World Journal of Gastrointestinal Surgery最新文献

{"title":"Dome <i>vs</i> tapered tip sphincterotomes in endoscopic retrograde cholangiopancreatography: A pilot study on cannulation success and postprocedural pancreatitis.","authors":"Jungnam Lee, Jin-Seok Park","doi":"10.4240/wjgs.v17.i5.104043","DOIUrl":"10.4240/wjgs.v17.i5.104043","url":null,"abstract":"<p><strong>Background: </strong>Despite advancements, endoscopic retrograde cholangiopancreatography (ERCP) poses challenges, including the risk of post-ERCP pancreatitis and difficulty of biliary cannulation.</p><p><strong>Aim: </strong>To compare dome and tapered tip sphincterotomes, focusing on their efficacy in achieving successful biliary cannulation and reducing the incidence of post-ERCP pancreatitis.</p><p><strong>Methods: </strong>In this prospective, single-blind, randomized pilot study conducted at Inha University Hospital, 85 patients undergoing ERCP were equally divided into dome and tapered tip sphincterotome groups. The co-primary outcomes were the success rate of selective biliary cannulation and incidence of post-ERCP pancreatitis. The secondary outcomes included biliary cannulation time, number of unintended pancreatic duct access events, and total procedure time.</p><p><strong>Results: </strong>The success rates of selective biliary cannulation were 74.4% and 85.7% in the dome and tapered tip groups, respectively, with no significant difference (<i>P</i> = 0.20). Similarly, the incidence of post-ERCP pancreatitis did not differ significantly between the groups (5 cases in the tapered tip group <i>vs</i> 6 in the dome tip group, <i>P</i> = 0.72). However, difficult cannulation was significantly more common in the dome tip group than in the tapered tip group (<i>P</i> = 0.05). Selective biliary cannulation time emerged as a significant predictor of post-ERCP pancreatitis (multivariate odds ratio = 9.33, 95% confidence interval: 1.31-66.44, <i>P</i> = 0.03).</p><p><strong>Conclusion: </strong>This study indicated that the sphincterotome tip type does not markedly affect biliary cannulation success or post-ERCP pancreatitis rates. However, cannulation duration is a key risk factor for post-ERCP pancreatitis. These findings provide preliminary insights that highlight the importance of refining ERCP practices, including sphincterotome selection, while underscoring the need for larger multicenter studies to improve procedure time and patient safety.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 5","pages":"104043"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275951","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":"Association between hematological disorders and gallbladder stones: A review of current evidence.","authors":"Zhi-Jie Qu, Yu-Ning Wang, Ya-Hui Liu, Rui-Heng Duan","doi":"10.4240/wjgs.v17.i5.105058","DOIUrl":"10.4240/wjgs.v17.i5.105058","url":null,"abstract":"<p><p>Gallbladder stones, a prevalent biliary tract disease, have multifactorial etiologies including metabolic, genetic, and environmental factors. Emerging evidence suggests that hematological disorders, particularly those involving hemolysis or impaired erythropoiesis, may play a significant role in the formation of gallbladder stones, predominantly pigment stones. This review explores the pathophysiological mechanisms linking hematological disorders, such as hemolytic anemias, myeloproliferative disorders, and hematological malignancies, with gallbladder stone development. We also examine the influence of treatments for hematological conditions, such as blood transfusions and chemotherapy, on gallstone risk. Additionally, this article discusses the clinical implications of gallbladder stones in patients with hematological disorders, including diagnostic challenges, management strategies, and surgical considerations. By providing a comprehensive overview of current knowledge, this review aims to highlight the need for further research into the interplay between hematological disorders and gallbladder stones, potentially improving preventive and therapeutic strategies in these patient populations.