Gastroenterologie a Hepatologie最新文献

{"title":"International autotransplantation of Langerhans islets into the portal tract after total pancreatectomy in a patient with chronic hereditary pancreatitis – case report and review of current literature","authors":"Daniel Bolek, L. Nosáková, M. Pindura, Patrik Horan, P. Bánovčin, B. Palkóci, P. Girman, J. Kříž, Lenka Németová, I. Leontovyc, K. Bittenglová, D. Osinová, J. Miklušica","doi":"10.48095/ccgh2023231","DOIUrl":"https://doi.org/10.48095/ccgh2023231","url":null,"abstract":"Summary: Chronic pancreatitis with repeated painful relapses is a severe multifactorial, fibroinflammatory syndrome that significantly affects the quality of life of patients, mainly in terms of pain, development of diabetes mellitus, and repeated attacks of acute pancreatitis. Autologous islet transplantation after total pancreatectomy is a potential option in selected patients with severe, recurrent painful episodes of chronic pancreatitis. In our case, we present a patient with severe recurrent chronic pancreatitis. The patient required frequent hospitalizations with repeated stenting of the pancreatic duct. After the confirmation of a genetic mutation, the members of the multidisciplinary session decided to perform a total pancreatectomy with islet autotransplantation. In this case, we present the first international islet cell autotransplantation of Langerhans islets in Slovakia after total pancreatectomy in a patient with chronic hereditary pancreatitis. Key words: hereditary pancreatitis – total pancreatectomy – autotransplantation of Langerhans islets","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89712309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic submucosal dissection in the rectum – our experience","authors":"Dušan Polák, K. Beráková, J. Váňa, A. Kalavská","doi":"10.48095/ccgh2023208","DOIUrl":"https://doi.org/10.48095/ccgh2023208","url":null,"abstract":"Summary: Introduction: Endoscopic submucosal dissection (ESD) is an endoscopic treatment method for the removal of neoplastic lesions of the digestive tract. Thanks to this technique, we can achieve complete (en bloc) R0 endoscopic resection of even large lesions in one piece. We thereby obtain a valuable resection for further histopathological evaluation and, with a suitably chosen lesion, achieve a curative resection. Methods: Retrospective analysis of our file in the period 1/2020–01/2023. The primary objective was to determine how endoscopic evaluation and selection of included rectal lesions treated with the ESD technique correlates with histopathological results. The secondary objective was to determine the curability of the treatment we performed in our group of patients. We included lesions over 20 mm with the assumption of maximum invasion into the surface parts of the submucosa, i.e., JNET 2B. In addition, we included recurrent lesions in the scar after previous endoscopic or surgical treatment, submucosal lesions up to 20 mm and lesions smaller than 20 mm, especially in the lower rectum, which cannot be radically removed en bloc by loop-based techniques. Results: We included a total of 76 rectal lesions. JNET 2B lesions were 59 of them (77.6%). The most common histopathological diagnosis was high-grade dysplasia (HGD) in 35 (46%) cases. We achieved curative endoscopic resection in the majority (93.4%) of patients. Five patients (5.26%) required subsequent surgical or oncological therapy after ESD and further staging. Conclusion: The results of our work confirm the effectiveness of ESD as a therapeutic method suitable for achieving en bloc R0 resection of rectal lesions and thus their correct histopathological evaluation. However, the correct selection of patients remains crucial. Key words: endoscopic submucosa dissection – rectal lesions – curative resection","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82943544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posthepatectomy liver failure – scoring systems in clinical practice","authors":"V. Rekeň, M. Sabol, Š. Nemergut, Luis Miguel Arciniegas Rodriguez, D. Šintál, Š. Durdík","doi":"10.48095/ccgh2023225","DOIUrl":"https://doi.org/10.48095/ccgh2023225","url":null,"abstract":"Summary: Introduction: Posthepatectomy liver failure (PHLF) is still a dreaded disease entity despite medical advances. The primary aim of the work was to retrospectively apply selected scoring systems used to assess the risk of PHLF to a group of patients after major liver resections operated at the authors‘ workplace. We anticipate that the latest scoring systems will provide a more accurate picture of PHLF risk. Methods: Between 2007 