xiao Bo Lu, Yu Shi, Yu Bao Zheng, Ying Li He, Wen Yi Gu, Liang Qiao, Jian Yi Wei, Pei Xuan Ji, Yue Xiang Bian, Kai He, Adila Abuduaini, Ya Wen Lu, Yan Zhang, Hai Li","doi":"10.1111/1751-2980.70075","DOIUrl":"https://doi.org/10.1111/1751-2980.70075","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the risk of acute-on-chronic liver failure (ACLF) and short-term outcomes among cirrhotic patients with single jaundice, acute decompensation (AD) (including ascites, variceal bleeding, hepatic encephalopathy, and/or bacterial infection), and non-AD non-jaundice.</p><p><strong>Methods: </strong>We analyzed cirrhotic inpatients without obstructive jaundice enrolled from two large multicenter prospective cohorts. Patients were divided at admission into classical AD, single jaundice, or non-AD non-jaundice groups. Baseline characteristics, ACLF development, and short-term outcomes were compared between groups.</p><p><strong>Results: </strong>Among 2645 cirrhotic patients, classical AD, single jaundice, and non-AD non-jaundice were observed in 2163 (81.78%), 267 (10.09%), and 215 (8.13%), respectively. The 90-day liver transplant (LT)-free mortality was comparable between single jaundice patients and classical AD patients (15.09% vs. 17.81%, p = 0.266), but significantly higher than non-AD non-jaundice patients (2.45%; p < 0.01). The prevalence of ACLF (16.10% vs. 16.09%, p = 1.000) and pre-ACLF (9.36% vs. 6.43%, p = 0.094) were comparable between the single jaundice and classical AD groups. Intrahepatic precipitants, particularly hepatitis B flare with hepatitis B virus (HBV) reactivation (odds ratio [OR] 2.69; p = 0.002), spontaneous hepatitis B flare with high HBV-DNA load (OR 23.75; p < 0.001), superimposed hepatitis A/E virus infection on HBV infection (OR 13.40; p < 0.001) and hepatotoxic drug usage (OR 3.64; p < 0.001) were associated with single jaundice.</p><p><strong>Conclusions: </strong>Cirrhotic inpatients with single jaundice show comparably high short-term mortality and ACLF risk to those with classical AD. Single jaundice shall be considered as an AD event and is predominantly triggered by intrahepatic insults, warranting surveillance equivalent to classical AD and prioritized management of the precipitants.</p>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182377","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}

{"title":"Central Nervous System Vasculitis Mimicking Glioma in a Patient With Ulcerative Colitis: A Case Report and Literature Review.","authors":"Bo Wen Tian, Feng Feng, Hong Zhi Guan, Yue Li","doi":"10.1111/1751-2980.70073","DOIUrl":"https://doi.org/10.1111/1751-2980.70073","url":null,"abstract":"<p><p>A patient with ulcerative colitis presented with progressive memory impairment and alexia, with brain imaging showing a mass-like lesion mimicking glioma. Histopathology confirmed central nervous system (CNS) vasculitis. The patient's memory and reading ability improved and finally recovered following corticosteroid treatment, with no recurrence during the long-term follow-up. The case report and literature review highlight that clinicians should consider CNS vasculitis in patients with ulcerative colitis and tumor-like brain lesions.</p>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166248","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}

{"title":"Gut Microbiota-Bile Acid Axis Correlates With Colonic Inflammation and Behavioral Deficits in Cirrhosis.","authors":"Li Juan Sun, Hui Chen, Wen Jing Fan, Zi Yi Shi, Yuan Jie Zhao, Ying Wang, Yong Zhan Nie","doi":"10.1111/1751-2980.70072","DOIUrl":"https://doi.org/10.1111/1751-2980.70072","url":null,"abstract":"<p><strong>Objectives: </strong>Hepatic encephalopathy (HE) is one of the common complications of cirrhosis. Gut-derived signals, including microbiota and bile acids, have been found to be involved in the gut-brain axis in cirrhosis. We aimed to explore the impact of the gut-microbiota-bile acid axis on behavioral deficits in cirrhosis.</p><p><strong>Methods: </strong>Mice were colonized with gut bacteria obtained from cirrhotic patients with or without HE via fecal microbiota transplantation. Serum bile acid profiles, intestinal histological features, and behaviors were assessed to evaluate the impacts of gut microbial disturbance on bile acids and gut-brain axis. Additionally, rodent cirrhotic models were induced by bile duct ligation (BDL), and the mice were treated with obeticholic acid (OCA) or rifaximin to evaluate the impact of bile acid remodeling on gut bacteria, gut injury, and behaviors. The 16S rRNA sequencing and LC-MS/MS were carried out to analyze gut microbiota composition and bile acid spectrum.</p><p><strong>Results: </strong>Gut bacteria transplanted from cirrhotic patients caused reduced levels of total and secondary bile acids in mice, which was accompanied by increased colonic lymphocytic infiltration, decreased exploratory behaviors, and higher expression of IBA-1. OCA intervention improved gut dysbiosis, alleviated liver injury and exploratory behavior impairment in the cirrhotic mouse model, accompanied by increased Farnesoid X receptor (FXR) expression and decreased ASBT, IBABP, and OSTα levels.</p><p><strong>Conclusion: </strong>Gut microbiota-bile acid axis correlates with colonic inflammation and behavioral deficits in cirrhosis.</p>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081130","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}

