Scandinavian Journal of Gastroenterology最新文献

{"title":"The diagnostic accuracy of plasma and serum calprotectin is inferior to C-reactive protein in patients with suspected Crohn's disease.","authors":"M H Rasmussen, J B Brodersen, C L Brasen, J S Madsen, T Knudsen, J Kjeldsen, M D Jensen","doi":"10.1080/00365521.2025.2459236","DOIUrl":"10.1080/00365521.2025.2459236","url":null,"abstract":"<p><strong>Background and aims: </strong>Prior studies indicate that serum calprotectin (SC) and plasma calprotectin (PC) can be used as biomarkers in Crohn's disease (CD). The aim of this study was to investigate the diagnostic accuracy of SC and PC in patients with a clinical suspicion of CD.</p><p><strong>Method: </strong>This biobank study included patients from a prospective, blinded, multicenter study examining minimally invasive modalities for diagnosing CD. Patients had a standardized work-up including ileocolonoscopy, pan-enteric capsule endoscopy, and blood samples within a 2-week period. Plasma and serum were stored at - 80 °C until further analysis. A routine C-reactive protein (CRP) was measured on the same day. Pan-endoscopy served as reference standard.</p><p><strong>Results: </strong>126 patients entered the study, and 58 (46.0%) were diagnosed with CD. Patients with CD had a median PC of 0.37 mg/L (IQR 0.20-0.70) compared to 0.29 mg/L (IQR 0.16-0.41) in non-CD patients (<i>p</i> = 0.03). The median SC was 1.09 mg/L (IQR 0.80-1.80) and 0.93 mg/L (IQR 0.66-1.25), respectively (<i>p</i> = 0.01). Receiver operating characteristics curves showed an AUC of 0.63 (CI 0.53-0.73) for SC and 0.61 (CI 0.51-0.71) for PC for detection of CD, which was inferior to that of CRP (AUC = 0.76, CI 0.68-0.85) (<i>p</i> < 0.02). None of the biomarkers reflected the endoscopic severity of CD.</p><p><strong>Conclusion: </strong>Although levels of PC and SC are elevated in patients with CD, diagnostic accuracies are inferior to CRP. SC and PC are not reliable as stand-alone blood-based biomarkers for diagnosing CD and selecting patients for endoscopy.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"235-242"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060518","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":"Prediction of survival after pancreatoduodenectomy for distal cholangiocarcinoma: independent external validation of a prognostic model for 3-year overall survival in Sweden.","authors":"Johannes Byrling, Bodil Andersson","doi":"10.1080/00365521.2024.2447518","DOIUrl":"10.1080/00365521.2024.2447518","url":null,"abstract":"<p><strong>Objectives: </strong>The only treatment with curative potential for distal cholangiocarcinoma (dCCA) is radical surgery which can be complemented with adjuvant chemotherapy. The aim of the present study was to perform an independent external validation of a prognostic model for 3-year overall survival based on routine clinicopathological variables for patients treated with pancreatoduodenectomy for dCCA.</p><p><strong>Materials and methods: </strong>All patients with a histopathological confirmed dCCA that underwent pancreatoduodenectomy in Sweden from 2009 through 2019 were identified in the Swedish National Registry for Pancreatic and Periampullary Cancer. Model performance was estimated using the C-index and calibration plots.</p><p><strong>Results: </strong>In total 220 patients were included in the study. The median survival was 33 months (IQR 26-40) and 3-year survival rate 47% (95% CI 40-53%). The prognostic model had a C-index of 0.69 (95% CI 0.62-0.72). Calibration plots revealed overestimated risk of death across risk groups in the full cohort. Calibration was good in the subgroup of patients that did not receive adjuvant treatment.</p><p><strong>Conclusions: </strong>The prognostic model showed reasonable discriminative ability but some miscalibration likely since the effect of adjuvant treatment is not included in the model. Given that the model was developed in cohorts treated prior to the current adjuvant standard of care the model can be used to estimate baseline risk prior to risk/benefit decision for adjuvant treatment as well as stratification for clinical trials but with a risk to underestimate 3-year overall survival for patients that receive adjuvant treatment.