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 5","pages":"105058"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275994","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":"Small intestine metastasis from lung adenocarcinoma: A case report and review of literature.","authors":"Rui-Xian Shi, Zhen-Ping Guo, Xin Li, Hui Wang, Bo Wang, Ming-Yue Du, Ji-Jun Wang, Zhen-Yu Dong","doi":"10.4240/wjgs.v17.i5.104049","DOIUrl":"10.4240/wjgs.v17.i5.104049","url":null,"abstract":"<p><strong>Background: </strong>The clinical metastasis rate of lung cancer is tremendously low in gastrointestinal tract. Individuals enduring small intestine metastasis of lung cancer are normally featured by less desirable prognosis and shorter survival than those with metastasis in other parts of the body. As a consequence, it holds crucial significance to conduct early diagnosis and development of systematic treatment for patients with gastrointestinal metastasis in lung cancer.</p><p><strong>Case summary: </strong>In this case, a 59-year-old female patient, diagnosed with lung adenocarcinoma, experienced intestinal obstruction attributable to subsequent small intestinal metastasis. Imaging confirmed the metastasis to the small intestine after the adenocarcinoma diagnosis, ultimately giving rise to advanced-stage intestinal obstruction. Conservative treatment proved ineffective, progressing to intestinal perforation in the later stages. This resulted in peritonitis and infectious toxic shock and other serious clinical manifestations. Aggressive surgical resection mitigated the risk of disease progression and even fatality, which tremendously ameliorated the patient's prognosis and prolonged her survival.</p><p><strong>Conclusion: </strong>Patients enduring lung cancer who exhibit acute abdominal symptoms should be mindful of the potential for small intestinal metastasis. Intestinal perforation typically occurs in advanced stages of the disease. Moreover, and aggressive surgical treatment can mitigate the risk of multifarious complications such as peritonitis, infectious toxic shock, and even fatality.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 5","pages":"104049"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276049","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":"Stent fracture after transjugular intrahepatic portosystemic shunt: A case report.","authors":"Tan-Yang Zhou, Hong-Liang Wang, Guo-Fang Tao, Sheng-Qun Chen","doi":"10.4240/wjgs.v17.i5.104893","DOIUrl":"10.4240/wjgs.v17.i5.104893","url":null,"abstract":"<p><strong>Background: </strong>Transjugular intrahepatic portosystemic shunt (TIPS) is a highly effective treatment for complications associated with portal hypertension. However, stent fracture, although extremely rare, represents a potentially serious complication following TIPS creation. Timely identification and management are crucial for preventing further adverse events.</p><p><strong>Case summary: </strong>We report a 56-year-old male patient who underwent a TIPS procedure for recurrent melena caused by portal hypertension secondary to hepatitis B and experienced a stent fracture 15 months post-procedure. He was readmitted 30 months after the initial TIPS due to recurrent esophagogastric variceal bleeding and ascites. An attempt to revise the dysfunctional shunt <i>via</i> a stent-in-stent approach was unsuccessful. Consequently, a parallel TIPS procedure was successfully performed <i>via</i> the proximal end of the fractured stent to decompress the portal venous system. At the 1-month follow-up, the patient exhibited no recurrent variceal bleeding, and his ascites had significantly decreased. Twelve-month postoperative monitoring revealed no hepatic encephalopathy and no recurrence of bleeding or ascites. Additionally, we review the existing literature on post-TIPS stent fractures to explore the underlying mechanisms contributing to this complication.</p><p><strong>Conclusion: </strong>Early recognition and prompt intervention are essential in managing stent fractures after TIPS creation to mitigate potential risks and ensure optimal patient outcomes.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 5","pages":"104893"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276050","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":"Effect of perioperative disinfection and isolation measures in infection control after gastrointestinal surgery: A retrospective analysis.","authors":"Hai-Yan Wang, Yan Zou, Li-Ya Shi, Xue Qin, Li-Juan Hong","doi":"10.4240/wjgs.v17.i5.102799","DOIUrl":"10.4240/wjgs.v17.i5.102799","url":null,"abstract":"<p><strong>Background: </strong>The application of perioperative disinfection and isolation measures to patients undergoing gastrointestinal surgery with postoperative infection can provide a data reference for reducing the postoperative infection rate, improving postoperative biochemical markers, and enhancing postoperative recovery outcomes.