World Journal of Gastrointestinal Surgery最新文献

{"title":"Effects of rapid recovery nursing after surgery in patients with acute calculous cholecystitis after laparoscopic cholecystectomy.","authors":"Zhong-Yi Chen, Xiao-Dan Han, Mei Liu, Ming-Yang Fu, Ying-Jie Nie, Feng-En Wang","doi":"10.4240/wjgs.v17.i9.106543","DOIUrl":"10.4240/wjgs.v17.i9.106543","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic cholecystectomy (LC) is the primary treatment for acute calculous cholecystitis. Although rapid recovery nursing is commonly implemented in postoperative care, its effect on acute calculous cholecystitis after LC remains unclear.</p><p><strong>Aim: </strong>To analyze the impact of rapid recovery nursing in patients with acute calculous cholecystitis undergoing LC.</p><p><strong>Methods: </strong>A retrospective study was conducted with a total of 120 patients with acute calculous cholecystitis who underwent LC at our hospital between October 2023 and October 2024. The patients were divided into two groups with 60 patients in each group according to the different nursing methods: Conventional nursing and rapid recovery nursing groups. Data was recorded from the electronic medical records. Gastrointestinal recovery, pain, quality of life, and nursing satisfaction were compared between the two groups before and after nursing.</p><p><strong>Results: </strong>Following nursing intervention, the visual analog scale scores on Days 3 and 7 post-surgery in the rapid recovery nursing group were notably lower than those of the conventional nursing group (<i>P</i> < 0.05). The rapid recovery nursing group experienced significantly reduced times for bowel sound recovery, getting out of bed, hospital stay, passing flatus, and first defecation compared with the conventional nursing group (<i>P</i> < 0.05), thereby experiencing significantly better quality of life and nursing satisfaction (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Rapid recovery nursing effectively promoted the recovery of gastrointestinal function, reducing pain and improving the quality of life of patients who underwent LC for acute calculous cholecystitis.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 9","pages":"106543"},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193259","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}

{"title":"Efficacy of single-lumen and double-lumen peripherally inserted central catheters in patients undergoing digestive surgery within bundled care contexts.","authors":"Xiao-Hui Ye, Rong-Hong Cui, Lei Xu, Mei-Jun Wang, Ling-Rong Ye, Ming Jiang","doi":"10.4240/wjgs.v17.i9.108621","DOIUrl":"10.4240/wjgs.v17.i9.108621","url":null,"abstract":"<p><strong>Background: </strong>Peripherally inserted central catheters (PICCs) are crucial for patients requiring long-term intravenous therapy, especially within digestive surgery under bundled care protocols.</p><p><strong>Aim: </strong>To evaluate and compare the efficacy, safety, and patient-reported outcomes of single-lumen <i>vs</i> double-lumen PICCs among patients undergoing digestive surgery within a structured bundled care framework.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed data from 249 patients who underwent digestive surgery and utilized either single-lumen (<i>n</i> = 117) or double-lumen (<i>n</i> = 132) PICCs between January 2021 and June 2024. Clinical outcomes, patient satisfaction, catheterization duration, and complication rates were compared using statistical analysis <i>via</i> SPSS (version 29.0). The bundled care protocol was consistently applied, focusing on standardized procedures, staff training, and patient support.</p><p><strong>Results: </strong>Single-lumen PICCs were associated with a significantly lower thrombosis rate (0.85%) than double-lumen PICCs (6.82%, <i>P</i> = 0.039). The single-lumen group experienced shorter catheterization durations (12.5 ± 3.14 days <i>vs</i> 13.6 ± 4.50 days, <i>P</i> = 0.025) and higher successful infusion rates (92.7% ± 5.32% <i>vs</i> 90.4% ± 6.60%, <i>P</i> = 0.003). This group also reported higher comfort scores (8.40 ± 1.20 <i>vs</i> 7.90 ± 1.50, <i>P</i> = 0.004) and lower pain levels (2.90 ± 0.70 <i>vs</i> 3.20 ± 0.80, <i>P</i> = 0.002). Aside from thrombosis, complication rates showed no significant difference between the groups.</p><p><strong>Conclusion: </strong>Within bundled care context, single-lumen PICCs demonstrated advantages in reducing thrombosis risk, procedural efficiency, patient comfort, and satisfaction compared with double-lumen PICCs. The findings underscore the importance of considering patient-specific needs and clinical scenarios in catheter choice.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 9","pages":"108621"},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193303","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}

