Journal of Gastrointestinal and Liver Diseases最新文献

{"title":"Prevalence of hepatitis B and C virus infection in a Roma Population in Cluj County, Romania.","authors":"Alina Ioana Tantau, Vladimir Petru Filip, Alexandru Pasca, Vasile Marcel Tantau","doi":"10.15403/jgld-4931","DOIUrl":"https://doi.org/10.15403/jgld-4931","url":null,"abstract":"","PeriodicalId":50189,"journal":{"name":"Journal of Gastrointestinal and Liver Diseases","volume":"32 2","pages":"262-263"},"PeriodicalIF":2.1,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9668234","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":"Percutaneous CT-guided Biopsy of Focal Liver Lesions - Long- term Experience with more than 300 Procedures.","authors":"Petr Hoffmann,&nbsp;Jiri Cyrany,&nbsp;Jindrich Kopecky,&nbsp;Martina Hoffmannova,&nbsp;Pavel Ryska,&nbsp;Michal Hulek,&nbsp;Petr Dvorak","doi":"10.15403/jgld-4653","DOIUrl":"https://doi.org/10.15403/jgld-4653","url":null,"abstract":"<p><strong>Background and aims: </strong>Despite the undeniable ongoing development of cross-sectional imaging methods, not all focal liver lesions (FLLs) have a typical pattern. An image-guided biopsy using a percutaneous approach might safely provide a final histological diagnosis of the FLLs. We aimed to evaluate the accuracy, efficiency, complication rate, technical features, and relationships between the followed parameters of computed tomography (CT)-guided percutaneous biopsies of FLLs using a retrospective approach.</p><p><strong>Methods: </strong>303 percutaneous biopsy procedures in 295 patients were carried out in patients with suspected or indeterminate FLLs over a 10-year period. The median size of the tumors was 44 mm (15 - 144 mm). Median age of patients was 67 years (25 to 87 years). Skin-to-lesion distance was variable, from 30 mm to 138 mm (median length 59 mm). In 200 procedures (66%) malignant disease was known from the patients´ clinical history.</p><p><strong>Results: </strong>In 288 biopsies (95%) the results were true positive or true negative; 15 procedures (4.95%) resulted in a histologically false negative and had to be confirmed using other approaches. Metastatic disease to hepatic parenchyma of various origins was the most frequent histological diagnosis (55.4%). Cholangiocarcinoma was the most common individual result (13.5%). In total 14 complications (4.6%) were confirmed, 4 of which were severe haemorrhages that needed angiographic treatment and in one case surgical revision. The mortality rate in our group was 0.3%. A statistically significant relationship between lesion size and diagnostic accuracy (p < 0.01) was revealed. The use of a 16 G needle calibre and at least two samples were suitable for hypo- and hypervascular lesions without a significant increase in the complication rate.</p><p><strong>Conclusions: </strong>Core needle biopsy using a percutaneous approach and a CT-guidance performed on patients with indetermined FLLs had a high overall accuracy in determining the final histological diagnosis including subtyping. Concurrently, the complication incidence was low.</p>","PeriodicalId":50189,"journal":{"name":"Journal of Gastrointestinal and Liver Diseases","volume":"32 2","pages":"197-205"},"PeriodicalIF":2.1,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9675977","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":"Endoscopic Mucosal Resection of Non-pedunculated Colorectal Polyps ≥20mm: Outcome in a Self-taught Skills Environment.","authors":"Markus Casper,&nbsp;Marcin Krawczyk,&nbsp;Frank Lammert","doi":"10.15403/jgld-4756","DOIUrl":"https://doi.org/10.15403/jgld-4756","url":null,"abstract":"<p><strong>Background and aims: </strong>Endoscopic mucosal resection (EMR) of non-pedunculated colorectal polyps ≥20mm is technically demanding and should preferentially be performed by specialist endoscopists in referral centres. Little is known about the outcome in institutions establishing this competency. Here, we report the learning curve on 100 consecutive large non-pedunculated polyps resected by a single endoscopist with self-taught acquisition of skills.</p><p><strong>Methods: </strong>We analysed data on 100 non-supervised EMR procedures performed at our academic endoscopy centre (2016-2021), representing a single endoscopist's learning curve beginning with the first polyp ≥20 mm.</p><p><strong>Results: </strong>The median polyp size was 30 mm (20-70mm), and 61% of all polyps were ≥30 mm. Predominant polyp morphology was 0-Is (34%) or 0-IIa (47%), and most polyps developed in the ascending colon (36%). In total, 20% of polyps showed high-grade intraepithelial neoplasia, and 8% included pT1 carcinoma. Adenoma recurrence rate after piecemeal resection was 21%. All but one recurrent adenoma were treated endoscopically. Deep mural injury, intra-procedural bleeding and post-procedural bleeding were detected and managed endoscopically in 3%, 21%, and 4% of procedures, respectively. Overall, surgery could be avoided in 91% of all and 98% of non- malignant polyps. Results for the first 50 polyps did not differ from results for the following polyps.