World Journal of Gastrointestinal Surgery最新文献

{"title":"Risk factors for enteral nutrition intolerance and its impact on prognosis in patients with severe acute pancreatitis.","authors":"Chang-Mei Wu, Wen-Jun Zhu, Xi Chen, Min Liu, Yuan Feng, Mei Wang","doi":"10.4240/wjgs.v18.i1.112334","DOIUrl":"10.4240/wjgs.v18.i1.112334","url":null,"abstract":"<p><strong>Background: </strong>Severe acute pancreatitis (SAP) affects 10%-20% of acute pancreatitis patients, with mortality rates of up to 30%, requiring early enteral nutrition (EN) within 24-48 hours per the European Society for Clinical Nutrition and Metabolism guidelines. However, intolerance to EN occurs in 25%-40% of SAP patients due to gastrointestinal dysfunction, leading to prolonged intensive care unit stays, increased infections, and compromised survival outcomes.</p><p><strong>Aim: </strong>To investigate the risk factors for EN intolerance in patients with SAP and its impact on prognosis, providing evidence for clinical nutrition therapy strategies.</p><p><strong>Methods: </strong>A retrospective cohort study design was adopted, and the clinical data of 195 SAP patients of our hospital were collected from January 2019 to June 2025. Patients were divided into an intolerance group (76 patients) and a tolerance group (119 patients) according to their EN intolerance status. Multivariate logistic regression analysis was used to identify independent risk factors for EN intolerance, and a Cox proportional hazards regression model was used to analyze independent factors affecting 28-day mortality.</p><p><strong>Results: </strong>The incidence of EN intolerance in SAP patients was 39.0%. Multivariate logistic regression analysis revealed that the Acute Physiology and Chronic Health Evaluation II score [odds ratio (OR) = 1.124, 95% confidence interval (CI): 1.042-1.213, <i>P</i> = 0.002], serum albumin level (OR = 0.879, 95%CI: 0.801-0.965, <i>P</i> = 0.006), and intra-abdominal pressure (OR = 1.152, 95%CI: 1.063-1.248, <i>P</i> = 0.001) were independent risk factors for EN intolerance. The 28-day mortality rate in the intolerance group was significantly greater than that in the tolerance group (25.0% <i>vs</i> 12.6%, <i>P</i> = 0.025). Cox regression analysis revealed that EN intolerance (hazard ratio = 2.164, 95%CI: 1.127-4.156, <i>P</i> = 0.020) was an independent risk factor for 28-day mortality.</p><p><strong>Conclusion: </strong>The incidence of EN intolerance in SAP patients is high, with the Acute Physiology and Chronic Health Evaluation II score, serum albumin level, and intra-abdominal pressure being independent risk factors. EN intolerance significantly increases the risk of mortality in patients and is an independent risk factor affecting prognosis. Early identification of high-risk factors and the development of individualized nutrition therapy strategies are crucial for improving patient outcomes.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 1","pages":"112334"},"PeriodicalIF":1.7,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202852","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":"Assessing predictive value of contrast-enhanced ultrasound combined with doppler ultrasound for post-transcatheter arterial chemoembolization prognosis in hepatocellular carcinoma.","authors":"Jia-Jiao Qian, Min Xu, Yan-Song Ji","doi":"10.4240/wjgs.v18.i1.114692","DOIUrl":"10.4240/wjgs.v18.i1.114692","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) is a significant global health issue that is often diagnosed in advanced stages. Transcatheter arterial chemoembolization (TACE) is a standard intervention for unresectable HCC; however, it is frequently followed by tumor recurrence, highlighting the need for reliable prognostic tools. This study evaluated the combined predictive value of contrast-enhanced ultrasound (CEUS) and Doppler ultrasound in assessing the clinical outcomes post-TACE.</p><p><strong>Aim: </strong>To develop a comprehensive imaging strategy that can guide personalized treatment planning through an improved assessment of tumor vascularization and liver function, assess the predictive value of CEUS combined with Doppler ultrasound in patients with HCC who underwent TACE.