Translational gastroenterology and hepatology最新文献_第8页

Post-cholecystectomy syndrome: a retrospective study analysing the associated demographics, aetiology, and healthcare utilization. 胆囊切除术后综合征:一项回顾性研究，分析了相关的人口统计学、病因学和医疗保健利用。

IF 3 4区医学

Translational gastroenterology and hepatology Pub Date : 2021-10-25 eCollection Date: 2021-01-01 DOI: 10.21037/tgh.2019.11.08

Saad Saleem, Simcha Weissman, Hector Gonzalez, Patricia Guzman Rojas, Faisal Inayat, Ali Alshati, Vinaya Gaduputi

{"title":"Post-cholecystectomy syndrome: a retrospective study analysing the associated demographics, aetiology, and healthcare utilization.","authors":"Saad Saleem, Simcha Weissman, Hector Gonzalez, Patricia Guzman Rojas, Faisal Inayat, Ali Alshati, Vinaya Gaduputi","doi":"10.21037/tgh.2019.11.08","DOIUrl":"https://doi.org/10.21037/tgh.2019.11.08","url":null,"abstract":"Background: Post-cholecystectomy syndrome (PCS) is a group of heterogeneous signs and symptoms, predominately consisting of right upper quadrant abdominal pain, dyspepsia, and/or jaundice, manifesting after undergoing a cholecystectomy. According to some studies, as many as 40% of post-cholecystectomy patients are in fact, affected by this syndrome. This study aims to determine the demographics, aetiology, average length of hospital stay, and health care burden associated with PCS.Methods: We queried the National Inpatient Sample (NIS) database to determine inpatient admissions of PCS between 2011 and 2014 using the ICD-9 primary diagnosis code 576.0.Results: From 2011 to 2014, the number of inpatient admissions with a principal diagnosis of PCS totally 275. The average length of hospital stay was 4.28±4.28, 3.42±2.73, 3.74±1.84, and 3.79±2.78 days in 2011, 2012, 2013, and 2014, respectively. The total yearly charges were $32,079±$24,697, $27,019±$22,633, $34,898.21±$24,408, and $35,204±$32,951 in 2011, 2012, 2013, and 2014, respectively. Notably, the primary cause of PCS in our patient sample between the year 2011 and 2014, was biliary duct dysfunction, followed by Peptic ulcer disease.Conclusions: In conclusion, there is a strong need to examine for and treat the underlying aetiology when approaching a post-cholecystectomy patient. We found that longer hospital stays, were associated with a greater health care burden, and visa versa. Furthermore, our findings help identify at-risk populations which can contribute to improving surveillance of this costly disease.","PeriodicalId":23267,"journal":{"name":"Translational gastroenterology and hepatology","volume":" ","pages":"58"},"PeriodicalIF":3.0,"publicationDate":"2021-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8573368/pdf/tgh-06-2019.11.08.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39644662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Endoscopic therapies for Barrett's esophagus. 巴雷特食管的内镜治疗。

IF 3 4区医学

Translational gastroenterology and hepatology Pub Date : 2021-10-25 eCollection Date: 2021-01-01 DOI: 10.21037/tgh.2020.02.04

Scott Ventre, Haroon Shahid

引用次数: 0

Value of alpha-fetoprotein in hepatocellular carcinoma. 甲胎蛋白在肝细胞癌中的价值。

IF 3 4区医学

Translational gastroenterology and hepatology Pub Date : 2021-10-25 eCollection Date: 2021-01-01 DOI: 10.21037/tgh.2019.12.19

Wei-Chen Lee

引用次数: 3

Narrative review of current and emerging pharmacological therapies for nonalcoholic steatohepatitis. 非酒精性脂肪性肝炎目前和新出现的药物治疗的叙述性回顾。

IF 3 4区医学

Translational gastroenterology and hepatology Pub Date : 2021-10-25 eCollection Date: 2021-01-01 DOI: 10.21037/tgh-20-247

