Scandinavian Journal of Gastroenterology最新文献

{"title":"Endoscopic radiofrequency ablation for unresectable cholangiocarcinoma: a single-centre retrospective cohort study with patient interviews.","authors":"Kenan Hajouz, Siri Marie Andersen, Khanh Do-Cong Pham, Inger Marie Løes, Roald Flesland Havre","doi":"10.1080/00365521.2026.2742242","DOIUrl":"https://doi.org/10.1080/00365521.2026.2742242","url":null,"abstract":"<p><strong>Background: </strong>This study assessed biliary drainage durability, survival, and patient experiences following endoscopic retrograde cholangiopancreatography (ERCP)-guided radiofrequency ablation (RFA) plus stenting for palliation in unresectable cholangiocarcinoma (CCA).</p><p><strong>Methods: </strong>Ten patients with unresectable CCA were identified in a single-centre retrospective cohort study conducted in Norway between January 2019 and June 2025. Three surviving patients participated in semi-structured interviews. Primary outcomes were biliary drainage durability, survival, and patient experiences. Secondary outcomes included biliary drainage success, peri-procedural adverse events, biochemical response, and healthcare utilisation.</p><p><strong>Results: </strong>The median time to unplanned biliary reintervention was 218 days, with 3- and 6-month estimates of 79.1% and 56.2%, respectively. The median survival from the first ERCP-RFA was 262 days, with 6- and 12-month estimates of 60.0% and 32.0%, respectively. Interviewed patients reported that feeling fit enough to continue chemotherapy and symptom relief were benefits of ERCP-RFA plus stenting. Post-procedure infection, which reduced time with family, was described as the main burden.</p><p><strong>Conclusion: </strong>ERCP-RFA plus stenting was feasible in this small cohort and was associated with short-term biliary decompression. Interviews indicated a perceived fitness for chemotherapy and meaningful symptom relief. However, frequent readmissions, mainly due to recurrent biliary obstruction, substantially increased the burden of hospital care during palliation. Future studies should evaluate ERCP-RFA plus stenting from a broader palliative perspective using patient-reported outcomes and hospitalisation burden as key endpoints.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-10"},"PeriodicalIF":1.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137603","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":"Increasing rate of liver transplantation in Iceland over the last decade: a nationwide study.","authors":"Bjarki Leó Snorrason, Sigurður Sölvi Sigurðarson, Lára Ósk Eggertsdóttir Claessen, Sigrún Helga Lund, Sigurður Ólafsson, Einar Stefán Björnsson","doi":"10.1080/00365521.2026.2742241","DOIUrl":"https://doi.org/10.1080/00365521.2026.2742241","url":null,"abstract":"<p><strong>Background and aims: </strong>Liver transplantation in Iceland has historically been infrequent, with primary biliary cholangitis the leading indication during 1984-2012. We analyzed trends in the incidence, indications, etiology, and outcomes of liver transplantation in Iceland from 2013 to 2024 and compared transplant rates with other Nordic countries.</p><p><strong>Methods: </strong>This nationwide retrospective cohort study included all Icelandic residents transplanted between January 2013 and December 2024, with adults and children analyzed separately. Indications, aetiology, and clinical outcomes were obtained from electronic medical records at Landspítali University Hospital. Crude rates were compared with Nordic countries in the Scandiatransplant registry and age- and sex-standardized rates were calculated for the adult Icelandic cohort.</p><p><strong>Results: </strong>Sixty transplantations, including four re-transplantations, were performed in 56 adult patients (61% male; median age 56 years), and seven in children. The mean annual crude rate was 16.0 per million per year, higher than Denmark (9.2), Finland (12.1), and Estonia (7.7), but lower than Norway (17.9) and Sweden (17.5). Leading aetiologies were metabolic dysfunction-associated steatotic liver disease (23.2%) and alcohol-related liver disease (19.6%). Overall survival was 96%, 94%, and 87% at 1, 3, and 5 years, although mortality was 4.6-fold higher than in the matched general population.</p><p><strong>Conclusions: </strong>Liver transplantation increased over the study period, driven mainly by metabolic dysfunction-associated steatotic liver disease and alcohol-related liver disease, a shift from the earlier dominance of autoimmune liver disease. Post-transplant survival was comparable to that reported by other Nordic and European registries, yet mortality remained above that in the matched general population.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-13"},"PeriodicalIF":1.