{"title":"Endoscopic and laparoscopic treatment of ileocecal laterally spreading tumor with concomitant appendiceal adenoma: A case report and review of literature.","authors":"Ying-Hui Huang, Li Ma, Bin Cao, Yue-Juan Zhang, Qun Gao, Zhen-Ming Zhu, Xiao-Lu Qiao, Lei Wang, Bao-Guo He","doi":"10.4240/wjgs.v17.i9.109952","DOIUrl":"10.4240/wjgs.v17.i9.109952","url":null,"abstract":"<p><strong>Background: </strong>Ileocecal laterally spreading tumors (LSTs) complicated by appendiceal tubular adenoma are rare and challenging to diagnose because of the absence of typical symptoms and specific diagnostic signs. Traditionally, the primary treatment has been laparoscopic appendectomy (LA).</p><p><strong>Case summary: </strong>A 63-year-old female presented with changes in bowel habits. Colonoscopy revealed an ileocecal LST. The patient underwent endoscopic submucosal dissection. Postoperative follow-up colonoscopy revealed mucosal elevation at the appendiceal orifice, with pathology confirming tubular adenoma. Abdominal computed tomography indicated a suspicious appendiceal tumor, leading to LA with partial cecectomy. The postoperative recovery was uneventful. At the 1-year follow-up, colonoscopy revealed no evidence of tumor recurrence.</p><p><strong>Conclusion: </strong>Ileocecal LSTs with appendiceal tubular adenomas are traditionally treated with LA. endoscopic submucosal dissection can also yield favorable outcomes.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 9","pages":"109952"},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193321","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}

{"title":"Long-term outcomes after open total pericystectomy for cystic echinococcosis.","authors":"Tristan Wagner, Sebastian Struck, Thorsten Persigehl, Dirk Nierhoff, Thomas Schmidt, Marielle Hummels, Christiane J Bruns, Dirk L Stippel, Michael N Thomas","doi":"10.4240/wjgs.v17.i9.106258","DOIUrl":"10.4240/wjgs.v17.i9.106258","url":null,"abstract":"<p><strong>Background: </strong>Liver hydatid cysts (LHC) liver requires effective surgical treatment. Open closed total pericystectomy removes the entire echinococcus cyst while preserving healthy liver tissue.</p><p><strong>Aim: </strong>To evaluate the outcomes of pericystectomy and its efficacy as a treatment modality for cystic echinococcosis (CE).</p><p><strong>Methods: </strong>Thirty-eight patients were analyzed after open total pericystectomy at the University Hospital of Cologne between January 2006 and January 2024. Demographic, clinical, and laboratory parameters were collected retrospectively. Intraoperative data and postoperative complications were documented and classified using the Clavien-Dindo classification. Throughout the follow-up period, patients underwent regular clinical, serological, and sonographic evaluations both at the outpatient department and by their general physicians.</p><p><strong>Results: </strong>Fifty-four cysts were treated with open total pericystectomy. Multiple cysts were found in 42.2% of cases. Singular cysts occurred in 57.8%. The right hepatic lobe was affected in 66.7%. Ectopic cysts occurred in 4 patients in the lung (<i>n</i> = 3) and spleen (<i>n</i> = 1). Median cyst size was 6.78 cm × 5.92 cm (range: 1.4-20.0 cm). The median surgical time of pericystectomy was 189 minutes (range: 78-455 minutes) with a median blood loss of 400 mL (range: 100-1400 mL). The complication rate (Clavien-Dindo > III) was 21.1%. The average hospital stay was 12.5 days. No recurrent disease could be detected after a median follow-up time of 97 months (range: 4-216 months). No recurrent cyst manifestation, postoperative liver failure or death was observed.</p><p><strong>Conclusion: </strong>The presented surgical procedure known as open total pericystectomy is a safe surgical technique in treatment of cystic echinococcosis.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 9","pages":"106258"},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193060","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}