Jinendra Satiya, Heather S Snyder, Shivaram Prasad Singh, Sanjaya K Satapathy

{"title":"Narrative review of current and emerging pharmacological therapies for nonalcoholic steatohepatitis.","authors":"Jinendra Satiya, Heather S Snyder, Shivaram Prasad Singh, Sanjaya K Satapathy","doi":"10.21037/tgh-20-247","DOIUrl":"https://doi.org/10.21037/tgh-20-247","url":null,"abstract":"Nonalcoholic steatohepatitis (NASH) is the most common cause of chronic liver disease today, and it has now emerged as the leading etiology of end-stage liver disease requiring liver transplantation. It is a progressive form of non-alcoholic fatty liver disease which can not only progress to cirrhosis of liver and hepatocellular carcinoma (HCC), but is associated with increased cardiovascular risks too. Despite all the advances in the understanding of the risk factors and the pathogenetic pathways involved in the pathogenesis and progression of NASH, an effective therapy for NASH has not been developed yet. Although lifestyle modifications including dietary modifications and physical activity remain the mainstay of therapy, there is an unmet need to develop a drug or a combination of drugs which can not only reduce the fatty infiltration of the liver, but also arrest the development and progression of fibrosis and advancement to cirrhosis of liver and HCC. The pharmacologic therapies which are being developed target the various components believed to be involved in the pathogenesis of nonalcoholic fatty liver disease (NAFLD)/NASH which includes insulin resistance, lipid metabolism oxidative stress, lipid peroxidation, inflammatory and cell death pathways, and fibrosis. In this review, we summarize the current state of knowledge on pharmacotherapy of NASH, and also highlight the recent developments in the field, for optimizing the management and treatment of NASH.","PeriodicalId":23267,"journal":{"name":"Translational gastroenterology and hepatology","volume":" ","pages":"60"},"PeriodicalIF":3.0,"publicationDate":"2021-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8573363/pdf/tgh-06-20-247.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39644664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 9

Ablative therapies of the biliary tree. 胆道的消融治疗。

IF 3 4区医学

Translational gastroenterology and hepatology Pub Date : 2021-10-25 eCollection Date: 2021-01-01 DOI: 10.21037/tgh.2020.02.03

Elizabeth S John, Paul R Tarnasky, Prashant Kedia

{"title":"Ablative therapies of the biliary tree.","authors":"Elizabeth S John, Paul R Tarnasky, Prashant Kedia","doi":"10.21037/tgh.2020.02.03","DOIUrl":"https://doi.org/10.21037/tgh.2020.02.03","url":null,"abstract":"Cholangiocarcinoma, a malignancy of the epithelial cells in the intrahepatic or extrahepatic biliary tree, is often diagnosed at later stages. Median survival duration ranges from 3 to 9 months with a less than ten percent 5-year survival rate. Thus, often treatment strategies are aimed more towards palliation instead of cure. With the majority of patients presenting with unresectable disease at the time of diagnosis, surgical intervention is not feasible, making less invasive endoscopic therapies more suitable. Initially, biliary stents were utilized for biliary decompression to mitigate cholestatic symptoms and prevent cholangitis; however, this strategy did not prove to provide significant survival benefit. Therefore, efforts to treat the tumor burden itself in addition to maintaining biliary patency became a focus of innovation and research in the endoscopic field. This study has led to the advent of therapies such as photodynamic therapy, radiofrequency ablation, and intraluminal brachytherapy. These options combined with biliary stenting have shown to not only offer the benefit of biliary decompression, but also to potentially improve stent patency and survival. Further, there is an anti-tumor effect of each of these modalities, portending an additional benefit in this subset of patients. Despite numerous retrospective and prospective studies assessing these ablative therapies, there is still a paucity of appropriately powered randomized controlled trials, and further research has yet to be done in the field. This review details the current literature entailing endobiliary ablative strategies.","PeriodicalId":23267,"journal":{"name":"Translational gastroenterology and hepatology","volume":" ","pages":"63"},"PeriodicalIF":3.0,"publicationDate":"2021-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8573373/pdf/tgh-06-2020.02.03.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39644667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Acute pancreatitis in a patient with COVID-19: a case report. COVID-19患者急性胰腺炎1例报告

IF 3 4区医学

Translational gastroenterology and hepatology Pub Date : 2021-10-25 eCollection Date: 2021-01-01 DOI: 10.21037/tgh-20-234

Chiranjeevi Gadiparthi, Sonmoon Mohapatra, Sowjanya Kanna, Vinit Vykuntam, William Chen