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138027","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":"Percutaneous endoscopic sigmoidopexy for recurrent sigmoid volvulus in high-risk adults: a systematic review.","authors":"O M Aigbokhae, M Hamid, A A Ayeni, S Zaman, A Akingboye","doi":"10.1080/00365521.2026.2742240","DOIUrl":"https://doi.org/10.1080/00365521.2026.2742240","url":null,"abstract":"<p><strong>Background: </strong>Recurrent sigmoid volvulus in frail, comorbid adults recurs frequently after detorsion and carries significant risks with resectional surgery. Percutaneous endoscopic sigmoidopexy (PES), defined as fixation of the sigmoid colon to the abdominal wall without an indwelling tube, has been proposed as a tube-free, minimally invasive alternative.</p><p><strong>Objective: </strong>To synthesise outcomes of strict PES (fixation-only; no tube) for recurrent sigmoid volvulus in adults at high surgical risk.</p><p><strong>Methods: </strong>PRISMA-guided review (2000-31 July 2025) registered prospectively with PROSPERO CRD420251111664. MEDLINE, Embase, PubMed, and Cochrane were searched. Inclusion: adults with recurrent sigmoid volvulus managed by PES using T-fasteners, anchor devices, sutures, or clips without a tube. Exclusion: tube-based percutaneous endoscopic colostomy (PEC), open/laparoscopic pexy, colectomy, paediatric/pregnancy cases, non-volvulus pathology. Dual screening/extraction; JBI case report/series appraisal; narrative certainty assessment. Primary outcomes: technical success, recurrence, procedure-related mortality, all-cause mortality. Proportions are reported with Wilson 95% confidence intervals.</p><p><strong>Results: </strong>Nine reports (2001-2025) including 25 patients met strict PES criteria. Patients were elderly and generally ASA III-IV where stated. Technical success was 100%. Recurrent volvulus occurred in 1/25 (4%); procedure-related mortality was 1/25 (4%); all-cause mortality during follow-up was 7/25 (28%). Complications were mostly minor (pneumoperitoneum, subcutaneous/surgical emphysema, superficial infection); one small-bowel obstruction (internal herniation) resolved by releasing sutures. Follow-up was heterogeneous (median 7.5 months; range 1-44). Evidence certainty is very low.</p><p><strong>Conclusions: </strong>In carefully selected high-risk adults with recurrent sigmoid volvulus, strict PES appears feasible with high technical success, low recurrence, and low procedure-related mortality while avoiding an indwelling tube. Prospective, standardised, multicentre research with ≥12-month follow-up is warranted.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-9"},"PeriodicalIF":1.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138246","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":"Associations between endoscopic findings and clinicopathological characteristics in primary gastrointestinal lymphoma: a single-center retrospective study.","authors":"Chun-Lin Ying, Tian-Qi Zhao, Xiao Zhang, Wei Liu, Yan-Ting Lin","doi":"10.1080/00365521.2026.2742238","DOIUrl":"https://doi.org/10.1080/00365521.2026.2742238","url":null,"abstract":"<p><strong>Background: </strong>Primary gastrointestinal lymphoma (PGIL) exhibits pronounced heterogeneity in its clinical and endoscopic manifestations; however, the potential associations between its macroscopic endoscopic morphology and clinicopathological characteristics remain poorly defined.</p><p><strong>Objective: </strong>To investigate the correlations between distinct PGIL endoscopic phenotypes and clinicopathological features, tumor burden, and systemic inflammatory status.</p><p><strong>Methods: </strong>We retrospectively reviewed 117 patients diagnosed with PGIL (between January 2019 and August 2025). Based on the predominant endoscopic presentations, 105 patients were stratified into ulcerative (<i>n</i> = 43), exophytic (<i>n</i> = 36), and diffuse infiltrative (<i>n</i> = 26) cohorts.</p><p><strong>Results: </strong>The ulcerative and exophytic cohorts tended to exhibit potentially elevated systemic tumor burden markers and immune-inflammatory indices. Aggressive diffuse large B-cell lymphoma (DLBCL) predominated in the ulcerative (62.8%) and exophytic (66.7%) groups, whereas the diffuse infiltrative type was primarily characterized by indolent mucosa-associated lymphoid tissue (MALT) lymphoma (88.5%). Radiologically, transmural wall thickening frequently accompanied the ulcerative type (78.0%), while peritumoral fat stranding (50.0%) and abdominopelvic effusion were prevalent in the exophytic type. Furthermore, exploratory regression suggested potential trends linking ulcerative and exophytic phenotypes to aggressive DLBCL, albeit with extremely wide confidence intervals. Therapeutically, the ulcerative type predominantly received systemic chemotherapy (48.8%), the exophytic cohort exhibited the highest rate of surgery combined with chemotherapy (27.8%), and the diffuse infiltrative type was managed conservatively, notably <i>via</i> anti-<i>Helicobacter pylori</i> eradication.