Zeitschrift fur Gastroenterologie最新文献

{"title":"[TIPS: current and innovative concepts].","authors":"Dominik Bettinger, Lukas Sturm, Marlene Reincke, Robert Thimme, Michael Schultheiß","doi":"10.1055/a-2700-9816","DOIUrl":"10.1055/a-2700-9816","url":null,"abstract":"<p><p>Implantation of a transjugular intrahepatic portosystemic shunt (TIPS) has become an established interventional procedure for treating decompensated liver cirrhosis and its complications, such as portal hypertension. Current research focuses on optimizing patient selection and timing to enhance outcomes further. TIPS effectively reduces portal vein pressure, mitigating bacterial translocation and systemic inflammation associated with cirrhosis. This reduction in inflammation has been shown to decrease decompensation events and improve survival rates. However, challenges remain regarding the precise adjustment of the portosystemic gradient (PSG) to balance symptom control with minimizing risks such as hepatic encephalopathy or cardiac complications. The main indications for TIPS include variceal bleeding (especially high-risk patients requiring preemptive TIPS within 72 hours), recurrent ascites, and Budd-Chiari syndrome. Strict patient selection is crucial to maximize benefits while minimizing risks. Emerging evidence highlights the importance of addressing both portal hypertension and inflammation to improve clinical outcomes. In summary, TIPS represents an effective approach to managing complications of liver cirrhosis that improves survival and quality of life for affected patients.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":"64 1","pages":"37-49"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146053947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinician-Scientists in University Medicine: status quo, challenges, and outlook in gastroenterology].","authors":"Robert Thimme, Britta Siegmund","doi":"10.1055/a-2741-4045","DOIUrl":"10.1055/a-2741-4045","url":null,"abstract":"<p><p>The job profile of the clinician scientist has established itself as a central pillar of university medicine in recent years. In view of increasing demands in clinical practice and research, targeted programs are necessary to offer physicians with an interest in science a protected working environment. Structured clinician scientist models enable a systematic connection and, in some phases, separation of clinical work and research, thus forming the basis for sustainable scientific careers - even beyond specialist training. This article highlights the structure, challenges, and future outlook of these specific programs using the discipline of gastroenterology as an example.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":"64 1","pages":"50-55"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146053939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Immunopathogenesis and therapy of primary sclerosing cholangitis].","authors":"Britta F Zecher, Christoph Schramm","doi":"10.1055/a-2730-4719","DOIUrl":"https://doi.org/10.1055/a-2730-4719","url":null,"abstract":"<p><p>Primary sclerosing cholangitis (PSC) is an immune-mediated disease of the biliary tract for which no prognosis-improving therapies are yet available. PSC is characterized by genetic risk factors, alterations in the microbiome and pathological immune activation leading to the development of biliary fibrosis. Cholangiocytes play an active role in the inflammatory processes, as they interact directly with the microbiome and immune cells. The concomitant chronic inflammatory bowel disease has a distinct phenotype and causes a reciprocal modulation of intestinal and hepatic disease activity via changes in the intestinal barrier and the enterohepatic circulation of bile acids. While the currently available drugs and endoscopic treatment options are only symptomatically effective, new pharmacologic therapies are under clinical evaluation. In this review, we aim to provide an insight into the current understanding of the pathogenesis of PSC and new therapeutic developments.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":"64 1","pages":"56-66"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146053919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatocellular Carcinoma - from Immunobiology to Immunotherapy.","authors":"Charlotte Rennert, Michael Schultheiß, Robert Thimme, Natascha Röhlen, Bertram Bengsch","doi":"10.1055/a-2722-5684","DOIUrl":"https://doi.org/10.1055/a-2722-5684","url":null,"abstract":"<p><p>Hepatocellular Carcinoma (HCC) is an entity characterized by a highly heterogenous tumor immune microenvironment. The introduction of immune checkpoint inhibitor (ICI) therapy as standard of care in advanced disease stages and with promising results in earlier stages has highlighted the need for a better understanding of the underlying immunobiology. In this review, we provide a summary about the immune landscape in HCC and discuss novel potential therapeutic targets as well as how spatial immune profiling may help identify optimal candidates for ICI therapy.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":"64 1","pages":"67-83"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146053872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatologie im Fokus: die GASL-Tagung 2026.","authors":"Robert Thimme","doi":"10.1055/a-2718-2070","DOIUrl":"https://doi.org/10.1055/a-2718-2070","url":null,"abstract":"","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":"64 1","pages":"35-36"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146053883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoskopische Therapie bei akuter Appendizitis - quod ERAT demonstrandum?","authors":"Christopher Moritz Schad, Felix Gundling","doi":"10.1055/a-2710-8074","DOIUrl":"https://doi.org/10.1055/a-2710-8074","url":null,"abstract":"","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":"63 12","pages":"1268-1271"},"PeriodicalIF":1.