{"title":"Effects of enhanced recovery after surgery on postoperative intestinal function and intestinal flora during laparoscopic gastric cancer surgery.","authors":"Xiao-Jie Lin, Jia-Ze Xu, Qiang Hu, Jie Chen","doi":"10.4240/wjgs.v17.i9.106286","DOIUrl":"10.4240/wjgs.v17.i9.106286","url":null,"abstract":"<p><strong>Background: </strong>Enhanced recovery after surgery (ERAS) protocols have emerged as a promising approach in perioperative care. This study evaluated ERAS's impact on gastrointestinal recovery and microbiota composition following laparoscopic gastric cancer surgery.</p><p><strong>Aim: </strong>To evaluate the impact of ERAS protocols on postoperative gastrointestinal function recovery and intestinal microbiota composition in patients undergoing laparoscopic gastric cancer surgery, and to identify factors associated with improved clinical outcomes and microbial diversity preservation.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 80 patients who underwent laparoscopic D2 gastrectomy, comparing ERAS (<i>n</i> = 40) <i>vs</i> traditional care (<i>n</i> = 40). Primary outcomes included postoperative gastrointestinal function recovery and complications. Intestinal microbiota was analyzed using 16S rRNA sequencing at multiple timepoints perioperatively.</p><p><strong>Results: </strong>ERAS patients demonstrated faster recovery of bowel function, with earlier return of bowel sounds (16.25 ± 6.41 hours <i>vs</i> 22.3 ± 6.49 hours), first flatus (23.95 ± 6.02 hours <i>vs</i> 28.45 ± 7.12 hours), and defecation (34.95 ± 9.34 hours <i>vs</i> 48.1 ± 15.64 hours), all <i>P</i> < 0.05. Complication rates, including antibiotic-associated diarrhea and surgical site infections, were comparable between groups. Microbial diversity indices and probiotic populations showed better preservation in the ERAS group postoperatively (<i>P</i> < 0.05), though neither group achieved complete restoration to preoperative levels at one month.</p><p><strong>Conclusion: </strong>These results support tailoring ERAS protocols to prioritize gut microbiome resilience through early feeding and shortened antibiotic courses, with particular benefits for younger patients.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 9","pages":"106286"},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193217","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}

{"title":"Epidemiology and risk of pulmonary complications following hepatobiliary surgical procedures: A retrospective study.","authors":"Hui-Jie Meng, Zhong-Hao Chen, Guang-Meng Nie, Zhao-Shuai Ji, Yu-Jie Wang, Yong-Fang Hu, Jing Tang","doi":"10.4240/wjgs.v17.i9.109631","DOIUrl":"10.4240/wjgs.v17.i9.109631","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pulmonary complications (PPCs) are the most common complications following major upper abdominal surgeries, particularly hepatobiliary procedures, and significantly compromise surgical outcomes and patients' quality of life. Although the adoption of laparoscopy has lowered their incidence, PPCs remain a frequent and serious concern after hepatobiliary surgery. Existing research on risk factors specific to hepatobiliary surgeries is limited, particularly regarding the epidemiology and risk factors of PPCs in liver and gallbladder surgeries in China. Therefore, this study aimed to investigate the risk factors for PPCs in a large hepatobiliary center.</p><p><strong>Aim: </strong>To identify the incidence and risk factors for PPCs following hepatobiliary surgery based on perioperative variables.</p><p><strong>Methods: </strong>Retrospective data were collected from patients who underwent liver, gallbladder, or pancreatic surgery at a hepatobiliary center in China between May 2023 and December 2023. We retrospectively reviewed comprehensive medical records to extract demographic and hospital admission information for determining PPC incidence. Statistically significant variables were initially screened through univariate analysis, followed by binary logistic regression modeling to identify independent predictors of PPCs. Hospitalization expenditures and duration of stay were further contrasted across the study cohorts.</p><p><strong>Results: </strong>This study included 1941 patients who underwent liver, gallbladder, or pancreatic surgery, of whom 78 developed PPCs, resulting in an incidence rate of 4.02%. Logistic regression analysis revealed two independent predictors of PPCs in hepatobiliary surgery patients: Age ≥ 75 year (odds ratio = 8.350, 95%CI: 3.521-19.798, <i>P</i> < 0.001) and prolonged anesthesia (odds ratio = 1.052, 95%CI: 1.015-1.091, <i>P</i> = 0.006). Patients with PPCs had significantly elevated healthcare resource utilization, including higher total hospitalization costs, increased medication expenses, longer hospital stays, and extended postoperative admissions (all <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Age ≥ 75 years and prolonged anesthesia emerged as independent predictors of PPCs following hepatobiliary surgery. These complications were correlated with protracted hospitalization and increased healthcare costs.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 9","pages":"109631"},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193285","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}