and 2016, 82 patients meeting the inclusion criteria (elective removal of three or more liver segments for neoplasm) were identified. Five scoring systems were applied to them, namely: “50-50” criterion, ISGLS classification, Hyder score, ALBI and Liu score. Results: Using the “50-50” criterion, none of the patients reached the diagnosis of PHLF. Applying the ISGLS scoring system, 68 patients (86%) had grade “A” and 11 had grade “B” PHLF on the 5th postoperative day. Hyder‘s score above 11 was achieved by two patients who died on the 14th and 34th postoperative day. In the ALBI score, only one patient achieved a value of more than –1.39 (–0.4), while he died on the second postoperative day. Within the Liu score, 55 patients had a predicted very serious risk of developing PHLF, while 46 patients died with an average survival of 27 months after resection. Of the five applied scoring systems, only in the case of ALBI and Liu scores was a statistically significant difference between subgroups of patients with different degrees of presence or prediction of PHLF. A marginally significant difference in the proportion of genders was also noted within the entire set, with men having a higher chance of death (OR 2.63; 95% CI 0.83–8.32). Discussion: The ALBI scoring system correlates with the literature. It has shown very good prediction in several meta-analyses of cohorts of patients after major liver resection. A significantly positive clinical factor of the use of this system is that it is based on preoperative values of laboratory blood tests and can be proposed as a stable prediction model for short-term results after liver resection. Conclusion: The presented scoring systems still represent a rather heterogeneous view of PHLF. Our work points to the ALBI score as the best scoring system. Consistent stratification of patients and treatment in high-volume centers are key pillars of prevention of PHLF. Key words: hepatectomy – liver failure – liver neoplasm – posthepatectomy liver failure – major liver resection – scoring systems","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81338511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bowel preparation before colonoscopy – comparison of bowel cleansing quality and patient’s tolerance of several bowel cleansing devices","authors":"M. Lukáš, J. Reissigová","doi":"10.48095/ccgh2023237","DOIUrl":"https://doi.org/10.48095/ccgh2023237","url":null,"abstract":"Summary: High quality of bowel preparation before colonoscopy seems to be the most important condition for safety and efficacious investigation of the large bowel. An analysis of 758 patients who underwent colonoscopy in one health care center showed that split preparation is significantly associated with higher quality of the bowel cleansing. Application of drugs with simethicon component significantly reduce the risk of bubbles. Patients prefer small volume laxatives with good palatability. Key words: colonoscopy – bowel cleansing – bowel preparation","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"157 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75613970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early onset colorectal cancer – personal experience 2012–2021","authors":"I. Mikoviny Kajzrlíková, P. Vítek, P. Klvaňa, J. Kuchař, J. Platoš, J. Chalupa","doi":"10.48095/ccgh2023221","DOIUrl":"https://doi.org/10.48095/ccgh2023221","url":null,"abstract":"Background: Early onset colorectal cancer is defined as cancer diagnosed before the age of 50 years. Its incidence has been increasing worldwide in recent years. The aim of our study was to assess the real-life incidence of early onset colorectal cancer, advanced neoplasias (colorectal cancer and/or advanced adenoma) and all neoplastic lesions in total in a single non-university endoscopic center. Methods: We retrospectively evaluated the incidence of all neoplastic lesions, advanced neoplasias and colorectal cancer in population under 50 years of age compared to population aged 50 years and older. We collected the data from all colonoscopic examinations performed in non-university Hospital Frydek-Mistek from January 2012 to the end of June 2021. Results: During the observed period, 18,257 colonoscopic examinations were performed in total, 14,728 in population aged 50 years and older and 3,529 in population under 50 years of age. In our study, there were 29 patients with early onset colorectal cancer (5.21% of 557 total) and 106 patients with early onset advanced neoplasias (4.47% of 2,371 total). The incidence of colorectal cancer, advanced neoplasias and all neoplasias was higher among men in older study group, but