{"title":"Acute pancreatitis in a patient with COVID-19: a case report.","authors":"Chiranjeevi Gadiparthi, Sonmoon Mohapatra, Sowjanya Kanna, Vinit Vykuntam, William Chen","doi":"10.21037/tgh-20-234","DOIUrl":"https://doi.org/10.21037/tgh-20-234","url":null,"abstract":"The global pandemic of coronavirus disease-2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is predominantly a respiratory illness, but gastrointestinal (GI) manifestations of variable severity have been reported. In patients with COVID-19 pneumonia, observational studies have demonstrated the elevation of pancreatic enzymes as surrogate markers for pancreatic injury without evidence of acute pancreatitis (AP). We report a case of AP in a patient with COVID-19 with SARS-CoV-2 as possible etiological agent with imaging evidence of pancreatitis. We hypothesize a causal relationship of SARS-CoV-2 in this patient with an otherwise unexplained presentation of AP after excluding the common causes. We postulate that AP in COVID-19 could be related to the abundant expression of angiotensin converting enzyme 2 (ACE 2) receptors in the pancreas which serve as viral entry binding receptors for SARS-CoV-2 or due to direct viral involvement of the pancreas. Although there seems to be an association between diabetes and AP, the available data regarding the etiological role of diabetes in causing AP is very limited. We also propose that imaging studies such as computerized tomography (CT) scan of the abdomen should be considered in the diagnosis of AP in patients with COVID-19 infection to exclude the false positive amylase and lipase.","PeriodicalId":23267,"journal":{"name":"Translational gastroenterology and hepatology","volume":" ","pages":"65"},"PeriodicalIF":3.0,"publicationDate":"2021-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8573359/pdf/tgh-06-20-234.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39645101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Evaluating quality and completeness of gastrectomy for gastric cancer: review of surgical videos from the public domain. 评价胃癌胃切除术的质量和完整性:对公开领域手术视频的回顾。

IF 3 4区医学

Translational gastroenterology and hepatology Pub Date : 2021-10-25 eCollection Date: 2021-01-01 DOI: 10.21037/tgh.2020.01.01

Matthew Dixon, Vanessa Palter, Savtaj Brar, Natalie Coburn

{"title":"Evaluating quality and completeness of gastrectomy for gastric cancer: review of surgical videos from the public domain.","authors":"Matthew Dixon, Vanessa Palter, Savtaj Brar, Natalie Coburn","doi":"10.21037/tgh.2020.01.01","DOIUrl":"https://doi.org/10.21037/tgh.2020.01.01","url":null,"abstract":"Background: YouTube® has provided a forum to share surgical videos in the public domain which may be used for education. The quality of surgery and accompanying educational material is unknown. YouTube® videos of gastrectomy with D2 lymphadenectomy (D2-LND) for gastric cancer were evaluated for quality and completeness.Methods: YouTube® was searched using the terms \"D2 lymphadenectomy\" and \"Gastric Cancer\" for open and laparoscopic videos. The Korean Laparoscopic Gastrointestinal Surgical Society (KLASS) outlined 22 steps that define quality and completeness of D2-LND. These guidelines were used to score D2-LND for each video. Four physician reviewers independently scored each surgical video. Scores were compared using Student's t-test.Results: Ten laparoscopic and 10 open surgery videos were assessed. Each video was scored for quality and completeness and assigned a score out of 22. Mean score for open D2-LND was 15 (95% CI: 12.54-17.46). Mean score for laparoscopic D2-LND was 15.4 (95% CI: 14.34-16.46; P=0.77). The most consistently performed steps were the dissection of lymph node stations 1, 3, 4 and 5. The most commonly omitted steps were the dissection of lymph node station 6: exposure and identification of the lowest anterior superior pancreaticoduodenal vein; removal of the prepancreatic soft tissues above the lowest anterior superior pancreaticoduodenal vein; removal of the prepancreatic soft tissues above the level of the bifurcation of the anterior superior pancreaticoduodenal vein and right gastroepiploic vein.Conclusions: There is a wide range of quality and completeness of D2-LND videos. On average, D2-LND videos are only two-thirds complete.","PeriodicalId":23267,"journal":{"name":"Translational gastroenterology and hepatology","volume":" ","pages":"57"},"PeriodicalIF":3.0,"publicationDate":"2021-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8573372/pdf/tgh-06-2020.01.01.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39644661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Enhancing polyp detection: technological advances in colonoscopy imaging. 增强息肉检测:结肠镜成像的技术进展。