</p><p><strong>Aim: </strong>To explore the effectiveness of perioperative disinfection and isolation measures in controlling postoperative infection following gastrointestinal surgery. It also sought to compare infection rates and biochemical markers between the observation and control groups and evaluate the impact of disinfection and isolation measures on reducing postoperative complications.</p><p><strong>Methods: </strong>A retrospective analysis was conducted. Ninety-six patients who underwent gastrointestinal surgery between January 2022 and December 2023 were selected and divided into an observation group and a control group, with 48 cases in each. The observation group received disinfection and isolation measures during the perioperative period, whereas the control group received standard nursing care. The incidence of infection, white blood cell count, C-reactive protein levels, hemoglobin levels, and liver function markers (alanine aminotransferase, aspartate aminotransferase, creatinine, and blood urea nitrogen) were monitored postoperatively in both groups.</p><p><strong>Results: </strong>The postoperative infection rate in the observation group was significantly lower than that in the control group (<i>P</i> < 0.05). White blood cell and C-reactive protein levels decreased significantly after surgery in the observation group and were significantly lower than those in the control group (<i>P</i> < 0.05). Alanine aminotransferase, aspartate aminotransferase, creatinine, and blood urea nitrogen levels in the observation group were lower than those in the control group on postoperative days 1 and 3, showing a significant difference (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Perioperative disinfection and isolation measures effectively reduce postoperative infection rates in gastrointestinal surgery patients and improve biochemical markers, thereby enhancing recovery outcomes. This study provides a valuable basis for postoperative infection control and has significant clinical applications.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 5","pages":"102799"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276059","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":"Insufficiency of ileocolic anastomosis in Crohn's disease patients - prevention and treatment.","authors":"Jarosław Cwaliński, Kamila Stawczyk-Eder, Agnieszka Cwalinska, Wiktoria Zasada, Hanna Cholerzyńska, Tomasz Banasiewicz, Jacek Paszkowski","doi":"10.4240/wjgs.v17.i5.102064","DOIUrl":"10.4240/wjgs.v17.i5.102064","url":null,"abstract":"<p><p>Resection of the terminal ileum and ileocecal valve remains the most commonly performed procedure in patients with Crohn's disease. However, despite radical treatment, there is a risk of disease recurrence at the site of the intestinal anastomosis in some cases. Therefore, long-term postoperative management is crucial and requires systematic clinical assessment, endoscopic surveillance, and pharmacological support when indicated. A key challenge is identifying the risk factors associated with the recurrence of anastomotic failure and defining the principles of follow-up care to prevent secondary intestinal insufficiency. This paper focuses on both surgical and non-surgical factors that may play a role in preventing complications in patients undergoing ileocecal resection, providing a comprehensive approach to postoperative management.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 5","pages":"102064"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276083","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":"Liver transplantation for combined hepatocellular cholangiocarcinoma: Current evidence, selection criteria, and therapeutic controversies.","authors":"Rui-Quan Zhou, Pei-Jun Yang, Tian-Tong Liu, Dong-Dong Han, Xiao-Lei Liu, Li-Guo Liu, Shuang Si, Shi-Wei Yang, Shuai-Shuai Xu, Yi-Wen Guo, Hai-Dong Tan","doi":"10.4240/wjgs.v17.i5.105783","DOIUrl":"10.4240/wjgs.v17.i5.105783","url":null,"abstract":"<p><p>Combined hepatocellular cholangiocarcinoma (cHCC-CCA) is a rare and aggressive primary liver malignancy characterized by features of both HCC and CCA. Preoperative diagnosis remains challenging because of overlapping imaging and histopathological features, which often lead to misclassification. Although liver resection is the primary curative therapy, the efficacy of liver transplantation (LT) remains controversial. Historically, LT has been considered contraindicated owing to the poor prognosis, high recurrence rate of cHCC-CCA, and the potential for organ wastage. Recent studies have suggested that LT may benefit carefully selected patients, particularly those with early-stage tumors or cirrhosis. However, there is no consensus on the criteria for LT in patients with cHCC-CCA. Lymphadenectomy and vascular resection strategies were discussed along with locoregional and systemic therapies. This review synthesized the current evidence on surgical strategies for cHCC-CCA, focusing on evolving LT criteria and outcomes.