the incidence of early onset colorectal cancer and advanced neoplasias in younger group did not significantly differ between the sexes, only the incidence of all neoplastic lesions was also higher among men. Positive family history of colorectal cancer was not significantly associated with risk of early onset colorectal cancer (p = 0.316) or early onset advanced neoplasia (p = 0.323) in our study. Conclusions: Early onset colorectal cancer represented 5.21% of all colorectal cancers diagnosed during the study period. The incidence of colorectal cancer and advanced neoplasias in population under 50 years of age was 0.82% and 3.00%, compared with 3.59% and 15.38% in older population. In contrast to older population, the incidence of early onset colorectal cancer and advanced neoplasias did not differ between the sexes. Keywords diagnosis, colorectal cancer, screening, population groups","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"107 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76240696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of fluorescence in situ hybridization in primary diagnosis of distal biliary strictures","authors":"V. Zoundjiekpon, P. Falt, J. Zapletalová, Daniela Kurfürstová, M. Loveček, L. Kunovský, Daniela Slobodová, D. Skanderová, G. Kořínková, P. Skalický, O. Urban, P. Vaněk, Peter Slodička, T. Tichý","doi":"10.48095/ccgh2023198","DOIUrl":"https://doi.org/10.48095/ccgh2023198","url":null,"abstract":"Summary: Background and aim: Primary diagnosis of the distal biliary stricture can be sometime difficult. Brush cytology (BC) is known to have low diagnostic sensitivity in these cases. Fluorescence in situ hybridization (FISH) has been reported as a useful adjunctive test in patients with biliary strictures. We aimed to determine performance characteristics of BC, FISH and their combination (BC + FISH) in the primary diagnosis of distal biliary strictures. Methods: This single-center prospective study was conducted between April 2019 and January 2021. Consecutive patients with unsampled biliary strictures undergoing first ERCP in our institution were included. Cytological and FISH analysis of tissue specimens from two standardized transpapillary brushings from the distal strictures were provided. Histopathological confirmation after surgery or 12-month follow-up was regarded as the reference standard for the final diagnosis. Results: A total of 109 patients were enrolled. Seven patients were lost from the final analysis and 26 suffered proximal stenosis. Of the 76 remaining patients (61.8% males, mean age 67.6, range 25–89 years) with distal stenosis, the proportions of benign and malignant strictures were 25 (32.9%) and 51 (67.1%), respectively. Of the subgroup of malignant strictures, 17.7% were cholangiocarcinoma, 74.5% were pancreatic tumors and 7.8% others. In comparison to BC alone, FISH increased the sensitivity from 0.373% to 0.706% (p = 0.0007) with a slight decrease in specificity (p = 0.045). Conclusions: Dual modality tissue evaluation using BC + FISH has better sensitivity for the primary diagnosis of distal biliary strictures, compared to BC alone. Key words: primary diagnosis of distal biliary strictures – first retrograde cholangiopancreatography – brush cytology – fluorescence in situ hybridization","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80069045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bleeding from duodenal varices as an unusual complication of portal hypertension","authors":"Ivana Rücklová, F. Shon, Zuzana Mandátová, Roman Klus","doi":"10.48095/ccghl2023215","DOIUrl":"https://doi.org/10.48095/ccghl2023215","url":null,"abstract":"Summary: Variceal bleeding is the most serious and often fatal complication of portal hypertension. In case of bleeding from duodenal varices, the primary endoscopic treatment is endoscopic occlusion with tissue glue (synthetic N-butyl-2-cyanoacrylate [Histoacryl®]) or ligation of the duodenal varix. If primary endoscopic treatment is not sufficient to stop variceal bleeding or if a high risk of recurrence of bleeding prevails and the patient is clinically fit for further therapy, we proceed to secondary interventional therapy – TIPS or surgery. In the presented patient, unusually, we used clipping instead of ligation in the first treatment period. Then, in the second period, the recommended occlusion with tissue glue. Our management was definitive given that the patient was suspected of having generalized hepatocellular carcinoma during hospitalization. Key words: duodenal varices – portal hypertension – endoscopy – varicose bleeding","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"103 