Current Opinion in Gastroenterology最新文献_第3页

My approach to managing the acute endoscopic perforation. 我处理急性内窥镜穿孔的方法。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-09-01 Epub Date: 2025-06-04 DOI: 10.1097/MOG.0000000000001114

Kasenee Tiankanon, Saowanee Ngamruengphong

引用次数: 0

Gastrointestinal endoscopy: keeping up with the times. 胃肠内镜：与时俱进。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-09-01 Epub Date: 2025-08-07 DOI: 10.1097/MOG.0000000000001117

Anthony Kalloo

引用次数: 0

Hypertriglyceridemic pancreatitis: perspectives from China. 高甘油三酯血症性胰腺炎：来自中国的观点。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-09-01 Epub Date: 2025-07-17 DOI: 10.1097/MOG.0000000000001123

Zhengyang Fan, Jianing Li, Dong Wu

{"title":"Hypertriglyceridemic pancreatitis: perspectives from China.","authors":"Zhengyang Fan, Jianing Li, Dong Wu","doi":"10.1097/MOG.0000000000001123","DOIUrl":"10.1097/MOG.0000000000001123","url":null,"abstract":"Purpose of review: This review aims to summarize the recent developments in hypertriglyceridemic acute pancreatitis (HTG-AP) research in China, focusing on its increasing prevalence, pathophysiology, prognosis, and novel treatment strategies, emphasizing the relevance of these findings in clinical practice and research.Recent findings: Recent studies have highlighted a rising incidence of HTG-AP in China, especially among young males, linked to dietary and lifestyle changes. Key research has identified lipoprotein metabolism abnormalities and genetic factors as predictors of recurrence. Advances in treatment include the combination of low-molecular-weight heparin, insulin, and plasma exchange, showing improved outcomes compared to traditional methods. Additionally, the use of traditional Chinese medicine has shown promise in managing inflammation and improving patient recovery.Summary: These findings emphasize the importance of early diagnosis, personalized treatment strategies, and integrated approaches in managing HTG-AP. Chinese research has made significant strides in understanding the pathophysiology and treatment of HTG-AP, which may influence both national healthcare strategies and global management of the condition.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"348-354"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pancreatic duct calculi: pathophysiology and management. 胰管结石：病理生理及处理。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-09-01 Epub Date: 2025-07-14 DOI: 10.1097/MOG.0000000000001125

Nikhil Bush, Manu Tandan

{"title":"Pancreatic duct calculi: pathophysiology and management.","authors":"Nikhil Bush, Manu Tandan","doi":"10.1097/MOG.0000000000001125","DOIUrl":"10.1097/MOG.0000000000001125","url":null,"abstract":"Purpose of review: Pancreatic ductal calculi (PDC) are a defining feature of chronic pancreatitis and contribute significantly to morbidity through pain and ductal obstruction. This review provides a timely update on the evolving understanding of PDC pathogenesis and highlights current and emerging strategies for their management.Recent findings: Stone formation in chronic pancreatitis is multifactorial, involving altered pancreatic juice composition, reduced lithostatic proteins, genetic predispositions, and environmental risk factors such as alcohol and smoking. Advances in endoscopic techniques, particularly the combination of extracorporeal shock wave lithotripsy (ESWL) and endoscopic retrograde cholangiopancreatography (ERCP), have improved ductal clearance and symptom control. Pancreatoscopy-guided lithotripsy is gaining traction in complex cases. Surgical options such as longitudinal pancreatojejunostomy and head resection remain vital in patients with extensive disease or failed endoscopic therapy, with evidence supporting superior long-term pain relief when performed early.Summary: Management of PDC requires a multidisciplinary, personalized approach. Endoscopic therapy is the first-line intervention in most cases, while surgery offers durable benefits in select patients. Future directions include identifying biomarkers for early intervention, refining patient selection, and exploring pharmacological strategies to prevent stone formation and recurrence.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"355-360"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evolving techniques in the endoscopic evaluation and management of pancreas cystic lesions. 胰腺囊性病变的内镜评估和治疗技术的发展。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-09-01 Epub Date: 2025-07-16 DOI: 10.1097/MOG.0000000000001119

Tassiana Maloof, Fred Karaisz, Ahmed Abdelbaki, Karthic Drishna Perumal, Somashekar G Krishna

