Scandinavian Journal of Gastroenterology最新文献

{"title":"Role of endoscopic ultrasonography in workup of patients with presumed idiopathic acute pancreatitis.","authors":"Serdar Akca, Osman Cagin Buldukoglu, Serkan Ocal","doi":"10.1080/00365521.2025.2537891","DOIUrl":"https://doi.org/10.1080/00365521.2025.2537891","url":null,"abstract":"","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-2"},"PeriodicalIF":1.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675608","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":"Low rate of general anaesthesia and hospital admission following colonic saline-immersion/irrigation technique (SITE) endoscopic submucosal dissection (ESD).","authors":"Alessandro Rimondi, Elisabetta Dell'Unto, Georgios Kalopitas, Elisabet Maristany Bosch, Hironori Yamamoto, Edward John Despott, Alberto Murino","doi":"10.1080/00365521.2025.2531436","DOIUrl":"https://doi.org/10.1080/00365521.2025.2531436","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic submucosal dissection (ESD) for colonic lesions frequently requires general anaesthesia (GA) or deep sedation to be performed. Saline-immersion/irrigation technique (SITE) improves tolerability as it reduces bowel distension and less stretching of the mesentery. We describe our experience with operator-delivered sedation (OdS) SITE-ESD on a cohort of colonic ESD.</p><p><strong>Materials and methods: </strong>Retrospective single-centre study of consecutive anonymised patients who underwent SITE-ESD for colonic lesions from Nov-2017 to Feb-2025. Characteristics of patients and lesions, procedure outcomes and adverse events, details of sedation, and hospital admission were recorded.</p><p><strong>Results: </strong>One-hundred-thirty-eight colonic lesions were included. Median age: 68 (IQR 62-76), ASA II was the most prevalent score (61.1%), the median maximum diameter of lesions was 40 mm (IQR 30-50), and the median resection time was 120 min (IQR 75-180). One-hundred-twenty-seven (127, 92.0%) procedures were performed under OdS with midazolam (median 6 mg; IQR 3.5-7.5) and fentanyl (137.5 mcg; IQR 100-200). No procedure was abandoned due to discomfort. Eighty-one (58.7%) procedures were day cases and of the remaining 57, 46 (80.7%) required less than 48 hrs admission. One case of moderate respiratory failure was recorded (AGREE II).</p><p><strong>Discussion: </strong>SITE with OdS can be considered for colonic ESD.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-6"},"PeriodicalIF":1.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660088","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":"Development of pancreatic exocrine insufficiency after first moderately severe or severe acute pancreatitis.","authors":"Outi Lindström, Elina Lietzen, Panu Mentula, Matti Tolonen, Päivi Siironen, Marianne Udd, Pauli Puolakkainen, Leena Kylänpää","doi":"10.1080/00365521.2025.2533337","DOIUrl":"https://doi.org/10.1080/00365521.2025.2533337","url":null,"abstract":"<p><strong>Objectives: </strong>Pancreatic necrosis may develop in moderately severe and severe acute pancreatitis (AP), and result in pancreatic exocrine insufficiency (PEI). The aim of this prospective study was to investigate development of PEI in patients recovering from the first attack of moderately severe or severe AP.</p><p><strong>Materials and methods: </strong>Altogether 70 patients were recruited. The development of PEI was determined by measuring the fecal elastase-1 (FE-1) during the hospitalization time, and in the follow up period 1-2 months and 12 months after discharge. Persistent PEI was defined as FE-1 level below 200 µg/g at 12 months follow up.</p><p><strong>Results: </strong>52 patients completed the study. The median age was 53 years, 65% were male, and 63% had severe AP. The most common etiology was alcohol (58%). After 12 months of discharge the FE-1 values were normal in 67% of patients, showed moderate insufficiency in 6% and severe insufficiency in 27% of patients. For pancreatic function there was a tendency to recover in one year follow up. However, four (17%) patients with initially normal FE-1 level developed persistent PEI, whereas three (25%) and eight (57%) patients with initially moderate or severe insufficiency, had persistent PEI at 12 months. During hospitalization new onset diabetes, extent (>50%) and anatomical site (body) of pancreatic necrosis, and low FE-1 level (median 28 µg/g, range 15-161) were predictive for persistent PEI at 12 months.</p><p><strong>Conclusion: </strong>Around a third of patients with first attack of moderately severe or severe AP develop PEI.</p><p><strong>Registered in: </strong>ClinicalTrials.gov (NCT02563080).ClinicalTrials.gov identifier: NCT02563080.