</p><p><strong>Conclusions: </strong>Structured training is advisable to acquire advanced EMR skills. Our data show that autonomous acquisition of skills after finishing a training course represents an acceptable alternative with good results in the setting of an open error culture. Continuous review of outcome parameters and complication rate is mandatory during the learning process.</p>","PeriodicalId":50189,"journal":{"name":"Journal of Gastrointestinal and Liver Diseases","volume":"32 2","pages":"150-155"},"PeriodicalIF":2.1,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9668232","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":"The Growing Interest in the Combined Hepatocellular-intrahepatic Cholangiocarcinoma (cHCC-CCA).","authors":"Monica Acalovschi","doi":"10.15403/jgld-5033","DOIUrl":"https://doi.org/10.15403/jgld-5033","url":null,"abstract":"Combined hepatocellularcholangiocarcinoma (cHCCCCA) is a rare primary liver cancer displaying both hepatocytic and cholangiocytic differentiation. This combined tumor has about 1% incidence among primary hepatic cancers, a more aggressive behaviour and a poorer prognosis as compared to hepatocellular carcinoma (HCC). While keeping the proportion of 1% among primary liver cancers, the cHCCCCA incidence is increasing. A systematic review and metaanalysis of 53 epidemiological studies performed both in Western and Asian countries between 2008 and 2019 demonstrated that cHHC-CCA incidence had increased in this period with an annual percentage change (APC) of + 4% as compared to HCC (APC + 2.6%) [1]. The increase occurred mainly in Western countries, whereas trends decreased in the Asian region, although still remaining high. The etiology of the combined tumor is the same as that of its components. Geographic variations in CCA incidence are related to the variations in risk factors. Classical risk factors for HCC and CCA seem also to predispose to the development of cHCC-CCA. In the context of a better control of viral B and C infections, the increased risk of primary liver cancers should probably be related to the worldwide increase in the prevalence of metabolic EDITORIAL DOI: http://dx.doi.org/10.15403/jgld-5033","PeriodicalId":50189,"journal":{"name":"Journal of Gastrointestinal and Liver Diseases","volume":"32 2","pages":"135-138"},"PeriodicalIF":2.1,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9674580","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":"Endoscopic Removal of an Embedded Fishbone in the Gastric Antrum.","authors":"Jiang Li,&nbsp;Xu Huan,&nbsp;Ma Bo-Yu,&nbsp;Shi Lei","doi":"10.15403/jgld-4940","DOIUrl":"https://doi.org/10.15403/jgld-4940","url":null,"abstract":"<p><p>This report showed the clinical manifestations of a 26-year-old patient who was admitted to our hospital with epigastric discomfort. Computed tomography (CT) showed a hyper-density linear object Esophagogastroduodenoscopy (EGD) revealed a submucosal bulge in the gastric antrum. And endoscopic ultrasonography (EUS) demonstrated a hyperechoic lesion with a posterior shadowing in the anechoic area. Based on the above results, a diagnosis of fishbone invasion into the antral submucosa was considered. Then endoscopic submucosal dissection (ESD) was performed and a 3-cm-long fishbone was extracted with the forceps. As a rare case, the imaging findings of the fishbone under the endoscopy and the computed tomography were described.</p>","PeriodicalId":50189,"journal":{"name":"Journal of Gastrointestinal and Liver Diseases","volume":"32 2","pages":"139"},"PeriodicalIF":2.1,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9674582","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":"A Novel Non-slip Banded Balloon Catheter for Endoscopic Papillary Balloon Dilation.","authors":"Tadahisa Inoue,&nbsp;Mayu Ibusuki,&nbsp;Hiromu Kutsumi","doi":"10.15403/jgld-4854","DOIUrl":"https://doi.org/10.15403/jgld-4854","url":null,"abstract":"Endoscopic papillary balloon dilation (EPBD) is an essential and established procedure for treating bile duct stones [1-3] and is especially useful over endoscopic sphincterotomy in cases involving antithrombotic agent use. A variety of EPBD balloons (length range, 30–50 mm) are currently available. However, balloon slips are often a problem interprocedurally as they require several re-expansions, resulting in unnecessary expansion and adverse events. This is especially likely to occur with shorter-length balloons. In contrast, in some cases, there is insufficient distance from the papilla and scope, or the stones are located near the papilla, such as in multiple stone accumulation cases. Endoscopic papillary balloon dilation is difficult to manage in these cases, particularly using longlength balloons. To overcome these challenges, a novel balloon catheter (RIGEL