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 5","pages":"105783"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276086","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":"Huangqi decoction ameliorated intestinal barrier dysfunction <i>via</i> regulating NF-κB signaling pathway in slow transit constipation model mice.","authors":"Hua-Xian Chen, Guo-Zhong Xiao, Chao-Xin Yang, Yi-Hui Zheng, Ming-Yuan Lei, Hao Xu, Dong-Lin Ren, Liang Huang, Qiu-Lan He, Hong-Cheng Lin","doi":"10.4240/wjgs.v17.i5.106000","DOIUrl":"10.4240/wjgs.v17.i5.106000","url":null,"abstract":"<p><strong>Background: </strong>The development of slow transit constipation (STC) is associated with intestinal barrier damage. Huangqi decoction (HQD) is effective in treating STC, but mechanisms are unclear.</p><p><strong>Aim: </strong>To investigate whether HQD alleviates STC by downregulating the nuclear factor κB (NF-κB) signaling pathway and restoring intestinal barrier function.</p><p><strong>Methods: </strong>KM mice were divided into control, model, and HQD treatment groups. Fresh colonic tissues were collected for single-cell RNA sequencing and spatial transcriptome sequencing. The expressions of claudin-1, mucin 2, and NF-κB P65 proteins were detected by immunohistochemistry. <i>In vitro</i> experiments evaluated the effects of HQD on the LS174T cell line.</p><p><strong>Results: </strong>HQD improved intestinal motility, restored mucosal epithelium function and morphology. Single-cell RNA sequencing and spatial transcriptome sequencing data showed a reduction in goblet cells, decreased mucin 2 secretion, and activated apoptotic pathways in STC mice. The population of intestinal stem cells was reduced, and proliferation along with Wnt/β-catenin pathways were inhibited. STC also altered the distribution of intestinal cell states, increasing immune-associated Enterocyte_C3. Aberrant NF-κB pathway activation was noted across various cell types. After HQD treatment, NF-κB pathway activity was down-regulated, while cell proliferation pathways were up-regulated, alongside an increase in Enterocyte_C1 related to material transport. Immunocytochemical, Western blot, and immunohistochemistry analyses confirmed NF-κB pathway activation in goblet cells of STC mice, with HQD inhibiting this aberrant activation.</p><p><strong>Conclusion: </strong>STC involves intestinal mucosal barrier damage. HQD may treat STC by suppressing NF-κB signaling in epithelial cells, restoring intestinal epithelial cell function, and promoting mucosal barrier repair.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 5","pages":"106000"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276081","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":"Results of endoscopic retrograde cholangiopancreatography procedures at surgical clinics: A multicenter observational study in Türkiye.","authors":"Sezgin Yilmaz, Esat Taylan Ugurlu, Alpen Yahya Gumusoglu, Mahmut Said Degerli, Kemal Dolay, Emre Balli, Yasin Kara, Ali Kocataş, Ekrem Çakar, Bünyamin Gürbulak, Sercan Yüksel, Soykan Arikan, Hasan Bektaş, Yusuf Emre Aytin, Doğan Albayrak, Ali Fuat Kaan Gok, Cemalettin Ertekin, Alpaslan Fedayi Çalta, Serhat Oğuz, Mustafa Örmeci, Ali Haldun Özcan, Barış Sevinç, Ömer Karahan, İhsan Tümkaya, Osman Kones, Mehlika Bilgi Kirmaci, Mustafa Yavuz, Emrah Akın, Merve Yeşilsancak","doi":"10.4240/wjgs.v17.i5.104618","DOIUrl":"10.4240/wjgs.v17.i5.104618","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive endoscopic procedure used mainly to treat hepato-pancreato-biliary (HPB) diseases. The need for ERCP has increased with the rising number of HPB diseases over the past decade. Thus, due to increased demand, ERCP is performed at more centers. Currently, it is performed by general surgeons, gastroenterology and invasive radiology specialists in the United States and Europe as recommended by the British Society of Gastroenterology (BSG).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To present the results of ERCP procedures from fourteen surgical centers in Türkiye.