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"158-164"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927595","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 the age-adjusted Charlson comorbidity index as a prognostic factor in patients with early gastric cancer after endoscopic submucosal dissection.","authors":"Xiao Shi, Ruibo Li, Xiaoyi Shi, Yuxing Yan, Aixia Gong","doi":"10.1080/00365521.2024.2449072","DOIUrl":"10.1080/00365521.2024.2449072","url":null,"abstract":"<p><strong>Background: </strong>The Charlson Comorbidity Index (CCI) and prognostic nutritional index (PNI) have proven to be valuable tools in predicting prognosis based on comorbidities and nutritional status in the context of surgical procedures and endoscopic resections. The age-Adjusted CCI (ACCI) has also shown utility in surgical settings, but its application to early gastric cancer (EGC) remains unexplored. Consequently, we aimed at clarifying the prognostic factors for EGC treated with endoscopic submucosal dissection (ESD).</p><p><strong>Methods: </strong>Patients who underwent ESD for EGC at the First Affiliated Hospital of Dalian Medical University from January 2015 to February 2023 were included. The overall survival (OS) and prognostic predictive ability were evaluated based on patients and lesion characteristics.</p><p><strong>Results: </strong>During a median follow-up period of 50 months, 15 patients died, but none from the gastric cancer. The 5-year survival rate was 90.0%. In univariate and multivariate analyses, a high ACCI (>4.5) was the only significant prognostic factor (Hazard ratio, 27.78; 95% confidence interval, 3.62-213.40; <i>p</i> < 0.01). The 5-year survival rates for patients with low ACCI (<4.5) and high ACCI were 98.9% and 72.9%, respectively (<i>p</i> < 0.01).</p><p><strong>Conclusions: </strong>A high ACCI is a significant prognostic indicator for 5-year survival and the risk of mortality caused by other comorbidities. EGC suitable for ESD is unlikely to serve as a prognostic factor, and ACCI should be considered as an important reference when considering additional surgical procedures in high-ACCI patients after ESD with endoscopic curability (eCura) C-2 for EGC.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"136-142"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring esophagogastric junction morphology and contractile integral: implications for refractory gastroesophageal reflux disease pathophysiology.","authors":"Sihui Lin, Zhilong Chen, Wei Jiang, Yucheng Zhu","doi":"10.1080/00365521.2025.2450042","DOIUrl":"10.1080/00365521.2025.2450042","url":null,"abstract":"<p><strong>Background: </strong>Evaluate the clinical significance of esophagogastric junction (EGJ) morphology and esophagogastric junction contractile integral (EGJ-CI) in refractory gastroesophageal reflux disease (RGERD) patients.</p><p><strong>Methods: </strong>From June 2021 to June 2023, 144 RGERD patients underwent comprehensive evaluation, recording symptom scores, demographic data. GERD classification (NERD or RE, A-D) was based on endoscopic findings. Reflux was assessed through 24-hour pH-impedance monitoring, and high-resolution esophageal manometry(HREM) measured parameters including EGJ-CI.</p><p><strong>Results: </strong>HREM revealed EGJ morphologies (type I, II, III) in 80.6%, 13.9%, and 5.6% of subjects, respectively. As the separation between the lower esophageal sphincter(LES) and crural diaphragm(CD) increased, EGJ-CI decreased (<i>p</i> < 0.005). Subjects with EGJ morphology types II and III had significantly higher acid exposure times(AET), DeMeester scores, and impedance reflux times than type I (<i>p</i> < 0.05). There was no statistical difference between types II and III. Impedance reflux times in subjects with type III morphology were significantly higher than those with types I and II (<i>p</i> < 0.05). The optimal EGJ-CI cutoff for distinguishing pathological reflux was 24.8 mmHg·cm, with 68% sensitivity, 72.3% specificity, and an AUC of 0.693 (95% CI 0.609-0.768). Logistic regression analysis identified EGJ-CI <24.8 mmHg·cm (OR = 2.5, 95% CI 1.1-5.5, <i>p</i> = 0.022) and ineffective esophageal motility(IEM) (OR = 2.4, 95% CI 1.2-5.2, <i>p</i> = 0.027) as independent risk factors.</p><p><strong>Conclusion: </strong>EGJ-CI is crucial for clinically assessing EGJ barrier function, predicting pathological reflux and selecting patients with persistent reflux symptoms for surgery.