</p><p><strong>Methods: </strong>This retrospective study analyzed 124 patients with HCC who underwent TACE. Based on 1-year outcomes, the patients were stratified into good (<i>n</i> = 86) and poor (<i>n</i> = 38) prognostic groups. We compared the clinical and ultrasound data (CEUS and Doppler parameters) between the groups to identify prognostic factors. Multivariate logistic regression was used to identify independent predictors, and receiver operating characteristic curve was used to evaluate the predictive power of the combined model for post-TACE prognosis.</p><p><strong>Results: </strong>Significant differences were observed between the two groups in terms of TNM stage, number of lesions, tumor size, arrival time (AT), washout time (WT), hepatic artery peak systolic velocity (VPs), portal vein velocity, and blood flow grading (<i>P</i> < 0.05). Logistic regression analysis showed that TNM stage, tumor size, number of lesions, hepatic artery VPs, and blood flow grading were risk factors affecting the prognosis of patients with HCC following TACE, whereas AT, WT, and portal vein velocity were protective factors (<i>P</i> < 0.05). Receiver operating characteristic curve analysis demonstrated that the area under the curve values for predicting post-TACE prognosis in patients with HCC were as follows: (1) 0.704 for AT; (2) 0.762 for WT; (3) 0.796 for hepatic artery VPs; (4) 0.796 for portal vein velocity; (5) 0.657 for blood flow grading; and (6) 0.942 for the combined model.</p><p><strong>Conclusion: </strong>The combination of CEUS and Doppler ultrasound parameters, which reflect tumor vascularization and liver function, has high a predictive value for the prognosis of patients with HCC following TACE.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 1","pages":"114692"},"PeriodicalIF":1.7,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202870","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 disease-free survival following preoperative diagnosis and laparoscopic radical resection for Meckel's diverticulum adenocarcinoma: A case report.","authors":"Ze-Hao Yu, Chun-Run Ling, Jun-Ying Yu, Qiu-Huan Zhang, Shan-Shan Wei","doi":"10.4240/wjgs.v18.i1.114022","DOIUrl":"10.4240/wjgs.v18.i1.114022","url":null,"abstract":"<p><strong>Background: </strong>Meckel's diverticulum (MD) is most commonly encountered during emergency interventions for complications or as an incidental finding during an unrelated procedure. Definitive pre-operative diagnosis of MD-associated adenocarcinoma, permitting radical resection, is very rare in clinical practice.</p><p><strong>Case summary: </strong>A 36-year-old male presented with recurrent dark-red hematochezia. Initial gastroscopy, colonoscopy, computed tomography, and tumor marker assessments were unremarkable. A technetium-99m pertechnetate Meckel scan (Meckel scan) revealed ectopic gastric mucosa, suggesting an MD. Double-balloon enteroscopy revealed an ulcerative stricture in the ileum, and biopsy confirmed a moderately differentiated adenocarcinoma. The patient underwent laparoscopic radical small bowel resection. Histopathology confirmed pT3N0M0, stage IIA (the American Joint Committee on Cancer 8^th edition) moderately differentiated adenocarcinoma with lymphovascular invasion. Adjuvant chemotherapy was administered postoperatively. No recurrence or metastasis was observed during a 36-month follow-up.</p><p><strong>Conclusion: </strong>For recurrent obscure gastrointestinal hemorrhage, combined Meckel scan and double-balloon enteroscopy is critical for diagnosing MD-associated, enabling curative resection.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 1","pages":"114022"},"PeriodicalIF":1.7,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202925","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":"Dynamic ultrasound monitoring of intraperitoneal effusion for predicting complications after laparoscopic gastrectomy.","authors":"Xing-Xing Gao, Sheng-Hui Su, Dan-Dan Huang","doi":"10.4240/wjgs.v18.i1.113894","DOIUrl":"10.4240/wjgs.v18.i1.113894","url":null,"abstract":"<p><strong>Background: </strong>Transabdominal ultrasound monitoring can predict the occurrence of intraperitoneal effusion after laparoscopic gastrectomy and provide data reference for early intervention for postoperative complications.