{"title":"Saccharomyces boulardii as an Adjunct to Helicobacter pylori Eradication Therapy: A Systematic Review and Meta-Analysis.","authors":"Hong Kai Chang, Lu Bo Shi, Hui Xin Song, Peng Li","doi":"10.1111/1751-2980.70071","DOIUrl":"https://doi.org/10.1111/1751-2980.70071","url":null,"abstract":"<p><strong>Objective: </strong>To systematically evaluate the efficacy, safety, and optimal administration parameters (dosage, treatment duration, regimen type, and publication era of the articles) of Saccharomyces boulardii as an adjunct therapy to Helicobacter pylori eradication therapy.</p><p><strong>Methods: </strong>We searched PubMed, Web of Science, and EMBASE databases for randomized controlled trials (RCTs) comparing S. boulardii and placebo in addition to H. pylori eradication that were published up to January 2026. Pooled risk ratio (RR) and the corresponding 95% confidence interval (CI), absolute risk differences (ARD), and numbers needed to treat (NNT) were calculated. Certainty of evidence was assessed using GRADE.</p><p><strong>Results: </strong>Nineteen RCTs were included for analysis. Adjuvant S. boulardii significantly improved H. pylori eradication in adults (n = 15; RR 1.07, 95% CI 1.03-1.10; ARD +5.7%; NNT 18) and children (n = 3; RR 1.12, 95% CI 1.03-1.23; ARD +9.8%; NNT 10). Eradication gain was significant with triple therapy (n = 12; RR 1.08, 95% CI 1.03-1.14). Eradication efficacy was consistent across different dosages, treatment durations, and publication eras (p > 0.05 for subgroup interactions). Furthermore, S. boulardii significantly halved overall adverse events (n = 11; 19.7% vs. 36.0%; RR 0.51, 95% CI 0.39-0.66; NNT 6). GRADE certainty was moderate for eradication and low for adverse events.</p><p><strong>Conclusions: </strong>S. boulardii modestly improves H. pylori eradication-particularly with triple therapy-and substantially mitigates gastrointestinal adverse events. Concurrent dosing of 5 × 10⁹-1 × 10¹⁰ CFU/day for 10-14 days appears to be a reasonable and pragmatic regimen.</p><p><strong>Systematic review registration: </strong>PROSPERO registration no. CRD420251271815.</p>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012321","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}

{"title":"Pancreatic Tuberculosis Complicated With Duodenal Bulb Fistula Mimics Walled-Off Necrosis: A Case Report","authors":"Yao Yan,&nbsp;Hui Fang Xiong","doi":"10.1111/1751-2980.70057","DOIUrl":"10.1111/1751-2980.70057","url":null,"abstract":"<p>We described a female patient whose abdominal imaging revealed a suspicious malignant mass in the neck of the pancreas, accompanied by signs of pancreatitis and walled-off necrosis. The diagnosis of granulomatous inflammation was ultimately established via endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB), with subsequent special staining and polymerase chain reaction confirming pancreatic tuberculosis. This case underscores the value of EUS-FNB in obtaining high-quality tissue samples, accurately targeting pancreatic lesions, avoiding unnecessary surgery, and enabling prompt and appropriate treatment planning. Pancreatic histopathological image: HE stain, ×40.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"27 5-6","pages":"262-265"},"PeriodicalIF":2.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148277540","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}