{"title":"Evolving techniques in the endoscopic evaluation and management of pancreas cystic lesions.","authors":"Tassiana Maloof, Fred Karaisz, Ahmed Abdelbaki, Karthic Drishna Perumal, Somashekar G Krishna","doi":"10.1097/MOG.0000000000001119","DOIUrl":"10.1097/MOG.0000000000001119","url":null,"abstract":"Purpose of review: Accurate diagnosis of pancreatic cystic lesions (PCLs) is essential to guide appropriate management and reduce unnecessary surgeries. Despite multiple guidelines in PCL management, a substantial proportion of patients still undergo major resections for benign cysts, and a majority of resected intraductal papillary mucinous neoplasms (IPMNs) show only low-grade dysplasia, leading to significant clinical, financial, and psychological burdens. This review highlights emerging endoscopic approaches that enhance diagnostic accuracy and support organ-sparing, minimally invasive management of PCLs.Recent findings: Recent studies suggest that endoscopic ultrasound (EUS) and its accessory techniques, such as contrast-enhanced EUS and needle-based confocal laser endomicroscopy, as well as next-generation sequencing analysis of cyst fluid, not only accurately characterize PCLs but are also well tolerated and cost-effective. Additionally, emerging therapeutics such as EUS-guided radiofrequency ablation (RFA) and EUS-chemoablation are promising as minimally invasive treatments for high-risk mucinous PCLs in patients who are not candidates for surgery.Summary: Accurate diagnosis of PCLs remains challenging, leading to many patients undergoing unnecessary surgery. Emerging endoscopic imaging biomarkers, artificial intelligence analysis, and molecular biomarkers enhance diagnostic precision. Additionally, novel endoscopic ablative therapies offer safe, minimally invasive, organ-sparing treatment options, thereby reducing the healthcare resource burdens associated with overtreatment.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"339-347"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12313136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Updates in endoscopic management of pain in chronic pancreatitis. 慢性胰腺炎疼痛的内镜治疗进展。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-09-01 Epub Date: 2025-07-14 DOI: 10.1097/MOG.0000000000001120

Anthony M Rainho, Owen C Battel, Vanessa M Shami

{"title":"Updates in endoscopic management of pain in chronic pancreatitis.","authors":"Anthony M Rainho, Owen C Battel, Vanessa M Shami","doi":"10.1097/MOG.0000000000001120","DOIUrl":"10.1097/MOG.0000000000001120","url":null,"abstract":"Purpose of review: This manuscript reviews recent updates on the management of pain in chronic pancreatitis, an entity that remains difficult to manage. In a time when opioid use disorder is on the rise, advanced endoscopists should be aware of the nonopioid options available to patients to help manage their pain.Recent findings: Although there is no standardized approach in the management of pain in chronic pancreatitis, societal guidelines and recommendations have recently been updated to help guide physicians in this matter. However, the available endoscopic approaches have remained relatively unchanged in recent years. Studies are underway to determine whether one endoscopic approach is superior to another, depending on the suspected mechanism of pain.Summary: Endoscopic management of pain in chronic pancreatitis remains challenging given the complex mechanisms at play. Surgery remains the most effective durable approach, though with significantly more morbidity and mortality compared to endoscopic options, which include endoscopic retrograde cholangiopancreatography (ERCP), extracorporeal shock wave lithotripsy (ESWL), pancreatoscopy-directed lithotripsy, and endoscopic ultrasound-guided celiac plexus block (EUS-CPB), depending on the predominant suspected cause of pain.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"290-297"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Idiopathic recurrent acute pancreatitis: current and future approaches to management. 特发性复发性急性胰腺炎：当前和未来的管理方法。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-09-01 Epub Date: 2025-07-11 DOI: 10.1097/MOG.0000000000001122

Pranjal Singh, Soumya Jagannath Mahapatra, Pramod Kumar Garg

{"title":"Idiopathic recurrent acute pancreatitis: current and future approaches to management.","authors":"Pranjal Singh, Soumya Jagannath Mahapatra, Pramod Kumar Garg","doi":"10.1097/MOG.0000000000001122","DOIUrl":"10.1097/MOG.0000000000001122","url":null,"abstract":"Purpose of review: Idiopathic recurrent acute pancreatitis (IRAP) is a clinically relevant condition with a high likelihood of progression to chronic pancreatitis (CP) in 20-50% of patients. This review outlines the importance of early diagnosis of IRAP and potential upcoming therapies to halt disease progression. It highlights a potential therapeutic window in the natural history of IRAP.Recent findings: Despite advancements in diagnostic modalities, identifying a definitive aetiology remains challenging in a significant proportion of cases. Current approaches emphasize structured, stepwise evaluation including metabolic, genetic, and structural factors. Emerging therapies aim to target inflammation, trypsin activation, and pancreatic fibrosis.Summary: While diagnostic tools have improved, therapeutic options remain limited in IRAP. Early identification of modifiable risk factors, use of advanced imaging, and application of evolving treatment strategies may offer an opportunity to prevent the transition from IRAP to CP. Future research must focus on validating disease-modifying treatments and optimizing individualized management strategies.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"361-368"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Key updates in Crohn's disease surgery for the gastroenterologist in 2025. 2025年胃肠病学家克罗恩病手术的关键更新。