</p><p><strong>Aim: </strong>To investigate dynamic monitoring of intraperitoneal effusion after laparoscopic gastrectomy and correlation with prognosis to guide intervention for postoperative complications.</p><p><strong>Methods: </strong>Eighty patients who underwent laparoscopic gastric cancer surgery in a general surgery department over four years was selected. Standardized transabdominal ultrasonography was performed on 1^st, 3^rd and 7^th day after surgery. The incidence and nature of the effusion and inflammatory indicators were measured simultaneously. Intraperitoneal effusion risk was analyzed using the generalized estimating equation, linear mixed model was used to evaluate the factors influencing effusion collection, and Cox regression and receiver operating characteristic curves were used to evaluate the effectiveness of complication prediction.</p><p><strong>Results: </strong>The incidence of intraperitoneal effusion peaked on the 3^rd postoperative day (52.50%, 42/80). Subgroup analysis showed a higher risk of fluid accumulation after total gastrectomy. The risk of intraperitoneal effusion after total gastrectomy was 2.10 times that of distal gastrectomy [odds ratio = 2.10, 95% confidence interval (CI): 1.14-3.87] and the risk of diabetes mellitus was increased by 85% (odds ratio = 1.85, 95%CI: 1.04-3.31). The complication risk of mixed effusion increased 3.86 times (hazard ratio = 3.86, 95%CI: 1.62-9.18), and the total complication rate reached 53.57% (15/28). Procalcitonin > 0.47 ng/mL on day 3 was the best predictor of infectious complications (area under the curve = 0.874, sensitivity: 82.9%, specificity: 81.7%), followed by C-reactive protein > 48.5 mg/L (area under the curve = 0.852). There was no significant difference in outcomes between the age subgroups.</p><p><strong>Conclusion: </strong>Transabdominal ultrasonography accurately captures the evolution of effusion after laparoscopic gastrectomy. It is recommended that high-risk patients undergo focused ultrasonographic at 72 hours postoperatively to facilitate early intervention.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 1","pages":"113894"},"PeriodicalIF":1.7,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202952","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":"Staging laparoscopy in esophagogastric junction cancer: Systematic review and meta-analysis.","authors":"Roberto de la Plaza Llamas, Diego Ribera Díaz, Paula Betancor Díaz, Daniel A Díaz Candelas, Raquel A Latorre-Fragua, Ludovica Gorini, Rodrigo Arellano González, Ignacio A Gemio Del Rey","doi":"10.4240/wjgs.v18.i1.115285","DOIUrl":"10.4240/wjgs.v18.i1.115285","url":null,"abstract":"<p><strong>Background: </strong>Staging laparoscopy (SL) is a valuable tool for detecting occult peritoneal or hepatic metastases in patients with gastroesophageal junction (GEJ) cancer, especially when imaging suggests resectability. Despite advances in cross-sectional imaging methodologies such as computed tomography, positron emission tomography/computed tomography and endoscopic ultrasound, these techniques may miss low-volume or superficial peritoneal disease. Early identification of metastatic spread through SL can avoid unnecessary surgery, reduce morbidity, and improve treatment planning. However, its use in GEJ tumors - particularly Siewert types I and II - remains debated. Understanding the diagnostic performance (DP) of SL is essential for optimizing staging strategies.</p><p><strong>Aim: </strong>To evaluate the DP of SL in identifying abdominal metastatic disease in patients with clinically resectable GEJ tumors.</p><p><strong>Methods: </strong>Systematic review and meta-analysis in accordance with PRISMA 2020 guidelines. A comprehensive PubMed search was performed up to March 29, 2024, using Medical Subject Headings terms related to GEJ, laparoscopy, and cancer staging. Inclusion criteria: Studies assessing SL in patients with GEJ tumors. Primary outcome was the rate of upstaging to stage IV due to peritoneal or hepatic metastases. Secondary outcomes included details on techniques, patient characteristics, and procedural factors. Risk of bias was evaluated using Risk of Bias in Non-randomised Studies of Interventions and certainty of evidence with Grading of Recommendations, Assessment, Development and Evaluation.