{"title":"Increasing Global Burden of Inflammatory Bowel Disease and Its Attributable Anemia in Adults Aged 60 Years and Older: A Comprehensive Analysis of the Global Burden of Disease Study 2021.","authors":"Jia Qi Wang, Ruo Chen Yan, Ying Ying Hu, Lu Yi Chen, Shu Jie Chen, Hao Liu","doi":"10.1111/1751-2980.70070","DOIUrl":"10.1111/1751-2980.70070","url":null,"abstract":"<p><strong>Objective: </strong>To quantify the global burden of inflammatory bowel disease (IBD) and IBD-attributable anemia in adults aged ≥ 60 years across 204 countries and territories from 1990 to 2021 and their projected trends through 2045 based on the Global Burden of Disease (GBD) 2021 database.</p><p><strong>Methods: </strong>Data were extracted from the GBD 2021 database. Age-standardized rates (ASRs) were calculated by age, sex, region, and sociodemographic index (SDI). Joinpoint regression analysis was used to quantify temporal trends. Decomposition analysis assessed drivers of burden change. Concentration index methodology quantified socioeconomic inequalities. And Bayesian age-period-cohort (BAPC) models projected burden through 2045.</p><p><strong>Results: </strong>Prevalent IBD cases among adults aged ≥ 60 years increased by 123% from 573 503 in 1990 to 1 278 194 in 2021, while the age-standardized prevalence rate (ASPR) remained stable. In contrast, the age-standardized incidence rate (ASIR) increased particularly among women (average annual percentage change [AAPC]: 0.31%) than in men (AAPC: 0.26%). IBD-attributable anemia affected 361 157 elder adults in 2021, with a rising ASPR in women. Mortality and disability inequalities widened, with concentration index increasing from 0.07 to 0.23 for mortality and from 0.14 to 0.25 for disability-adjusted life-years (DALYs). By 2045, prevalent cases are projected to reach 2 161 387.</p><p><strong>Conclusions: </strong>Burdens of IBD and IBD-attributable anemia in adults aged ≥ 60 years have increased substantially, driven predominantly by the demographic expansion of this population. The ASIR continues to rise, particularly among women and in lower-SDI regions, together with widening socioeconomic inequalities, highlighting the need for early diagnosis, anemia screening, frailty assessment, and equitable resource allocation.</p>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911964","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}

{"title":"Emerging Concepts in the Prevention and Treatment of Severe Acute Pancreatitis","authors":"Chengwei Tang,&nbsp;Zhiyin Huang","doi":"10.1111/1751-2980.70054","DOIUrl":"10.1111/1751-2980.70054","url":null,"abstract":"","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"27 5-6","pages":"182-185"},"PeriodicalIF":2.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138271","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}

{"title":"Is Endoscopic Submucosal Dissection Entering Into a New Era?","authors":"Kelly Schulte,&nbsp;Qiang Cai","doi":"10.1111/1751-2980.70067","DOIUrl":"10.1111/1751-2980.70067","url":null,"abstract":"&lt;p&gt;The primary modality for resection of gastrointestinal cancer is surgery. With wide resection margins and adequate lymphadenectomy, surgical treatment has typically been associated with a good prognosis with curative intent. However, it is invasive and can be associated with postoperative complications leading to morbidity which can negatively affect patient's quality of life and even death [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Endoscopic resection (ER) is a minimally invasive procedure and was developed to remove precancerous tissues or early-stage cancers confined to the mucosal and submucosal layers of the gastrointestinal tract during endoscopic procedures [&lt;span&gt;2-6&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Many systematic reviews and meta-analyses have consistently shown that for early-stage tumors confined to the superficial mucosal layers without lymph node involvement, endoscopic methods like endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) achieve long-term overall survival rates comparable to conventional surgery. However, traditional surgical approaches provide higher complete (R0) resection rates and superior regional lymph node control [&lt;span&gt;2-6&lt;/span&gt;]. ER and surgery are comparably safe and effective treatments for early gastrointestinal cancers. ER offers lower rates of adverse events and shorter overall length of hospital stay compared to surgery. Although ER is associated with lower complete resection rates and a higher risk of recurrence, the 5-year cancer-specific survival rates and 5-year overall survival are similar between both approaches [&lt;span&gt;2-6&lt;/span&gt;]. Since ER requires no external incisions, it has been quickly accepted as a first-line therapeutic modality for eligible patients [&lt;span&gt;2-6&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Although biopsy, including cold and hot, during endoscopy is primarily used to obtain mucosal tissues for histological examination, it can also be utilized for resecting focal areas of abnormal tissues [&lt;span&gt;7&lt;/span&gt;]. Initially, the modern ER started as a polypectomy in late 1960s [&lt;span&gt;8&lt;/span&gt;]. Since then, several exponential advancements have occurred, including saline-assisted endoscopic mucosal resection (EMR) (1970s) [&lt;span&gt;9&lt;/span&gt;], cap-assisted EMR (early 1990s) [&lt;span&gt;10&lt;/span&gt;], band-assisted EMR (late 1990s) [&lt;span&gt;11&lt;/span&gt;], ESD (late 1990s–early 2000s) [&lt;span&gt;12-17&lt;/span&gt;], exposed/nonexposed endoscopic full-thickness resection (EFTR), and submucosal tunneling endoscopic resection (STER) (early 2010s) [&lt;span&gt;18-20&lt;/span&gt;]. EMR and ESD were mainly developed in Japan [&lt;span&gt;2-9&lt;/span&gt;], while exposed EFTR and STER were largely established in China [&lt;span&gt;19, 20&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;ER can be applied to early-stage cancers in the esophagus, stomach, and small intestine. It is also used to remove precancerous lesions before they progress to cancer, such as Barrett's esophagus and large advanced polyps in the colon. EMR, ESD, EFTR, and STER are the main types of ER and their application depends on the size, depth, an","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"27 5-6","pages":"186-189"},"PeriodicalIF":2.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1751-2980.70067","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829199","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}