{"title":"Clinical management and therapeutic strategies for biliary leakage after liver transplantation.","authors":"Yue Xiao, Hong-Qiao Cai","doi":"10.4240/wjgs.v17.i9.108275","DOIUrl":"10.4240/wjgs.v17.i9.108275","url":null,"abstract":"<p><p>Biliary leakage is a potentially life-threatening complication following liver transplantation and is associated with significant postoperative morbidity, prolonged hospitalization, and potential graft failure. Its incidence underscores the need for timely diagnosis and effective intervention. Diagnostic modalities such as magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography offer both anatomical and functional insights. Endoscopic management with endoscopic retrograde cholangiopancreatography remains the mainstay of treatment, while percutaneous transhepatic cholangiography offers an alternative in patients with altered anatomy or failed endoscopic access. Surgical revision is considered a last resort after other methods have failed. Preventive strategies, including machine perfusion and meticulous surgical techniques, are essential in reducing incidence and improving outcomes. This editorial provides a comprehensive overview of clinical management and therapeutic strategies for biliary leakage after liver transplantation.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 9","pages":"108275"},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193166","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}

{"title":"Complete appendiceal intussusception and appendiceal mucinous tumor: A case report and review of literature.","authors":"Qi Guo, Han-Ying Lu, Hua Lyu, Hao Tian, Qiang Zhao, Yang-Chun Zheng","doi":"10.4240/wjgs.v17.i9.109320","DOIUrl":"10.4240/wjgs.v17.i9.109320","url":null,"abstract":"<p><strong>Background: </strong>Complete appendiceal intussusception (CAI) coexisting with appendiceal tumor represents an exceptionally rare clinical tumor. This study presented a retrospective analysis of a case involving CAI complicated by appendiceal mucinous tumor, supplemented by a review of 10 previously reported cases to distill diagnostic and therapeutic insights.</p><p><strong>Case summary: </strong>A 74-year-old male patient presented with abdominal pain. Abdominal contrast-enhanced computed tomography (CECT) initially suggested a colonic tumor with intussusception. Colonoscopy identified a mass in the colon 60 cm from the anus. Intraoperative exploration confirmed CAI secondary to an appendiceal neoplasm. The patient underwent laparoscopic right hemicolectomy with regional lymphadenectomy under general anesthesia. Postoperative recovery was uneventful, and the patient was discharged 9 days post-surgery. Twelve-month follow-up revealed no evidence of recurrence or metastasis.</p><p><strong>Conclusion: </strong>Plain abdominal computed tomography may underestimate the presence of CAI and appendiceal mucinous tumor, whereas CECT significantly improves diagnostic accuracy. Preoperative suspicion of appendiceal malignancy should be entertained in cases of CAI. In the absence of definitive biopsy results, intraoperative frozen section analysis is recommended to guide radical resection.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 9","pages":"109320"},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193179","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}

