JGH Open最新文献

{"title":"Conventional Upper-Intestinal Endoscopy Value in Predicting Histopathological Features Related to <i>Helicobacter pylori</i> Infection: A Comparative Study Between Endoscopy and Histology Findings Among Dyspeptic Outpatients in Cameroon.","authors":"Laure Brigitte Kouitcheu Mabeku, Lionel Danny Tali Nguefak, Ghislaine Florice Faujo Nintewoue, Stanley Ngimgoh Ngemeshe, Jude-Marcel Nzoume Nsope Mengang, Ghislaine Ngatcha, Carole Marlyse Menzy Moungo-Ndjole, Paul Talla","doi":"10.1002/jgh3.70222","DOIUrl":"10.1002/jgh3.70222","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to determine the prevalence of <i>Helicobacter pylori</i> in relation to endoscopic and histopathology features and to find out the correlation between the two diagnostic methods.</p><p><strong>Methods: </strong>Gastroduodenal biopsy specimens were collected from 475 dyspeptic outpatients who attended the Department of Gastroenterology in reference hospitals in Cameroon. The study was approved by the local and national ethical committees on human health research in Cameroon. Informed consent was obtained from all subjects before inclusion. A full endoscopic evaluation of the esophagus, stomach, and duodenum was performed in all patients. Biopsy samples were collected from each participant for <i>H. pylori</i> detection using histology and rapid urease test. Hematoxylin and eosin stain was used for histomorphological features examination.</p><p><strong>Results: </strong><i>Helicobacter pylori</i> was found in 57.89% of the dyspeptic outpatients. In endoscopy, 40.00% of our patients had gastritis, of which 58.42% were <i>H. pylori</i> infected. Erythematous-exudative gastritis was the most common gastritis type (46.00%) and also the most common gastritis type found among <i>H. pylori</i>-infected subjects (43.1%). Histologically, chronic gastritis was the most common histological finding recorded (46.11%) and the abnormality with the highest rate of <i>H. pylori</i> infection (44.00%). The highest rate of <i>H. pylori</i> infection was found among patients with moderate neutrophil activity (46.18%). Gastritis types were significantly correlated with histological findings (<i>p</i> = 0.016). Endoscopic findings were significantly correlated with neutrophil activity (<i>p</i> = 0.0005).</p><p><strong>Conclusion: </strong>The current poor correlation observed between endoscopy and histology findings emphasizes the role of histology in the diagnosis of gastroduodenal pathological features in dyspeptic patients in our context.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 8","pages":"e70222"},"PeriodicalIF":1.5,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12329001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dose Performing Multiple Biopsy Strokes From the Same Site Improve Specimen Adequacy in Cholangioscopy-Guided Mapping Biopsy for Extrahepatic Cholangiocarcinoma?","authors":"Takahisa Ogawa,&nbsp;Yoshihide Kanno,&nbsp;Shinsuke Koshita,&nbsp;Hiroaki Kusunose,&nbsp;Toshitaka Sakai,&nbsp;Keisuke Yonamine,&nbsp;Kazuaki Miyamoto,&nbsp;Fumisato Kozakai,&nbsp;Haruka Okano,&nbsp;Kento Hosokawa,&nbsp;Hidehito Sumiya,&nbsp;Yutaka Noda,&nbsp;Kei Ito","doi":"10.1002/jgh3.70246","DOIUrl":"https://doi.org/10.1002/jgh3.70246","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Cholangioscopy-guided mapping biopsy (CMB) is performed for preoperative evaluation of extrahepatic cholangiocarcinoma. The aim of this study was to evaluate the usefulness of CMB using a SpyBite Max and to determine the effectiveness of multiple biopsy strokes from the same site.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Between August 2020 and October 2022, 21 patients with extrahepatic cholangiocarcinoma were enrolled in this prospective observational study. The primary outcome was the rate of site-based successful biopsies, which was defined as the acquisition of epithelium-containing material appropriate for diagnosing benignity/malignancy from each site. The cumulative success rate of obtaining appropriate materials increased by increasing biopsy strokes from 1 to 4.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cholangioscope could be advanced to all 80 target sites. The overall adequate specimen rate was 67% (142/212). The overall rate of site-based successful biopsies was 83% (66/80). The cumulative success rate of obtaining appropriate materials did not significantly improve by increasing the number of biopsy strokes from 1 (81%) to 4 (86%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The biopsy material was obtained for 83% of the required sites. However, repetitive biopsy strokes for the same site did not improve the rate of site-based successful biopsy. This study was registered in UMIN (UMIN000041530).