</p><p><strong>Results: </strong>Eighteen studies involving 1591 patients were included. SL upstaged 22% of patients (95% confidence interval: 17-27) to stage IV due to occult metastatic disease. The pooled positivity rates were positive peritoneal malignancy (17.5%), peritoneal carcinomatosis (13%), malignant peritoneal cytology (9%), and hepatic metastases (9.2%). SL avoided unnecessary surgery in 19.8% of cases. Subgroup analysis revealed consistent performance in Siewert II tumors (DP = 13%, <i>I</i> ² = 0), while in Siewert I tumors it was more heterogeneous (DP = 18%, <i>I</i> ² = 93.7%). Only five studies reported complications, mostly minor, with no procedure-related mortality. No comorbidities, carcinomatosis scoring, conversion to open surgery, complications of follow-up, readmissions, postoperative length of stay, or delay in initiating neoadjuvant therapy were recorded.</p><p><strong>Conclusion: </strong>SL improves staging accuracy in GEJ cancers, especially Siewert II. Despite heterogeneity and limited data stratification, SL may guide therapeutic decisions and help avoid unnecessary or futile surgeries.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 1","pages":"115285"},"PeriodicalIF":1.7,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202871","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":"Timeliness of postoperative serum carcinoembryonic antigen monitoring for predicting recurrence after gastric cancer surgery.","authors":"Xin-Xing Duan, Xiong Yu, Li Zhou","doi":"10.4240/wjgs.v18.i1.114309","DOIUrl":"10.4240/wjgs.v18.i1.114309","url":null,"abstract":"<p><strong>Background: </strong>Postoperative recurrence remains a major challenge in gastric cancer management. Monitoring serum biomarkers such as carcinoembryonic antigen (CEA) may enable earlier detection of recurrence and improve patient outcomes.</p><p><strong>Aim: </strong>To evaluate postoperative serum CEA expression and its efficacy in predicting gastric cancer recurrence.</p><p><strong>Methods: </strong>This retrospective study analyzed clinical data from 120 patients with primary gastric cancer treated between January 2022 and January 2023. Patients were categorized into recurrence and non-recurrence groups. Serum levels of CEA, alpha-fetoprotein (AFP), and carbohydrate antigen 19-9 (CA19-9) were measured at one week, three months, and six months postoperatively. Logistic regression identified independent risk factors for recurrence, Pearson correlation assessed the association with recurrence timing, and receiver operating characteristic (ROC) curves evaluated the predictive performance of combined CEA and AFP levels.</p><p><strong>Results: </strong>During 24 months of follow-up, 39 patients (32.50%) experienced recurrence. No significant baseline differences were observed between groups (<i>P</i> > 0.05). CEA, AFP, and CA19-9 levels at one week were comparable between groups (<i>P</i> > 0.05), whereas levels at three and six months were significantly higher in the recurrence group (<i>P</i> < 0.05). Logistic regression identified postoperative CEA and AFP as independent risk factors for recurrence (<i>P</i> < 0.05). Pearson correlation showed a negative association between CEA and AFP levels and recurrence interval (<i>P</i> < 0.05). ROC curve analysis demonstrated that combined CEA and AFP yielded an area under the curve of 0.826, with specificity of 94.36% and sensitivity of 90.50%, outperforming either marker alone (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Dynamic postoperative monitoring of serum CEA and AFP enables early prediction and detection of gastric cancer recurrence.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 1","pages":"114309"},"PeriodicalIF":1.7,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202883","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":"Mesenteric Castleman disease: Two case reports and review of literature.","authors":"Se-Niu Jizhi, Xing-Yu Chen, Shan-Shan Wu, Zhong-Lu Chen, A-Niu Liu, Shu-Mei Zheng","doi":"10.4240/wjgs.v18.i1.114697","DOIUrl":"10.4240/wjgs.v18.i1.114697","url":null,"abstract":"<p><strong>Background: </strong>Castleman disease (CD) is a rare lymphoproliferative disorder most commonly occurring in the mediastinum and hilar regions. Mesenteric involvement is rare, and diagnosis primarily relies on histopathological examination.