Balloon Dilatation Catheter; Japan Lifeline Co., Ltd., Tokyo, Japan) with a very short length of 15 mm and preventive function for slippage, has been developed. A 5 mm ductile band is equipped in the center of the balloon and detects delayed expansion of the central portion, leading to slippage prevention (Fig. 1). An 83-year-old man, who was using antithrombotic agents, developed obstructive jaundice with cholangitis due to choledocholithiasis. Urgent endoscopic retrograde cholangiography was performed, and biliary canulation was achieved using a wire-guided method. An 8 mm diameter novel balloon was inserted over the guidewire, and the band was located at the papilla. Then, the balloon was gradually inflated to 8 atm, with delayed expansion of the central part (Fig. 2). Full expansion was achieved without slippage (Fig. 3). After EPBD, the bile duct stone was completely removed using a retrieval basket catheter. The patient’s symptoms were improved rapidly without any adverse events. Our balloon offers a new device option for EPBD. The short balloon length and strong non-slip function simplify procedures without added disadvantages.","PeriodicalId":50189,"journal":{"name":"Journal of Gastrointestinal and Liver Diseases","volume":"32 2","pages":"142"},"PeriodicalIF":2.1,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9675972","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":"Endoscopic Papillary Balloon Dilation Can Be Safely Performed in Patients on Dual Antiplatelet Therapy: A Pilot Study.","authors":"Sakue Masuda,&nbsp;Ryuhei Jinushi,&nbsp;Kazuya Koizumi,&nbsp;Makomo Makazu,&nbsp;Takashi Nishino,&nbsp;Kento Shionoya,&nbsp;Karen Kimura,&nbsp;Chihiro Sumida,&nbsp;Jun Kubota,&nbsp;Chikamasa Ichita,&nbsp;Akiko Sasaki,&nbsp;Masahiro Kobayashi,&nbsp;Makoto Kako,&nbsp;Haruki Uojima,&nbsp;Ayumu Sugitani","doi":"10.15403/jgld-4764","DOIUrl":"https://doi.org/10.15403/jgld-4764","url":null,"abstract":"<p><strong>Background and aims: </strong>Endoscopic papillary balloon dilation (EPBD), a low-risk procedure for bleeding, has been suggested as an alternative to endoscopic sphincterotomy for papillary dilatation in patients undergoing endoscopic stone removal who are at a higher risk of bleeding. Several guidelines recommend that combination of two antiplatelet agents should be reduced to single antiplatelet therapy when endoscopic sphincterotomy is performed. However, there is no evidence that EPBD affects the risk of bleeding in patients receiving a combination of two antiplatelet agents; thus, we aimed to explore this problem.</p><p><strong>Methods: </strong>We included 31 patients who underwent EPBD for common bile duct stones at our hospital from May 2014 to August 2022 and received either a combination of two antiplatelet agents or single antiplatelet therapy prior to the procedure. The group receiving a combination of two antiplatelet agents included patients who underwent EPBT without antiplatelet therapy withdrawal or with a shorter withdrawal period than those recommended by the guidelines.</p><p><strong>Results: </strong>In the group that received a combination of two antiplatelet agents, one of the two antiplatelet agents used was thienopyridine. No bleeding was observed after EPBD in this study. We did not find any significant between-group differences in hemoglobin levels and rate of post-endoscopic retrograde cholangiopancreatography pancreatitis.</p><p><strong>Conclusions: </strong>In patients treated with a combination of two antiplatelet agents, EPBD could be safely performed without bleeding. Therefore, future prospective studies are warranted.</p>","PeriodicalId":50189,"journal":{"name":"Journal of Gastrointestinal and Liver Diseases","volume":"32 2","pages":"216-221"},"PeriodicalIF":2.1,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9675979","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":"Combined endoscopic EUS-guided cystogastrostomy and laparoscopic cholecystectomy: two birds with one stone.","authors":"Dario Gambaccini,&nbsp;Luigi Ruggiero,&nbsp;Piero Vincenzo Lippolis,&nbsp;Emanuele Marciano","doi":"10.15403/jgld-4633","DOIUrl":"https://doi.org/10.15403/jgld-4633","url":null,"abstract":"","PeriodicalId":50189,"journal":{"name":"Journal of Gastrointestinal and Liver Diseases","volume":"32 2","pages":"265-266"},"PeriodicalIF":2.1,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9675973","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":"Activated Hepatic Stellate Cells (Ito Cells) - Marker of Advanced Fibrosis in Chronic Viral Hepatitis C: A Pilot Study.","authors":"Rada Teodora Sufletel,&nbsp;Carmen Stanca Melincovici,&nbsp;Olga Hilda Orășan,&nbsp;Toader Zaharie,&nbsp;Bogdan Alexandru Gheban,&nbsp;Alexandru Istrate,&nbsp;Anne-Marie Constantin,&nbsp;Carmen Mihaela Mihu","doi":"10.15403/jgld-4726","DOIUrl":"https://doi.org/10.15403/jgld-4726","url":null,"abstract":"<p><strong>Background and aims: </strong>The aim of this study is to determine whether activated hepatic stellate cells (HSCs) may represent a prognostic marker of progressive liver fibrosis in chronic viral hepatitis C (VHC) before antiviral therapy. The possible correlation between HSCs immunohistochemical features, histopathological aspects and clinical data before therapy were also studied.