</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70246","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144782703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Management of Bouveret's Syndrome in an Elderly Patient: A Case Report","authors":"Meng Zhang,&nbsp;Ya-Nan Sun,&nbsp;Feng Gao,&nbsp;Yong Sun,&nbsp;Wen Jia,&nbsp;Jian-Feng Huo,&nbsp;Jiang-Ning Gu,&nbsp;Zhuo Yang","doi":"10.1002/jgh3.70251","DOIUrl":"https://doi.org/10.1002/jgh3.70251","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Bouveret syndrome, a rare complication of cholelithiasis, is nonspecific symptoms and high mortality rates, with no established standard treatment. Here, we detail a case of effective endoscopic intervention in an elderly patient.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 91-year-old female patient who presented with a one-month history of nausea, vomiting, and significant abdominal distension. An abdominal CT scan revealed a biliary-enteric fistula, pneumobilia, gallstones, a calcified mass in the horizontal portion of the duodenum, and gastric dilatation. Endoscopic examination confirmed the presence of a biliary-enteric fistula and a large impacted gallstone in the duodenum. The patient subsequently underwent endoscopic lithotripsy and gallstone extraction, which successfully alleviated her symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The endoscopic management of Bouveret syndrome in elderly patients is both safe and efficacious. Clinicians should maintain suspicion for this uncommon condition when managing cholelithiasis patients presenting with signs of intestinal obstruction, emphasizing the significance of prompt intervention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70251","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144773631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Test Accuracy of Cytosponge-Trefoil Factor 3 for Barrett Esophagus: A Systemic Review and Meta Analysis","authors":"Muhammad Talha Kakar,&nbsp;Aadarsh Kumar Ramani,&nbsp;Akshay Kumar,&nbsp;Amar Lal,&nbsp;Dileep Kumar Lohana,&nbsp;F. N. U. Radhika,&nbsp;Adil Mushtaq,&nbsp;Sanam Shaikh,&nbsp;Rabia Kamran,&nbsp;Jaya Kumari,&nbsp;Muhammad Burhan,&nbsp;Mohammad Jawwad,&nbsp;Hira Riaz","doi":"10.1002/jgh3.70248","DOIUrl":"https://doi.org/10.1002/jgh3.70248","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Barrett's esophagus (BE), characterized by the replacement of normal esophageal squamous epithelium with columnar metaplasia, poses a risk of progression to esophageal adenocarcinoma. Early detection is essential to prevent malignant transformation. The Cytosponge, a novel, minimally invasive cell collection device, has been proposed as a diagnostic tool for BE by identifying trefoil factor 3 (TFF3)-positive cells. This meta-analysis evaluates the diagnostic accuracy of the Cytosponge technique for detecting BE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic literature search was performed using PubMed and Web of Science for studies published up to May 2024. Two reviewers independently screened studies, extracted data, and assessed the risk of bias using the QUADAS-2 tool. A bivariate random-effects model was used to estimate pooled sensitivity, specificity, and diagnostic odds ratio (DOR) with 95% confidence intervals (CIs). Summary receiver operating characteristic (SROC) curves were generated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six studies comprising 3438 participants were included. For detecting BE with circumferential length &gt; 1 cm (C1), pooled sensitivity and specificity were 0.75 (95% CI: 0.70–0.79) and 0.88 (95% CI: 0.76–0.94), respectively, with an area under the SROC curve (AUC) of 0.80 (0.77–0.84). For any circumferential length of metaplasia, sensitivity and specificity were 0.81 (95% CI: 0.76–0.85) and 0.89 (95% CI: 0.82–0.93), with an AUC of 0.90 (0.87–0.92).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The Cytosponge demonstrates high diagnostic accuracy for detecting BE, especially for any length of metaplasia. Further large-scale studies are warranted to validate its routine clinical use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70248","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144767358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics, Interventions and Adverse Outcomes of Acute Lower Gastrointestinal Bleeding: A Cohort Study Conducted in Vietnam","authors":"An Qui Thien Hoang,&nbsp;Thong Duy Vo","doi":"10.1002/jgh3.70249","DOIUrl":"https://doi.org/10.1002/jgh3.70249","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Despite medical advances, the incidence of acute lower gastrointestinal bleeding (ALGIB) is gradually increasing in Asia and Vietnam, with many cases being severe. However, recent data on clinical