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85535793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Results of robotic colorectal surgery at IIIrd surgical department 1st Faculty of Medicine Charles University","authors":"B. Jisova, J. Skořepa, Jan Pastor, P. Hladík, R. Lischke","doi":"10.48095/ccgh2023154","DOIUrl":"https://doi.org/10.48095/ccgh2023154","url":null,"abstract":"Introduction: Robotic surgery is a rapidly developing field both in our country and abroad. The beginnings of robotic surgery dated back to the 1980s, but development took place after 2000, especially with the robotic systems from the company Intuitive. In the Czech Republic, the first robotic surgery was performed in October 2005, whereas at our surgical department, it was in June 2018. Robotic surgery techniques are now part of the standard procedures of our workplace. Method: Retrospective analysis of patients from our results database. We included all 150 patients operated between June 2018 to October 2022. Results: The operation technique is almost identical to laparoscopic or open surgery. The difference is so-called docking of the robotic system and the correct placement of the robotic arms. Now in the databases are 150 patients with colon and rectal resection. Most patients underwent rectal resection. 9.4% of the patients had anastomosis leak, which is a figure comparable to foreign literature. The conversion was necessary for 2.4% of patients. The length of hospitalization was reduced to a median of 6 days. Conclusion: Robotic surgery is certainly the future of surgery as such. The advantage over classic operations is a shorter hospitalization period, faster recovery, less painful surgical wounds, fewer wound infections, a lower risk of hernia in the scar and fewer conversions. The disadvantage is certainly the lack of tactile perception and the high purchase price as well as higher costs for the operation. Keywords colorectal surgery, robotic surgery, robotic resection, miniinvasive surgery","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"87 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81351682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Roundtable: Subcutaneous infl iximab in the treatment of IBD and therapeutic monitoring of drug levels in practice","authors":"K. Černá","doi":"10.48095/ccgh2023147","DOIUrl":"https://doi.org/10.48095/ccgh2023147","url":null,"abstract":"","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75778299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical course of patients with hepatorenal tyrosinemia treated with nitisinone – a 10-year prospective cohort study","authors":"S. Dehghani, Leyla Salarian, F. Parooie, M. Salarzaei, Masood Tahani, Farnaz Samiee, A. Amirhakimi, M. Delaramnasab, I. Shahramian","doi":"10.48095/ccgh202397","DOIUrl":"https://doi.org/10.48095/ccgh202397","url":null,"abstract":"ntroduction: Untreated type 1 tyrosinemia, when manifesting in infancy, causes severe liver enlargement, or, later in the first year, damages the hepatic and renal tubular function, leading to developmental impairment. Nitisinone (NTBC) treatment has been able to control liver dysfunction in patients and the extrahepatic manifestations of HT1. The present study aimed to eval- uate the effect of nitisinone on the clinical course of patients with tyrosinemia type 1. Methods: This prospective 10-year cohort study focused on patients with type 1 tyrosinemia referred to Shiraz Pediatric Gastroenterology Clinic between March 20, 2010, and March 20, 2018. The clinical course of patients treated with nitisinone was evaluated. Statistical analysis was performed using SPSS 20 software. Results: This study included 145 patients. The results showed clear correlation between the severity of clinical complications of tyrosinemia and the proper use of the drug. The outcome among the patients taking the medications (95%) was observed to be good in 52.6%, while 12.6% of patients were on the waiting list, 32.6% had undergone transplantation, and 2.1% passed away. On the other hand, out of 54 patients who did not take NTBC, only 12% showed good outcomes, 6% were on the waiting list, 56% had undergone transplantation, and 26% died. Conclusion: The results of this study support the role of nitisinone in decreasing the complications of type 1 tyrosinemia and improving clinical symptoms, as well as reducing mortality in these patients. Keywords tyrosinemia type 1, nitisinone (NTBC), liver transplantation, tyrosine","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84087074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}