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":"60 2","pages":"130-135"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123531","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":"Mitochondrial dysfunction and lipid alterations in primary sclerosing cholangitis.","authors":"Guri Fossdal, Peder Braadland, Johannes Roksund Hov, Eystein Sverre Husebye, Trine Folseraas, Per Magne Ueland, Arve Ulvik, Tom Hemming Karlsen, Rolf Kristian Berge, Mette Vesterhus","doi":"10.1080/00365521.2024.2447521","DOIUrl":"10.1080/00365521.2024.2447521","url":null,"abstract":"<p><strong>Objectives: </strong>Indications of mitochondrial dysfunction are commonly seen in liver diseases, but data are scarce in primary sclerosing cholangitis (PSC). Analyzing circulating and liver-resident molecules indirectly reflecting mitochondrial dysfunction, we aimed to comprehensively characterize this deficit in PSC, and whether this was PSC specific or associated with cholestasis.</p><p><strong>Materials and methods: </strong>We retrospectively included plasma from 191 non-transplant patients with large-duct PSC and 100 healthy controls and explanted liver tissue extracts from 24 PSC patients and 18 non-cholestatic liver disease controls. Using mass spectroscopy, we profiled lipids and fatty acids, carnitine, acylcarnitines, and metabolites in the tryptophan-kynurenine-nicotinamide pathway.</p><p><strong>Results: </strong>Hierarchal clustering of fatty acid levels identified patients with PSC and healthy controls as separate clusters. Compared to healthy controls, PSC patients had increased levels of monounsaturated fatty acids (MUFA) and palmitate (C16:0) in plasma, but reduced levels of long-chain saturated fatty acids (SFAs). These findings were more pronounced in PSC patients with cholestasis. Several n-3 polyunsaturated fatty acids were elevated in PSC but not associated with cholestasis. Acylcarnitine ratios C2/C5 and C2/C3 were elevated while C2/C16 was reduced in PSC, indicating impaired mitochondrial fatty acid oxidation of medium-long chained fatty acids. Levels of intermediates in the tryptophan-kynurenine pathway indicated impaired NAD biosynthesis, suggesting impaired energy supply to mitochondria in PSC.</p><p><strong>Conclusions: </strong>We found that mitochondrial dysfunction was prominent in PSC and associated with increasing cholestasis. Whether this is merely a marker of liver disease and severity, or an underlying driver and potential therapeutic target in PSC remains to be explored.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":"60 2","pages":"165-173"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123532","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":"Endoscopic mucosal resection and open-lid submucosal biopsy for the diagnosis of diffuse infiltrative gastric cancer: a retrospective observational study.","authors":"Yushi Kawakami, Satoki Shichijo, Noriya Uedo, James Weiquan Li, Renata Nobre, Yasuhiro Tani, Daiki Kitagawa, Takehiro Ninomiya, Tomoya Ueda, Yuya Asada, Yuki Okubo, Atsuko Kizawa, Shunsuke Yoshii, Takashi Kanesaka, Koji Higashino, Tomoki Michida, Ryu Ishihara, Naoki Shinno, Hisashi Hara, Takeshi Omori, Yasuhito Tanaka","doi":"10.1080/00365521.2024.2447526","DOIUrl":"10.1080/00365521.2024.2447526","url":null,"abstract":"<p><strong>Background and study aims: </strong>Diffuse infiltrative gastric cancer can be difficult to diagnose owing to a lack of endoscopic features in the superficial mucosa. Moreover, a forceps biopsy may not reveal a pathological diagnosis. We aimed to evaluate the diagnostic yield and safety of endoscopic mucosal resection (EMR) and 'open-lid submucosal biopsy', a technique wherein EMR followed by biopsy of the ulcer floor is performed for a pathological diagnosis.</p><p><strong>Patients and methods: </strong>This retrospective observational study involved patients with suspected diffuse invasive gastric cancer on endoscopy and cross-sectional imaging in whom endoscopic forceps biopsy did not lead to a pathological diagnosis. Patients who underwent EMR and open-lid submucosal biopsy were included. The primary outcome was the total diagnostic yield. The secondary outcomes were the diagnostic yields of EMR and open-lid submucosal biopsy and incidence of complications.</p><p><strong>Results: </strong>Between June 2011 and February 2022, EMR and open-lid submucosal biopsy for diagnostic purposes were performed on seven patients without complications. EMR was diagnostic in four (57%) cases of diffuse infiltrative gastric cancer. Open-lid submucosal biopsy was diagnostic in five (71%) cases. As the primary endpoint, the combination of EMR and open-lid submucosal biopsy led to a pathological diagnosis in six cases (86%). Secondary analysis revealed gastric adenocarcinoma in 9 of 22 (41%) EMR specimens, while open-lid submucosal biopsies were positive for adenocarcinoma in 14 of 60 specimens (23%).</p><p><strong>Conclusions: </strong>The combination of EMR and open-lid submucosal biopsy was safe and showed good accuracy for the diagnosis of diffuse infiltrative gastric cancer.