IF 3 4区医学

Translational gastroenterology and hepatology Pub Date : 2021-10-25 eCollection Date: 2021-01-01 DOI: 10.21037/tgh.2020.02.05

Antonio Lee, Nicholas Tutticci

{"title":"Enhancing polyp detection: technological advances in colonoscopy imaging.","authors":"Antonio Lee, Nicholas Tutticci","doi":"10.21037/tgh.2020.02.05","DOIUrl":"https://doi.org/10.21037/tgh.2020.02.05","url":null,"abstract":"The detection and removal of polyps at colonoscopy is core to the current colorectal cancer (CRC) prevention strategy. However, colonoscopy is flawed with a well described miss rate and variability in detection rates associated with incomplete protection from CRC. Consequently, there is significant interest in techniques and technologies which increase polyp detection with the aim to remedy colonoscopy's ills. Technologic advances in colonoscope imaging are numerous and include; increased definition of imaging, widening field of view, virtual technologies to supplant conventional chromocolonoscopy (CC) and now computer assisted detection. However, despite nearly two decades of technologic advances, data on gains in detection from individual technologies have been modest at best and heterogenous and conflicted as a rule. This state of detection technology science is exacerbated by use of relatively blunt metrics of improvement without consensus, the myopic search for gains over single generations of technology improvement and an unhealthy focus on adenomatous lesions. Yet there remains cause for optimism as detection gains from new technology, while small, may still improve CRC prevention. The technologies are also readily available in current generation colonoscopes and have roles beyond simply detection such as lesion characterization, further improving their worth. Coupled with the imminent expansion of computer assisted detection the detection future from colonoscope imaging advances looks bright. This review aims to cover the major imaging advances and evidence for improvement in polyp detection.","PeriodicalId":23267,"journal":{"name":"Translational gastroenterology and hepatology","volume":" ","pages":"61"},"PeriodicalIF":3.0,"publicationDate":"2021-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8573375/pdf/tgh-06-2020.02.05.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39644665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Minimally invasive surgery of the pancreas: a narrative review of current practice. 胰腺微创手术:当前实践的叙述回顾。

IF 3 4区医学

Translational gastroenterology and hepatology Pub Date : 2021-07-25 eCollection Date: 2021-01-01 DOI: 10.21037/tgh-20-220

Morgan K Richards, Matthew S Clifton

{"title":"Minimally invasive surgery of the pancreas: a narrative review of current practice.","authors":"Morgan K Richards, Matthew S Clifton","doi":"10.21037/tgh-20-220","DOIUrl":"https://doi.org/10.21037/tgh-20-220","url":null,"abstract":"Minimally invasive surgery has moved from the fringe of pediatric surgery to the mainstream to address a variety of problems. Pancreatic pathology, though uncommon and complex, is frequently amenable to laparoscopic intervention. Indications for pediatric pancreatic operative intervention includes trauma, congenital hyperinsulinemia and neoplasm. Children may require distal pancreatectomy, subtotal pancreatectomy, enucleation, lateral pancreaticojejunostomy and pancreaticoduodenectomy. Of these operations, all but pancreaticoduodenectomy have been successfully described in children using a minimally invasive approach. Traumatic transection of the main pancreatic duct may require operative intervention if endoscopic techniques are unsuccessful. Distal pancreatectomy has been successfully utilized in this circumstance. Additionally, near total pancreatectomy may also be performed laparoscopically although successful reports are limited. Enucleation, especially with the use of intraoperative ultrasound may avoid a large laparotomy for isolated benign masses. Finally, chronic pancreatitis resulting in a dilated main pancreatic duct may benefit from a lateral pancreaticojejunostomy. This operation has also successfully been performed in children. Included is a review of pediatric pancreatic minimally invasive operations paired with corresponding pathology.","PeriodicalId":23267,"journal":{"name":"Translational gastroenterology and hepatology","volume":" ","pages":"38"},"PeriodicalIF":3.0,"publicationDate":"2021-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8343413/pdf/tgh-06-20-220.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39335347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Pediatric surgical care: have we done enough? 小儿外科护理:我们做得够不够?

IF 3 4区医学

Translational gastroenterology and hepatology Pub Date : 2021-07-25 eCollection Date: 2021-01-01 DOI: 10.21037/tgh-2021-01

Eduardo A Perez, Samir Pandya, Matthew S Clifton

引用次数: 0