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-7"},"PeriodicalIF":1.6,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650291","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":"Treatment patterns and clinical outcomes of patients with hepatocellular carcinoma-a cohort study of 1020 patients in Sweden.","authors":"Bonnie Bengtsson, Linnea Widman, Per Stål, Hannes Hagström","doi":"10.1080/00365521.2025.2531042","DOIUrl":"https://doi.org/10.1080/00365521.2025.2531042","url":null,"abstract":"<p><strong>Objectives: </strong>Hepatocellular carcinoma (HCC) is a significant global health burden. Examining treatment sequencing before the introduction of immune-based therapies is important for understanding the role and necessity of modern treatment approaches.</p><p><strong>Material and methods: </strong>This retrospective study analysed 1020 patients with HCC treated at Karolinska University Hospital, Stockholm, between 2010 and 2017 to explore treatment sequencing, and clinical outcomes. Treatment decisions followed a modified Barcelona Clinic Liver Cancer (BCLC) algorithm, and patients were stratified by disease stage and by type of treatment.</p><p><strong>Results: </strong>Initial treatment strategies included best supportive care (BSC, 32%), ablation (20%), transarterial chemoembolization (TACE, 22%), systemic therapy (12%), resection (12%), and liver transplantation (3%). Median survival ranged from 4.8 years in BCLC 0 to 2.3 months in BCLC D. Curative treatments, particularly liver transplantation, achieved the highest five-year survival (82%), whereas systemic therapy and BSC had the poorest five-year survival (2% and 0%). Despite curative intent, disease recurrence was common, necessitating further treatment in most patients. Treatment sequencing revealed that 37% of patients required a second treatment, and 18% progressed to a third line of therapy.</p><p><strong>Conclusions: </strong>This study underscores the challenges of managing HCC in a real-world setting, including late diagnosis and high recurrence rates following curative treatments. Real-world treatment deviations from guidelines were observed, often influenced by patient comorbidities, performance status, or other clinical considerations.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643320","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":"Key variables associated with gastroparesis in diabetes patients with gastroparesis-like symptoms.","authors":"Mattis Bekkelund, Elisabeth K Steinsvik, Jørgen Valeur, Eirik Søfteland, Georg Dimcevski, Dag A Sangnes","doi":"10.1080/00365521.2025.2531038","DOIUrl":"https://doi.org/10.1080/00365521.2025.2531038","url":null,"abstract":"<p><strong>Background/aims: </strong>Gastroparesis is a late complication of diabetes mellitus characterized by delayed gastric emptying and upper gastrointestinal symptoms. The disorder substantially impacts the quality of life, glycemic stability, nutrition and absorption of orally administered drugs. Since symptom severity is a poor predictor of gastric emptying status, the clinician has little to aid them in whom to refer for gastric emptying testing. In this study, we aim to identify clinical characteristics associated with delayed gastric emptying in diabetes patients with gastroparesis-like symptoms.</p><p><strong>Materials and methods: </strong>Diabetes patients consecutively referred to Haukeland University Hospital for assessment of gastroparesis-like symptoms underwent gastric emptying scintigraphy, blood samples and questionnaires for assessing gastrointestinal symptoms (Gastrointestinal Symptom Rating Scale), neuroticism (Eysenck Personality Questionnaire-Short Form), and symptoms of anxiety and depression (Hospital Anxiety & Depression Scale).</p><p><p><b>Results:</b> Seventy-one patients were included in the study, of which 28 displayed delayed gastric emptying. Delayed gastric emptying was characterized by having type 1 diabetes, younger age, lower BMI, presence of other late complications including distal symmetric polyneuropathy and retinopathy, higher Hb1Ac levels and lower albumin and hemoglobin levels. Symptoms were not related to gastric emptying status.</p><p><strong>Conclusion: </strong>We identified several clinical variables associated with delayed gastric emptying in diabetes patients with gastroparesis-like symptoms. These variables are commonly assessed during a medical consultation and may be used to aid the clinician in choosing who to refer for gastric emptying testing.