{"title":"Evaluation of efficacy and safety of different endoscopic polypectomy techniques for colonic polyps.","authors":"De-Hui Ji, Zhong-An Guan","doi":"10.4240/wjgs.v17.i9.110347","DOIUrl":"10.4240/wjgs.v17.i9.110347","url":null,"abstract":"<p><strong>Background: </strong>Colorectal polypectomy is fundamental to the prevention of colorectal cancer, utilizing several endoscopic techniques. Robust comparative data regarding the efficacy and safety of these modalities in clinical practice are limited.</p><p><strong>Aim: </strong>To evaluate and compare the efficacy and safety of three endoscopic polypectomy techniques, namely, high-frequency electroresection (HFE), cold snare polypectomy (CSP), and endoscopic mucosal resection (EMR), for the treatment of colonic polyps.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included adults who underwent endoscopic resection of pathologically confirmed colorectal polyps at Central Hospital Affiliated to Shandong First Medical University between January 2015 and December 2023. Patients were grouped by technique: HFE (<i>n</i> = 107), CSP (<i>n</i> = 106), and EMR (<i>n</i> = 108). Standardized preoperative, intraoperative, and postoperative protocols were applied. Outcome measures included resection status (<i>en bloc</i>, R0, R1, and Rx), adverse events (immediate/delayed bleeding, perforation, and post-polypectomy coagulation syndrome), postoperative pain (visual analog scale at 1, 3, and 5 hours), and 12-month recurrence rate.</p><p><strong>Results: </strong>Baseline demographics and polyp characteristics, except for polyp diameter, were comparable among groups. CSP achieved the highest <i>en bloc</i> resection rate, whereas HFE had a higher R0 resection rate. Polyp diameter was largest in the EMR group. Procedure duration was shortest with HFE. Adverse reactions were more frequent with HFE, particularly post-polypectomy bleeding and delayed perforation, whereas CSP demonstrated a superior safety profile and the lowest incidence of complications. Postoperative pain diminished in all groups over time but was consistently low for CSP and EMR. Recurrence rates were significantly higher in the EMR group <i>vs</i> CSP group, with HFE showing intermediate recurrence.</p><p><strong>Conclusion: </strong>CSP offers the best safety profile and lowest recurrence rate among patients undergoing endoscopic resection of colorectal polyps, whereas HFE confers a high R0 resection rate but increased risk of adverse events. EMR remains essential for large polyps despite elevated recurrence. Technique selection should be tailored according to polyp characteristics and patient risk factors to optimize outcomes.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 9","pages":"110347"},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193341","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}

{"title":"Therapeutic outcomes and predictors of efficacy for endoscopic variceal ligation plus propranolol in liver cirrhosis-related upper gastrointestinal bleeding.","authors":"Dan-Feng Gong, Long Cheng","doi":"10.4240/wjgs.v17.i9.109152","DOIUrl":"10.4240/wjgs.v17.i9.109152","url":null,"abstract":"<p><strong>Background: </strong>Cirrhosis-related upper gastrointestinal bleeding (UGIB) poses a fatal risk, and endoscopic ligation as a sole intervention shows inadequate effectiveness.</p><p><strong>Aim: </strong>To evaluate the therapeutic efficacy of endoscopic variceal ligation (EVL) plus propranolol <i>vs</i> EVL monotherapy in patients with cirrhosis complicated with acute UGIB and identify predictors for clinical outcomes.</p><p><strong>Methods: </strong>This study enrolled 99 consecutive patients with cirrhosis presenting with acute UGIB between January 2024 and January 2025. Participants were allocated to either the control group (<i>n</i> = 49) receiving EVL alone or (2) the research group (<i>n</i> = 50) receiving EVL plus propranolol. Primary outcomes included treatment efficacy, venous blood flow [portal venous flow (PVF)/splenic venous flow (SVF)], and postoperative outcomes (hemostasis time, length of hospital stay, and rebleeding rates). Univariate and multivariate regression analyses were conducted to determine independent predictors of treatment response.</p><p><strong>Results: </strong>Compared with the control group, the research group demonstrated significantly better outcomes, including higher overall treatment efficacy, greater reductions in PVF and SVF, shorter hemostasis time and hospital stay, and lower rebleeding rates. Univariate analysis demonstrated significant associations between treatment efficacy and age, cirrhosis duration, Child-Pugh grade, bleeding duration, and treatment approach in patients with cirrhosis complicated with acute UGIB. Multivariate logistic regression identified three independent risk factors for poor outcomes, namely, advanced age (> 55 years), prolonged cirrhosis duration (≥ 4 years), and delayed bleeding intervention (> 24 hours).</p><p><strong>Conclusion: </strong>The EVL plus propranolol regimen demonstrates significant efficacy in treating UGIB in cirrhosis, outperforming EVL alone in improving hemodynamics (PVF/SVF), shortening hemostasis and hospitalization duration, and reducing rebleeding rates. Moreover, advanced age, prolonged disease duration, and longer bleeding times are independent risk factors for poor therapeutic outcomes.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 9","pages":"109152"},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193377","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}