features, interventions, and outcomes in Vietnam remain limited. This study aims to characterize the presentation, treatment, and outcomes of ALGIB in Vietnamese patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A retrospective and prospective cohort study was conducted on 222 patients aged 18 years and older with ALGIB at the Department of Gastroenterology, University Medical Center Ho Chi Minh City. Clinical characteristics, interventions, and adverse outcomes were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 222 patients were included in the study, with a female-to-male ratio of 1.02 and a mean age of 63.7 years. Among them, 85.6% were admitted with symptoms of bright red blood per rectum, maroon-colored stool, or stool with clots. The most common causes of acute lower gastrointestinal bleeding were hemorrhoids (20.7%) and colonic diverticulosis (20.3%). The rates of blood transfusion, endoscopic intervention, radiologic intervention, and surgery were 38.7%, 19.4%, 2.7%, and 2.7%, respectively. Severe lower gastrointestinal bleeding was observed in 59 patients (26.6%). There were two in-hospital deaths (0.9%), one related to underlying comorbidities and one due to persistent, uncontrollable bleeding.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Hemorrhoids were the most common cause of acute lower gastrointestinal bleeding. The rates of blood transfusion, endoscopic intervention, radiologic intervention, and surgery were 38.7%, 19.4%, 2.7%, and 2.7%, respectively. Overall, 26.6% of cases progressed to severe lower gastrointestinal bleeding.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70249","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144751290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation of Point-of-Care Intestinal Ultrasound With Endoscopic Disease Severity in Crohn's Disease","authors":"Kayal Vizhi Nagarajan,&nbsp;Anupama Nagar Krishnamurthy,&nbsp;Amit Yelsangikar,&nbsp;Nikhil Patil,&nbsp;Rishabh Agarwal,&nbsp;Supriya Indi,&nbsp;Anand Bang,&nbsp;Shravani Reddy,&nbsp;Vinay Bhat,&nbsp;Naresh Bhat","doi":"10.1002/jgh3.70231","DOIUrl":"https://doi.org/10.1002/jgh3.70231","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Intestinal ultrasound is increasingly being used in the management of patients with inflammatory bowel disease (IBD). We aim to evaluate the accuracy of intestinal ultrasound in a point-of-care setting in India and compare it with ileo-colonoscopy, the current gold standard.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this prospective observational study, consecutive patients with a diagnosis of Crohn's disease seen at initial presentation or follow-up were included. At the out-patient visit, clinical severity and biomarkers were documented, and point-of-care intestinal ultrasound was performed. Colonoscopy was performed within 1 week for all patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 254 patients with Crohn's disease who underwent ileo-colonoscopy were included in the study. The mean bowel wall thickness (BWT) in patients with normal endoscopy (SES-CD &lt; 2) was 2.09 mm. The mean BWT in patients with mild, moderate to severe, and severe disease activity was 4.7, 5.23, and 6.25 mm, respectively. A threshold of 3.4 mm had the best ability to predict the presence of endoscopic disease activity, with a sensitivity of 93%, specificity of 90%, and AUC of 0.96 in this study. The presence of color Doppler signals had a sensitivity of 96.3% and specificity of 91.2% to predict the presence of endoscopic disease activity. Inflammatory fat and bowel wall stratification (BWS) had a higher odds ratio to predict more severe disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Point-of-care—intestinal ultrasound has good correlation with ileocolonoscopy and can be utilized to assess and monitor disease activity, which should facilitate real-time decision making in the management of patients with IBD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70231","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144740505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refractory Ascites in Patients With Cirrhosis","authors":"Madhumita Premkumar","doi":"10.1002/jgh3.70245","DOIUrl":"https://doi.org/10.1002/jgh3.70245","url":null,"abstract":"<p>Recurrent ascites refers to fluid accumulation in the abdomen that returns at least three times per year, despite dietary sodium restriction and diuretic treatment. It may precede the development of refractory ascites (RA). RA is characterized by ascites that cannot be resolved or whose early recurrence (after large volume paracentesis [LVP]) is not prevented by medical therapy [<span>1</span>]. RA is typically classified as either diuretic resistant or diuretic intolerant.