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Fourteen surgical centers performing ERCP were included in the present study. The age, gender, ERCP indication, success status, post-ERCP complications, ERCP reports and the files of 66993 patients who underwent ERCP were collected from the participating centers. The results are discussed according to the targets declared by the BSG, which are volume load per annum, proportion of successful cannulation (&gt; 85%), bile duct clearance rate (&gt; 75%), stenting rate for strictures (&gt; 80%) and complications (&lt; 6%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 66993 ERCP procedures were performed in the centers included in the study up to August 2024. 29250 (43.6%) of the procedures were performed urgently, especially for suppurative cholangitis, biliary tract injuries, &lt;i&gt;etc.&lt;/i&gt; The remaining 37743 (56.4%) cases were performed electively. 50.2% of the patients were female and 49.8% were male. The average ages were 56.5 years for women and 55.9 years for men. General anesthesia was used in 84.1% of the patients while sedation was used in 15.9%. The indications were bile duct stone (78.7%), pancreatic tumor (3.9%), papillary tumor (3.3%), cholangiocarcinoma (2.6%), Oddi sphincter dysfunction (2.4%), bile leakage after cholecystectomy (2%), bile leakage after hydatid cyst surgery (1.9%), biliary stricture (1.7%), and other diseases (3.1%). Hyperamylasemia and post-ERCP pancreatitis were the most common complications as observed in 8.1% of the patients. They were usually self-limited and responded to supportive measures. The frequency of the other complications was also consistent with the literature.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;There is a huge shortage of ERCP endoscopists worldwide due to insufficient ERCP training and centers especially in developing and underdeveloped countries. As patients requiring ERCP usually present to surgical practitioners, the incorporation of surgeons into this training program is an effective and reliable solution. The BSG recommends the incorporation of surgeons and radiologists in addition to gastroenterology specialists. This study is the first to present the results of ERCP procedures from fourteen surgical centers throughout Türkiye. The results suggest that the surgical centers included were able to achieve the targets set by the BSG. This stud","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 5","pages":"104618"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276046","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 diagnostic laparoscopy results in Turkish patients with unexplained ascites.","authors":"Ali R Caliskan, Mehmet A Erdogan, Adil Baskiran, Ibrahim H Ocal, Huseyin Kacmaz","doi":"10.4240/wjgs.v17.i5.104803","DOIUrl":"10.4240/wjgs.v17.i5.104803","url":null,"abstract":"<p><strong>Background: </strong>Diagnostic laparoscopy is a minimally invasive surgical method to diagnose intra-abdominal diseases.</p><p><strong>Aim: </strong>To evaluate patients with unexplained ascites who could not be definitively diagnosed <i>via</i> advanced radiological and endoscopic methods and serological, cytological, and microbiological examinations and, therefore, underwent diagnostic laparoscopy.</p><p><strong>Methods: </strong>This retrospective analysis evaluated 82 patients who underwent diagnostic laparoscopy due to unexplained ascites. Patients' medical records were obtained from the hospital database. Their age, sex, complaints at admission, laboratory results, radiological imaging results, diagnostic laparoscopy reports, and pathology reports were analyzed.</p><p><strong>Results: </strong>The serum-ascites albumin gradient was < 1.1 in 96.3% of the patients (<i>n</i> = 79). Among patients, 22 (26.8%) had benign diagnoses and 60 (73.2%) had malignant diagnoses. In addition, 55 (67.1%) were deceased, and the median follow-up time from diagnosis to death was four months. The overall follow-up time ranged from 1 to 142 months, with a median of 14 months. Patients' diagnoses were significantly associated with their survival (<i>P</i> < 0.05, <i>χ</i> ² test). The mortality rate was 86.7% among patients with malignant diagnoses and 13.6% among patients with benign diagnoses.</p><p><strong>Conclusion: </strong>Diagnostic laparoscopy is minimally invasive, has a low complication rate, and requires a short hospital stay. It can be safely performed to diagnose and treat ascites that remain unexplained after advanced radiological and endoscopic examinations.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 5","pages":"104803"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276079","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}