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144619958","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":"Underwater versus standard endoscopic submucosal dissection for superficial colorectal neoplasms: a propensity score matched analysis.","authors":"Gianluca Andrisani, Giulio Antonelli, Takehide Fukuchi, Leonardo Frazzoni, Jun Hamanaka, Cesare Hassan, Giovanni Parente, Francesco Maria Di Matteo, Kingo Hirasawa","doi":"10.1080/00365521.2025.2531040","DOIUrl":"10.1080/00365521.2025.2531040","url":null,"abstract":"<p><strong>Background and study aims: </strong>Underwater ESD (UESD) has recently emerged as a less complex technical alternative to standard endoscopic submucosal dissection (SESD), but only small retrospective data are currently available. Our aim was to evaluate the effectiveness and safety of UESD, as compared to the current standard of care.</p><p><strong>Patients and methods: </strong>We performed a 1-to-4 nearest-neighbor retrospective propensity-score-matched-analysis between all UESD cases and all SESD cases performed and collected prospectively in a Western and an Eastern interventional endoscopy referral center, respectively. The primary outcomes were the rate of resections with histologically negative lateral and deep margins and the en-bloc resection rate. The secondary outcomes were procedure speed (mm²/min) and procedure time. The secondary outcomes were procedure speed (mm²/min) and procedure time.</p><p><strong>Results: </strong>Overall, 100 patients for UESD and 400 patients for SESD were included, matched for all baseline parameters. According to the Kudo and Paris classifications, in both groups most of lesions were laterally spreading tumours, granular type (LST-G) (60.7% vs. 55%). The mean size of lesions in the SESD group was 40.9 ± 14.7 mm. In the UESD group, the mean size of lesions was 57.4 ± 27.9 mm. UESD yielded higher rate of en-bloc resection (100% vs. 86.5%, <i>p</i> < 0.001) and lower rate of perforation (1% vs. 9.5%, <i>p</i> = 0.009). No significant difference between the two techniques was observed in terms of vertical R0 resection rate, speed and time of dissection, and delayed bleeding rate.</p><p><strong>Conclusion: </strong>Our findings suggest that UESD allows to achieve resection speed and procedure times comparable to those of expert Japanese endoscopists, with a significant reduction in the risk of perforation.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-7"},"PeriodicalIF":1.6,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144612362","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":"Correction.","authors":"","doi":"10.1080/00365521.2025.2530908","DOIUrl":"https://doi.org/10.1080/00365521.2025.2530908","url":null,"abstract":"","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1"},"PeriodicalIF":1.6,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601387","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 impact of gallstone intervention during pregnancy on maternal and perinatal outcomes: a nationwide population-based cohort study.","authors":"Bodil Andersson, Jonas Hedström, Dag Wide-Swensson, Johan Nilsson","doi":"10.1080/00365521.2025.2526773","DOIUrl":"https://doi.org/10.1080/00365521.2025.2526773","url":null,"abstract":"<p><strong>Background and aims: </strong>Gallstone disease during pregnancy can have varying consequences, from mild to severe and even life-threatening. The aim was to investigate how gallstone intervention during pregnancy impacts pregnancy, delivery and the newborn child.</p><p><strong>Methods: </strong>Pregnant patients 18-45 years identified from the Swedish National Register for Gallstone Surgery and Endoscopic Retrograde Cholangiopancreatography (GallRiks) 2009-2016 constituted the intervention group and were cross-linked with the Swedish National Medical Birth Register. A 1:5 matched control group of patients without gallstone intervention during pregnancy was established.</p><p><strong>Results: </strong>In total, 1620 women were included, and of these, 274 underwent gallstone intervention during pregnancy. Some 221 women underwent cholecystectomy only, and 53 underwent ERCP only or combined with cholecystectomy. The women in the intervention group had a higher BMI at the start of pregnancy (24 vs 28, <i>p</i> < .001) and were more often smokers (21.7% vs. 15.7%, <i>p</i> = .019). Overall, labour started most often spontaneously, (intervention group 67.0% vs. control group 75.3%, <i>p</i> = .004), and elective caesarean section was more common in the intervention group (13.2 vs. 9.0%, <i>p</i> = .034). Premature birth was more common in the intervention group (19 [6.93%] vs. 5 [3.94%], <i>p</i> = .029), with an adjusted odds ratio of 1.8 (CI 1.1-3.3, <i>p</i> < .001). There were no differences in the children's birth weights or APGAR scores.</p><p><strong>Conclusions: </strong>Caesarean section was more common, and the duration of pregnancy was shorter, including preterm births, in the group with gallstone intervention during pregnancy. However, for the newborn child, birth weight corrected for gestational age and APGAR score was not affected.