</p><p>Management of RA includes ongoing sodium restriction with regular monitoring, frequent LVP, ≥ 5 L combined with infusion to prevent paracentesis-induced circulatory dysfunction, and possibly albumin infusions outside of paracentesis. For RA patients who do not respond to diuretics or experience significant side effects at maximum doses, alternative treatments should be considered, as further use increases complications without benefit. In the ANSWER study, Caraceni et al. [<span>2</span>] reported that long-term human albumin therapy improved overall survival in cirrhosis patients with uncomplicated ascites compared to standard treatment. Tolvaptan has been used as adjunctive therapy in patients with hyponatremia and RA [<span>3, 4</span>]. In suitable patients with preserved liver function, a covered, smaller-diameter transjugular-intrahepatic portosystemic shunt (TIPS) can improve quality of life and survival post-ascites clearance. Patients with RA are also likely to have recurrent episodes of hepatorenal syndrome-acute kidney injury (HRS-AKI) [<span>5</span>] and also cirrhotic cardiomyopathy (CCM) [<span>6</span>], which in turn impairs the health-related quality of life (HRQoL). For patients with RA who cannot undergo liver transplantation (LT) or TIPS, LVP and albumin infusion are the only treatments [<span>7</span>]. Future options may include automated low-flow ascites pumps [<span>8</span>].</p><p>LVPs are often needed weekly or fortnightly, straining hospital resources and causing unplanned admissions that reduce quality of life (QoL) and increase costs. Also, LVPs require point-of-care ultrasound guidance [<span>9</span>] to minimize the risks of bleeding [<span>10</span>] and infection.</p><p>Regular home drainage could prevent these frequent hospitalizations. As ascites drainage is palliative in patients unsuitable for LT, it should follow palliative care principles [<span>11</span>]. Indwelling catheters, commonly used in malignant ascites and hydrothorax, offer a viable care model.</p><p>In this issue of JGHOpen, Ramachandran et al. [<span>12</span>] describe the palliative impact of long-term abdominal drain (LTAD) insertion in patients with RA. Fifty-one cirrhosis patients with RA were screened; 7 underwent LT, 6 chose TIPS, and 12 had drains inserted for analysis. Six deaths occurred; none related to LTAD. All participants preferred LTAD over LVPs and were highly satisfied. Of the four who completed 6 months, three continued LTAD; the fourth had imp","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70245","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144751678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prophylactic Biliary Stenting After Stone Clearance Improves the Safety of Needle-Knife Fistulotomy: A Propensity Score-Matched Analysis","authors":"Amir Sadeghi,&nbsp;Erfan Arabpour,&nbsp;Mohammad Abdehagh,&nbsp;Mohammad Reza Zali","doi":"10.1002/jgh3.70244","DOIUrl":"https://doi.org/10.1002/jgh3.70244","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Needle-knife fistulotomy is an advanced technique for gaining biliary access in endoscopic retrograde cholangiopancreatography (ERCP). This study assesses the hypothesis of whether biliary stenting after needle-knife fistulotomy could improve the safety of the ERCP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review of the medical records of patients who referred for ERCP between 2021–2024 was performed. All patients with naïve papilla and choledocholithiasis who underwent needle-knife fistulotomy were included in the study. Patients were categorized into the two groups of with and without biliary stent.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 402 included patients, 331 had successful stone extraction, among whom 50 (15.1%) and 281 (84.9%) recieved and not received a biliary stent, respectively. After 1:4 propensity score matching, age, sex, difficult cannulation, and pancreatic duct cannulation were comparable between the groups (<i>p</i> &gt; 0.05). Patients with biliary stent had a borderline significant lower rate of post-ERCP pancreatitis (2.3% vs. 13.1%, <i>p</i> = 0.054). No delayed perforation was observed in either groups. There were no significant differences in cholangitis and bleeding between the groups (<i>p</i> &gt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This is the first study investigating the impact of prophylactic biliary stenting after needle-knife fistulotomy, suggesting that prophylactic biliary stenting after needle-knife fistulotomy and successful stone removal may improve the safety of ERCP by reducing the rate of post-ERCP pancreatitis. Further large-scale prospective studies are warranted to validate these findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70244","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144740435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Polymerase Proofreading-Associated Polyposis: Challenges in Genetic Diagnosis","authors":"Haruka Ito,&nbsp;Akiko Chino,&nbsp;Arisa Ueki,&nbsp;Keika Kaneko,&nbsp;Shoichi Saito","doi":"10.1002/jgh3.70240","DOIUrl":"https://doi.org/10.1002/jgh3.70240","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Polymerase proofreading-associated polyposis (PPAP) is a rare autosomal dominant hereditary syndrome caused by germline pathogenic variants in the POLE or POLD1 genes. It is clinically similar to familial adenomatous polyposis (FAP) and Lynch syndrome, making diagnosis difficult. Although the number of reported cases is increasing globally, PPAP remains underrecognized, particularly in Japan. Accurate diagnosis often requires comprehensive genetic testing, including multi-gene panel analysis and variant reinterpretation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>We report a rare case of PPAP in a 50-year-old woman with a complex clinical history involving multiple primary malignancies. The patient developed ovarian cancer in her 20s, followed by endometrial and contralateral ovarian cancers in her 30s. She was also diagnosed with early-stage colorectal cancer and polyposis, for which she underwent total colectomy with ileorectal anastomosis. Initially, she was suspected to have FAP or Lynch syndrome, but genetic testing revealed no pathogenic variants in APC, MUTYH, or mismatch repair genes. Subsequent multi-gene panel testing identified a POLE variant of uncertain significance (VUS), which was later reclassified as likely pathogenic. Based on this reinterpretation and her clinical phenotype, a diagnosis of PPAP was made. Her disease course included recurrent rectal polyps and carcinoma after colectomy, as well as breast cancer. No upper gastrointestinal polyposis was observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case represents one of the few reported instances of PPAP in Japan and illustrates the diagnostic complexity of hereditary polyposis syndromes. It highlights the critical role of multi-gene panel testing and the importance of variant reinterpretation in establishing a definitive diagnosis. Continued surveillance and multidisciplinary care are essential for managing patients with PPAP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70240","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144725529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of 10-Day Minocycline Twice Daily in Bismuth-Containing Quadruple Therapy as the First-Line Treatment of Helicobacter pylori Infection: A Prospective Single-Arm Study","authors":"Peiwei Li,&nbsp;Yan Li,&nbsp;Yan Chen,&nbsp;Cheng Fang,&nbsp;Qin Du,&nbsp;Yuehua Han","doi":"10.1002/jgh3.70233","DOIUrl":"https://doi.org/10.1002/jgh3.70233","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Tetracycline has limited clinical application in <i>Helicobacter pylori</i> treatment because of difficulty in obtaining and increased adverse reactions. As a semisynthetic tetracycline, minocycline has demonstrated good potential for eradicating <i>H. pylori</i> infection. This study aimed to evaluate the efficacy and safety of 10-day minocycline-based quadruple therapy for <i>H. pylori</i> first-line treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this prospective trial, treatment-naïve adults with <i>H. pylori</i> infection received eradication therapy with rabeprazole 10 mg, minocycline 100 mg, amoxicillin 1000 mg, and bismuth potassium citrate 220 mg each given twice a day for 10 days. The primary outcome was the eradication rate. The secondary outcome was adverse effects. Eradication was confirmed by a negative urea breath test at least 6 weeks after the end of therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 133 patients were included in the study. All of the patients completed the course of medication. We found that 10-day minocycline-amoxicillin quadruple therapy achieved an eradication rate of 83.5% (111/133, 95% CI 80.3%–86.7%) in intention-to-treat analysis and 90.2% (111/123, 95% CI 87.6%–92.8%) in per-protocol analysis. The treatment-emergent adverse events (TEAEs) were 15% (20/133), with the most common adverse event being dizziness (14/133, 10.5%). No severe adverse event was observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Ten-day minocycline-amoxicillin twice daily in bismuth-containing quadruple therapy appears to be effective and safe for naïve <i>H. pylori</i> patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 8","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70233","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144716902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}