{"title":"Ustekinumab for Intestinal Behçet's Disease: The First Cohort with a Novel Therapy","authors":"Hong Sheng Yang,&nbsp;Ze Fang Xia,&nbsp;Chu Rong Lin,&nbsp;Zhao Peng Huang,&nbsp;Xiang Gao,&nbsp;Miao Li,&nbsp;Pin Jin Hu","doi":"10.1111/1751-2980.70059","DOIUrl":"10.1111/1751-2980.70059","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Evidence-based treatments for intestinal Behçet's disease (BD) remain limited. There is an unmet need for the development of effective therapies for refractory cases. We aimed to evaluate the safety and efficacy of ustekinumab, an anti-interleukin (IL)-12/23 monoclonal antibody, for intestinal BD treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study was conducted on intestinal BD patients who received ≥ 1 dose of ustekinumab and had ≥ 3-month follow-up. The primary outcome was clinical response at 3 months. Secondary outcomes included clinical remission at 3, 6, and 12 months, endoscopic/radiologic/ultrasound responses and remissions, mucosal healing, and safety profiles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixteen patients were enrolled, among whom 87.5% and 68.8% achieved clinical response and clinical remission at 3 months. At 6 months, 72.7% (8/11) of patients achieved clinical response and 45.5% (5/11) achieved clinical remission. In addition, 80.0% (8/10) had endoscopic response, 70.0% (7/10) achieved mucosal healing, 87.5% (7/8) had radiologic response, and 55.6% (5/9) had ultrasound response, respectively. At 12 months, 85.7% (6/7) patients achieved both clinical response and remission, with 100% endoscopic response, 83.4% mucosal healing, 100% (5/5) ultrasound response, 40.0% (2/5) ultrasound remission, 66.7% (2/3) radiologic response and remission. All five steroid users at baseline discontinued corticosteroids by 6 months. Only 18.8% (3/16) experienced self-limiting adverse events, and no patient discontinued treatment due to adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Ustekinumab appears to be an effective, well-tolerated treatment for intestinal BD, particularly for refractory cases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"27 5-6","pages":"234-242"},"PeriodicalIF":2.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404907","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}

{"title":"Endoscopic Intervention and Surgical Treatment of Benign Biliary-Enteric Anastomotic Stricture: Real-World Clinical Impact","authors":"Hang Yu Chen,&nbsp;Cong Zhang,&nbsp;Jia Yu Fan,&nbsp;Ping Ping Zhang,&nbsp;Chen Tao Ma,&nbsp;Xi He,&nbsp;Jia Yang Hu,&nbsp;Kai Xuan Wang,&nbsp;Gang Li","doi":"10.1111/1751-2980.70066","DOIUrl":"10.1111/1751-2980.70066","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Although endoscopic interventions and surgery are both used for treating bening biliary-enteric anastomotic stricture (BEAS), their comparative efficacy, safety, and economic impact have not been established. We conducted this study to address that gap.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients who underwent endoscopic intervention or surgical treatment for benign BEAS at Changhai Hospital, The First Affiliated Hospital of Naval Medical University (Shanghai, China) from February 2013 to February 2024 were included. The primary end-point was stricture resolution rate. Secondary end-points included adverse events (AEs), length of hospital stay, and total hospitalization cost.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 65 and 58 patients underwent endoscopic intervention and surgical treatment for benign BEAS, respectively. The stricture resolution rate was lower in the endoscopic intervention group than in the surgical treatment group (78.5% vs. 93.1%, <i>p</i> = 0.024); however, endoscopic intervention achieved an ultimate stricture resolution rate of 90.8%. Endoscopic intervention had significantly lower rates of overall AE (9.2% vs. 27.6%, <i>p</i> = 0.01) and early AE (occurred within 30 days after surgery/endoscopic intervention) (4.6% vs. 25.9%, <i>p</i> = 0.002). In addition, endoscopic intervention resulted in a shorter length of hospital stay (10 days vs. 13 days, <i>p</i> = 0.013) and a lower hospitalization cost (CNY 24 355 vs. CNY 35 663, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In benign BEAS, surgery achieved a higher stricture resolution rate, whereas endoscopic intervention offered superior short-term outcomes, including shorter hospital stay, lower costs, and fewer AEs. Hence, we recommend initial endoscopic intervention with surgery reserved for nonresponders and recurrent cases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"27 5-6","pages":"252-261"},"PeriodicalIF":2.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764712","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}