</p><p><strong>Methods: </strong>This retrospective pilot study was conducted on 27 liver biopsies from VHC patients before antiviral therapy. HSCs's immunohistochemical analysis used the antibodies alpha-smooth muscle actin (α-SMA), glial fibrillary acidic protein (GFAP) and vinculin. We correlated immunopositive HSCs with HCV load, liver stiffness (LS), fibrosis stage and necro-inflammatory degree before treatment. Also, we assessed the association between liver fibrosis after therapy, the sustained virological response at 12 weeks after therapy (SVR 12) and the type of therapy.</p><p><strong>Results: </strong>HSCs were increased in VHC patients compared to controls, mainly in the intermediate and periportal lobular regions. α-SMA and vinculin HSCs correlated positively with fibrosis stage (p=0.044), (p=0.028). Furthermore, α-SMA and vinculin HSCs were associated with LS (p=0.027), (p=0.002) and viral load (p=0.021), (p=0.006), but not with necro-inflammation degree. GFAP HSCs inversely correlated with fibrosis stage (r= -0.475), LS (r= -0.422) and HCV load (r= -0.517), but positively with necro-inflammation degree (p=0.038). Liver fibrosis post therapy correlated positively with SVR12 (p<0.001) and the type of therapy (p=0.006) and SVR12 correlated positively with treatment's type (p=0.002).</p><p><strong>Conclusions: </strong>Activated HSCs may represent a marker of increased liver fibrosis in VHC. Different immunohistochemical markers can detect various HSCs subpopulations involved in the evolution of VHC and liver fibrosis.</p>","PeriodicalId":50189,"journal":{"name":"Journal of Gastrointestinal and Liver Diseases","volume":"32 2","pages":"170-181"},"PeriodicalIF":2.1,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9675974","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":"Factors Affecting Performance of DNA Methylation as a Potential Biomarker in Ascites for Peritonitis and Peritoneal Carcinomatosis.","authors":"Katrin Bose,&nbsp;Florian G Scurt,&nbsp;Cosima Thon,&nbsp;Sabine Franke,&nbsp;Christain Schulz,&nbsp;Peter Malfertheiner,&nbsp;Alexander Link","doi":"10.15403/jgld-4710","DOIUrl":"https://doi.org/10.15403/jgld-4710","url":null,"abstract":"<p><strong>Background and aims: </strong>Despite limited sensitivity, the gold standard for the diagnosis of malignant cells in ascites is still cytology. The aim of this prospective proof-of-principle study was to evaluate DNA methylation as a molecular tool for the differential diagnosis of benign and malignant ascites.</p><p><strong>Methods: </strong>A cohort of 79 patients with malignant and non-malignant ascites was prospectively enrolled. Ascites was assessed by cytopathological and laboratory examination. Cell pellets obtained by centrifugation were analyzed for differences in DNA methylation of of long interspersed nuclear element-1 (LINE-1) and microRNA-137. Quantitative determination of methylation in bisulfite-converted DNA was performed by pyrosequencing. In a subsequent stage, we compared our data to previously published data in the field following systematic review of the literature.</p><p><strong>Results: </strong>Methylation status of studied LINE-1 and microRNA-137 could be reliably detected in all samples. Systematic evaluation revealed reliable reproducibility with satisfactory short- and long-term stability against degradation. Ascites from patients with a malignancy had a significantly higher methylation level of microRNA-137 compared with patients without tumor disease, whereas patients with peritonitis had significantly decreased methylation of microRNA-137. In contrast, differences in the measurement of the methylation status of LINE-1 could only be detected between patients with portal hypertension and a combination of malignant and infectious ascites. Inflammatory cells reflecting peritonitis correlated to DNA methylation changes.</p><p><strong>Conclusions: </strong>Analysis of DNA methylation in ascites is technically feasible, well reproducible and may lead to identification of potential biomarkers for peritoneal carcinomatosis and other conditions. Inflammatory cells due to peritonitis may also be associated with DNA methylation changes and need to be considered in future studies. Profiling studied under standardized conditions will be needed to identify the appropriate biomarkers for differential diagnosis of ascites.</p>","PeriodicalId":50189,"journal":{"name":"Journal of Gastrointestinal and Liver Diseases","volume":"32 2","pages":"206-215"},"PeriodicalIF":2.1,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9675978","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}