</p><p><strong>Case summary: </strong>We report two cases of mesenteric CD with gastrointestinal symptoms accompanied by weight loss. Case 1 underwent complete surgical resection of the lesion. Postoperative pathology confirmed the hyaline vascular type, and the prognosis was favorable. Case 2 also underwent complete surgical resection initially, with postoperative pathology confirming the plasma cell type. However, the disease followed an aggressive course. A second surgery was performed five months later, and postoperative pathology confirmed mesenteric peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS). The patient died postoperatively due to acute renal failure.</p><p><strong>Conclusion: </strong>To our knowledge, this is the first reported case of mesenteric CD transforming into PTCL-NOS, highlighting the complexity and heterogeneity of the clinical course of mesenteric CD. These findings provide insights into the personalized treatment and clinical management of this disease.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 1","pages":"114697"},"PeriodicalIF":1.7,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202922","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":"Naloxone plus enteral nutrition for gastrointestinal dysfunction in elderly cerebral infarction and peptic ulcer patients.","authors":"Xin-Xin Chen, Xue-Fei Han, Yan Chu","doi":"10.4240/wjgs.v18.i1.115201","DOIUrl":"10.4240/wjgs.v18.i1.115201","url":null,"abstract":"<p><strong>Background: </strong>Cerebral infarction (CI) is a major subtype of ischemic stroke, with high incidence, recurrence rate, disability rate, and mortality rate in the elderly. Elderly CI patients are prone to peptic ulcer due to long-term use of antiplatelet drugs and stress factors, which further leads to gastrointestinal dysfunction, seriously affecting nutritional intake and rehabilitation. Naloxone, an opioid receptor antagonist, has neuroprotective potential, and enteral nutrition (EN) can improve gastrointestinal function. This study aims to explore the intervention effect of their combination.</p><p><strong>Aim: </strong>To investigate the efficacy of naloxone combined with EN on gastrointestinal dysfunction in elderly patients with CI and peptic ulcer.</p><p><strong>Methods: </strong>In this randomized controlled trial, 110 elderly patients with CI and peptic ulcer were equally assigned to a control group (receiving standard therapy combined with EN) or a combination group (receiving standard therapy, EN, and naloxone). The National Institute of Health Stroke Scale (NIHSS) scores, Barthel Index (BI), Chinese version of the MOS 36-Item Short Form Health Survey (SF-36) scores, gastrointestinal function scores, and serum levels of motilin (MTL), gastrin (GAS), and somatostatin (SS) were compared. Adverse reactions were also recorded.</p><p><strong>Results: </strong>Compared with the control group, the combination group had lower NIHSS scores (5.88 ± 1.07 <i>vs</i> 8.73 ± 1.14, <i>P</i> < 0.001) and gastrointestinal dysfunction scores (5.14 ± 1.27 <i>vs</i> 8.62 ± 1.31, <i>P</i> < 0.001), higher BI (87.36 ± 4.42 <i>vs</i> 72.29 ± 3.23, <i>P</i> < 0.001) and SF-36 scores (76.26 ± 3.85 <i>vs</i> 70.21 ± 3.66, <i>P</i> < 0.001), increased serum MTL (201.31 ± 12.35 ng/L <i>vs</i> 186.81 ± 11.18 ng/L, <i>P</i> < 0.001) and GAS levels (94.46 ± 9.64 pg/mL <i>vs</i> 103.15 ± 10.52 pg/mL, <i>P</i> < 0.001), and decreased SS levels (5.69 ± 1.25 pg/mL <i>vs</i> 8.31 ± 1.19 pg/mL, <i>P</i> < 0.001). No significant difference in the incidence of adverse reactions was found between the two groups.</p><p><strong>Conclusion: </strong>The combination of naloxone and EN is a safe and efficacious therapeutic approach for ameliorating gastrointestinal dysfunction and promoting overall recovery in elderly individuals with CI and peptic ulcer.