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-7"},"PeriodicalIF":1.6,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592133","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":"Should chest computed tomography be routine in patients referred to abdominal computed tomography for major emergency abdominal pathology: an exploratory clinical study.","authors":"Jannick Brander Hansen, Lasse Lykkebo Hald, Nicolas Storm, Michael Brun Andersen, Christoph Felix Müller, Morten Vester-Andersen","doi":"10.1080/00365521.2025.2525906","DOIUrl":"https://doi.org/10.1080/00365521.2025.2525906","url":null,"abstract":"<p><strong>Purpose: </strong>The introduction of optimised care bundles in emergency major abdominal surgery has reduced mortality. Core elements are fast diagnostic work-up with abdominal computed tomography (CT) and surgery without delay. Given the diagnostic challenges in patients with abdominal pain, we aimed to investigate if the addition of a full contrast-enhanced chest CT provides additional clinically significant diagnostic information in patients referred to an emergency abdominal CT.</p><p><strong>Methods: </strong>This retrospective cohort study included patients with suspected major abdominal pathology referred to an emergency abdominal CT with complementary chest CT (extended CT) from 1 April 2020 to 9 September 2020. This population was compared to a historic cohort with a regular emergency abdominal CT. The primary outcome was chest CT findings leading to treatment or intervention during index admission.</p><p><strong>Results: </strong>A total of 187 patients were scanned in the study period and compared to 170 historic controls. The two groups were comparable. The extended CT group had more clinically significant chest findings 28 (15.0%) compared to the standard group 9 (5.3%) (<i>p</i> = 0.002), of which pneumonia was found 18 versus 3 times, respectively. The extended CT group had more suspicious findings 22 versus 7 (<i>p</i> = 0.008) but did not result in significantly more out-patient referrals (8 versus 4, <i>p</i> = 0.38).</p><p><strong>Conclusion: </strong>In patients with suspected major abdominal pathology, an extended CT protocol which includes a full chest CT provides additional diagnostic information without reducing mortality.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-8"},"PeriodicalIF":1.6,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592132","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":"Initial experience with robotic-assisted resection for suspected or confirmed gallbladder cancer - comparison with open technique in a single centre retrospective observational cohort study.","authors":"Hannes Wållgren, Stefan Gilg, Christoph Ansorge, Ernesto Sparrelid, Christian Sturesson","doi":"10.1080/00365521.2025.2525902","DOIUrl":"https://doi.org/10.1080/00365521.2025.2525902","url":null,"abstract":"<p><strong>Background and aim: </strong>Robotic-assisted surgery has become increasingly common and is now the gold standard for many procedures. In hepato-pancreato-biliary surgery, it has shown promise but remains insufficiently studied. This study reports our initial experience with robotic-assisted radical cholecystectomy for suspected or confirmed gallbladder cancer. The primary objective was to compare hospital length-of-stay - used as a proxy for functional recovery - between robotic-assisted and open surgery. The secondary objective was to assess surgical quality by comparing the number of retrieved lymph nodes.</p><p><strong>Methods: </strong>All patients with suspected or confirmed gallbladder cancer accepted for radical cholecystectomy at Karolinska University Hospital between January 2019 and December 2022 were reviewed. Ninety-five patients were identified; 22 were excluded. Of the remaining 73, 23 underwent robotic-assisted surgery and 50 underwent open surgery.</p><p><strong>Results: </strong>Robotic-assisted surgery was associated with shorter hospital stays: a median of four days compared to seven days for open surgery (<i>p</i> < 0.001). The number of retrieved lymph nodes was low in both groups but lower in the robotic group (median 1 vs. 3, <i>p</i> = 0.013). No difference regarding severe complications, readmissions or positive margin resections was found.</p><p><strong>Conclusion: </strong>In this single-centre retrospective observational study, robotic-assisted radical cholecystectomy was associated with faster recovery compared to open surgery. To confirm these findings, a multi-centre randomized clinical trial has been initiated (ClinicalTrials.gov NCT06246448).</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-6"},"PeriodicalIF":1.6,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576190","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}