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-07-01 Epub Date: 2025-05-02 DOI: 10.1097/MOG.0000000000001102

Gassan Kassim, Stefan D Holubar, Benjamin L Cohen

{"title":"Key updates in Crohn's disease surgery for the gastroenterologist in 2025.","authors":"Gassan Kassim, Stefan D Holubar, Benjamin L Cohen","doi":"10.1097/MOG.0000000000001102","DOIUrl":"10.1097/MOG.0000000000001102","url":null,"abstract":"Purpose of review: The field of inflammatory bowel disease (IBD) has been evolving at an unprecedented rate. Not only does this apply to the medical management of IBD but also to its surgical management. This review aims to highlight the major updates in the current surgical approach in Crohn's disease.Recent findings: Surgery for Crohn's disease is no longer considered only for medically refractory disease or for disease-related complications but can rather be considered as an effective first-line treatment option. The concept of multimodal prehabilitation is becoming more solidified in Crohn's disease, as strong evidence continues to indicate its positive impact on surgical outcomes. The impact of the mesentery as well as the type of surgical anastomosis on postsurgical Crohn's disease recurrence is being closely reexamined. The optimal approach for surgical management of perianal Crohn's disease is also being redefined.Summary: Surgery is an integral part of the care of Crohn's disease patients and keeping up with the evolving paradigm of surgery in Crohn's disease is critical for all providers taking care of Crohn's disease patients to ensure patients are getting the best care possible.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"208-215"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Management of paraesophageal hernia 2025. 食管旁疝的治疗2025。

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-07-01 Epub Date: 2025-05-14 DOI: 10.1097/MOG.0000000000001111

Erwin Rieder, Sebastian F Schoppmann

{"title":"Management of paraesophageal hernia 2025.","authors":"Erwin Rieder, Sebastian F Schoppmann","doi":"10.1097/MOG.0000000000001111","DOIUrl":"10.1097/MOG.0000000000001111","url":null,"abstract":"Purpose of review: A paraesophageal hernia (PEH) is the condition in which the fundus of the stomach protrudes through the diaphragmatic hiatus into the chest adjacent to the esophagus. Such hernias can result in serious complications such as bleeding, obstruction, ischemia, and perforation. There is considerable controversy regarding the optimal management of PEH and, in this report, we review recent publications that address this issue.Recent findings: After surgical repair of PEH, the rate of recurrence remains high, and recent data do not document a clear advantage for the use of a mesh for crural buttressing in preventing recurrence. There also appears to be no significant difference among different types of mesh for preventing recurrence in the long term. The optimal shape, positioning, and material for mesh remain controversial topics. Recent reports suggest benefit for performing gastropexy routinely during PEH repair, and the addition of a fundoplication does not seem to reduce rates of recurrence or gastroesophageal reflux. Promising early results have been described for new techniques of PEH repair such as the use of posterior rectus sheath fascia for hiatal augmentation, and anterior crural reconstruction.Summary: This report summarizes the most recent data on key issues in the management of PEH such as the use of mesh, gastropexy, fundoplication, the role of age, and novel techniques for PEH repair.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"234-238"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Individualizing the choice of surgical therapy for gastroesophageal reflux disease. 胃食管反流病手术治疗的个体化选择。

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-07-01 Epub Date: 2025-02-17 DOI: 10.1097/MOG.0000000000001082

Luigi Bonavina

{"title":"Individualizing the choice of surgical therapy for gastroesophageal reflux disease.","authors":"Luigi Bonavina","doi":"10.1097/MOG.0000000000001082","DOIUrl":"10.1097/MOG.0000000000001082","url":null,"abstract":"Purpose of review: Proton-pump inhibitor therapy does not provide complete relief of symptoms in up to 40% of patients with gastroesophageal reflux disease (GERD). Antireflux surgery (ARS) aims to reconstruct the natural antireflux barrier consisting of the diaphragmatic crura, the lower esophageal sphincter, and the gastroesophageal flap valve.Recent findings: Although the 360° Nissen fundoplication combined with crural repair remains the gold-standard ARS treatment for GERD, the Toupet and Dor partial fundoplications and the magnetic sphincter augmentation (LINX) procedure have emerged as suitable alternative options with fewer side-effects. Randomized and observational clinical studies show that reflux control with partial fundoplications and LINX is acceptable and the risk of side-effects is minimal. Early results with the novel Refluxstop procedure show that restoration of distal esophageal length and the gastroesophageal flap valve, combined with anterior fundoplication and a silicon prosthesis to stabilize the esophagogastric junction below the diaphragm, can also provide excellent reflux control with minimal side-effects.Summary: Laparoscopic ARS should be performed in centers offering a comprehensive diagnostic pathway and a spectrum of techniques tailored to the individual GERD patient's phenotype and expectations. Further research is needed to provide more personalized and durable ARS.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"245-250"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0