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"208-212"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142897089","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":"Remote ischemic preconditioning on perioperative autonomic nervous system function and postoperative recovery in patients undergoing cholecystectomy.","authors":"Siyu Chen, Yuwei Ma, Yue Liu, Jianrong Ye, Yutong Li, Yubao Ma, Yumiti Aili, Yan Ma","doi":"10.1080/00365521.2024.2440801","DOIUrl":"10.1080/00365521.2024.2440801","url":null,"abstract":"<p><strong>Background: </strong>Cholecystectomy often disrupts autonomic balance, impacting recovery. Remote ischemic preconditioning (RIPC) may enhance ANS function and protect organs, but its role in cholecystectomy is unclear.</p><p><strong>Methods: </strong>In this randomized controlled trial, 80 patients aged 45 to 65 years, scheduled for elective laparoscopic cholecystectomy, were randomly assigned to either the RIPC group or the control group. The primary outcomes were mean arterial pressure (MAP), heart rate variability (HRV), and the low-frequency to high-frequency ratio (LF/HF) measured at various time points during the perioperative period. Secondary outcomes included liver and kidney function markers, postoperative hospital stay, and 30-day mortality rates.</p><p><strong>Results: </strong>RIPC group significantly improved HRV compared to the control group at 5 minutes post-anesthesia induction (42.5 ± 9.8 ms vs. 36.4 ± 10.1 ms, <i>P</i> = 0.02) and at the end of surgery (44.8 ± 10.5 ms vs. 37.1 ± 9.3 ms, <i>P</i> = 0.01). The LF/HF ratio was significantly lower in the RIPC group at 30 minutes into surgery (1.25 ± 0.35 vs. 1.67 ± 0.42, <i>P</i> = 0.04) and at the end of surgery (1.19 ± 0.31 vs. 1.71 ± 0.39, <i>P</i> = 0.03), indicating improved autonomic balance. There were no significant differences in MAP, liver function markers (ALT), or kidney function (SCr) between groups at any time point.</p><p><strong>Conclusions: </strong>RIPC may improve ANS function and MAP stability during cholecystectomy, as shown by better HRV and lower LF/HF ratios. Though the impact on recovery was not significant.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"143-148"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915566","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":"Efficacy and safety of anticoagulation in asymptomatic cirrhotic patients with portal vein thrombosis: a systematic review and meta-analysis.","authors":"Qingping Wu, Xingfen Zhang, Anyi Xu, Sidong Zhu, Xiaoming Zhang, Qi Wu, Shengying Zhang","doi":"10.1080/00365521.2025.2450043","DOIUrl":"10.1080/00365521.2025.2450043","url":null,"abstract":"<p><strong>Background: </strong>The role of anticoagulation in asymptomatic cirrhotic patients with portal vein thrombosis (PVT) remains unclear. This study aims to evaluate the efficacy and safety of anticoagulation in this patient population.</p><p><strong>Methods: </strong>We systematically searched PubMed, Web of Science, Cochrane Library, and Embase up to August 2024. The primary outcomes analyzed were PVT recanalization, progression of PVT, bleeding events, and mortality. Odds ratios (OR) with 95% confidence intervals (CI) were calculated for dichotomous variables.</p><p><strong>Results: </strong>Seventeen studies, including randomized controlled trials (RCTs) and observational studies, were included in the analysis. Compared to no intervention, anticoagulation significantly increased the PVT recanalization rate (OR = 3.89, <i>p</i> < .001) and decreased the PVT progression rate (OR = 0.28, <i>p</i> < .001) as well as overall mortality (OR = 0.66, <i>p</i> = .008). Importantly, anticoagulation did not significantly increase the bleeding rate (OR = 1.21, <i>p</i> = .41). Subgroup analysis revealed a greater benefit in PVT recanalization within the short-term treatment subgroup (≤ 6 months) compared to long-term treatment subgroup (> 6 months), and in the Asian subgroup compared to the European or United States of America (USA) subgroup. In the Warfarin subgroup, while the total bleeding rate increased significantly, there was no significant rise in major bleeding events. Additionally, a downward trend in variceal bleeding was observed in the Asian subgroup (OR = 0.44; 95% CI: 0.19-1.04; <i>p</i> = .06).</p><p><strong>Conclusion: </strong>Anticoagulation is both safe and effective for asymptomatic cirrhotic patients with PVT. It not only treats PVT and reduces all-cause mortality, but also does so without significantly increasing the risk of bleeding events.