</p><p><strong>Conclusion: </strong>Distinct PGIL endoscopic phenotypes may indicate variations in histopathology, infiltration, and systemic inflammation. Integrating macroscopic, serological, and radiological features aids in the preliminary tumor assessment; however, these associations remain strictly exploratory and require validation in larger cohorts.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-13"},"PeriodicalIF":1.8,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114224","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":"Acute upper gastrointestinal bleeding: a population-based cohort study from Southern Iceland.","authors":"Vigdis S Sverrisdottir, Johann P Hreinsson, Arnar B Ingason, Helgi K Bjornsson, Einar S Bjornsson, Elias S Eythorsson","doi":"10.1080/00365521.2026.2694748","DOIUrl":"10.1080/00365521.2026.2694748","url":null,"abstract":"<p><strong>Background: </strong>Acute upper gastrointestinal bleeding (AUGIB) is a common reason for emergency room presentation and can cause significant morbidity and mortality. Most studies only describe outcomes among admitted individuals. The aim of the study was to evaluate incidence, outcomes, and prediction model usage for all AUGIB presentations at Landspitali University Hospital, Iceland regardless of hospital admission.</p><p><strong>Methods: </strong>A retrospective chart review was performed on all visits to Landspitali 2017-2023 with ICD-10 codes indicating UGIB. AUGIB incidence was calculated for individuals who resided in the hospital's catchment area and analyzed using Poisson regression. Characteristics upon presentation, endoscopy results and outcomes were collected. Survival analysis was performed with the Kaplan-Meier method.</p><p><strong>Results: </strong>During the study period, 1129 AUGIB cases occurred among 1017 individuals. At first presentation, mean age was 60.0 years, 376 (37%) were females, and 685 (67%) were admitted. Overall, annual AUGIB incidence was 75/100,000, with incidence of admitted cases 51/100,000, both decreased over the study period. Admitted patients were more likely to undergo endoscopy (661 [96%] vs 218 [66%], OR 14.4 95%CI 9.04-23.0) and receive blood transfusions (424 [62%] vs 3 [0.9%], OR 178 95%CI 56.6-561). Thirty-day all-cause mortality was 6.7% (95%CI 4.8%-8.6%) for admitted and 0.9% (95%CI 0%-1.9%) for non-admitted cases, OR 7.89 (95%CI 2.44-25.6). The Glasgow-Blatchford score was reported in 1% of cases.</p><p><strong>Discussion: </strong>AUGIB incidence in Iceland was low and appeared to be decreasing. A substantial proportion of patients were not admitted. Triage was excellent despite limited prediction model usage, as intervention was rare among discharged individuals.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1045-1054"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353631","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":"Comorbid type 2 diabetes and cardiovascular disease drive higher healthcare costs in MASLD/MASH: a retrospective Swedish cohort study.","authors":"Helena Skröder, Mattias Ekstedt, Stergios Kechagias, Riku Ota, Ying Shang, Fotis Tefos, Emilie Toresson Grip, Johan Vessby, Hannes Hagström","doi":"10.1080/00365521.2026.2698838","DOIUrl":"10.1080/00365521.2026.2698838","url":null,"abstract":"<p><strong>Objectives: </strong>We compared healthcare resource utilization (HCRU) and healthcare costs in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) or metabolic dysfunction-associated steatohepatitis (MASH) with or without obesity, type 2 diabetes (T2D) or cardiovascular disease (CVD).</p><p><strong>Methods: </strong>This cohort study included adults with biopsy-confirmed MASLD/MASH from three Swedish university hospitals (1974-2020). Clinical data were linked to national registers to capture long-term outcomes, HCRU and costs. In addition to the overall cohort, patients were stratified into comorbidity-positive and comorbidity-negative subgroups for obesity, T2D and CVD. HCRU outcomes were hospitalizations, length of stay and outpatient visits. Total costs were the sum of direct costs (hospitalizations, outpatient visits, prescribed drugs) and indirect costs (sickness, early retirement benefits). Negative binomial and generalized linear models were used to estimate adjusted annual HCRU and costs, respectively.</p><p><strong>Results: </strong>Among 959 patients, 40%, 25% and 11% were living with obesity, T2D and CVD, respectively. Patients with T2D or CVD had more advanced fibrosis at baseline and a higher incidence of cirrhosis or hepatocellular carcinoma during follow-up (up to 46 years depending on outcome), compared with those without T2D or CVD. T2D and CVD were linked to substantially greater HCRU and costs: mean annual total costs were approximately 76% higher for CVD and 71% higher for T2D compared with subgroups without these comorbidities.