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145715963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Watch-and-Wait and surveillance in gastric MALT-lymphoma after exclusive Helicobacter pylori eradication under special consideration of patients' compliance].","authors":"Wolfgang Fischbach, Johannes Herold, Matthias Eck","doi":"10.1055/a-2685-2913","DOIUrl":"10.1055/a-2685-2913","url":null,"abstract":"<p><p>The EGILs (European Gastro-Intestinal Lymphoma Study) consensus report recommends H. pylori eradication as therapy of choice in gastric MALT lymphoma. Complete lymphoma remission is followed by a structured follow-up. In case of minimal histological residuals a watch-and-wait strategy with regular endoscopic-bioptic controls is recommended. A prerequisite for the success of this strategy is a good patient compliance.106 patients (50 female and 56 male; 59 years, range 33-85) with gastric MALT lymphoma and exclusive H. pylori eradication were retrospectively analyzed. According to EGILs they should receive follow-up investigations every 6-12 months after complete remission was achieved. Compliance was calculated as rate of performed follow-up to individual total follow-up.94 of 106 patients (89%) revealed complete lymphoma remission or stable minimal histological residuals after H. pylori eradication. Related to the time interval between primary diagnosis and last follow-up 85% (mean) and 95% (median) of patients, respectively, were compliant.Results of H. pylori eradication and prognosis were excellent. The willingness of the patients to undergo follow-up investigations after complete remission and during watch-and-wait underlines the security of this therapeutic strategy and the clinical management of these patients.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":" ","pages":"1246-1252"},"PeriodicalIF":1.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics of newly diagnosed patients with primary biliary cholangitis (PBC) indicate the need for better awareness on timely diagnosis and adequate UDCA therapy.","authors":"Kerstin Stein, Wolf P Hofmann, Annegret Franke, David Petroff, Tobias Müller, Heike Bantel, Rainer Günther, Gerald Denk, Philipp A Reuken, Jörn M Schattenberg, Uwe Naumann, Tobias Böttler, Andreas Weber, Stefan Zeuzem, Matthias Hinz, Robin Greinert, Christoph Berg, Thaddäus Till Wissniowski, Karl-Georg Simon, Jonel Trebicka, Rüdiger Behrens, Harald Grümmer, Nektarios Dikopoulos, Christoph Sarrazin, Elke Roeb, Andreas E Kremer, Marion Muche, Marc Ringelhan, Andreas Teufel, Uta Merle, Verena Keitel, Jens U Marquardt, Achim Kautz, Frank Tacke, Katja Piotrowski, Nicole Köppe-Bauernfeind, Christian Trautwein, Thomas Berg, Johannes Wiegand","doi":"10.1055/a-2721-1160","DOIUrl":"10.1055/a-2721-1160","url":null,"abstract":"<p><p>Guidelines on primary biliary cholangitis (PBC) recommend therapy with 13-15 mg/kg ursodeoxycholic acid (UDCA) and assessment of treatment response after 12 months. We evaluated to which extent these recommendations are followed in newly diagnosed patients.The German PBC Registry recruited three subgroups: Adequate or inadequate UDCA treatment responders (Paris II criteria) and newly diagnosed patients (<6 months prior to recruitment). We focus on newly diagnosed patients with UDCA monotherapy.82 patients were recruited (43 at 12 tertiary and 39 at 9 secondary centers) thereof 22% with cirrhosis. Individuals with cirrhosis were older (71 ± 9 vs. 55 ± 14 years, p<0.001) and presented more frequently with diabetes mellitus (44% vs. 13%, p=0.0054) and arterial hypertension (78% vs. 42%, p=0.0076) compared to cases without cirrhosis.12 months follow-up data were available in 62 patients. UDCA underdosing (<13 mg/kg/d) occurred in 47% and 74% of cases (p=0.013) at tertiary and secondary care at treatment initiation and in 29% and 73% (p=0.002) after 12 months, respectively. Paris II criteria were achieved in 74% and a deep UDCA response (alkaline phosphatase < ULN and bilirubin < 0.6 × ULN) in 32% of cases.Newly diagnosed PBC patients include a substantial proportion of late presenters with cirrhosis. UDCA dosage is suboptimal in many cases. Time point of diagnosis and UDCA dosage should be improved.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":"63 12","pages":"1260-1267"},"PeriodicalIF":1.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145715947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Food impactions in the esophagus: incidence, causes, and treatment.","authors":"Florian Hentschel, Isabel Elena Haller, Juliane Emily Wruck, Benedikt Seckinger, Götz Mollenhauer, Till Bornscheuer, Stefan Lüth","doi":"10.1055/a-2703-6336","DOIUrl":"10.1055/a-2703-6336","url":null,"abstract":"<p><p>Food impactions in the esophagus are gastroenterologic emergencies. Their incidence is suspected to increase. Standard therapy is endoscopic removal. According to European guidelines from 2016, gently pushing the food forward with the endoscope is safe and efficient. This has recently been doubted, and a retrograde extraction of the food bolus was supposed to be safer.We retrospectively analyzed all food impactions in our database over 16 years regarding incidence per year, age, sex, underlying disease, method of removal, success rate, and safety.From 2008 to 2024, 99 patients were included. Incidence of food impactions increased logarithmically from one per year to 22 per year (p < 0.001). Seventy-nine patients were male (80%; p < 0.001). Underlying diseases were reflux-associated lesions, eosinophilic esophagitis, pseudo-diverticulosis, hernia, achalasia, candidiasis, and others. Fifty-five were pushed forward prior to 2016, afterwards it were 74 (56% and 75% respectively; p < 0.001). Success rate was 100 percent for all techniques. We observed two minor adverse events in the forward-pushing group vs. one in the extraction group (not significant).Our data confirms that food obstructions are on the rise and that the vast majority of patients are male. There is no typical underlying disease but a wide variety of rare diseases which together form the basis for the increase. Pushing forward is as safe as is extracting the food, so we see no necessity to change the existing guidelines.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":" ","pages":"1239-1245"},"PeriodicalIF":1.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12688656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252919","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 polypoid mass in the coecum in an 86-year-old patient with iron deficiency anemia after previous colonoscopy - overlooked or new?]","authors":"Felix Gundling, Jens Neumann","doi":"10.1055/a-2707-4546","DOIUrl":"https://doi.org/10.1055/a-2707-4546","url":null,"abstract":"","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":"63 12","pages":"1235-1238"},"PeriodicalIF":1.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145715958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}