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 1","pages":"115201"},"PeriodicalIF":1.7,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202947","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":"Feasibility analysis of ultrasound-guided percutaneous catheter drainage for pyogenic liver abscess in non-liquefied stages.","authors":"Qin-Zhi Liu, Lei Zeng, Nian-Zhe Sun","doi":"10.4240/wjgs.v18.i1.113758","DOIUrl":"10.4240/wjgs.v18.i1.113758","url":null,"abstract":"<p><p>This letter systematically evaluated a retrospective comparative study by Qiu <i>et al</i> investigating ultrasound-guided percutaneous catheter drainage (PCD) for pyogenic liver abscess management during the non-liquefaction phase. The results demonstrated that early ultrasound-guided PCD significantly shortened hospitalization duration, accelerated fever resolution, and promoted > 50% abscess volume reduction compared to delayed intervention after liquefaction, without increasing procedural risks. While challenging the conventional \"wait-for-liquefaction\" paradigm, the evidence quality limitations warrant caution, highlighting the need for multicenter prospective randomized controlled trials. Current clinical practice recommends early PCD for severe manifestations (persistent fever, leukocytosis) or immunocompromised patients (including those with diabetes), while prioritizing antibiotic therapy for small abscesses (diameter < 3 cm) or mild cases. Dynamic imaging reassessment and multidisciplinary collaboration remain essential for individualized management. This study provides critical evidence supporting the paradigm shift from empirical observation to precision intervention in pyogenic liver abscess management, though risk-benefit evaluation should precede widespread clinical adoption.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 1","pages":"113758"},"PeriodicalIF":1.7,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202957","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":"Comparing efficacy of a jejunostomy tube <i>vs</i> a nasojejunal nutrient tube after pancreatectomy.","authors":"Yan Guo, Ming Zhang, Na Liu, Xing-Kai Meng, Jun Li","doi":"10.4240/wjgs.v18.i1.113967","DOIUrl":"10.4240/wjgs.v18.i1.113967","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic surgery is highly invasive and associated with prolonged postoperative recovery. Safe, effective postoperative nutritional support is essential for patient recovery. The impact of two modes of nutritional support-jejunostomy tube (JT) and nasojejunal tube (NJT), on recovery after resolution of novel coronavirus infection has been rarely reported.</p><p><strong>Aim: </strong>To compare the effects of JT with those of NJT after pancreatectomy.</p><p><strong>Methods: </strong>We retrospectively analyzed clinical data from 60 patients who underwent pancreatic surgery between January 2023 and May 2025 and classified them into an NJT group (<i>n</i> = 39) and a JT group (<i>n</i> = 21) according to the nutritional method used. Postoperative nutritional status and related complication rates were compared between the two groups.</p><p><strong>Results: </strong>No statistically significant differences were observed in sex, age, body mass index, preoperative hemoglobin level, or preoperative jaundice status between the two groups; postoperative pathologic type, incidence of delayed gastric emptying, time to transoral feeding, and time to defecation also did not differ (<i>P</i> > 0.05). The postoperative albumin level in the JT group was higher than in the NJT group, whereas the incidences of vomiting, pharyngeal discomfort, and hypostatic pneumonia, as well as the postoperative length of stay, were significantly lower (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>The use of JT for nutritional support after pancreatectomy is safe and effective, significantly reducing complication incidence and shortening postoperative length of stay; therefore, it is worthy of clinical selection and standardized use.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 1","pages":"113967"},"PeriodicalIF":1.7,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202831","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}