</p><p><strong>Conclusions: </strong>T2D and CVD are linked to an increased economic burden in MASLD/MASH. Holistic, multidisciplinary management is essential to help mitigate disease progression and the associated clinical and economic burden.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1117-1128"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437816","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":"Textbook outcome after esophagectomy in Norway - a national cohort study of low- to medium-volume centers.","authors":"Tobias Hauge, Egil Johnson, Eirik Kjus Aahlin, Kjell Kåre Øvrebø, Tien Pham, Lars Cato Rekstad, Tom Mala","doi":"10.1080/00365521.2026.2694746","DOIUrl":"10.1080/00365521.2026.2694746","url":null,"abstract":"<p><strong>Background and aims: </strong>Textbook outcome (TO) and textbook oncological outcome (TOO) are two multidimensional quality measures designed to evaluate and benchmark the surgical and oncological outcomes following esophagectomy. Most studies on TO and TOO originate from high-volume tertiary centers, whereas less is known about the outcome from low- to medium-sized centers.</p><p><strong>Methods: </strong>Retrospective national cohort study of patients operated for esophageal cancer with Ivor Lewis or McKeown esophagectomy between 07/2021 and 06/2025. The primary outcome was the fraction of patients achieving TO defined as no 30-days mortality, no Clavien-Dindo complications ≥ III, length of hospital stay < 21 days, R0 resection, no re-admissions within 30 days, ≥ 15 lymph nodes harvested and no intraoperative complications. The main secondary outcome was the proportion of patients achieving TOO, defined as achievement of TO and completed neoadjuvant (radio)chemotherapy. Patients were grouped according to type of resection.</p><p><strong>Results: </strong>A total of 317 patients were included. 97 (31%) of all patients achieved TO and 83 (27%) TOO, with no difference between the two surgical techniques (<i>p</i> = 0.40 and <i>p</i> = 0.94, respectively); 30-day mortality was 1%. No predictive variables of TO were identified, specifically no association was found with the annual procedural center volume, type of resection or the use of robotic-assisted technique.</p><p><strong>Conclusions: </strong>Less than one in three patients achieved TO or TOO. Neither the annual procedure volume of the individual treatment centers nor the type of resection predicted TO. The lack of a consensus-based definition of TO and TOO makes comparisons across patient series challenging.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1129-1137"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369607","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":"Evaluating the role and effectiveness of protocol liver biopsies in pediatric post-transplant care: a systematic review.","authors":"Eyad Gadour, Razan Bader, Ahmed Zaidan, Syed Anjum Gardezi, Hadi Kuriry, Noora H Alfaraj, Elsayed Ghoneem, Mohammed Saad AlQahtani","doi":"10.1080/00365521.2026.2694747","DOIUrl":"10.1080/00365521.2026.2694747","url":null,"abstract":"<p><strong>Introduction: </strong>Pediatric liver transplantation has improved long-term survival, but optimal surveillance strategies for late graft injury remain uncertain. This systematic review evaluated the utility of protocol liver biopsies for detecting subclinical histopathological abnormalities after pediatric liver transplantation, particularly fibrosis, inflammation, steatosis, and rejection.</p><p><strong>Methods: </strong>We conducted a PRISMA-compliant systematic review of PubMed and ScienceDirect, with supplementary hand-searching of references and trial registries. Eligible studies included English-language primary studies of pediatric liver transplant recipients undergoing surveillance liver biopsy. Two reviewers independently screened studies, extracted data, and assessed methodological quality using the Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>Fifteen studies comprising 2004 pediatric liver transplant recipients were included. Protocol biopsies frequently identified histological abnormalities despite minimal or absent clinical symptoms. Fibrosis was common and appeared to increase over time, with crude estimates suggesting any fibrosis in approximately 66.2% of patients at 1 year and 81.6% at 15 years post-transplant. Inflammation was also prevalent but tended to decline over time. Several factors were inconsistently associated with fibrosis and inflammation, including donor gender, graft type, immunosuppression regimen, donor-specific antibodies, and surgical complications. In comparative data, protocol biopsies detected more subclinical rejection than for-cause biopsies in stable recipients.</p><p><strong>Conclusions: </strong>In selected cases, repeat protocol or targeted follow-up biopsies after treatment modification may help determine whether inflammation or fibrosis is stabilizing, improving, or progressing. Protocol liver biopsies are a valuable surveillance tool in pediatric liver transplant follow-up, enabling early detection of clinically silent graft pathology and potentially informing timely immunosuppression adjustment.