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"197-207"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954182","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":"Ultrasonographic predictors of acute gangrenous cholecystitis in patients treated with laparoscopic cholecystectomy: a single center retrospective study.","authors":"Ha Young Kim, Jeong Hwan Lee, Su Geun Kim, Soo Ho Lee, Soya Paik, Hyuk Jung Kim, Suk Ki Jang, Ah Young Lee, Sang-Jung Kim, Sang Woon Park, Sang Jong Park, Eunjeong Jang, Ju Sang Park, Jun-Young Seo","doi":"10.1080/00365521.2024.2447525","DOIUrl":"10.1080/00365521.2024.2447525","url":null,"abstract":"<p><strong>Background: </strong>Acute gangrenous cholecystitis, a severe complication of cholecystitis, carries a high risk of morbidity and mortality. Despite its severity, preoperative diagnosis is challenging, often only confirmed during surgery. Therefore, we analyzed various factors that could predict acute gangrenous cholecystitis in patients undergoing cholecystectomy.</p><p><strong>Methods: </strong>We retrospectively reviewed patients who underwent laparoscopic cholecystectomy at Bundang Jasaeng General Hospital from January 2018 to December 2021. Only patients who proceeded directly to surgery without radiologic interventions were included, and all underwent trans-abdominal ultrasonography before surgery.</p><p><strong>Results: </strong>Our study investigated 305 patients diagnosed with acute cholecystitis, identifying 37 with acute gangrenous cholecystitis. Analysis showed that patients with gangrenous cholecystitis were significantly older, more likely to be male, and had a higher prevalence of diabetes mellitus compared to those with uncomplicated cholecystitis. Ultrasound findings revealed a higher incidence of sonographic Murphy's signs, thickened gallbladder walls, gallbladder wall defects, and pericholecystic fluid in gangrenous cases. Multivariate analyses showed that a thickened gallbladder wall and the presence of pericholecystic fluid were significantly associated with gangrenous cholecystitis.</p><p><strong>Conclusion: </strong>Our study showed that ultrasound findings of a thickened gallbladder wall, along with pericholecystic fluid, could be predictors of gangrenous cholecystitis. Additionally, leukocytosis and high CRP values strongly indicate the likelihood of this condition. Therefore, urgent management is recommended due to the high morbidity and mortality associated with gangrenous cholecystitis.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":"60 2","pages":"174-183"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190273","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":"Recurrence of gallstones: a comprehensive multivariate analysis of clinical and biochemical risk factors in a large Chinese cohort of 16,763 patients.","authors":"Xin Li, Rongrong Song, Mi Min Liu, Jing He, Xiao Yue Zhao, Xue Wei Zhuang","doi":"10.1080/00365521.2024.2446626","DOIUrl":"10.1080/00365521.2024.2446626","url":null,"abstract":"<p><strong>Background: </strong>Gallstone disease is common, with a prevalence of 5%-22% in Western countries and 6.3%-12.1% in Chinese adults, increasing with age. Postsurgery recurrence is high and analyzing recurrence factors helps identify high-risk patients and preventive strategies. This study explores the differences in stone types and factors associated with postoperative recurrence.</p><p><strong>Method: </strong>Data from 16,763 patients treated for gallstones at Shandong Third Hospital (2017-2023) were collected. Variables such as age, gender, stone type and size, comorbidities and biochemical results were analyzed using rank sum test, chi-square test, odds ratio (OR) and logistic regression.</p><p><strong>Results: </strong>Among 16,763 patients, females were slightly more numerous, with ages predominantly in the 60-74 range. Gallbladder stones were the most common type, with a low recurrence rate. Recurrence was significantly associated with stone size, venous thrombosis, respiratory diseases, and cirrhosis. Different stone types varied in terms of complications, gender, age, and recurrence.</p><p><strong>Conclusions: </strong>Different stone types varied by comorbidities, gender, age, and recurrence, influencing recurrence risk. While the direct effect of stone type on recurrence is unclear, comorbidities play a crucial role. Larger, multicenter studies are needed to improve treatment guidance.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"149-157"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142897125","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}