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1104-1116"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148339924","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":"Endoloop-clip closure versus hemoclips for large sigmoid colon perforations: a randomized controlled <i>ex vivo</i> study.","authors":"Geun Hyuk Choi, Jae Kook Yang, Young Sin Cho, Il-Kwun Chung, Yunho Jung","doi":"10.1080/00365521.2026.2694753","DOIUrl":"10.1080/00365521.2026.2694753","url":null,"abstract":"<p><strong>Background/aims: </strong>Sigmoid colon perforations during colonoscopy are technically challenging to close endoscopically because of fixed angulation and luminal redundancy. This study compared the endoloop-clip technique with conventional hemoclips for the closure of large sigmoid colon perforations.</p><p><strong>Methods: </strong>In this prospective, randomized, controlled <i>ex vivo</i> study, 40 standardized full-thickness 3-cm defects were created in fresh porcine sigmoid colon specimens and randomly assigned (1:1) to hemoclip closure (<i>n</i> = 20) or endoloop-clip closure (<i>n</i> = 20). Two experienced endoscopists each performed 10 closures per group. An independent observer recorded total procedure time, ineffective clip placements, and closure outcomes using air insufflation and underwater leak testing.</p><p><strong>Results: </strong>Closure was successfully achieved in most cases, with a technical success rate of 95% in both groups. Procedure time was shorter with endoloop-clip than with hemoclips alone (10.8 ± 2.5 vs 14.5 ± 7.3 min; <i>p</i> = 0.044), and ineffective clip placements per case were fewer (0.05 ± 0.22 vs 0.70 ± 0.98; <i>p</i> = 0.009). The mean number of hemoclips used was not significantly different (7.9 ± 1.7 vs 9.1 ± 2.4; <i>p</i> = 0.083). Complete closure by air insufflation and underwater leak testing was achieved in 65% (13/20) vs 50% (10/20) (<i>p</i> = 0.337). Inter-operator differences in procedure time and clip use were observed in the hemoclip group, although these did not reach statistical significance.</p><p><strong>Conclusion: </strong>In a standardized <i>ex vivo</i> porcine model of a 3-cm sigmoid colon perforation, the endoloop-clip technique reduced procedure time and ineffective clip placement while achieving closure outcomes comparable to those of hemoclips alone.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1029-1036"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369566","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 calprotectin concentration in adults with and without <i>Helicobacter pylori</i> infection.","authors":"Tarek Mazzawi, Sameer A Al Haj Mahmoud","doi":"10.1080/00365521.2026.2694750","DOIUrl":"10.1080/00365521.2026.2694750","url":null,"abstract":"<p><strong>Background: </strong><i>Helicobacter pylori</i> (<i>H.p.</i>) is a very common cause of chronic gastritis. As an acute phase protein, calprotectin (CP) has a significant function during inflammation. The aims were to investigate the difference of fecal CP concentration in adults with and without <i>H.p</i>. infection, the effect of eradication therapy on fecal CP concentration, and to correlate between fecal CP concentration and the grade of activity of chronic gastritis in both groups.</p><p><strong>Methods: </strong>Patients complaining of abdominal pain, referred to the gastroenterology outpatient clinic, were recruited in this prospective study. They provided stool samples to be tested for fecal CP, <i>H.p.</i> antigen and stool analysis with culture. Upper and lower endoscopies were offered, within 48 h, to all eligible patients with elevated fecal CP concentration irrespective of <i>H.p.</i> infectivity. Patients with <i>H.p.</i> infection received eradication treatment and were asked to provide a new stool sample to test fecal CP and <i>H. pylori</i> antigen.</p><p><strong>Results: </strong>A total of 186 patients (93 males and 93 females) were enrolled and divided into two groups according to their <i>H.p.</i> infectivity: 105 negative- and 81 positive-<i>H.p.</i> infection. Fecal CP concentration was significantly higher in the <i>H.p.</i> positive than negative group (<i>p</i> = 0·004) and significantly decreased (<i>p</i> < 0·0001) after receiving eradication therapy. Fecal CP concentration correlated significantly (<i>r</i> 0·60, <i>p</i> < 0·0001) with the grade of activity of <i>H.p.</i> induced gastritis.</p><p><strong>Conclusion: </strong>Fecal CP concentration can be affected by <i>H.p.</i> infection. <i>Helicobacter pylori eradication</i> may improve fecal CP concentration.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1076-1081"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369625","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}